Investigation of 5-Year Interconnections between Local Earth Magnetic Field Fluctuations and Acute Myocardial Infarction in Lithuania

The impact of the local Earth magnetic field (LEMF) on cardiovascular events has been studied recently. Data gathered during past years encouraged us to conduct this epidemiological analysis evaluating the association between changes in LEMF and hospital admissions due to AMI in Lithuania between August 2014 and September 2019. This study is unique due to its coverage of all Lithuanian patients. The frequency of morbidity of AMI was compared with the intensity of the LEMF and correlation coefficient was evaluated. The LEMF was measured by the Global Coherence Monitoring Network magnetometer located in Lithuania. LEMF was measured by pikotesla square (pT²). The LEMF was analized in five frequency ranges [Hz], generally called between Schumann resonance, which overlap with the human brain activity waves on electroencefalogram (EEG) frequency ranges (here, they are named as SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and SGamma (32-65Hz) to distinguish from the EEG bands). Significant correlations between weekly admissions of AMI cases and the weekly LEMF strength in five frequency ranges and in total range was found. A clear negative correlation was observed between cases of AMI in female group and LEMF frequency ranges SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and in total range. In the second half of the year the number of AMI is lower, therefore negative correlations between SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz) and SBeta (15-32Hz) ranges are stronger than in the first one. This is particularly noticeable in 2016 and 2018 years

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A Simple Strategy to Reduce Contrast Media Use and Risk of Contrast-Induced Renal Injury during PCI: Introduction of an “Optimal Contrast Volume Protocol” to Daily Clinical Practice

Contrast-induced acute kidney injury is the leading cause of iatrogenic acute nephropathy. Development of contrast-induced nephropathy (CIN) increases the risk of adverse long- and short-term patients outcomes, the hospital costs, and length of hospitalization. There are a couple of methods described for CIN prevention (statin prescription, prehydration, contrast media (CM) clearance from the blood system, and decrease amounts of contrast volume). The CM volume to patient’s creatinine clearance ratio is the main factor to predict the risk of CIN development. The safe CM to creatinine clearance ratio limits have been established. The usage of CM amount depends on personal operators habits and inside center regulations. There is no standardized contrast usage protocol worldwide. The aim of this study was to establish an easy to use, cheap, and efficient protocol to estimate a personalized safe CM dose limit for every patient based on their kidney function. These limits are announced during the “Time Out” before the procedure. Our study included 519 patients undergoing interventional coronary procedures: 207 patients into the “Optimal Contrast Volume” arm and 312 into the control group. Applying the protocol into a daily clinical practice leads to a significant reduction in CM volume used for all type of procedures and the development of CIN in comparison with a control group

Investigation of 5-Year Interconnections between Local Earth Magnetic Field Fluctuations and Acute Myocardial Infarction in Lithuania

The impact of the local Earth magnetic field (LEMF) on cardiovascular events has been studied recently. Data gathered during past years encouraged us to conduct this epidemiological analysis evaluating the association between changes in LEMF and hospital admissions due to AMI in Lithuania between August 2014 and September 2019. This study is unique due to its coverage of all Lithuanian patients. The frequency of morbidity of AMI was compared with the intensity of the LEMF and correlation coefficient was evaluated. The LEMF was measured by the Global Coherence Monitoring Network magnetometer located in Lithuania. LEMF was measured by pikotesla square (pT²). The LEMF was analized in five frequency ranges [Hz], generally called between Schumann resonance, which overlap with the human brain activity waves on electroencefalogram (EEG) frequency ranges (here, they are named as SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and SGamma (32-65Hz) to distinguish from the EEG bands). Significant correlations between weekly admissions of AMI cases and the weekly LEMF strength in five frequency ranges and in total range was found. A clear negative correlation was observed between cases of AMI in female group and LEMF frequency ranges SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz), SBeta (15-32Hz) and in total range. In the second half of the year the number of AMI is lower, therefore negative correlations between SDelta (0-3.5Hz), STheta (3.5-7Hz), SAlpha (7-15Hz) and SBeta (15-32Hz) ranges are stronger than in the first one. This is particularly noticeable in 2016 and 2018 years.</jats:p

Cardiovascular System Interactions With The Local Earth Magnetic Field Fluctuations: A Cohort Study

Abstract Background: Geomagnetic storms strongly affect the human cardiovascular system, misbalancing adaptive mechanisms and causing severe adaptive stress responses at all levels of body regulation. Most physiological changes occur after a defined period following geomagnetic climate alterations, this ‘delay period’ lasts for 2-3 days. Methods: In total, 4730 patients admitted between 2015 and 2017 due to acute coronary syndrome (ACS) and acute onset of arrhythmias have been included into the study.Results: Higher time varying magnetic field (TVMF) activity in low frequency ranges is associated with lower number of admissions due to ACS, while higher TVMF activity in high frequency ranges is associated with increased risk for ACS occurrence. The greater TVMF activity in low frequency ranges is associated with higher rates of admission due to cardiac arrhythmias. Additional ACS analysis showed that red blood cell count decreases with increased MF strength in low frequency ranges, while white blood cells and platelets count increases in the same MF frequency ranges. The highest serum osteocalcin level was found 3 days after certain MF strength changes in low frequency ranges in patients with ACS. Strong correlations were found between more than 2 cases of AMI per day and MF strength changes 2- and 3- days before admission. Conclusions: Earth’s local magnetic field is strongly related on human cardiovascular system metabolism and neural regulation. Increased Magnetic field activity in low frequency ranges is associated with heart metabolism and may induce better cardiovascular health, while increased magnetic field activity in high frequency ranges leads to heart problems especially to occurrence of ischemic heart disease and arterial hypertension.</jats:p

Treating MERS-CoV during an outbreak

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding: DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant