Resuscitation After Prolonged Cardiac Arrest: Role of Cardiopulmonary Bypass and Systemic Hyperkalemia

The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF)

Caracterización laboral de psicólogos noveles en educación de la región del Biobío, Chile

The tasks and role of educational psychologists is an important topic, but little researched; even less so with regard to new professionals, who have just entered the labor field. A study carried out in 2020, in the Biobío region in Chile, which analyzes the professional and labor characteristics of 27 new psychologists work- ing in educational establishments, is presented. A questionnaire of working and professional conditions applied in other studies on tasks and functions of the educational psychologist was used. The main results show that, at the labor level, most of them work in PIE programs and in school coexistence, have fixed-term contracts and have space and materials for their work. In the professional aspects, it is observed that a little more than half of them are taking a specialization course, their main tasks are individual and group intervention, and further back, individual diagnosis, while the least performed task is research. At the level of perception of the valuation of their area, a little less than half say that they perform other tasks that are not related to their functions; although 62 % say that their function con- tributes to the objectives of the establishment, only 17 % say that they can perform their tasks as educational psychologists.Las tareas y el rol de los psicólogos educacionales es un tema importante, pero poco investigado; menos aún en lo concerniente a los profesionales noveles, que recién se integran al campo laboral. Se presenta un estudio realizado en 2020, en la región del Biobío en Chile, que analiza las características profesionales y laborales de 27 psicólogos/as noveles que se desempeñan en establecimientos educativos. Se utilizó un cuestionario de condiciones laborales y profesionales aplicado en otros estudios sobre tareas y funciones del psicólogo educacional. Los principales resultados muestran que, a nivel laboral, se desempeñan mayoritariamente en programas PIE y en convivencia escolar, presentan contratos a plazo fijo y cuentan con espacios y materiales para su trabajo. En los aspectos profesionales se observa que poco más de la mitad se encuentra realizando un curso de especialización, sus principales tareas son la intervención individual y grupal, y más atrás, el diagnóstico individual, mientras que la menos realizada es investigación. A nivel de percepción de la valoración de su área, poco menos de la mitad señala realizar otras tareas que no tienen relación con sus funciones; aunque el 62 % señala que su función aporta a los objetivos del establecimiento, solo el 17 % menciona que puede realizar sus labores como psicólogos educacionales

Quantitative Analysis of Hypoperfusion in Acute Stroke

Background and purposeThis study compares the concordance between arterial spin labeling (ASL) and dynamic susceptibility contrast (DSC) for the identification of regional hypoperfusion and diffusion-perfusion mismatch tissue classification using a quantitative method.MethodsThe inclusion criteria for this retrospective study were as follows: patients with acute ischemic syndrome with symptom onset <24 hours and acquisition of both ASL and DSC MR perfusion. The volumes of infarction and hypoperfused lesions were calculated on ASL and DSC multi-parametric maps. Patients were classified into reperfused, matched, or mismatch groups using time to maximum >6 sec as the reference. In a subset of patients who were successfully recanalized, the identical analysis was performed and the infarction and hypoperfused lesion volumes were used for paired pre- and posttreatment comparisons.ResultsForty-one patients met our inclusion criteria. Twenty patients underwent successful endovascular revascularization (TICI>2a), resulting in a total of 61 ASL-DSC data pairs for comparison. The hypoperfusion volume on ASL-cerebral blood flow best approximated the DSC-time to peak volume (r=0.83) in pretreatment group and time to maximum (r=0.46) after recanalization. Both ASL-cerebral blood flow and DSC-TTP overestimated the hypoperfusion volume compared with time to maximum volume in pretreatment (F=27.41, P<0.0001) and recanalized patients (F=8.78, P<0.0001).ConclusionsASL-cerebral blood flow overestimates the DSC time to maximum hypoperfusion volume and mismatch classification in patients with acute ischemic syndrome. Continued overestimation of hypoperfused volume after recanalization suggests flow pattern and velocity changes in addition to arterial transit delay can affects the performance of ASL

An integrated, ontology-driven approach to constructing observational databases for research.

The electronic health record (EHR) contains a diverse set of clinical observations that are captured as part of routine care, but the incomplete, inconsistent, and sometimes incorrect nature of clinical data poses significant impediments for its secondary use in retrospective studies or comparative effectiveness research. In this work, we describe an ontology-driven approach for extracting and analyzing data from the patient record in a longitudinal and continuous manner. We demonstrate how the ontology helps enforce consistent data representation, integrates phenotypes generated through analyses of available clinical data sources, and facilitates subsequent studies to identify clinical predictors for an outcome of interest. Development and evaluation of our approach are described in the context of studying factors that influence intracranial aneurysm (ICA) growth and rupture. We report our experiences in capturing information on 78 individuals with a total of 120 aneurysms. Two example applications related to assessing the relationship between aneurysm size, growth, gene expression modules, and rupture are described. Our work highlights the challenges with respect to data quality, workflow, and analysis of data and its implications toward a learning health system paradigm

An integrated, ontology-driven approach to constructing observational databases for research.

The electronic health record (EHR) contains a diverse set of clinical observations that are captured as part of routine care, but the incomplete, inconsistent, and sometimes incorrect nature of clinical data poses significant impediments for its secondary use in retrospective studies or comparative effectiveness research. In this work, we describe an ontology-driven approach for extracting and analyzing data from the patient record in a longitudinal and continuous manner. We demonstrate how the ontology helps enforce consistent data representation, integrates phenotypes generated through analyses of available clinical data sources, and facilitates subsequent studies to identify clinical predictors for an outcome of interest. Development and evaluation of our approach are described in the context of studying factors that influence intracranial aneurysm (ICA) growth and rupture. We report our experiences in capturing information on 78 individuals with a total of 120 aneurysms. Two example applications related to assessing the relationship between aneurysm size, growth, gene expression modules, and rupture are described. Our work highlights the challenges with respect to data quality, workflow, and analysis of data and its implications toward a learning health system paradigm