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Coronavirus Epidemics and the Current COVID-19 Pandemic
Published in Debmalya Barh, Kenneth Lundstrom, COVID-19, 2022
Aparna Bhardwaj, Prateek Kumar, Shivani Krishna Kapuganti, Vladimir N. Uversky, Rajanish Giri
The current COVID-19 disease caused by the outbreak of SARS-CoV-2 has been responsible for over 3.5 million deaths, as of June 2021. Furthermore, there are over 171.5 million confirmed cases globally [37]. The infection was first detected in a seafood market in Wuhan, China. SARS-CoV-2 bears a close resemblance to bat CoVs, and similar coronaviruses have been identified in pangolins, sold at Chinese seafood markets as food and components of traditional Chinese medication. This prompted the theory that the infection probably began in bats, while pangolins likely acted as intermediate hosts. SARS-CoV-2 quickly spread from one individual to another [38]. Infected individuals show common symptoms such as sore throat, fever, shortness of breath, and pneumonia. Death is caused by multi-organ failure, generally including lungs and kidneys. In the current pandemic, the cases of infections and mortality are much higher than in previous epidemics. Although the mortality rates for SARS, MERS, and COVID-19 are 9.6%, 34.5%, and 2.1%, respectively, the number of infections and deaths are certainly higher for COVID-19 than the two HCoV-related epidemics. Hence it is important to understand the difference between molecular structures of the different viruses. The section below compares the SARS-CoV-2 proteome to the proteomes of other HCoVs.
Management of Conditions and Symptoms
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
An inevitable but often unpredictable occurrence with every individual facing a life-threatening illness is death, and unless sudden death occurs, it is important for team members to be able to identify when death is approaching. In general, there are key signs and symptoms that may indicate that death may be imminent; sometimes this is called actively dying. Once identified, the interdisciplinary team will be able to mobilize resources and take strategic steps to facilitate the dying process with as much comfort and dignity as possible. Often this means providing enough medication to facilitate comfort for some of the key conditions and symptoms. Ideally, this would be organized by a protocol or series of standardized steps; the National Hospice and Palliative Care Organization (NHPCO) terms this as an imminent death protocol.87
Death: Process or Event?
Published in David Lamb, Death, Brain Death and Ethics, 2020
Scepticism regarding the event of death is often attributable to a failure to articulate clearly which concept of death is being employed in a given discussion or proposal. In fact, most of the confusion underlying the ‘event’ versus ‘process’ debate is generated by a failure to distinguish between clinical death – death of the organism as a whole – and biological death – death of the whole organism. Clinical death can be defined as an event which marks ‘the cessation of integrative action between all organ systems of the body’. (Collins, 1980, p. 3) Conversely, life has been said to entail the integrated function of at least nine organ systems. According to Angrist: (1958, p. 2150) Death may be defined as the cessation of integrated life functions. Life depends on integration of the following physiological functions: ingestion, digestion, absorption, respiration, distribution (circulation), integration (nervous system and endocrines), metabolism, excretion, and egestion (elimination). Death occurs if any one of these functions is much impaired or arrested. A long period of symptoms usually precedes death whilst impairment occurs in the three first and three last listed functions.
Dialysis Refusal: Discerning the Credibility of a Prior Verbal Directive
Published in The American Journal of Bioethics, 2023
Sean Morrison, the Senior Associate Editor of the Journal of Palliative Medicine, recently depicted advance directives (ADs) and advance care planning (ACP) as “clear, simple, and wrong” (Morrison 2020). He lists reasons familiar to many, including: Living wills do not appropriately inform the myriad medical decisions that need to be made during critical illness;Health care surrogates feel uncertain about what the patient truly wants or burdened by life-or-death decision-making;Health care providers lack skills to appropriately elicit the patient’s end-of-life preferences and goals of care;Providers fail to appropriately document a patient’s goals of care conversations and end-of-life preferences to effectively inform future medical decisions at critical care junctures.
Likely and Looming? The Labyrinthine ELSI Landscape of Copying Consciousness
Published in AJOB Neuroscience, 2023
Jacob Freund, Guy Halevi, Hila Tavdi, Dov Greenbaum
Perhaps the most crucial ethical issue related to copying consciousness is the need to redefine the concept of death. The legal definition of death has evolved in response to technological advances, with a focus on the cessation of critical bodily functions. Previously, legal death was defined as cardiac death, but technological advancements in the mid-twentieth century allowed for continued life even after cardiac failure. This prompted a revised definition of death as the irreversible cessation of all brain function, including the brainstem. In the 1980s, the US Uniform Determination of Death Act (UDDA) defined death as either the irreversible cessation of circulatory and respiratory functions or the irreversible cessation of all brain function, including the brainstem (Sarbey 2016).
The efficacy and safety of ceftolozane-tazobactam in the treatment of GNB infections: a systematic review and meta-analysis of clinical studies
Published in Expert Review of Anti-infective Therapy, 2023
Yulong Chi, Juan Xu, Nan Bai, Beibei Liang, Yun Cai
No significant differences were found in mortality, AEs, SAEs, and drug discontinuation due to AEs. Possible causes of death included deterioration of primary disease or complications of organ failure. The overall all-cause mortality of ceftolozane-tazobactam was higher than previous study [41]. It was worth noting that 45.5% (6/12) of the studies reported that the primary type of infection was NP, and its mortality was 25.0% (166/663). In contrast, the combined mortality of the remaining six articles was 1.63% (19/1,168), which was consistent with previous studies [61,62]. Through analysis, we found that the higher mortality of the five studies with the main infection type of NP might be related to older age (Table 1) and more complications. The retrospective studies [39,60] have pointed out that it may also be associated with the insufficient arrival of drugs to the lungs, which is the reason for the use of 3 g ceftolozane-tazobactam. The intensity of most AEs was mild to moderate. Gastrointestinal intolerance was the most frequently reported AEs, including nausea, vomiting, and diarrhea. AEs of the hematopoietic system and cardiovascular system were rare.