Assessing Testing Strategies and Duration of Quarantine in Contact Tracing for SARS-CoV-2: A Retrospective Study of San Francisco's COVID-19 Contact Tracing Program, June-August 2020

We sought to assess the proportion of elicited close contacts diagnosed with coronavirus disease 2019 at the start of and before exiting quarantine in San Francisco. From June 8 to August 31, 6946 contacts were identified: 3008 (46.3%) were tested, 940 (13.5%) tested positive, and 90% tested positive in the first 9 days of quarantine.

Hypothermia and rewarming injury in hippocampal neurons involve intracellular Ca2+ and glutamate excitotoxicity

This study examines the causes of hypothermia and rewarming injury in CA1, CA3, and dentate neurons in rat hippocampal slice cultures. Neuronal death, assessed with propidium iodide or Sytox fluorescence, Fluoro-Jade labeling, and Cresyl Violet staining, depended on the severity and duration of hypothermia. More than 6 h at temperatures less than 12 °C followed by rewarming to 37 °C (profound hypothermia and rewarming, PH/RW) caused swelling and death in large number of neurons in CA1, CA3, and dentate. During PH, [ATP] decreased and [Ca(2+)](I) and extracellular [glutamate] increased, with neuron rupture and nuclear condensation following RW. The data support the hypothesis that neuronal death from PH/RW is excitotoxic, due to ATP loss, glutamate receptor activation and Ca(2+) influx. We found that antagonism of N-methyl-D-aspartate (NMDA) receptors, but not 2-amino-3-(5-methyl-3-oxo-1,2- oxazol-4-yl) propanoic acid or metabotropic glutamate receptors, decreased neuron death and prevented increases in [Ca(2+)](I) caused by PH/RW. Chelating extracellular Ca(2+) decreased PH/RW injury, but inhibiting L- and T-type voltage-gated Ca(2+) channels, K+ channels, Ca(2+) release from the endoplasmic reticulum, and reverse Na(+)/Ca(2+) exchange did not affect the Ca(2+) changes or cell death. We conclude that the mechanism of PH/RW neuronal injury in hippocampal slices primarily involves intracellular Ca(2+) accumulation mediated by NMDA receptors that activates necrotic, but not apoptotic processes.

Nursing management of the adolescent with idiopathic scoliosis

Management of the adolescent idiopathic scoliosis patient has many intricate considerations. Whether the patient is braced or surgery is recommended, there is a lot of teaching, assessing, and compassion when dealing with adolescents whose biggest concern is being like their peers. It is important to allow as much independence in decision making as possible, whether it be about bracing or surgical intervention, as long as they clearly understand the consequences. Newer, better surgical instruments, anesthesia, nursing care, and postoperative mobility all have changed the management of the operative scoliosis patient significantly. Nursing assessment of neurologic, respiratory, function, emotional, and developmental needs of the adolescent patient, however, have not changed. If we, as nurses, understand the rationale for assessments, treatments, and restrictions, we can teach our patients and their families.

Pedicle screw fixation in the lumbar spine. Part 2

Pedicle screw fixation devices are a versatile means of providing stability and alignment to the lumbar spine for many problems which include fractures, tumors, multiple level laminectomies, spondylolisthesis, and other degenerative problems. An understanding of the pedicle screw fixation device, its uses, and care of patients with pedicle screw fixation will help orthopaedic nurses successfully manage their patients.