Challenges and Strategies in Pediatric Critical Care: Insights From Low-Resource Settings.

Pediatric critical care in low-resource settings faces challenges like inadequate infrastructure, limited personnel, financial constraints, and cultural considerations, leading to poor outcomes for critically ill children. This review synthesizes information from 2 articles on pediatric intensive care units (PICUs) in low- and middle-income countries (LMICs). It identifies challenges such as high care costs, cultural preferences, and resource allocation issues.

'Pill-in-the-pocket' Oral Anticoagulation Guided by Daily Rhythm Monitoring for Stroke Prevention in Patients with AF: A Systematic Review and Meta-analysis.

Aims: In patients with a low AF burden and long periods of sinus rhythm, 'pill-in-the-pocket' oral anticoagulation (OAC) may, taken as needed in response to AF episodes, offer the same thromboembolic protection as continuous, life-long OAC, while reducing bleeding complications at the same time. The purpose of this study is to systematically summarise available evidence pertaining to the feasibility, safety and efficacy of pill-in-the-pocket OAC.

Methods: Medline and Embase were searched from inception to July 2022 for studies adopting a pill-in-the-pocket OAC strategy in AF patients guided by daily rhythm monitoring (PROSPERO/CRD42020209564).

Conformational Panorama of Cycloundecanone: A Rotational Spectroscopy Study.

The conformational landscape of the medium-size cyclic ketone cycloundecanone has been investigated using chirped-pulse Fourier transform microwave spectroscopy and computational calculations. Nine conformations were observed in the rotational spectrum and identified from the comparison of experimental and theoretical rotational constants as well as the observed and predicted types of rotational transitions. All singly substituted C isotopologues were observed for the most abundant conformer, which allowed the determination of partial substitution and effective structures.

[Acute myocardial infarction and cardiogenic shock in patient with COVID-19].

The conditions of the pandemic caused by the novel coronavirus infection (COVID-19) are associated with overloading intensive care units, conversion of hospitals, and changes in routing of patients with acute cardiovascular pathology. At the same time, medical practice is still challenged to provide medical care to patients with acute coronary syndrome (ACS). Patients with COVID-19 and acute myocardial infarction (AMI) are at a higher risk of death while the incidence of this combination of diseases will be growing.

Blood culture negative infective endocarditis in adult congenital heart disease patients with prosthetic grafts: a case series.

Background: Blood culture negative infective endocarditis (BCNIE) is often a diagnostic challenge in adult congenital heart disease patients leading to misdiagnosis, treatment delay and associated high mortality. Studies of BCNIE in adult congenital heart disease patients repaired with prosthetic cardiovascular grafts are limited.

Case Summary: We report two cases of BCNIE where serology testing, multiple polymerase chain reaction testing of explanted valve material and multi-modality imaging including F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) were utilized not only to confirm the diagnosis but also to guide management strategy and inform prognosis.

Left or bilateral internal mammary artery employment in coronary artery bypass grafting: midterm results.

Background: The gold standard for coronary artery bypass grafting to the left anterior descending artery is use of the left internal mammary artery. Better long-term survival has been reported using bilateral internal mammary arteries compared to left internal mammary artery only, but many surgeons are reluctant to employ bilateral internal mammary arteries in coronary artery bypass grafting. This study aimed to evaluate the effectiveness and safety of bilateral internal mammary artery use.

Early surgical myocardial revascularization as an effective method of treating patients with acute coronary syndrome.

Background: One of the main methods of treating patients with acute coronary syndrome (ACS) is percutaneous coronary intervention (PCI), however in patients with multivascular, abnormal, or technically complicated coronary lesions, early surgical myocardial revascularization is more promising. Despite modern development of surgical and interventional techniques, the application of one strategy for all patients with acute coronary syndrome is problematic and should be based on the heart team's decision and patient data.

Aim: The study was aimed at assessing the results of early surgical myocardial revascularization in patients with acute coronary syndrome.

[Immediate and intermediate results of staged carotid endarterectomy in combination with coronary artery bypass grafting].

The purpose of our investigation was to evaluate the immediate and intermediate results of staged operations of carotid endarterectomy and coronary artery bypass grafting in patients with multifocal atherosclerosis. We analysed a total of 475 operations. Of these, 371 (78.

Falsely Elevated Vancomycin Concentrations in a Patient Not Receiving Vancomycin.

Therapeutic drug monitoring (TDM) of vancomycin is commonly performed using immunoassays. This case describes falsely elevated vancomycin serum concentrations, possibly secondary to endogenous protein interference. Vancomycin was prescribed for a patient with a suspected septic knee.

Abuse and depression among Filipino foreign domestic helpers. A cross-sectional survey in Hong Kong.

Objectives: The objectives of this study are to (1) explore physical and verbal abuse experience, perpetrators of abuse and abuse reporting behaviours of Filipino foreign domestic helpers in Hong Kong and (2) examine associations between their abuse experience and depression level.

Study Design: A cross-sectional survey METHODS: We purposively sampled participants at the Statue Square of Hong Kong on three Sunday afternoons between June and August 2017. Using a self-administered questionnaire, measures include sociodemographic and housing environment variables, physical and verbal abuse experience and depression level measured using the Depression Subscale of Depression Anxiety Stress Scale 21 (DASS-21-D).

