An Unusual Lawn Mower Injury: A Case Report.

Penetrating abdominal injuries can be life-threatening and require prompt recognition and surgical intervention. We present the case of a 48-year-old male patient who presented to the emergency department with abdominal pain that began while mowing his lawn just before arrival but without any external signs of trauma. Point-of-care ultrasound revealed a possible linear hyperechoic foreign body just beneath the abdominal wall, a finding confirmed by computed tomography.

PEN-FAST-ED: Utilizing the PEN-FAST decision tool to guide antibiotic prescribing in the emergency department.

Background: Patient-reported penicillin allergies are frequently encountered in the emergency department (ED), which often lead to non-beta-lactam antibiotic use despite beta-lactams' place as first-line therapy in most bacterial infections. The PEN-FAST clinical decision tool was developed and validated to identify patients with a low risk of true penicillin allergies that do not require formal skin testing for rechallenging. The tool consists of four questions that add up to a total score ranging from 0 to 5.

Affinity maturation endows potent activity onto class 6 SARS-CoV-2 broadly neutralizing antibodies.

The emergence of SARS-CoV-2 variants of concern (VOCs) has greatly diminished the neutralizing activity of previously FDA-approved monoclonal antibodies (mAbs), including that of antibody cocktails and of first-generation broadly neutralizing antibodies such as S309 (Sotrovimab). In contrast, antibodies targeting cryptic conformational epitopes of the receptor binding domain (RBD) have demonstrated broad activity against emerging variants, but exert only moderate neutralizing activity, which has so far hindered clinical development. Here, we utilize in vitro display technology to identify and affinity-mature antibodies targeting the cryptic class 6 epitope, accessible only in the "up" conformation of the SARS-CoV-2 spike trimer.

Diphenhydramine Overdose: A Case Report and Topic Review of Prehospital Diagnosis and Treatment.

Diphenhydramine (DPH), a readily available first-generation H1 receptor antihistamine, can have severe consequences when taken in excessive amounts and can lead to grave outcomes such as seizures, dysrhythmias, coma, and death. Recognizing the early signs and symptoms of DPH toxicity is crucial. Fortunately, fatal adult cases of DPH overdose are rare.