Background: Out-of-hospital cardiac arrest (OHCA) investigations may elect to exclude cases with resuscitation terminated for reasons other than a full resuscitative attempt. We sought to examine characteristics of these cases and regional variability in classification.
Methods: Using the North American Resuscitation Outcomes Consortium Epistry, we included adult emergency medical services (EMS)-treated cases, examining the rationale ("futility", do-not resuscitate [DNR] order, "verbal directive", or "obvious death") and timing of resuscitation termination, and the timing of ROSC among hospital-discharge survivors. We tested regional variability in EMS patient arrival-to-termination intervals with one-way ANOVA.
Results: Of 63,554 included cases, 27,232 were declared dead in the prehospital setting: (1) 23,009 (36%) for futility (after a median of 24 minutes [IQR 19-31] of professional resuscitation); (2) 1622 (2.6%) for a DNR order (at 6.3 minutes [IQR 3.0-11]); (3) 1018 (1.6%) for a verbal directive (at 12 minutes [IQR 7.0-17]); and, (4) 1583 (2.5%) for obvious death (at 5.4 minutes [IQR 3.0-9.0]). The EMS patient arrival-to-ROSC interval among hospital-discharge survivors was 7.7 (3.8-13) minutes. Among regions, 0.20-12% and 0.20-5.3% were terminated to due to obvious death or verbal directives, respectively. There were significant regional differences in the EMS patient arrival-to-termination interval for futility (p < 0.010) and obvious death (p < 0.010).
Conclusion: There is significant variation in the rationale and interval until termination of resuscitation between regions. Cases terminated due to obvious death or DNR orders/verbal directives are often treated with similar durations of resuscitation as survivors. These data highlight a considerable risk of bias in between-region comparisons or observational analyses.
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http://dx.doi.org/10.1016/j.resuscitation.2022.01.013 | DOI Listing |
BMC Neurol
January 2025
Department of Neurology, Haiyan People's Hospital, Jiaxing City, 314300, Zhejiang Province, China.
Background: Sodium-glucose cotransporter-2(SGLT-2) inhibitors are a newer class of antidiabetic drugs with the increased risk of euglycemic diabetic ketoacidosis(EuDKA). Encephalopathy is a rare but life-threatening event of EuDKA. Due to paradoxically normal or slightly elevated serum glucose levels, it's easy to be mimicked by cerebral infarction, structural brain damage, thus leading to delayed diagnosis and causing seriously irreversible brain injury.
View Article and Find Full Text PDFSupport Care Cancer
January 2025
Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta - Arthur M. Blank Hospital, 2220 North Druid Hills Road NE, Atlanta, GA, 30329, USA.
Purpose: Childhood cancer survivors (CCS) are at risk for therapy-related late effects. Physical activity (PA) can minimize some late effects risk, but rates of PA are low in CCS. We aimed to determine how perception of survivor health status and presence of chronic conditions are associated with patient- or proxy-reported PA.
View Article and Find Full Text PDFAdv Biol Regul
December 2024
Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.
TP53 is normally a tumor suppressor. However, it is mutated in at least 50% of human cancers. Usually, we assume that mutation of the TP53 is associated with loss of sensitivity to various drugs as in most cases wild type (WT) TP53 activity is lost.
View Article and Find Full Text PDFUltrasound Med Biol
January 2025
Echosens, Paris, France.
Objective: Although FibroScan (FS), based on Vibration-Controlled Transient Elastography (VCTE), is a widely used non-invasive device for assessing liver fibrosis and steatosis, its current standard-VCTE examination remains timely and difficult on patients with obesity. The Guided-VCTE examination uses continuous shear waves to locate the liver by providing a real-time predictive indicator for shear wave propagation and uses shear wave maps averaging to increase the signal-to-noise ratio in difficult to assess patients. We aimed to evaluate the effectiveness of the new indicator, as well as compare examination times and success rates with both standard-VCTE and Guided-VCTE examinations.
View Article and Find Full Text PDFLangmuir
January 2025
College of Optoelectronic Materials and Technology, Jianghan University, Wuhan, Hubei 430056, People's Republic of China.
Adsorption is an efficient and highly selective method for gold recovery. Introducing rich N/S organic groups to combine with metal-organic frameworks (MOFs) as adsorbents is regarded as a practical and efficient approach to enhance gold recovery. Herein, a MOF (zirconium isothiocyanatobenzenedicarboxylate MOF, UiO-66-NCS) was designed to combine with amidinothiourea (AT) to form UiO-66-AT (zirconium amidothiourea-benzenedicarboxylate MOF) for efficient and rapid adsorption.
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