Evaluation of Standardization of Transfer of Accountability between Inpatient Pharmacists.

Background: A compelling body of evidence supports the notion that transfer of accountability (TOA) improves communication, continuity of care, and patient safety. TOA involves the transmission and receipt of information between clinicians at each transition of care. Without a notification system alerting pharmacists to patient transfers, pharmacists' ability to seek out and complete TOA may be hindered.

[Minimally invasive operations for varicose disease of lower extremities].

The authors discuss specific using minimally invasive surgical technique of ablation of the saphenous vein trunks by a modified Oesch PIN stripper method proposed by the authors. An experience with surgical treatment of 245 patients with varicose veins using the same modified technique is analyzed. Postoperative complications and medium-term results are evaluated.

[Age-dependent occupational stress in doctors of various specialties].

A comparative assessment of the extent and structure of the various forms of professional burnout among doctors-organizers as well as therapeutists and surgeons depending on age was given. It is shown that the professional burnout in doctors-organizers conjugates with a high level of emotional tension manifested in avoidance of over-saturated emotional and professional communication outside professional activities, increased irritability and temper, reluctance to exercise empathy towards colleagues and compassion for patients. The comparison of three age groups of physicians to each other in terms of the level and features of the burnout was adduced; the results demonstrate the significant differences between the age periods of 30 and 40 years and over 41 years old.

Attentional signatures of perception: multiple object tracking reveals the automaticity of contour interpolation.

Multiple object tracking (MOT) is an attentional task wherein observers attempt to track multiple targets among moving distractors. Contour interpolation is a perceptual process that fills-in nonvisible edges on the basis of how surrounding edges (inducers) are spatiotemporally related. In five experiments, we explored the automaticity of interpolation through its influences on tracking.

Estimating atrial action potential duration from electrograms.

Electrogram analysis is important in clinical and experimental settings. Activation recovery interval (ARI) has been used to measure ventricular action potential duration (APD) but its suitability for the atria has not been addressed. Mapping of atrial repolarization may be especially important during nerve stimulation since large heterogenous APD changes may manifest.

Atrial action potential heterogeneity measured by unipolar electrograms.

Vagally-induced action potential duration (APD) heterogeneity can lead to the breakdown of atrial flutter into fibrillation. The exact distribution of vagal mediated effects in the atria is unknown, however. This study analyzed canine electrograms in order to determine changes in APD.

Immunohistochemical evidence of inducible nitric oxide synthase and nitrotyrosine in a case of clinically isolated optic neuritis.

Background: Optic neuritis (ON) is a demyelinating inflammation of the optic nerve that may occur as an isolated disease or related to multiple sclerosis (MS). There is little evidence of whether the immunohistochemistry of ON resembles that of typical cerebral MS lesions.

Methods: Pathologic optic nerves were obtained from a patient who died of causes unrelated to ON after clinical recovery from clinically isolated ON.

The effect of vagally induced dispersion of action potential duration on atrial arrhythmogenesis.

Objective: The purpose of this study is to ascertain the effects of spatially variable ACh distributions on arrhythmogenesis in a morphologically realistic computer model of canine atria.

Background: Vagal stimulation releases acetylcholine (ACh), which causes a dose-dependent reduction in action potential duration (APD) in the atria. Due to the nonuniform distribution of nerve endings, APD dispersion may result, which has been shown to play a role in the breakup of activity.

Current-driven resonances in magnetic multilayers.

We describe complex variations in resistance of a Co/Cu multilayer, generated by injection of an adjustable dc current density ( approximately 10(9) A/cm(2)) via a point contact. We attribute these variations to coupling of current-induced spin waves to lattice vibrations, leading especially to current-driven resonant excitations of phonons. We propose a simple model to explain the observed structured behavior of the variations as a function of the applied current and magnetic field.

Generation and detection of phase-coherent current-driven magnons in magnetic multilayers.

The magnetic state of a ferromagnet can affect the electrical transport properties of the material; for example, the relative orientation of the magnetic moments in magnetic multilayers underlies the phenomenon of giant magnetoresistance. The inverse effect--in which a large electrical current density can perturb the magnetic state of a multilayer--has been predicted and observed experimentally with point contacts and lithographically patterned samples. Some of these observations were taken as indirect evidence for current-induced excitation of spin waves, or 'magnons'.

[The diagnostic and treatment characteristics of El Tor cholera and its combinations with other infectious diseases in an outbreak of multiple intestinal infection].

The article summarizes the experience of diagnosis and treatment of El Tor cholera in servicemen during an outbreak of intestinal polyinfection in the conditions of dry hot climate in desert and mountainous terrain of Afghanistan. The authors describe the clinical course of El Tor cholera which is stipulated by the mixed character of dehydration, polymorphism of clinical symptoms and more severe forms of concomitant infections.

[A dose-rate meter of visible laser radiation].

To measure the laser radiation power in the experimental and clinical medicine the authors developed a compact, easily inserted in any laser medical installation power measurer. The measurer consists of the photodetector--silicon photoresistor, temperature-compensating photoresistor, operational amplifier and feeding block. The merit of the measurer is its constructive simplicity, reliability in work.