COVID-19 : The Mysteries Still To Be Solved

In late December 2019, reports emerged of a mysterious pneumonia in Wuhan, China, a city of 11 million people in the southeastern province of Hubei. The cause, Chinese scientists quickly determined, was a new coronavirus distantly related to the SARS virus that had emerged in China in 2003, before spreading globally and killing nearly 800 people.

Six months and more than ten million confirmed cases later, the COVID-19 pandemic has become the worst public-health crisis in a century. More than 500,000 people have died worldwide. It has also catalysed a research revolution, as scientists, doctors and other scholars have worked at breakneck speed to understand COVID-19 and the virus that causes it: SARS-CoV-2.

How deadly is the coronavirus? Scientists are close to an answer

They have learnt how the virus enters and hijacks cells, how some people fight it off and how it eventually kills others. They have identified drugs that benefit the sickest patients, and many more potential treatments are in the works. They have developed nearly 200 potential vaccines — the first of which could be proved effective by the end of the year.

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Switching From General to Regional Anaesthesia May Reduce Greenhouse Gas Emissions

Switching from general to regional anaesthesia may help cut greenhouse emissions and ultimately help reduce global warming, indicates a real life example at one US hospital over the course of a year, and reported in the Journal Regional Anesthesia & Pain Medicine.

The evidence suggests that regional anaesthesia provides more effective pain relief, has fewer unpleasant side effects than general anaesthesia, shortens hospital stay, and may be preferred by patients, say the authors.

But it may also have an important environmental role that is “truly global in nature,” they add.

Unlike general anaesthesia, it doesn’t use volatile halogenated agents, such as desflurane, or nitrous oxide. These greenhouse gases, which can be retained in the atmosphere for up to 114 years, damage the earth’s ozone layer, increasing the risk of global warming and climate change. 

Regional anaesthesia, instead, uses a local nerve block along with intravenous sedatives.

In 2009, in the USA alone, more than a million hip and knee replacement procedures were carried out, lasting an average of 2 hours.

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SAVR Following TAVR May Present Extra Risks

Patients undergoing surgical aortic-valve replacement (SAVR) following problems with an initial transcatheter aortic-valve replacement (TAVR) appear to have particularly poor outcomes, according to a retrospective analysis.

As Dr. Oliver K. Jawitz told Reuters Health by email, “SAVR after early failure of TAVR devices appears to be a complex, technically demanding procedure associated with long operative times, increased perioperative morbidity, and higher than expected operative mortality.”

In a paper in JACC: Cardiovascular Interventions, Dr. Jawitz of Duke University School of Medicine, in Durham, North Carolina, and colleagues observe that as TAVR grows more popular, management of device failure will become increasingly important. “However,” they say, “the outcomes of re-operation for TAVR failure are unknown.”

Out of about 40,000 TAVR procedures in the Society of Thoracic Surgeons Adult Cardiac Surgery Database, the researchers identified 123 patients with a history of prior TAVR who underwent SAVR between 2011 and 2015.

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