For now, the best way to prevent the current spikes from becoming a proper fourth wave is vaccination (which, even if cases continue to rise, can help prevent hospitalizations and deaths), increased surveillance, and a return to mitigation measures. Indeed, Los Angeles County on Sunday reinstituted mandatory mask-wearing in businesses and public areas, a major rollback after the U. S. Centers for Disease Control and Prevention said on May 13 that fully vaccinated individuals could shed their masks in many scenarios. Unless states can rapidly revive widespread and easily available testing, L. A. will be far from the last county to ask residents to mask up once again.

Insulin is a peptide therapeutic used to manage type 1 diabetes, which affects more than 20 million people worldwide according to the international diabetes federation. a significant limitation to the broad distribution and use of insulin to treat type 1 diabetes is the fact that it must be administered by injection rather than orally. why is insulin administered by injection and not orally?

The parents of a 9-year-old girl bring their daughter to the ed. for the last 12 hours, the child has suffered severe nausea and vomiting, as well as diarrhoea and abdominal cramps. further discussion with the child indicates that she suffers from blurred vision and headache. the parents originally were worried about bringing the child to the ed because they feared deportation since the family are illegal immigrants employed to pick strawberries on a nearby farm. on direct questionning, the parents admit that the child was assisting with spraying crops with pesticides the previous day. none of the family members was wearing any protecting clothing. her bp is 88/48 mmhg, pulse is 90/min, rr 33/min, temp 38 c. the child appears sweaty and confused. auscultation of the lungs reveals a diffuse wheeze bilaterally. pupils are miotic and the child has diffuse muscle weakness. which of the following interventions is the most appropriate treatment? - atropine- charcoal- glucagon- naloxone- exposure: consider organophosphate poisoning, which inhibits cholinesterase and results in accumulation of ach in both muscarinic and nicotinic sites. pralidoxime activates achatropine competes with ach only at muscarinic receptors, but will not reverse nicotinic effectscharcoal = gastric decontaminationglucagon = reverse beta-blocker overdosenaloxone = reverse effects of opioids

A48-year-old male presents with an 8-day history of productive cough, subjective fevers, and malaise. he is otherwise healthy without any active medical problems. he is a social drinker of alcohol, and denies any tobacco or drug use. on physical examination, the patient is alert and oriented. his temperature is 100.4 0 f, pulse rate is 56, respiratory rate is 18, and blood pressure is 133/64. heent is within normal limits and a chest exam has diffuse expiratory wheeze with decreased sounds to the right lower lung fields. blood labs reveal wbc 14.4, hgb 11.3, plt 233, alt 65, ast 102, and po 4 2.1. a chest x-ray reveals a dense consolidation with bulging fissures. based on these findings, what is the most likely pathogen affecting this patient?