Tomografia impedancyjna w diagnostyce i monitorowaniu zaburzeń funkcji płuc na oddziale intensywnej terapii — opis przypadku i przegląd piśmiennictwa

  The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan. After identifying the causing factor (Pneumocyctis jiroveci), EIT monitoring was maintained to assess the effectiveness of targeted microbial treatment. In the following days, we observed an improvement of regional ventilation of the upper and middle segments of the left lung that corresponded well with laboratory test results, especially arterial blood gas analysis. The use of Electrical Impedance Tomography enables non-invasive, bedside, continuous assessment of regional lung ventilation. It is possible to use it in both mechanically ventilated and spontaneously breathing patients. It allows efficient and dynamic monitoring of the course of the therapeutic process. Interpretation of the results is relatively easy to learn and does not require specialist knowledge. Moreover, it is possible to use EIT in those cases where other methods are of high risk or contraindicated.    The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan. After identifying the causing factor (Pneumocyctis jiroveci), EIT monitoring was maintained to assess the effectiveness of targeted microbial treatment. In the following days, we observed an improvement of regional ventilation of the upper and middle segments of the left lung that corresponded well with laboratory test results, especially arterial blood gas analysis. The use of Electrical Impedance Tomography enables non-invasive, bedside, continuous assessment of regional lung ventilation. It is possible to use it in both mechanically ventilated and spontaneously breathing patients. It allows efficient and dynamic monitoring of the course of the therapeutic process. Interpretation of the results is relatively easy to learn and does not require specialist knowledge. Moreover, it is possible to use EIT in those cases where other methods are of high risk or contraindicated.

Twój smartfon może uratować komuś życie

INTRODUCTION: Each year in Europe there are about 350 thousand deaths recorded, following sudden cardiac arrest (SCA). To reduce this number, new methods are being looked for to assist non-medical people in CPR. The objective of this contribution is to compare the efficacy of cardio-pulmonary resuscitation and its compliance with the BLS algorithm in persons showing no medical background, using generally available means of support. MATERIAL AND METHODS: The conducted randomized pilot study comprised 50 volunteers with no medical background. The participants were randomized into two test groups. Group 1 – with smartphone applications, Group 2 – no support. RESULTS: The persons making use of mobile application support showed better compliance with the initial steps of the algorithm. Improved chest compression quality was also observed, in particular regarding the cHOT parameter. Statistically, the application users also proved better in evaluating the victim’s breathing. CONCLUSIONS: A smartphone application may be helpful in first aid procedures performed by people with no medical background, mainly for the common use of this type of mobile phones. It is recommended to extend the scope of knowledge of AED defibrillators.WSTĘP: Każdego roku w Europie dochodzi do około 350 tysięcy zgonów po nieskutecznej resuscytacji krążeniowo-oddechowej (RKO). Dążąc do zmniejszenia liczby zgonów, poszukuje się nowych metod wsparcia osób bez wykształcenia medycznego przy wykonywaniu RKO. Celem pracy jest porównanie skuteczności wykonania resuscytacji krążeniowo-oddechowej oraz zgodności z algorytmem BLS przez osoby bez wykształcenia medycznego, z wykorzystaniem ogólnodostępnych metod wsparcia. MATERIAŁ I METODY: Przeprowadzono pilotażowe, randomizowane badanie, do którego zrekrutowano 50 ochotników bez wykształcenia medycznego. Uczestnicy zostali zrandomizowani do dwóch grup badawczych: Grupa 1 – posiadająca aplikację na smartfone, Grupa 2 – brak wsparcia. WYNIKI: Osoby korzystające ze wsparcia w postaci aplikacji mobilnej wykazywali większą zgodność przy wykonywaniu początkowych kroków algorytmu. Stwierdzono również poprawę parametrów opisujących jakość ucisków klatki piersiowej, szczególnie parametru cHOT. Osoby korzystające z pomocy aplikacji również statystycznie lepiej oceniały oddech poszkodowanego. WNIOSKI: Aplikacja mobilna na smartfona może pomóc w udzieleniu pierwszej pomocy osobom bez wykształcenia medycznego, dzięki dużej popularności telefonów typu smartfon. Zaleca się szerzenie wiedzy na temat defibrylatorów AED

Somatic Tissue Engineering in Mouse Models Reveals an Actionable Role for WNT Pathway Alterations in Prostate Cancer Metastasis.

To study genetic factors influencing the progression and therapeutic responses of advanced prostate cancer, we developed a fast and flexible system that introduces genetic alterations relevant to human disease directly into the prostate glands of mice using tissue electroporation. These electroporation-based genetically engineered mouse models (EPO-GEMM) recapitulate features of traditional germline models and, by modeling genetic factors linked to late-stage human disease, can produce tumors that are metastatic and castration-resistant. A subset of tumors with alterations acquired spontaneous WNT pathway alterations, which are also associated with metastatic prostate cancer in humans. Using the EPO-GEMM approach and an orthogonal organoid-based model, we show that WNT pathway activation drives metastatic disease that is sensitive to pharmacologic WNT pathway inhibition. Thus, by leveraging EPO-GEMMs, we reveal a functional role for WNT signaling in driving prostate cancer metastasis and validate the WNT pathway as therapeutic target in metastatic prostate cancer. SIGNIFICANCE: Our understanding of the factors driving metastatic prostate cancer is limited by the paucity of models of late-stage disease. Here, we develop EPO-GEMMs of prostate cancer and use them to identify and validate the WNT pathway as an actionable driver of aggressive metastatic disease.