Medical science monitor : international medical journal of experimental and clinical research
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BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a significant clinical challenge for emergency medical systems worldwide. The first step towards ensuring patient survival is achieving return of spontaneous circulation (ROSC). The purpose of the study was to analyze the cases of OHCA to which HEMS teams were dispatched. ⋯ In the group studied, ROSC was achieved more commonly in women, in patients younger than age 40 years, in CA cases of cardiac origin, and in cases with shockable rhythms (p<0.05). CONCLUSIONS The study results are consistent with global trends in terms of OHCA incidence and the effectiveness of CPR performed on scene. The study also demonstrates that HEMS dispatch to OHCA cases is justified both as a means of providing assistance to EMS teams on scene and as the first choice.
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BACKGROUND This study explored the diagnostic value of a combined modality of Superb Microvascular Imaging (SMI) and shear-wave elastography in differentiating malignant and benign breast lesions. MATERIAL AND METHODS A total of 121 patients with 123 breast lesions enrolled underwent conventional ultrasound exam (US), Color Doppler Flow Imaging (CDFI), SMI examination, and Virtual Touch Tissue Quantification (VTQ) measurement between May 2016 and October 2017. Vessels were detected by both CDFI and SMI in a quantitative manner. ⋯ CONCLUSIONS Superb Microvascular Imaging yields more detailed vascular information in the bloodstream in benign and malignant breast masses compared with conventional ultrasonography. VTQ provides standardized quantified results in assessing tissue stiffness. The combined modality of SMI+VTQ added to conventional ultrasonography presented a better diagnostic performance in differentiating malignant breast neoplasms.
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BACKGROUND The aim of this study was to observe apolipoprotein M (ApoM) level in obese patients and to explore its correlation with inflammatory factors. MATERIAL AND METHODS A total number of 96 participants were recruited and divided into 2 groups: the control group (or healthy group) whose participants had normal body weight (n=58), and the obese group with all its participants diagnosed with obesity (n=38). Data on blood pressure, body weight, height, body mass index, diastolic function of brachial artery endothelium, fasting venous blood glucose, blood lipids, plasmatic ApoM, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), fasting insulin, and adiponectin levels were collected for both groups. ⋯ For the obese group, plasmatic ApoM level was positively correlated with HDL-C level and negatively correlated with levels of IL-6, TNF-α, CRP, insulin, and insulin resistance index. However, no significant correlations were revealed between plasmatic ApoM and the diastolic function of brachial artery endothelium, adiponectin level, blood pressure, and blood glucose level. CONCLUSIONS Obese patients showed significantly lower plasmatic ApoM levels than people with normal body weight, and ApoM level showed a strong correlation with CRP, TNF-α, and IL-6 levels, which indicated that ApoM might be regulated by these inflammatory factors.
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BACKGROUND Pulmonary aspiration of the gastric contents is a serious perioperative complication. The aim of this study was to evaluate the efficacy of portable ultrasonography in the preoperative evaluation of the gastric contents of patients. The secondary aim was to examine the relationship between gastric antrum cross-sectional area and age and body mass index (BMI). ⋯ It was determined that 20.8% of the patients exceeded the high-risk stomach antral cutoff cross-sectional area that was defined as 340 mm2 in patients fasting for at least 8 hours. CONCLUSIONS It was determined that bedside ultrasonography is a useful, non-invasive tool in the determination of gastric content and volume. A significant proportion of surgical patients may not present with an empty stomach despite the recommended fasting protocols.
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BACKGROUND The aim of this study was to evaluate the effects of carotid artery angioplasty and carotid artery stenting (CAS) on cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) in patients with preoperative cerebrovascular hemodynamic impairment. MATERIAL AND METHODS Seventeen patients with unilateral severe internal carotid artery (ICA) stenosis and ipsilateral CVR impairment underwent CAS. CBF and CVR were measured by single photon emission computed tomography (SPECT) with inhalation of carbon dioxide (CO2) one week before and three months after CAS. ⋯ CAS significantly increased CBF in ROIs with preoperative impaired CBF and impaired CVR, indicating severe hemodynamic impairment (79.1±7.5% vs. 86.7±10.0%) (p<0.001). Following CAS, ROIs with normal CBF and impaired CVR had a significantly increased percentage of improved CVR (p=0.047); ROIs with impaired CBF and impaired CVR had a significantly increased percentage of improved CBF (p=0.027). CONCLUSIONS The severity of preoperative hemodynamic impairment, which is related to the degree of carotid artery stenosis and cerebral collateral flow, may influence hemodynamic benefits by CAS.