CZ:Featured article/Current: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Chunbum Park
imported>John Stephenson
(template)
 
(83 intermediate revisions by 5 users not shown)
Line 1: Line 1:
== '''[[Pulmonary embolism]]''' ==
{{:{{FeaturedArticleTitle}}}}
----
<small>
'''Pulmonary embolism''' (PE) is form of [[embolism and thromboembolism]] in which a blockage of the [[pulmonary artery]] (or one of its branches), usually when a [[deep vein thrombosis]] (blood clot from a vein), becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs.<ref name="pmid18322285">{{cite journal |author=Tapson VF |title=Acute pulmonary embolism |journal=N. Engl. J. Med. |volume=358 |issue=10 |pages=1037–52 |year=2008 |month=March |pmid=18322285 |doi=10.1056/NEJMra072753 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18322285&promo=ONFLNS19 |issn=}}</ref> This process is termed ''thromboembolism''.
==Footnotes==
{{TOC|right}}
===Pathophysiology===
The development of thrombosis is classically due to a group of causes named [[Virchow's triad]] (alterations in blood flow, factors in the vessel wall and factors affecting the properties of the blood). Often, more than one risk factor is present.
* ''Alterations in blood flow'': immobilization (after surgery, [[Physical trauma|injury]] or [[Economy class syndrome|long-distance air travel]]), [[pregnancy]] (also procoagulant), [[obesity]] (also procoagulant)
* ''Factors in the vessel wall'': of limited direct relevance in VTE
* ''Factors affecting the properties of the blood'' (procoagulant state):
** [[Estrogen]]-containing [[hormonal contraception]]
** Genetic thrombophilia ([[factor V Leiden]],  [[protein C deficiency]], [[protein S deficiency]], [[antithrombin]] deficiency, [[hyperhomocysteinemia]] and [[plasminogen]]/[[fibrinolysis]] disorders). The role of [[prothrombin]] mutation G20210A, is  unclear.<ref name="pmid19531787">{{cite journal |author=Segal JB, Brotman DJ, Necochea AJ, ''et al.'' |title=Predictive value of factor V Leiden and prothrombin G20210A in adults with venous thromboembolism and in family members of those with a mutation: a systematic review |journal=JAMA |volume=301 |issue=23 |pages=2472–85 |year=2009 |month=June |pmid=19531787 |doi=10.1001/jama.2009.853 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=19531787 |issn=}}</ref>
** Acquired thrombophilia (malignancy, [[antiphospholipid syndrome]], [[nephrotic syndrome]], [[paroxysmal nocturnal hemoglobinuria]])
===Diagnosis===
The diagnosis of PE is based primarily on validated clinical criteria combined with selective testing because the typical clinical presentation ([[shortness of breath]], [[chest pain]]) cannot be definitively differentiated from other causes of chest pain and shortness of breath.<ref name="pmid14657070">{{cite journal |author=Chunilal SD, Eikelboom JW, Attia J, ''et al'' |title=Does this patient have pulmonary embolism? |journal=JAMA |volume=290 |issue=21 |pages=2849–58 |year=2003 |pmid=14657070 |doi=10.1001/jama.290.21.2849 |issn=}}</ref> Patients can present with atypical syndromes such as unexplained exacerbations of chronic obstructive pulmonary disease.<ref name="pmid16549851">{{cite journal |author=Tillie-Leblond I, Marquette CH, Perez T, ''et al'' |title=Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors |journal=Ann. Intern. Med. |volume=144 |issue=6 |pages=390–6 |year=2006 |month=March |pmid=16549851 |doi= |url= |issn=}}</ref>
''[[Pulmonary embolism|.... (read more)]]''
 
{| class="wikitable collapsible collapsed" style="width: 90%; float: center; margin: 0.5em 1em 0.8em 0px;"
|-
! style="text-align: center;" | &nbsp;[[Pulmonary embolism#References|notes]]
|-
|
{{reflist|2}}
{{reflist|2}}
|}
</small>

Latest revision as of 10:19, 11 September 2020

Categories of smart home devices shown on Amazon's website in April 2023.

The phrase smart home refers to home automation devices that have internet access. Home automation, a broader category, includes any device that can be monitored or controlled via wireless radio signals, not just those having internet access. Whether the device is powered by the electrical grid or by battery, if it uses the home Wi-Fi network and if an internet logon needs to be created to use it, then it is smart home technology.

Collectively, all the smart home devices on every home's Wi-Fi network helps to make up what is called the Internet of Things (IoT), a huge sea of sensors and control devices across the world that are capable of being accessed from afar via the internet. One of the key reasons such devices need internet access is so that the manufacturer can periodically download updated firmware to the device to keep it up-to-date. However, being available via the internet also means that such devices are, potentially, available for spying or hacking. Today, homes may contain dozens or even hundreds of such devices, and consumers may enjoy their benefits while knowing little about how they work, or even realizing that they are present.

Not all home automation is "smart"

Many remotely controllable devices do not require internet access. They may instead have physical control devices that use either RF (“Radio Frequency”) or IR (“Infrared”) beams, two different kinds of energy used in remote controls to communicate commands. Non-"smart" home automation may also present security risks, because the control signals can be hijacked by bad actors with the right signaling equipment. Garage door openers are of particular note in this regard. Modern automobiles, in fact, are full of automation similar to home automation, and cars are hackable by bad actors in a number of ways. See Wikipedia's Automotive hacking article for more information.

Incompatibility hassles

At present, consumers must make sure that the smart device they wish to use is specified to be compatible whichever phone/tablet operating system they use (Apple vs. Android). Since smart home products emerged in the absence of any standard, a morass of competing methods for networking, control and monitoring now exist. For some products, consumers may need to buy an expensive hub, or bridge, a device that is specific to one vendor. Products made by different manufacturers but performing the same function are typically not interoperable. Consumers often need to open a different app on their smartphone or tablet in order to control devices by each manufacturer. This may make it too expensive and awkward to try out competing devices, leaving consumers stuck with the product they bought originally or else having to add yet more apps to their phones.

Security concerns

Security for smart home products has been uneven and sometimes seriously inadequate. Smart thermostats which can monitor whether a home's occupants are present or not, entry-way locks, robotic vacuums that work with a map of the house, and other smart home devices can present very real dangers if hackers can access their data.

Matter, an emerging standard

Matter is emerging standard in 2023 intended to increase security, reliability and inter-operability of smart-home devices. About ten years ago, industry consortiums formed to work on standards for smart home device communications, and their underlying wireless communications, which would make it possible for products from all vendors to work together seamlessly and provide fast performance, privacy, and security and would work even if there is not connection to the outside internet (i.e., no connection to "the cloud" or to servers).

Footnotes