International survey of neurosurgical anesthesia (iSonata)

Die Anaesthesiologie - No standardized recommendations have been currently defined for anesthesia management of patients undergoing elective intracranial surgery. It can therefore be assumed that...     

Role of Student Nurse in the Prehospital Medical Teams Responding to the Scene of A Terrorist Attack in France

BackgroundThe terrorist attacks in Paris and in Saint-Denis in November 2015 were unprecedented events involving various human and material resources. These events question the role of nurse students in prehospital teams.PurposeTo investigate nursing students’ preference about whether they wished to participate in the prehospital care during a terrorist attack.MethodsThis cross-sectional study was conducted with student nurses, from two nursing schools in the Greater Paris area. They completed an anonymous survey assessing the desire to be called to help the mobile intensive care units (MICU) or another ward; whether their presence should be mandatory, and the feelings associated with their experience. The responses were collected with a visual analogue scale and could range from 1 (yes, very much) to 10 (no, not at all). A Chi-square test was performed for qualitative variables and a Mann–Whitney test for quantitative variables.FindingsAmong 225 students, 205 (91%) responded, 133 (65%) were women. When on duty, 169 (82%) would have preferred to accompany the MICU team, compared with 31 (15%) who would have preferred not to go. Overall, 146 students (71%) considered that this presence should be optional. Only gender was significantly associated with the choice to accompany the MICU team (W = 87% vs. M = 13%; p = .002). Students expressed a moderate feeling of frustration and fear.DiscussionStudents would prefer to assist the MICU team responding to the scene of a terrorist attack but feel this choice should be optional. A discussion in nursing schools and universities should be considered for the implementation of a “systematic” procedure to ensure the student's willingness to participate in such interventions.     

Constellation of lipoproteins in patients with hyperlipoproteinemia and in rabbits fed a cholesterol diet with reference to vascular permeability]

By feeding of rabbits with cholesterol a hyperlipoproteinaemia (HLP) was created and the changes of the cholesterol and triglyceride (TGL) level were compared with the changes of the portions of the pre-beta- and beta-lipoproteins. The electrophoresis with a gel of agar-agarose are more suitable for the densitometric evaluation than electrophoresis with cellulose acetate films. Tests with Evan's blue of the angiopermeability of rabbits feeded with cholesterol showed that the permeability of the cutaneous vessels decreased strikingly during test period, while a change of the permeability of the aorta was not to be proved under the conditions of our tests. HLP patients had been treated with clofibrinic acid, nicotinic acid derivatives and metabolism basic diet for 3 years. The cholesterol and TGL values as well as the pre-beta-/beta-lipoprotein quotients have been determined before and after treatment. The pre-beta-/beta-lipoprotein quotient has proved as suitable complementary parameter for pursuit of the therapeutic result with HLP patients. The changes of the quotients corresponded well with the found changes of the HLP types. The decrease of the TGL content of HLP patients of the type IV or IIb being treated with metabolism basic diet or clofibrinic acid may be estimated (with nearly constant cholesterol level) from the per cent decrease of the pre-beta-/beta-quotient.     

Changes in Neuron-Specific Enolase are More Suitable Than Its Absolute Serum Levels for the Prediction of Neurologic Outcome in Hypothermia-Treated Patients with Out-of-Hospital Cardiac Arrest

Background

To determine neurologic outcome in patients with out-of-hospital cardiac arrest (OHCA) and treatment with mild therapeutic hypothermia (MTH).

Methods

Seventy-three consecutive OHCA patients treated with MTH were retrospectively analyzed. Serum neuron-specific enolase (NSE) was measured 24, 48, and 72 h after admission. In patients with no motor response 48 h after termination of analgosedation (n = 40), clinical neurological examination and evoked potentials (EPs) were determined. Neurological outcome was assessed after 2 months based on the cerebral performance categories (CPC), and categorized as good (CPC 1–3) or poor (CPC 4 and 5).

Results

Forty-three patients had a CPC score of 1–3 and 30 patients had a CPC 4–5. The best predictive value for poor neurologic outcome was an increase of NSE by ≥4.3 ng/mL between day 1 and day 2 (sensitivity 80 %, specificity 100 %, positive predictive value (PPV) 100 %, negative predictive value 86 %). Absolute NSE values were less reliable in the prediction of poor outcome with the highest sensitivity (88 %) and specificity (95 %) if values reached ≥36.3 ng/mL on day 3. Somatosensory EPs (SSEPs) showed a specificity of 100 % and PPV of 100 %; however, sensitivity for evoked potentials was low (29 %). Intriguingly, two initially comatose patients with excessive NSE values (24 h NSE: 101 and 256 ng/mL, and 48 h NSE: 93 and 110 ng/mL, respectively) had physiological SSEPs and regained a CPC score of 1.

Conclusion

In patients treated with MTH after OHCA changes in NSE are more suitable than its absolute serum levels for the prediction of poor neurologic outcome. Since unequivocal prediction of poor neurologic outcome is of utmost importance in these patients the decision to limit therapy must be based on several prediction tools with the highest PPV and specificity including SSEPs.     

Approaches to optimize therapeutic bacteriophage and bacteriophage-derived products to combat bacterial infections

Virus Genes - The emerging occurrence of antibiotic-resistant bacterial pathogens leads to a recollection of bacteriophage as antimicrobial therapeutics. This article presents a short overview of...     

Complete genome characterization of mosavirus (family Picornaviridae) identified in droppings of a European roller (Coracias garrulus) in Hungary

Mosavirus (mosavirus A1, M-7/2010/USA, JF973687), a novel picornavirus, was found in a canyon mouse (Peromyscus crinitus) in the USA in 2010. It represents a novel species (Mosavirus A) in a novel genus (Mosavirus) in the family Picornaviridae. In this study, the first complete genome sequence of another mosavirus, SZAL6-MoV/2011/HUN (KF958461), was determined from one out of 18 fecal samples from an Afro-Palearctic migratory bird, the European roller (Coracias garrulus). The complete genome of SZAL6-MoV/2011/HUN is 8385 nt long (from poly(C) tract to poly(A) tail), contains a 646-nt-long 5′UTR that forms a type II IRES, and encodes a potential 2550-aa-long polyprotein precursor including an aphthovirus-like L^pro-proteinase, a small aphthovirus-like 2A^NPG↓P, and two 3B^VPg proteins. SZAL6-MoV/2011/HUN has 67 %, 74 %, and 76 % aa sequence identity in the P1, P2, and P3 region, respectively, to M-7/2010/USA and represents a second mosavirus type, mosavirus A2.