In-hospital cardiac arrest--an Utstein style report of seven years experience from the Sahlgrenska University Hospital

BACKGROUND: In-hospital cardiac arrest is one of the most stressful situations in modern medicine. Since 1997, there has been a uniform way of reporting - the Utstein guidelines for in-hospital cardiac arrest reporting. MATERIAL AND METHODS: We have studied all consecutive cardiac arrest in the Sahlgrenska University Hospital (SU) between 1994 and 2001 for who the rescue team was alerted in all 833 patients. The primary endpoint for this study was survival to discharge. RESULTS: Thirty-seven percent survived to hospital discharge. Among patients who were discharged alive, 86% were alive 1 year later. The survivors have a good cerebral outcome (94% among those who were discharged alive had cerebral performance category (CPC) score 1 or 2). The organization at SU is efficient; 80% of the cardiac arrest had CPR within 1 min. Time from cardiac arrest to first defibrillation is a median of 2 min. Almost two-thirds of the patients were admitted for cardiac related diagnoses. CONCLUSION: The current study is the largest single-centre study of in hospital cardiac arrest reported according to the Utstein guidelines. We report a high survival for in-hospital cardiac arrest. We have pointed out that a functional chain of survival, short intervals before the start of CPR and defibrillation are probably contributing factors for this.     

Implications of In-Use Photostability: Proposed Guidance for Photostability Testing and Labeling to Support the Administration of Photosensitive Pharmaceutical Products,Part 1: Drug Products Administered by Injection

Basic guidance on the photostability testing of pharmaceuticals, designed to cover manufacturing and storage over shelf life, has long been established within ICH Q1(ICH,B¹⁰, but the guideline does not cover the photostability of drugs during or after administration (i.e., under conditions of use). To date, there has been a paucity of guidance covering the additional testing that would be of value during the clinical preparation and use of products. This commentary suggests a systematic approach, based on realistic “worst case” photoexposure scenarios and the existing ICH Option 1 and 2 light sources, to provide valuable data to pharmaceutical manufacturers and compounding pharmacists for the safe and effective use of photosensitive injection products. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:3888-3899, 2013     

Measuring the level of compulsory hospitalisation in mental health care: The performance of different measures across areas and over time

ObjectiveA variety of measures are used for reporting levels of compulsory psychiatric hospitalisation. This complicates comparisons between studies and makes it hard to establish the extent of geographic variation. We aimed to investigate how measures based on events, individuals and duration portray geographical variation differently and perform over time, how they correlate and how well they predict future ranked levels of compulsory hospitalisation.MethodsSmall‐area analysis, correlation analysis and linear regressions of data from a Norwegian health registry containing whole population data from 2014 to 2018.ResultsThe average compulsory hospitalisation rate per 100,000 inhabitant was 5.6 times higher in the highest area, compared to the lowest, while the difference for the compulsory inpatient rate was 3.2. Population rates based on inpatients correlate strongly with rates of compulsory hospitalisations (r = 0.88) and duration (r = 0.78). 68%–81% of ranked compulsory hospitalisation rates could be explained by each area''s rank the previous year.ConclusionThere are stable differences in service delivery between catchment areas in Norway. In future research, multiple measures of the level of compulsory hospitalisation should ideally be included when investigating geographical variation. It is important that researchers describe accurately the measure upon which their results are based.     

Ecophysiological requirements and survival of a Trichoderma atroviride isolate with biocontrol potential

Trichoderma atroviride SC1, isolated from decayed hazelnut wood in northern Italy in 2000, is a promising fungal agent for biological control of soil-borne plant pathogens. The objective of this research was to characterize the biology and ecology of this fungus, in order to determine its environmental parameter tolerance levels and its behavior in the phylloplane and soil systems. To better characterize T. atroviride SC1, the influences of pH, temperature, water activity and different nitrogen and carbon sources on its in vitro growth were evaluated. T. atroviride SC1 survival was assessed on strawberry leaves under controlled conditions in a greenhouse and in sterilized and non-sterilized soil samples kept at room temperature. Results showed that isolate SC1 is mesophilic and grows best at 25 degrees C. The fungus tolerates a wide range of pH levels, but growth was reduced on alkaline media (pH >or= 8). The nitrogen and carbon sources peptone, tryptone, nitrate, mannose, galactose and sucrose were associated with the highest mycelial biomass production, as compared with other potential sources of nitrogen and carbon. The fungus survived on strawberry leaves under greenhouse conditions (25 +/- 2 degrees C, RH = 60 +/- 10%) and grew in sterilized soils at room temperature (23 +/- 2 degrees C) for 45 d. However, no increase in mycelial dry weight was observed in non-sterilized soils. T. atroviride SC1 survived under the test conditions, showing a good potential for use in soil and foliar biocontrol applications.     

Transforming growth factor-beta receptor type II mutation in a patient with bicuspid aortic valve disease and intraoperative aortic dissection

We report on a patient with familial bicuspid aortic valve disease operated on for proximal aortic aneurysm. The surgery was complicated by intraoperative aortic dissection. Multi-generational genetic analysis demonstrated a mutation in the transforming growth factor-beta receptor type II gene. This case confirms the clinical hypothesis that the proximal aortic disease has a genetic origin in some bicuspid aortic valve patients.