An Experimental Model of Heat Storage in Working Firefighters

Objective. Develop experimental models to study uncompensable heat stress (UCHS) in working firefighters (FFs). Methods. FFs ingested core temperature (Tc) capsules prior to performing sequential tasks in 40°C andpersonal protective ensemble (PPE), or 18°C andno PPE. Both trials were conducted in an environmental chamber with FFs using self-contained breathing apparatus (SCBA). Results. FFs exercising in heat andPPE reproduced UCHS conditions. For every FF in both trials for whom the capsules worked, Tc was elevated, andTc_max occurred after completion of study protocol. Trials with PPE resulted in a mean maximum temperature of 38.94°C (± 0.37°C); Tc_max reached 40.4°C. Without PPE, maximum Tc averaged 37.79°C (± 0.07°C). Heat storage values ranged from 131 to 1205 kJ, averaging 578 kJ (± 151.47kJ) with PPE and210.83 kJ (± 21.77kJ) without PPE. Conclusions. An experimental model has been developed that simulates the initial phases of an interior fire attack to study the physiology of UCHS in FF. The hot environment andPPE increase maximum Tc andheat storage over that due to the exertion required to perform the tasks andmay decrease time to volitional fatigue. This model will permit controlled studies to optimize work-rest cycles, rehab conditions, andphysical conditioning of FFs.     

基于核酸预混室温储运技术的荧光定量PCR快速检测鼠疫耶尔森氏菌

目的 实现荧光定量PCR技术在鼠疫现场和基层的应用。方法 本试验将已建立的基于核酸预混室温储运技术的荧光定量PCR方法应用于我国各鼠疫疫源地野生菌株的检测,进行特异性评价。选取分布于我国境内不同鼠疫疫源地野生鼠疫耶尔森氏菌株、鼠疫减毒菌株、耶尔森菌属近缘菌株假结核菌及小肠结肠炎菌进行荧光定量PCR检测。结果 55株鼠疫耶尔森氏菌及鼠疫减毒菌株扩增阳性,假结核耶尔森氏菌、小肠结肠炎耶尔森氏菌无阳性扩增,冻干试剂在室温25 ℃和37 ℃条件下可保存6个月,敏感性与冷冻保存无差异,核酸扩增诊断可在1 h内完成。结论 应用基于核酸预混室温储运技术的荧光定量PCR方法对我国各鼠疫疫源地55株鼠疫耶尔森氏菌检测呈现高度特异性,本试验冻干试剂具有可室温保存、便于运输、检测结果精准、快速等特点,具有较好的鼠疫现场应用前景。     

Integrated image storage solutions for the Cath department

Contemporary Image Storage systems for the Catheterization department manage and distribute digital cardiac images according to the cine-film paradigm. The images are digital, but the applications have not changed much. This situation will change in the near future. New systems are being developed to store additional (clinical related) data with X-ray Angiographic (XA) Images. Furthermore, the image storage domains are no longer an island in the hospital infrastructure. Efficiency requires the availability of images with other data at the various point of care locations. This in turn raises requirements and expectations about the standards in the area of application interoperability, since no single vendor can supply the complete solution. Recent DICOM (Digital Imaging and Communications in Medicine) standardization activities play an important role in extending the current scope of image oriented storage solutions towards a more integrated imaging and information (clinical) folder for the Cath department. The paper will address the following issues: New requirements on self-contained Image Storage solutions for the Cath lab. How to deal with the demand for interdepartmental communication using upcoming (new) DICOM standards and HL7 (Health Level Seven) in this area. The increasing influence of computer technology, replacing vendor-specific solutions by general-accepted standards from the Information Technology (IT) world. A step-wise approach to come to an integrated clinical (patient) folder with inherent capabilities for data interchange with other Cardiology departments and the hospitals information infrastructure.     

Perioperative management of benign hepatic tumors in patients with glycogen storage disease type Ia

Glycogen storage disease type Ia (GSD-Ia; von Gierke disease) is an inherited disorder caused by glucose-6-phosphatase deficiency, and there have been some reports of hepatic tumors in patients with this disease. We report two patients with benign hepatic tumors with GSD-Ia. One is a 19-year-old man who underwent segmentectomy 4 for a focal nodular hyperplasia, and the other is a 31-year-old woman who underwent segmentectomies 3, 5, and 6 for hepatic adenomas. Two significant perioperative complications, resulting from the carbohydrate metabolic disorders, hypoglycemia and metabolic acidosis, occurred in both patients. We managed the metabolic complications successfully by administering a sufficient volume of glucose intravenously. Close perioperative monitoring of blood glucose and lactate concentrations is essential in the perioperative management of patients with GSD-Ia. The intravenous administration of glucose, starting with a smaller dose and then increasing the dose, is adequate management for lactic acidosis with or without hypoglycemia during the perioperative period.     

