Raschclifford1110

Frequent premature ventricular contractions (PVCs) can lead to cardiomyopathy; it is unclear if there are abnormal myocardial mechanics operative in the PVC and non-PVC beats.

The aim of this study was to investigate regional and global myocardial mechanics, including dyssynchrony, in patients with frequent PVCs.

Fifty-six consecutive patients referred for PVC ablation were prospectively studied. During sinus rhythm (SR) and PVC beats, left ventricular (LV) global longitudinal strain (GLS), LV dyssynchrony (measured as the SD of time to peak GLS), and dyssynergy (measured as maximum regional strain minus minimum regional strain at aortic valve closure) were quantified using 2-dimensional strain echocardiography. GLS, dyssynchrony, and dyssynergy were compared in remote SR, pre-PVC SR, PVC, and post-PVC SR beats.

In SR beats remote from the PVC, GLS was-17.3% ± 4%, dyssynchrony was 49 ± 14ms, and dyssynergy was22% ± 9%. Myocardial mechanics were significantly abnormal during PVCs compared with remote Sh as excitation-contraction coupling may underlie the generation of frequent PVCs.There is a need for more effective clinical interventions to assist individuals in healing from lingering negative and traumatic experiences. Furthermore, healing from such experiences and coping with residual symptoms are conceptionally separate yet important outcomes in psychotherapy. This report describes a Phase I investigation that evaluates an innovative integrative psychotherapy technique that promotes healing in addition to providing a method of coping while treatment is in progress. 43 patients were treated by 2 separate psychologists using Heart Assisted Therapy (HAT) in their private practices. There was a total of 81 specific upsetting and/or traumatic life events treated. tetrathiomolybdate All patients completed a standardized form to rate their degree of distress before and after HAT for each life event. Follow-up data were also collected ranging from 3 months to over 18 months post-treatment. Data analysis revealed the average number of HAT sessions for a treated incident was 3 - 4. The mean distress level was 7.55 before HAT and 0.00 after HAT for an exploratory study (n=13; p less then .0000001), and 8.31 before HAT and 0.02 after HAT for a confirmatory study (n = 30; p less then .0000001). These improvements were replicated across therapists, gender, and veteran status. The combined findings suggest that the integrative Heart Assisted Therapy model has important practical as well as theoretical significance. Future Phase II and Phase III studies can be performed to confirm the large magnitude of the patients perceived clinical effects and evaluate potential moderating variables such as expectancy.

Treatment of significant coagulopathic cardiac surgical field bleeding with immediate higher-dose prothrombin complex concentrate (PCC) without fresh frozen plasma (FFP) or fibrinogen concentrate is unexplored.

To study characteristics, chest drainage, and clinical outcomes of patients with significant coagulopathic surgical field bleeding treated with immediate higher-dose (defined at >15 IU/kg based on factor IX) PCC without FFP or fibrinogen concentrate.

We screened sequential cardiac surgery patients. We reviewed electronic blood bank data, Australian Society of Cardiothoracic Surgery database information and anaesthetic, intensive care unit (ICU), ward and radiological charts and electronic data. We identified patients deemed by the operating surgeon to require treatment for significant coagulopathic surgical field bleeding who underwent immediate higher-dose PCC without FFP or fibrinogen concentrate.

Among 168 patients, we identified 30 who underwent immediate higher-dose PCC without FFP or fture controlled studies.

Recently, the impact of the lack of standard modifiable risk factors, including hypertension, diabetes, dyslipidaemia, and current smoking, has been investigated in ST-segment elevation myocardial infarction (MI). The present study aimed to evaluate clinical characteristics and prognosis of the patients with no standard risk factors in acute MI.

This bi-centre registry included 1,093 patients with acute MI undergoing percutaneous coronary intervention. The participants were divided into two groups patients having at least one of the four standard risk factors and those having none of the risk factors. The study endpoints included major adverse cardiovascular events (MACE) (death, recurrent MI, and stroke) and major bleeding events during hospitalisation. Any MACE and major bleeding events after discharge were also evaluated as an exploratory analysis.

Of 1,093 patients, 64 (5.9%) had none of the four standard risk factors. The patients with no standard risk factors were likely to present with Killip class IV and cardiac arrest. The rate of in-hospital MACE was higher in patients with no risk factors than in their counterparts (25.0% vs 9.9%; p<0.001), whereas the incidence of in-hospital major bleeding was not significantly different between the two groups (9.4% vs 6.7%; p=0.44). Active cancer and autoimmune/inflammatory diseases were often found in patients with no standard risk factors. After discharge, no significant differences were observed in the risks of MACE and major bleeding events between the two groups.

No standard modifiable risk factors were not uncommon and were associated with poor short-term outcomes in patients with acute MI.

No standard modifiable risk factors were not uncommon and were associated with poor short-term outcomes in patients with acute MI.

This study compared the casualties and types of rescues conducted on the main climbing route (MCR) and accessory climbing routes (ACRs) in Yushan National Park (YSNP) between 2008 and 2019.

We collected the following information for all documented mountain rescue operations conducted on the MCRs and ACRs in YSNP between 2008 and 2019 accident location, casualty type, victim number, and type of rescue. The victims were categorized as to injury, illness, mortality, or no medical problem (NMP) groups according to their condition at the time of rescue.

