Association of the time to first epinephrine administration and outcomes in out-of-hospital cardiac arrest: SOS-KANTO 2012 study

Objective

This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.

Association Between Anti-Helicobacter pylori Antibody Seropositive and De Novo Gallstone Formation After Laparoscopic Sleeve Gastrectomy for Japanese Patients with Severe Obesity

Purpose

Patients who have undergone bariatric surgery are at risk for gallstone formation. However, the incidence of gallstone formation after bariatric surgery has not been adequately studied in the Japanese population. We aimed to elucidate the incidence and risk factors for gallstone formation after laparoscopic sleeve gastrectomy (LSG) for Japanese patients with severe obesity.

Methods

We conducted a retrospective cohort study among patients with severe obesity treated with LSG between April 2017 and June 2020 at two institutions. Patients who had received previous cholecystectomy, had preoperative gallstones, and had received postoperative prophylactic ursodeoxycholic acid were excluded. Body weight, body mass index, and blood data were collected at each follow-up visit before and after the surgery. Follow-up abdominal ultrasonography was performed 6–12 months after surgery, and the incidence of gallstones was calculated. The association between the data and gallstone formation was evaluated.

Results

During the study period, we performed LSG for 98 patients. Of these, 61 cases remained by above conditions and were examined using abdominal ultrasonography over 6 months after surgery. The incidence of gallstones was 23.0% and that of symptomatic gallstones was 3.3%. Anti-Helicobacter pylori antibody seropositive and titer were the only factors that showed significant association with de novo gallstone formation after LSG.

Conclusions

Anti-Helicobacter pylori antibody seropositive may be associated with de novo gallstone formation after LSG for Japanese patients with severe obesity.

Graphical abstract

     

Correlation between Transient Hypotension and Exclusively Exercise-induced Symptoms of Two-to-One Atrioventricular Block

A 62-year-old woman with activity-dependent two-to-one atrioventricular block (2:1AVB) and a normal left ventricular ejection fraction was referred to our department for the evaluation of exclusively exercise-induced marked symptoms. The treadmill test helped establish a clear correlation between 2:1AVB and symptoms. The test results demonstrated that exercise-induced marked symptoms were attributed to abrupt transient hypotension combined with relative bradycardia, probably due to increased diastolic mitral and tricuspid regurgitation because of 2:1AVB during moderate-to-heavy exercise. After pacemaker implantation for 2:1AVB, the symptoms and transient hypotension disappeared, and her exercise capacity improved.     

Maternal administration of bisphenol A alters the microglial profile in the neocortex of mouse weanlings

Bisphenol A (BPA) is known to cause abnormal neurogenesis in the developing neocortex. The mechanisms of BPA toxicity concerning neuroinflammatory-related endpoints are incompletely characterized. To evaluate the microglial morphology and the gene expression of pro-inflammatory cytokines in the newborn neocortex, ICR mice were exposed to BPA 200 μg/kg/d on gestational day 6 through post-partum day 21. Weanlings exposed during prenatal and postnatal period to BPA showed an increased number of amoeboid-type microglia, a microglial differentiation disruption (the M1/M2 microglial ratio), and an abnormal expression of genes encoding pro-inflammatory factors. These findings suggest that the well-known neurodevelopmental toxicity of BPA may be related to an increased microglial activation and neuroinflammation in the neocortex.     

Endocrine disrupting chemicals, 4‐nonylphenol,bisphenol A and butyl benzyl phthalate,impair metabolism of estradiol in male and female rats as assessed by levels of 15α‐hydroxyestrogens and catechol estrogens in urine

Bisphenol A (BPA), 4‐nonylphenol (NP) and butyl benzyl phthalate (BBP), termed endocrine‐disrupting chemicals, are known to mimic estrogen activity. The effects of these chemicals on 17β‐estradiol (E₂) metabolism in vivo in rats were examined. Male and female rats were given NP (250 mg kg^–1 day^–1), BPA (250 μg kg^–1 day^–1) or BBP (500 mg kg^–1 day^–1) by gavage for 14 days, followed by a single intraperitoneal injection of E₂ (5 mg kg^–1) on the final day. The urinary excretion over 72 hours of 2‐hydroxyestrone 1‐N‐acetylcysteine thioether, 2‐hydroxyestrone 4‐N‐acetylcysteine thioether, 4‐hydroxyestrone 2‐N‐acetylcysteine thioether, 2‐hydroxy‐17β‐estradiol (2‐OHE₂), 2‐hydroxyestrone (2‐OHE₁), 4‐hydroxy‐17β‐estradiol, 4‐hydroxyestrone, 15α‐hydroxyestriol (E₄), 15α‐hydroxy‐17β‐estradiol and 15α‐hydroxyestrone was measured. Increases in urinary excretion of 2‐OHE₁ and decreases in E₄ were observed in males treated with NP or BBP. Decreases in urinary excretion of 2‐OHE₂ and E₄ were observed in males treated with BPA. Decreases in urinary excretion of 2‐OHE₁ and 2‐OHE₂ were observed in females treated with BBP. Normalized liver and weights were increased in both sexes treated with NP or BBP. Histologic observations revealed marked changes in the distal tubules and collecting ducts in the kidneys of rats exposed to NP and BBP, and hypertrophy in the hepatocytes of the centrilobular zone of the liver. No BPA‐related effects on organ weight and on liver or kidney histopathology were found. These results suggest that the 14 day oral dosing of NP and BBP disrupted E₂ metabolism, resulting from marked morphological and functional alterations in the liver and kidneys. In addition, BPA could induce metabolic and endocrine disruption.     

Dynamic viscoelastic properties of models composed of posterior denture teeth and denture base resin

The purpose of this investigation was to compare the dynamic viscoelastic properties of various models composed of denture teeth and heat-cured denture base resin. The specimens were porcelain and resin teeth mounted in denture base resin. Compressive dynamic stiffness and phase differences were measured with a viscoelastic spectrometer. Measurements of the viscoelastic frequency spectrum based on the fast Fourier transform of displacement to applied random forces were analyzed with a spectrum analyzer. The stiffness of the specimens was independent of the frequency. The stiffness of the porcelain specimens was higher than that of the resin ones measured under the same conditions. The phase lag of the specimens was dependent on the frequency. The phase lag of the porcelain specimens was lower than that of the resin ones measured under the same conditions. This study suggested that the acrylic resin teeth had greater toughness and higher shock-absorbing ability than the porcelain teeth, and that the porcelain teeth were more brittle than the acrylic resin ones, whether the teeth were isolated or in dentures.