Effect of storage time on metabolite profile and alpha-glucosidase inhibitory activity of Cosmos caudatus leaves – GCMS based metabolomics approach

Cosmos caudatus, which is a commonly consumed vegetable in Malaysia, is locally known as “Ulam Raja”. It is a local Malaysian herb traditionally used as a food and medicinal herb to treat several maladies. Its bioactive or nutritional constituents consist of a wide range of metabolites, including glucosinolates, phenolics, amino acids, organic acids, and sugars. However, many of these metabolites are not stable and easily degraded or modified during storage. In order to investigate the metabolomics changes occurring during post-harvest storage, C. caudatus samples were subjected to seven different storage times (0 hours, 2 hours, 4 hours, 6 hours, 8 hours, 10 hours, and 12 hours) at room temperature. As the model experiment, the metabolites identified by gas chromatography-mass spectrometry (GC-MS) were correlated with α-glucosidase inhibitory activity analyzed with multivariate data analysis (MVDA) to find out the variation among samples and metabolites contributing to the activity. Orthogonal partial least squares (OPLS) analysis was applied to investigate the metabolomics changes. A profound chemical alteration, both in primary and secondary metabolites, was observed. The α-tocopherol, catechin, cyclohexen-1-carboxylic acid, benzoic acid, myo-inositol, stigmasterol, and lycopenecompoundswerefoundtobethediscriminatingmetabolitesatearlystorage;however, sugars such as sucrose, α-d-galactopyranose, and turanose were detected, which was attributed to the discriminating metabolites for late storage. The result shows that the MVDA method is a promising technique to identify biomarker compounds relative to storage at different times.     

We Built This House; It’s Time to Move in: Leveraging Existing DICOM Structure to More Completely Utilize Readily Available Detailed Contrast Administration Information

The Digital Imaging and Communications in Medicine (DICOM) standard is the universal format for interoperability in medical imaging. In addition to imaging data, DICOM has evolved to support a wide range of imaging metadata including contrast administration data that is readily available from many modern contrast injectors. Contrast agent, route of administration, start and stop time, volume, flow rate, and duration can be recorded using DICOM attributes [1]. While this information is sparsely and inconsistently recorded in routine clinical practice, it could potentially be of significant diagnostic value. This work will describe parameters recorded by automatic contrast injectors, summarize the DICOM mechanisms available for tracking contrast injection data, and discuss the role of such data in clinical radiology.     

Red cell transfusion in paediatric patients with thalassaemia and sickle cell disease: Current status,challenges and perspectives

Notwithstanding the high safety level of the currently available blood for transfusion and the decreasing frequency of transfusion-related complications, administration of labile blood products to paediatric patients still poses unique challenges and considerations. The incidence of thalassaemia and sickle cell disease in the paediatric population may be high enough under specific racial and geographical contexts. Red cell transfusion is the cornerstone of β-thalassaemia treatment and one of the most effective ways to prevent or correct specific acute and chronic complications of sickle cell disease. However, this life-saving strategy comes with its own complications, such as additional iron overload, alloimmunization and haemolytic reactions, among others. In paediatrics, the dependency of the transfusion outcome upon disease and other recipient characteristics is more prominent compared with the adults, owing to differences in developmental maturity and physiology that render them more susceptible to common risks, exacerbate the host response to transfused cells, and modify the type or the clinical severity of the transfusion-related morbidity. The adverse branch of red cell transfusion is likely the overall effect of several factors acting synergistically to shape the clinical phenotype of this therapy, including inherent donor/blood unit variables, like antigenicity, red cell deformability and extracellular vesicles, as well as recipient variables, such as history of alloimmunization and inflammation level at time of transfusion. This review focuses on paediatric patients with β-thalassaemia and sickle cell disease as a recipient group with distinct transfusion-related characteristics, and introduces new concepts for consideration, not adequately studied and elucidated so far.