Two-hundred forty-four rescue operations involving 329 victims were conducted during the 12-y study period. Among them, 105 (32%) did not require medical treatment, 102 (31%) were injured, 82 (25%) were ill, and 40 (12%) were deceased. Of the 82 individuals with illness, 69 (84%) had acute altitude sickness. The accident and mortality rates on the ACRs were significantly higher than those on the MCR (P<0.001; χ

). The ACR incidents involved significantly higher percentages of helicopter-based rescues and victims in the NMP group (P<0.001).

Acute altitude sickness accounted for most of the rescues. ACRs had higher injury and mortality rates and required more helicopter-based rescues for patients who did not have medical problems. This study may serve as a reference to reduce casualties and overuse of helicopters by educating tourists on the appropriate use of maps and the evaluation of trails in relation to weather conditions.

Acute altitude sickness accounted for most of the rescues. ACRs had higher injury and mortality rates and required more helicopter-based rescues for patients who did not have medical problems. This study may serve as a reference to reduce casualties and overuse of helicopters by educating tourists on the appropriate use of maps and the evaluation of trails in relation to weather conditions.

Drones can transmit live video and geographic coordinates during the planning stages for search and rescue operations and the operations themselves. There are few simulation studies in which drones provided rescue support. However, the literature does not contain any simulation studies involving the use of drones to locate lost "victims" represented by dummies in rivers. We developed a simulation model to compare the first visual contact times for drone-assisted search techniques (DAST) and classic search techniques (CST).

In this prospective experimental simulation study, we used both DAST and CST to perform a series of river searches for unconscious victims (represented by dummies). We calculated the first visual contact times, total scanned area, scanned area per minute, flight-walking distances, and flight-walking speeds and compared the results between both groups. The data are presented as mean±SD.

We performed 20 search and rescue operations, 10 with the CST and 10 with the DAST. The time to reach the victim was 823±177 s using CST and 80±14 s using DAST. The area scanned by unit time was 3091±54 m

·min

using CST and 22,640±1622 m

·min

using DAST.

The drone-assisted search technique located a simulated victim drifting in a river faster than the classic search technique. The use of drones in search and rescue operations could improve the time to find victims.

The drone-assisted search technique located a simulated victim drifting in a river faster than the classic search technique. The use of drones in search and rescue operations could improve the time to find victims.Streptococcus pneumoniae is a major cause of pneumonia, meningitis, and septicaemia worldwide. Pneumococcal antimicrobial resistance (AMR) has been highlighted by the WHO as an important public health concern, with emerging serotypes showing resistance to multiple antibiotics. Indeed, although the introduction of pneumococcal conjugate vaccines (PCVs) has been associated with an overall decline in pneumococcal AMR, there have been increases in prevalence of potentially disease-causing AMR serotypes not targeted by vaccination. Here, we discuss a variety of evolutionary mechanisms at the host, pathogen, and environmental levels that may contribute to changes in the prevalence of pneumococcal AMR in the post-vaccination era. The relative importance of these factors may vary by population, pneumococcal lineage, geography, and time, leading to the complex relationship between vaccination, antibiotic use, and AMR.Plant-associated microbiota are becoming central in the development of ways to improve plant productivity and health. However, most research has focussed mainly on a few model plant species. It is essential to translate discoveries to the many nonmodel crops, allowing the design and application of effective synthetic microbiota.This case report describes a 17-month-old child with ingestion of a button battery. The clinical presentation, diagnostic reasoning, national guidelines, hospital course, and follow-up are discussed. Between 1995 and 2015, an estimated 759,074 children aged less then 6 years were seen in emergency departments for suspected or confirmed foreign body ingestions, representing a 93.3% increase in cases . The most common objects ingested were coins, toys, jewelry, and batteries. The most common battery ingested was a button battery. Although 80% to 90% of ingested foreign objects pass without intervention, a button battery positioned in the esophagus is an emergency requiring immediate removal.

Concerns have been raised on the impact of coronavirus disease (COVID-19) on lung transplant (LTx) patients. The aim of this study was to evaluate the transplant function pre- and post-COVID-19 in LTx patients.

Data were retrospectively collected from LTx patients with confirmed COVID-19 from all 3 Dutch transplant centers, between February 2020 and September 2021. Spirometry results were collected pre-COVID-19, 3- and 6-months post infection.

Seventy-four LTx patients were included. Forty-two (57%) patients were admitted, 19 (26%) to the intensive care unit (ICU). The in-hospital mortality was 20%. Twelve out of 19 ICU patients died (63%), a further 3 died on general wards. Patients with available spirometry (78% at 3 months, 65% at 6 months) showed a significant decline in mean forced expiratory volume in 1 second (FEV1) (ΔFEV1 138 ± 39 ml, p=0.001), and forced vital capacity (FVC) (ΔFVC 233 ±74 ml, p=0.000) 3 months post infection. Lung function improved slightly from 3 to 6 months after COVID-19 (ΔFEV1 24 ± 38 ml; ΔFVC 100 ± 46 ml), but remained significantly lower than pre-COVID-19 values (ΔFEV1 86 ml ± 36 ml, p=0.