Experience in implementing a program for basic life support and available automated defibrillation in a cancer center

Unified approaches to ensuring the chain of survival can improve the patient’s prognosis both in out-of-hospital and in-hospital cardiac arrest.Aim. To discuss practical issues of introducing a program for the availability of automated external defibrillation in a cancer center.Material and methods. For four years, our healthcare facility has been implementing a training program for basic and advanced life support according to the European Resuscitation Council standards, combined with the creation and development of an infrastructure for the availability of automatic defibrillation. A roadmap and infrastructure were developed for the project implementation.Results. In 2018-2022, 229 employees (114 doctors, 85 nurses and 30 nonmedical workers) were trained under the basic life support program. Fifteen defibrillators were placed in various units. During the specified period, first aid in case of sudden cardiac arrest using an automated external defibrillator before the resuscitation team arrival was independently provided by doctors and nurses of departments three times. To implement training in the continuous education system, the curriculum has passed the examination and accreditation in the edu. rosminzdrav system.Conclusion. The development and implementation of such initiatives requires significant organizational and methodological work, including continuous education system. However, in our opinion, this is an extremely useful tool for improving the safety and quality of medical care

The experience of radiofrequency ablation of atrial tachycardia focus with the use of high-density myocardial mapping

The article presents a case of successful treatment of focal atrial tachycardia by radiofrequency ablation using high-density myocardial mapping. The aim of the work was to evaluate the possibilities of high-resolution myocardial mapping by EnsitePrecision® navigation system in the treatment of complex arrhythmias. The analysis of clinical data and results of electrophysiological examination of a 29-year-old patient with continuous recurrent focal atrial tachycardia was carried out. The patient was admitted with complaints of heart rate disorders and frequent short attacks of palpitations. According to electrocardiography, frequent short paroxysms of focal atrial tachycardia were revealed. The patient was taken for electrophysiological examination and radiofrequency ablation of the focus of atrial tachycardia. The focus of atrial tachycardia was located in the anterior septal part of the left atrium, which is a rare localization. After radiofrequency ablation tachycardia was terminated, no complications and recurrences were registered. The patient was discharged with the sinus rhythm. Navigation system EnsitePrecision® enables conducting high-density myocardial mapping, which helps to accurately determine the localization of the source of tachycardia. The radiation load on the patient and ablation time are reduced, which reduces the frequency of complications from the procedure

Production of Bst polymerase for diagnosis of different infections using loop-mediated isothermal amplification

Introduction. The large fragment of DNA polymerase I from Geobacillus stearothermophilus GIM1.543 (Bst DNA polymerase) possesses 5'-3' DNA polymerase activity, 5'-3' displacement activity and high processivity. These properties make it possible to use Bst DNA polymerase in loop-mediated isothermal amplification (LAMP), which provides highly specific amplification of the target sequence and is used for rapid detection of agents causing human infectious diseases. The purpose of the study was to produce a recombinant Bst polymerase enzyme in the bacterial expression system and to assess its properties for LAMP-based diagnostics of infectious diseases. Materials and methods. Expression constructs carrying the Bst polymerase gene were obtained using genetic engineering techniques. Different Escherichia coli strains were used for protein expression. Metal-chelate and gel filtration chromatography techniques were used for protein purification. Catalytic characteristics of the enzyme were assessed in loop-mediated isothermal amplification reactions using AmpliSens SARS-CoV-2-IT, AmpliSens IAV-IT and AmpliSens IBV-IT diagnostic systems designed for high-quality detection of SARS-CoV-2, influenza A virus (IAV) and influenza B virus (IBV) RNA, respectively. Results. The offered protocol for production, extraction and purification of recombinant Bst polymerase makes it possible to produce the enzyme in the bacterial expression system using E. coli cells in a soluble form and reaching the yield up to 20% of the total cell mass. In LAMP reactions, the obtained enzyme demonstrates activity comparable with that of the commercial enzyme Bst 2.0 (NEB). Conclusion. Considering the fast purification and production of the enzyme, the obtained recombinant Bst polymerase can be used in LAMP-based diagnostic kits

The Impact of COVID-19 on UK informant use and management

The effect of COVID-19 on informant use and management, during the peak of the imposed Government lockdown measures was felt across English and Welsh police Dedicated Source Units. Within these restrictions, staff managing informants had to develop and then implement new strategies that delivered safe, yet effective, informant handling capacity and capability. Based on a survey of 205 respondents directly involved in the handling, control or authorisation of informants, this article examined their perceptions of the effect of COVID-19 in this highly specialised policing activity. The research findings revealed five broad themes associated with the impact of COVID-19 on informant management practices: (i) health protection; (ii) governance; (iii) innovation and technology; (iv) recruitment, communication and informant development; and (v) tradecraft and intelligence. The article explored the organisational responses to initiating and maintaining informant-handler relationships and ensuring the flow of intelligence within this unique operational environment. Participants perceived that handler-informant relationships were strengthened, and also indications of a willingness to adapt policy and procedure associated with the informant management cycle: targeting, initial recruitment contact, assessment and evaluation, tasking and deployment and payment of informant rewards. It also highlighted a wider consensus that there was further scope for enhancing resilience to similar future pandemics including the use of enabling technology and responsive policy adaptation

Empagliflozin in patients hospitalized for acute decompensated heart failure: an expert resolution on the discussion of the EMPULSE trial

An online expert meeting held on November 17, 2021 reviewed the results of the randomized, double-blind, multinational, parallel-group EMPULSE trial, evaluating the clinical benefit and safety of the sodium-glucose co-transporter-2 inhibitor (SGLT2i) empagliflozin compared with placebo in patients hospitalized with acute decompensated heart failure (ADHF). Patients were included in the study regardless of ejection fraction (EF) and the presence of diabetes and randomized during hospitalization after stabilization. In addition, the EMPULSE trial used a composite result analyzed using a stratified benefit ratio — Win Ratio analysis. There is evidence of clinical benefit of empagliflozin in hospitalized patients with preserved and reduced LVEF, as well as in patients with newly diagnosed ADHF or with acute decompensation of chronic heart failure (CHF) compared with placebo, regardless of type 2 diabetes presence. The importance of the favorable results of the EMPULSE trial and its significance for clinical practice, which implies the early administration of empagliflozin for inpatients, is noted. A number of proposals have been adopted to accelerate the introduction of empagliflozin into clinical practice for patients with ADHF