Dispatcher-assisted cardiopulmonary resuscitation for paediatric out-of-hospital cardiac arrest

Aim To evaluate communication issues during dispatcher-assisted cardiopulmonary resuscitation (DACPR) for paediatric out-of-hospital cardiac arrest in a structured manner to facilitate recommendations for training improvement. Methods A retrospective observational study evaluated DACPR communication issues using the SACCIA ® Safe Communication typology (Sufficiency, Accuracy, Clarity, Contextualization, Interpersonal Adaptation). Telephone recordings of 31 cases were transcribed verbatim and analysed with respect to encoding, decoding and transactional communication issues. Results Sixty SACCIA communication issues were observed in the 31 cases, averaging 1.9 issues per case. A majority of the issues were related to sufficiency (35%) and accuracy (35%) of communication between dispatcher and caller. Situation specific guideline application was observed in CPR practice, (co)counting and methods of compressions. Conclusion This structured evaluation identified specific issues in paediatric DACPR communication. Our training recommendations focus on situation and language specific guideline application and moving beyond verbal communication by utilizing the smart phone’s functions. Prospective efforts are necessary to follow-up its translation into better paediatric DACPR outcomes

Guidelines for chemotherapy of biliary tract and ampullary carcinomas

Few randomized controlled trials (RCTs) with large numbers of patients have been conducted to date in patients with biliary tract cancer, and standard chemotherapy has not been established yet. In this article we review previous studies and clinical trials regarding chemotherapy for unresectable biliary tract cancer, and we present guidelines for the appropriate use of chemotherapy in patients with biliary tract cancer. According to an RCT comparing chemotherapy and best supportive care for these patients, survival was significantly longer and quality of life was significantly better in the chemotherapy group than in the control group. Thus, chemotherapy for patients with biliary tract cancer seems to be a significant treatment of choice. However, chemotherapy for patients with biliary tract cancer should be indicated for those with unresectable, locally advanced disease or distant metastasis, or for those with recurrence after resection. That is why making the diagnosis of unresectable disease should be done with greatest care. As a rule, pathological diagnosis, including cytology or histopathological diagnosis, is preferable. Chemotherapy is recommended in patients with a good general condition, because in patients with general deterioration, such as those with a performance status of 2 or 3 or those with insufficient biliary decompression, the benefit of chemotherapy is limited. As chemotherapy for unresectable biliary tract cancer, the use of gemcitabine or tegafur/gimeracil/oteracil potassium is recommended. As postoperative adjuvant chemotherapy, no effective adjuvant therapy has been established at the present time. It is recommended that further clinical trials, especially large multi-institutional RCTs (phase III studies) using novel agents such as gemcitabine should be performed as soon as possible in order to establish a standard treatment

Autologous bone marrow-derived mesenchymal stem cells versus autologous chondrocyte implantation: An observational cohort study

10.1177/0363546509359067American Journal of Sports Medicine3861110-1116AJSM

Catalytic and Electrocatalytic Activation of Methane over Manganese Oxides Deposited on YSZ

The catalytic and the electrocatalytic behavior of MnO(x) oxides deposited on Yttria Stabilized Zirconia (YSZ) in the form of thin porous films, was studied during the reaction of methane activation at high methane to oxygen ratios. Experiments were carried out in a continuous flow well-mixed reactor (CSTR), at atmospheric total pressure and in a temperature range between 500-850 degrees C. It was found that the electrochemical pumping of oxygen anions (O(2-)) through the solid electrolyte (YSZ) affect drastically the rates of CO(2), C(2)H(4) and C(2)H(6) formation and consequently the C(2) selectivity