Role of nurses' electrocardiography competency in emergent situations

Electrocardiography is an essential tool in emergency care and monitoring of patients with severe cardiovascular diseases. Nurses are at the center of this evaluation and play an important role in the outcome of therapy. Data shows that nurses are limited in their ability to record and interpret electrocardiography diagrams accurately. Little is known about the role nurses play in electrocardiographic evaluation in an emergency. This narrative literature review assesses the competency of nurses in electrocardiography in an emergency, the implications for medical practice, and tries to identify possible improvement solutions

Estimating Geophysical Bedrock Depth Using Single Station Analysis and Geophysical Data in the Extra-Carpathian Area of Romania

Local site evaluation is an essential step in understanding the amplification of seismic motion induced by the complex geological structure and their estimation for future strong earthquakes in urban regions. One of the critical parameters on evaluating amplification effects is the depth of the geophysical bedrock, whose interface to soft sediments is responsible for the development of destructive resonance phenomena. The present study is focused on the estimation of the geophysical bedrock depth along the extra-Carpathian area of Romania (Moesian Platform and surroundings) by correlating and interpolating the results obtained from single station measurements with the available geological/geophysical data. Each site was investigated through the computation of horizontal-to-vertical (H/V) spectral ratios from three-component single station measurements of ambient vibrations. The geophysical bedrock depth was computed using a two-step inversion scheme, based on the retrieval of the Rayleigh-wave ellipticity peak at each seismic station using a regional generic velocity profile. The fundamental frequency of resonance reaches the lowest value in the deepest side (0.07 Hz) and is rising to 13 Hz in the South of the Moesian Platform, where a shallow bedrock is present. The computed bedrock depths (from 30 to ~ 3100 m) show a dipping tendency towards the Southern Carpathians and complex features such as local outcrops and lateral depth variations superpose this gradually dipping trend. In the Carpathian foreland, the bedrock is interpreted as the transition between different sediment layers of Neogene, while outside this area as the Neogene—Cretaceous transition. © 2020, Springer Nature Switzerland AG.ISSN:0033-4553ISSN:1420-9136ISSN:1557-736

Anti-Psoriasis Effect of Diclofenac and Celecoxib Using the Tail Model for Psoriasis

Non-steroidal anti-inflammatory drugs (NSAIDs) showed effects in some hyperproliferative dermatologic pathologies. The aim of the study is the assessment of anti-psoriasis effect of diclofenac and celecoxib using a mice tail model. The topical application of substances on the proximal mice tails was performed for two weeks. The effects on the epidermal granular layer and mean epidermal thickness (excluding the stratum corneum) were evaluated using hematoxylin–eosin staining. Orthokeratosis degree and percentual drug activity were calculated. A positive control group treated with tretinoin and two negative controls (white soft paraffin and untreated mice) were used. Orthokeratosis degree significantly increased in all the NSAIDs groups (celecoxib 1%, 2% and diclofenac 1%, 2%) and in the tretinoin 0.05% group, versus negative controls. Celecoxib 1% and 2%, tretinoin 0.05% and white soft paraffin significantly increased mean epidermal thickness, versus untreated mice. The values obtained in the case of celecoxib 2% ointment regarding the orthokeratosis degree and percentual drug activity are providing premises for further investigations regarding this effect and the mechanisms of action involved. Celecoxib 2% had the greatest percentual drug activity and is a promising substance for the anti-psoriasis topical treatment. Along with the COX-2 inhibition, celecoxib might have an anti-psoriasis effect by other independent mechanisms

Formulation and Characterization of Niacinamide and Collagen Emulsion and Its Investigation as a Potential Cosmeceutical Product

Cosmeceuticals are one of the fast-growing areas of the natural personal care industry. Cosmeceuticals are cosmetic products with medicinal or drug-like benefits that can affect the biological functioning of the skin depending on the ingredients in the composition. The development of one formulation acting on the dermis and stimulating the collagen production is very important for the hydration of the skin. The association of collagen with other ingredients can have a positive effect on increasing the natural production of collagen in the skin. An example of such an ingredient is niacinamide, which, having a recognized nutritional value, has been quite recently studied. Considering these aspects, this study focused on developing oil-in-water (O/W) emulsions, based on natural ingredients (vegetable oils, floral waters, and essential oils) and hydrolyzed collagen and niacinamide as active ingredients, and on evaluating the stability, pH, optical, superficial, rheological and textural properties, as well as microbiological tests of the emulsions, in order to investigate their potential as a cosmeceutical product. All the obtained emulsions proved to be stable at variable temperatures and had a pH value compatible with natural pH of the skin, allowing their safe application. Over goniometric analysis, a partial wetting and a hydrophilic character of the emulsions were emphasized. Following the rheological analyses, all dermatocosmetic emulsions exhibited non-Newtonian pseudoplastic behavior and a thixotropic character, these properties being very important for their production process and their application on the skin surface to generate an optimal therapeutic effect. The textural characteristics recorded for all emulsions indicated adequate spreadability at the application site. All tested samples respected the Pharmacopoeia limits of microbiological contamination. All prepared emulsions have good stability, are safe for the skin and have appropriate physicochemical and microbiological characteristics; therefore, they can be used as a cosmeceutical product

Novel Polyurethanes Based on Recycled Polyethylene Terephthalate: Synthesis, Characterization, and Formulation of Binders for Environmentally Responsible Rocket Propellants

Novel polyurethane-based binders, specifically designed for environmentally responsible rocket propellant composites, were obtained by employing the polyester-polyols that resulted from the degradation of polyethylene terephthalate waste. A new class of “greener” rocket propellants, comprising polyurethanes (based on recycled PET) as the binder, phase stabilized ammonium nitrate (PSAN) as the eco-friendly oxidizer, and triethylene glycol dinitrate (TEGDN) as the energetic plasticizer, together with aluminum as fuel and Fe2O3 as the catalyst, is herein reported. The components of the energetic mixtures were investigated (individually and as composite materials) through specific analytical tools: 1H-NMR, FT-IR, SEM-EDX, DTA and TGA, tensile and compression tests, DMA, and micro-CT. Moreover, the feasibility of this innovative solution is sustained by the ballistic performances exhibited by these composite materials in a subscale rocket motor, proving that these new formulations are suitable for rocket propellant applications

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk