Abstract 14213: Injury Characteristics of Chest Compressions in a Swine Model of Infant Asphyxial Cardiac Arrest Using Either 1.5 inch or 1/3 Anterior-Posterior Diameter Depth Targets

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
David D Salcido ◽  
Allison C Koller ◽  
Ericka L Fink ◽  
Robert A Berg ◽  
James J Menegazzi
Keyword(s):  
Spontaneous Circulation ◽  
Swine Model ◽  
Chest Compressions ◽  
Injury Characteristics ◽  
Group Assignment ◽  
Chi Squared ◽  
Group 2 ◽  
Vessel Dissection ◽  
Anterior Posterior ◽  
Group 1

Background: Current AHA guidelines for the delivery of chest compressions (CC) for infants and children are largely consensus based, and recommended depths of 1.5 inches or 1/3 anterior-posterior chest diameter (APD). It is unclear whether these have equal potential for injury. Objectives: We sought to examine and compare injury characteristics of CC delivered at 1.5 inches or 1/3 APD in an infant-sized model of asphyxial OHCA. Methods: Thirty-six juvenile swine weighing 10.6kg +/- 0.84 (approximating the 50 th percentile for a 12-month-old) were anesthetized, paralyzed, intubated, and mechanically ventilated (FiO2 21%). APD was measured and by two investigators via a sliding T-square. After instrumentation, the endotracheal tube was manually occluded to induce asphyxia, and occlusion was maintained for 9 minutes. Animals with an organized rhythm after 8 minutes 45 seconds of asphyxia received a single, 3-second transthoracic shock to induce ventricular fibrillation. At 9 minutes, each was then randomized to receive CC with a depth of 1.5 inches (Group 1) or 1/3 APD (Group 2), both with a rate of 100 per minute. ALS drugs were administered after 13 minutes, followed by initial defibrillation attempt at 14 minutes. Resuscitation continued until return of spontaneous circulation (ROSC) or 20 minutes of failed resuscitation. Survivors were sacrificed with KCl after 20 minutes of observation. Veterinary staff blinded to group assignment conducted necropsies to assess lung injury, rib fracture, hemothorax, airway bleeding, great vessel dissection, and heart/liver/spleen contusion. Characteristics were compared via Chi-Squared test or Mann-Whitney U-test using an alpha = 0.05. Results: Group 1 had n=18 and Group 2 had n=18 animals. Mean (SD) APD overall was 5.58 (0.22) inches, yielding a mean 1/3 APD depth of 1.86 inches. APD did not differ between groups. ROSC rates did not differ between groups (Group 1: 66.7% vs Group 2: 83.33%; p = 0.248. No injury characteristics differed significantly between groups. Airway bleeding rates were noteworthy though not different between groups (Group 1: 18.8% vs Group 2: 42.1%; p = 0.219). Conclusions: In a swine model of infant OHCA and resuscitation, both CC depth strategies had similar injury characteristics.

scholarly journals Combination of Alcohol and EVOH as a New Embolic Agent: Midterm Tissue and Inflammatory Effects in a Swine Model

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Jean-François Hak ◽  
Farouk Tradi ◽  
Mickael Bobot ◽  
Pauline Brige ◽  
Paul Habert ◽  
...  
Keyword(s):  
Vascular Occlusion ◽  
Embolic Agent ◽  
Swine Model ◽  
Blood Alcohol ◽  
Alcohol Content ◽  
Ethylene Vinyl Alcohol ◽  
Blood Alcohol Content ◽  
Tubular Necrosis ◽  
Group 2 ◽  
Group 1

Objective. To evaluate the vascular occlusion and midterm tissue toxicity properties of a combination of ethylene-vinyl alcohol (EVOH) (Squid 18®) (75%) and alcohol (25%)—Alco-Squid 18—in a swine model. Materials and Methods. Alco-Squid 18 (75% Squid 18® mixed with 25% alcohol) (AS18) was compared to embolization with 96% alcohol alone and to embolization with Squid 18® (S18®) alone. An arteriovenous malformation (AVM) model was created in group 1 (n = 2). Each AVM model was then embolized with AS18 or S18® alone with evaluation of a ratio between the volume of embolic agent divided by the volume of the AVM (evaluated by CT). For group 2 (n = 5), each agent was tested on three different kidneys (upper pole kidney artery). Pre- and postinterventional CTs, angiographies, blood alcohol content dosages, and histological studies (3 months postintervention) were performed. Results. AS18 has better distal distribution than S18® alone, both in the kidneys (mean capsule-S18® distance: 3.9 mm (±0.23) and mean capsule-AS18 distance: 2.3 mm (±0.11) ( p = 0.029 ) and in the AVM model. Histological exploration found a higher rate of tubular necrosis with AS18 compared with S18® alone and alcohol alone (3.78 ± 0.44 compared to 2.33 ± 1.22 p   =  0 . 012 and 1.22 ± 0.67 p   < 0   . 0001 ). The blood alcohol content was negligible in all cases. Conclusion. AS18 can suggest a better distal sclerotic and embolic character as compared with S18® alone without systemic toxicity.

Abstract 167: Epinephrine Plus Chest Compressions May Be Superior to Epinephrine Alone in a Hypoxia-Induced Porcine Model of Lifeless Shock

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Felipe Teran ◽  
Claire Centeno ◽  
Alex L Lindqwister ◽  
William J Hunckler ◽  
William Landis ◽  
...  
Keyword(s):  
Chest Compression ◽  
Porcine Model ◽  
Contractile Activity ◽  
Coronary Perfusion Pressure ◽  
Spontaneous Circulation ◽  
Swine Model ◽  
Coronary Perfusion ◽  
Chest Compressions ◽  
Fraction Of Inspired Oxygen ◽  
External Chest Compressions

Background: Lifeless shock (LS) (previously called EMD and pseudo-PEA) is a global hypotensive ischemic state with retained coordinated myocardial contractile activity and an organized ECG. We have previously described our hypoxic LS model. The role of standard external chest compressions remains unclear in the setting of LS and its associated intrinsic hemodynamics. Although it is known the patients with LS have better prognosis compared to PEA, it is unclear what is the best treatment strategy. Prior work has shown that chest compressions (CC) when synchronized with native systole results in significant hemodynamic improvement, most notably coronary perfusion pressure (CPP), and hence it is plausible that standard dyssynchronous CC may be detrimental to hemodynamics. Furthermore, retrospective clinical data has shown that LS patients treated with vasopressors and no CC, may have better outcomes. We compared epinephrine only versus epinephrine and chest compression, in a porcine model of LS. Methods: Our porcine model of hypoxic LS has previously been described. We randomized pigs to episodes of LS treated with epinephrine only (control) (0.0015 mg/kg) versus epinephrine plus standard external chest compressions (intervention). Animals were endotracheally intubated and mechanically ventilated, and the fraction of inspired oxygen (FiO 2 ) was gradually lowered from room air (20-30% O 2 ) to a target FiO 2 of 3-7% O 2 . This target FiO 2 was maintained until the systolic blood pressure (SBP) dropped to 30 mmHg for 30 seconds, or the animal became bradycardic (HR less than 40), which was defined as the start of LS. FiO 2 was then raised to 100%, and then animal would receive control or intervention. Return of spontaneous circulation (ROSC) was defined as SBP 60 mmHg, stable after 2 minutes. Results: Twenty-six episodes of LS in 11 animals received epinephrine only control and 21 episodes the epinephrine plus chest compression intervention. The rates of ROSC in two minutes or less were 5/26 (19%) in the control arm vs 14/21 (67%) in the intervention arm (P=0.001;95% CI 19.7 %-67.2%). Conclusions: In a swine model of hypoxia induced LS, epinephrine plus CPR may be superior to epinephrine alone.

scholarly journals Biomechanical Analysis of Stability of Posterior Antiglide Plating in Osteoporotic Pronation Abduction Ankle Fracture Model With Posterior Tibial Fragment

2016 ◽  
Vol 38 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Kathleen Hartwich ◽  
Alejandro Lorente Gomez ◽  
Jaroslaw Pyrc ◽  
Radosław Gut ◽  
Stefan Rammelt ◽  
...  
Keyword(s):  
Ultimate Strength ◽  
Ankle Fracture ◽  
Plate Fixation ◽  
Fracture Model ◽  
Stage Iii ◽  
Mineral Density ◽  
Posterior Tibial ◽  
Group 2 ◽  
Anterior Posterior ◽  
Group 1

Background: We performed a biomechanical comparison of 2 methods for operative stabilization of pronation-abduction stage III ankle fractures; group 1: Anterior-posterior lag screws fixing the posterior tibial fragment and lateral fibula plating (LSLFP) versus group 2: locked plate fixation of the posterior tibial fragment and posterior antiglide plate fixation of the fibula (LPFP). Methods: Seven pairs of fresh-frozen osteoligamentous lower leg specimens (2 male, and 5 female donors) were used for the biomechanical testing. Bone mineral density (BMD) of each specimen was assessed by means of dual-energy x-ray absorptiometry. After open transection of the deltoid ligament, an osteotomy model of pronation abduction stage III ankle fracture was created. Specimens were systematically assigned to LSLFP (group 1, left ankles) or LPPFP (group 2, right ankles). After surgery, all specimens were evaluated via CT to verify reduction and fixation. Axial load was then applied onto each specimen using a servohydraulic testing machine starting from 0 N (Zwick/Roell, Ulm, Germany) at a speed of 10 N/s with the foot fixed in a 10 degrees pronation and 15 degrees dorsiflexion position. Construct stiffness, yield, and ultimate strength were measured and dislocation patterns were documented with a high-speed camera. The normal distribution of all data was analyzed using Shapiro-Wilk test. The group comparison was performed using paired Student t test. Statistical significance was assumed at a P value of .05. Results: All specimens had BMD values consistent with osteoporosis. BMD values did not differ between the left and right ankles of the same pair ( P = .762). The mean BMD values between feet of men (0.603 g/cm2) and women (0.329 g/cm2) were statistically different ( P = .005). The ultimate strength for LSLFP (group 1) with 1139 ± 669 N and LPPFP (group 2) with 2008 ± 943 N was statistically different ( P = .036) as well as the yield in LSLFP (group 1) 812 ± 452 N and LPPFD (group 2) 1292 ± 625 N ( P = .016). Construct stiffness trended to be higher in group 2 (179 ± 100 kNn) compared to group 1 (127 ± 73 kN/m) but this difference was not statistically significant ( P = .120). BMD correlated with bone-construct failure. Conclusion: Fixation of the posterior tibial edge with a posterolateral locking plate resulted in higher biomechanical stability than anterior-posterior lag screw fixation in an osteoporotic pronation-abduction fracture model. Clinical Relevance: The clinical implication of this biomechanical study is that the posterior antiglide plating might be advantageous in patients with osteoporotic pronation abduction stage III ankle fracture.

236 SUPEROVULATION IN SHEEP WITH REDUCED INJECTION FSH/eCG PROTOCOLS FOLLOWED BY TRANSFER OF FRESH OR VITRIFIED EMBRYOS

2016 ◽  
Vol 28 (2) ◽  
pp. 250
Author(s):  
R. C. Fry ◽  
R. Mapletroft ◽  
G. A. Bo ◽  
M. M. Izzo ◽  
M. A. Humphris
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Large Scale ◽  
Ovarian Response ◽  
Fertilization Rate ◽  
Chi Squared ◽  
Injection Protocol ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of this experiment was to compare a single FSH/eCG, or double FSH-0.5% hyaluronan/eCG injection protocol with a multiple FSH/eCG injection protocol on the superovulatory response and embryo production in sheep. In addition, the effect of vitrification of these embryos on the pregnancy rate following embryo transfer was evaluated. Eighty Dohne Merino ewes received an 8-day CIDR-S device (0.33 g P4; Zoetis, Florham Park, NJ, USA) plus 10 mg of FSH i.m. (Folltropin-V; Vetoquinol, Lavaltrie, QC, Canada) and 400 IU of eCG i.m. (Pregnecol; Vetoquinol) in 3 treatment groups. Group 1 (n = 21) received a single 10-mg FSH injection in saline and 400 IU of eCG in saline 2.5 days before CIDR withdrawal. Group 2 (n = 23) received 6.7 mg of FSH in hyaluronan (MAP-5, 50 mg; Vetoquinol) and 400 IU of eCG in saline 2.5 days before CIDR withdrawal and 3.3 mg of FSH in hyaluronan 0.5 days before CIDR withdrawal. Group 3 (n = 36) received 7 injections (am, pm) of FSH in saline (2.5, 2.0, 1.5, 1.5, 1.0, 1.0, 0.5 mg) starting 2.5 days before CIDR withdrawal and 400 IU of eCG in saline at the first injection. Ewes were inseminated with semen collected from 1 of 5 rams at 36 to 40 h after CIDR withdrawal. Donor ewes were slaughtered 6 days after AI (Day 0), CL were counted and ova/embryos were collected. Viable embryos were transferred in singles into Day 6 synchronised recipients as either fresh (n = 128) or following vitrification/thawing using the CVM (CryoLogic, Blackburn, VIC, Australia; n = 97; Fry et al. 2005 Reprod. Fertil. Dev. 17, 243). Pregnancy was diagnosed by ultrasound scanning on Day 45. Data for CL and transferable embryo were analysed by the Kruskall-Wallis test and differences between groups determined by the Dunn test. Data for pregnancy rates was compared by chi-squared analysis. The mean number of CL in Groups 2 and 3 were both significantly higher than that in Group 1 (12.3 and 12.0 v. 8.5; P < 0.05). Similarly, the total number of embryos/ova recovered in Groups 2 and 3 were significantly higher than for Group 1 (8.3 and 7.0 v. 5.0; P < 0.05). Group 3 produced more viable embryos than either Group 2 or Group 1 (4.6 v. 2.7 and 2.1; P < 0.05); however, data were skewed by the extensive use of semen from one ram in Group 2 that had a low fertilization rate (28%). The transfer of vitrified/thawed embryos resulted a nonsignificant (P > 0.05) 10% decrease in pregnancy rate compared with fresh embryos (66% v. 76%). In conclusion, the administration of the sustained release FSH-MAP-5 in a 2-injection protocol in sheep was as effective as a multiple FSH injection protocol in inducing an ovarian response but more research is required to elucidate the effect of FSH-MAP-5 on embryo quality. The successful vitrification of sheep embryos provides a promising technique for the storage and transport of embryos in large-scale sheep embryo transfer programs.

Abstract 434: A Randomized Blinded Trial of Three Chest Compression Strategies in a Porcine Model of Pediatric Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
James J Menegazzi ◽  
David D Salcido ◽  
Allison C Koller ◽  
Cornelia Genbrugge ◽  
Ericka L Fink ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Lung Injury ◽  
Chest Compression ◽  
Porcine Model ◽  
Lung Injury Score ◽  
Coronary Perfusion ◽  
Chest Compressions ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Current guidelines recommend that chest compressions for children be done at either 1.5 inches depth and 100 per minute, or one-third the chest A-P diameter depth and 100 per minute. Neither of these recommendations is based on scientific evidence. Objective: As part of an ongoing efficacy trial, we sought to compare the safety of three different chest compression strategies in a porcine model of pediatric cardiac arrest. Methods: Following anesthesia, instrumentation, and induction of asphyxial cardiac arrest, we randomly assigned 48 domestic swine to one of three groups (n=16 per group). The mean mass of 25.7 kg approximates the 50 th percentile for a 7 year old. Group 1 had fixed chest compression depth of 1.5 inches/rate 100; group 2 had fixed proportional depth of one-third the A-P diameter/rate 100; group 3 used an adaptive algorithm that incrementally increased chest compression rate and/or depth from baseline 1.5in (max: 2.13in) and 100/min (max; 130/min) every 25s while coronary perfusion pressure was below 25mmHg. Necropsies were independently performed by a veterinarian and veterinary technologist who were blinded to group assignment. The primary safety outcome was unrecoverable injury (i.e. toxicity), which we defined as either a total lung injury score ≥16 (score can range from 0 to 20) plus presence of hemothorax, or disruption of either the aorta or vena cava. Data were analyzed with the Bayesian Beta Binomial to determine if within-group toxicity exceeded an unacceptable level (30%) with a pre-selected posterior predictive threshold of 0.75(ptox). Lung injury scores between groups were compared with Kruskal-Wallis tests. Results: Median total lung injury scores were: 12 for group 1; 18 for group 2; 14 for group 3. Group 2 was significantly different from both groups 1 and 3 (p<0.001). Groups 1 and 3 did not differ (p=0.24). Toxicity occurred in zero animals in group 1 (ptox=0.0001); 7 animals in group 2 (ptox=0.8180); and 1 animal in group 3 (ptox=0.0076). The posterior probability threshold was exceeded in group 2 which warranted termination of the treatment arm for safety. Conclusions: Chest compressions performed at a depth of one-third the A-P diameter are unsafe. The safety of this approach in children should be carefully evaluated.

scholarly journals Practice Patterns in Reporting Tertiary Grades at Radical Prostatectomy: Survey of a Large Group of Experienced Urologic Pathologists

2019 ◽  
Vol 144 (3) ◽  
pp. 356-360
Author(s):  
Samson W. Fine ◽  
Debra L. Meisels ◽  
Andrew J. Vickers ◽  
Hikmat Al-Ahmadie ◽  
Ying-Bei Chen ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Online Survey ◽  
Practice Patterns ◽  
Grade Group ◽  
Future Studies ◽  
Group Assignment ◽  
Group 2 ◽  
High Consistency ◽  
Minor Pattern ◽  
Group 1

Context.— In prostate cancer, “tertiary” higher-grade patterns (TPs) have been associated with biochemical recurrence after radical prostatectomy. Objective.— To determine variation regarding definition and application of TPs. Design.— Online survey regarding TPs in a range of grading scenarios circulated to 105 experienced urologic pathologists. Results.— Among 95 respondents, 40 of 95 (42%) defined TPs as “third most common pattern” and 55 (58%) as “minor pattern/less than 5% of tumor.” In a tumor with pattern 3 and less than 5% pattern 4, of the 95 respondents, 35 (37%) assigned 3 + 3 = 6 with TP4, while 56 (59%) assigned 3 + 4 = 7. In a tumor with pattern 4 and less than 5% pattern 5, of the 95 respondents, 51 (54%) assigned 4 + 4 = 8 with TP5, while 43 (45%) assigned 4 + 5 = 9. Six scenarios were presented in which the order of most common patterns was 3, 4, and 5 (Group 1) or 4, 3, and 5 (Group 2) with varying percentages. In both groups, when pattern 5 was less than 5%, we found that 98% and 93% of respondents would assign 3 + 4 = 7 or 4 + 3 = 7 with TP5. In scenarios with 15% or 25% pattern 5, most respondents (70% and 80%, respectively) would include pattern 5 as the secondary grade, that is, 3 + 5 = 8 (Group 1) or 4 + 5 = 9 (Group 2). For 85 of 95 (89%), a TP would not impact Grade Group assignment. Conclusions.— This survey highlights substantial variation in practice patterns regarding definition and application of “tertiary” grading in radical prostatectomy specimens. High consistency was observed in 3 + 4 = 7/4 + 3 = 7 scenarios with truly minor pattern 5. These findings should inform future studies assessing the standardization and predictive value of “tertiary” patterns.

scholarly journals Efficacy of Different Concentrations of Chlorhexidine Mouthwash on Plaque Accumulation and Periodontal Parameters

2016 ◽  
Vol 8 (1) ◽  
pp. 8-11
Author(s):  
Ali Zarandi ◽  
Sina Salahaddin ◽  
Masoumeh Faramarzi
Keyword(s):  
Statistical Significance ◽  
Clinical Parameters ◽  
Chemical Agents ◽  
Probing Depth ◽  
Before And After ◽  
Chi Squared ◽  
Plaque Control ◽  
Group 2 ◽  
Antibacterial Potential ◽  
Group 1

Background and aims. Dental plaque and gingivitis were controlled by administration of chemical agents such as chlorhexidine (CHX) which is recognized as a gold standard of chemical agents. The aim of this study was to compare the effects of two mouthwashes (0.2% CHX and Kin Gingival) on clinical parameters. Materials and methods. A total of 88 subjects were included in this interventional‒experimental study. The subjects were divided into two groups of 44 (group 1: 0.2% CHX and group 2: Kin Gingival). The study involved no mechanical plaque control methods. Patients used the mouthwashes twice a day for two weeks. Clinical parameters included plaque index (PI), gingival index (GI), probing depth (PD) and bleeding on probing (BOP), which were measured before and after the use of mouthwashes. The results were analyzed by Man-Whitney U and chi-squared tests. Statistical significance was set at P < 0.05. Results. The results indicated that PI, GI and PD significantly decreased in group 2 (Kin Gingival) in comparison with group 1 (0.2% CHX) (P < 0.05). However, the two mouthwashes did not differ significantly from each other in relation to BOP (P > 0.05). Conclusion. Based on the results it can be concluded that Kin Gingival and 0.2% CHX mouthwashes decrease the clinical parameters in patients significantly. However, Kin Gingival is more effective than 0.2% CHX, which might be attributed to the synergic antibacterial potential of Kin Gingival ingredients like sodium fluoride.

