Early Outcomes of Out-of-Hospital Cardiac Arrest after Early Defibrillation: a 24 Months Retrospective Analysis

Introduction: Cardiovascular disease remains the most common cause of death in the United States and most other Western nations. Among these deaths, sudden, out-of-hospital cardiac arrest claims approximately 1000 lives each day in the United States alone. Most of these cardiac arrests are due to ventricular fibrillation. Though highly reversible with the rapid application of a defibrillator, ventricular fibrillation is otherwise fatal within minutes, even when cardiopulmonary resuscitation is provided immediately. The overall survival rate in the United States is estimated to be less than 5 percent. Recent developments in automated-external-defibrillator technology have provided a means of increasing the rate of prompt defibrillation after out-of-hospital cardiac arrest. After minimal training, nonmedical personnel (e.g., flight attendants and casino workers) are also able to use defibrillators in the workplace, with lifesaving effects. Nonetheless, such programs have involved designated personnel whose job description includes assisting persons who have had sudden cardiac arrest. Data are still lacking on the success of programs in which automated external defibrillators have been installed in public places to be used by persons who have no specific training or duty to act. Materials and Methods: All patients who had an out-of-hospital cardiac arrest between January 2003 and December 2004 and who received early defibrillation for ventricular fibrillation were included. We conducted a 24 months retrospective population-based analysis of the outcome in our population. Results: Over a 24 month period, 446 people had non–traumatic cardiac arrest, and in all of them it was observed to be ventricular fibrillation. In a very few cases, the defibrillator operators were good Samaritans, acting voluntarily. Eighty-nine patients (about 19%) with ventricular fibrillation were successfully resuscitated, including eighteen who regained consciousness before hospital admission. Conclusion: Automated external defibrillators deployed in readily accessible, well-marked areas, are really very effective in assisting patients with cardiac arrest. However, it's quite true that, in the cases of survivors, most of our users had good prior training in the use of these devices

Infertility and assisted reproduction: legislative and cultural evolution in Italy. Infertilità e procreazione assistita: evoluzione legislativa e culturale in Italia

The social representation of the infertility coming out from the national newspapers has been explored in relation to the enactment of the Law 40/2004 and the 2005 referendum. All the articles (n=731), published in the last 15 years by the highest circulation Italian newspapers, have been collected in a corpus (token=360345) that underwent a multivariate analysis of textual data. Results show a difficulty in complementing together the mind and the body. The “biologic” is represented as the place of the technical and medical intervention while the “psycho-social” is conceived as the place of the family storytelling of the personal experiences of infertility and the public ethical debate on it. Before the law, newspapers deal with the theme of the family experience probably supporting the law enactment. After the referendum this thematic is dismissed and the theme of infertility as a pathology to treat emerges, bringing back infertility to the medical issu