The American journal of the medical sciences
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The Covid-19 pandemic struck physicians at a time of unprecedented dissatisfaction and burnout, providing a stress test whose lessons might guide structural changes in healthcare. While selflessly rescuing patients from death, many doctors were exposed to unacceptable risk, with little protection for themselves, and, by extension, for their families and patients. ⋯ Such questions predated coronavirus but were brought to the forefront because of the epidemic. As physicians process their experiences, we hope to begin a deeper moral and social conversation that might help us be better prepared for future crises.
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Review Case Reports
Hemophagocytic Lymphohistiocytosis Secondary to Ehrlichia Chaffeensis in Adults: A Case Series From Oklahoma.
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of pathologic immune activation that occurs as either a familial disorder or as a sporadic condition in association with a variety of triggers. Infections are the most common cause of HLH in adults and should be searched for as early treatment usually results in a favorable outcome. ⋯ Treatment for secondary HLH is aimed at reducing hypercytokinemia and eradicating inflammatory and infected cells. It is important to promptly initiate doxycycline when tick-borne diseases are being entertained as a possible trigger, as the antibiotic is effective, safe and inexpensive.
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Effects of cardiovascular (CV) risk factors on the diameter of the thoracic aorta have not been fully studied. This study examined the associations between CV risk factors and diameter of thoracic aorta. ⋯ The study results suggest that decreasing BMI and management of CV risk factors such as hypertension and modifying behavioral risk factors such as smoking are likely to be emphasized in order to decrease the rate of aortic dilatation and subsequent aortic dissection, if aortic dilatation is detected during a CT scan.