P–223 The necrotic oocyte: does the uncontrolled release of cell contents affect adjacently, group cultured embryos?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Newman ◽  
H Smale ◽  
A Barrie ◽  
A Campbell
Keyword(s):  
Cohort Analysis ◽  
Time Lapse ◽  
Division Rate ◽  
Chi Squared ◽  
Utilisation Rate ◽  
Standard Culture ◽  
Registration Number ◽  
A Cell ◽  
Group 2 ◽  
Group 1

Abstract Study question Is embryo utilisation rate, embryo morphokinetics and the incidence of irregular divisions affected when embryos are group-cultured adjacent to a necrotic oocyte? Summary answer This study demonstrates that embryos cultured adjacent to necrotic oocytes appear to be unaffected both in terms of utilisation, morphokinetics and incidence of irregular divisions. What is known already Necrosis is a form of uncontrolled cell death, usually resulting from external injury, causing the cell’s contents to release into the surrounding environment1. A cell undergoing necrosis will first visibly swell before the collapse of the plasma membrane causes it to subsequently shrink and the cell to lyse2. An escalation of inflammation occurs due to the release of intracellular factors3. Neighbouring embryos are believed to be negatively affected by a necrotic oocyte with some laboratories choosing to remove necrotic oocytes from culture dishes, however, little is known regarding this impact. Study design, size, duration The project was a single site, retrospective cohort analysis using time-lapse data from August 2017 to December 2018. Only patients with at least one necrotic oocyte, a minimum of one adjacent embryo to the necrotic oocyte and those cultured in the EmbryoScope+® were included in the analysis. Participants/materials, setting, methods The study included 868 embryos from 89 patients. The embryos were categorised as adjacent to a necrotic oocyte (group 1, n = 208) and not adjacent to a necrotic oocyte (group 2, n = 660). The utilisation rate and irregular division rate were analysed using a Chi-squared test, the morphokinetic parameters was analysed using a t-test. Morphokinetic data included; tPB2, tPNa, tPNf, t2, t3, t4, t5, t6, t7, t8, t9, tSC, tM, tSB and tB. Main results and the role of chance Utilisation rate between the two groups was not significantly different (group 1; 40.9% versus group 2; 47.6%, p = 0.09). Incidence of irregular division was not significantly different between the two groups (group 1; 24.0% vs group 2; 21.7%, p = 0.51). No morphokinetic parameter was statistically significantly different when comparing group 1 to group 2, respectively: tPB2, 3.61 vs 3.73, p = 0.38; tPNa, 7.01 vs 6.91, p = 0.59; tPNf, 23.64 vs 23.66, p = 0.95; t2, 3.44 vs 2.98, p = 0.09; t3, 14.56 vs 14.41, p = 0.75; t4, 15.96 vs 15.8, p = 0.77; t5, 15.96 vs 15.8, p = 0.77; t6, 30.33 vs 30.46, p = 0.86; t7, 33.11 vs 33.16, p = 0.95; t8, 37.93 vs 36.92, p = 0.34; t9, 48.66 vs 48.97, p = 0.73; tSC, 58.04 vs 57.89, p = 0.88; tM, 74.02 vs 73.76, p = 0.8; tSB, 75.55 vs 75.42, p = 0.9; tB, 87.06 vs 87.2, p = 0.91. Limitations, reasons for caution The time at which the oocytes became necrotic was not analysed therefore the effect, if any, of exposure time could not be determined. Of the 169 necrotic oocytes, two were from IVF and 167 from ICSI; the increased exposure of the embryos derived from ICSI was not controlled for. Wider implications of the findings: Necrotic oocytes are easily identified in standard culture observations and in time-lapse imaging, therefore, their removal may be an unnecessary practice. More harm could be caused by removing the dish from the incubator, as this would unnecessarily expose any viable embryos contained within the dish to a suboptimal environment. Trial registration number Not applicable

Abstract 1122‐000049: Safety and Efficacy of Daily Intra‐Arterial Endovascular Therapy for Refractory Cerebral Vasospasm Following Subarachnoid Hemorrhage

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Rahul Chandra
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Safety And Efficacy ◽  
Primary Endpoints ◽  
Secondary Endpoints ◽  
Group 2 ◽  
Favorable Clinical Outcome ◽  
Vessel Dissection ◽  
Group 1

Introduction : Delayed cerebral ischemia (DCI) and cerebral infarction (CI) due to vasospasm is a major cause of death and disability after aneurysmal subarachnoid hemorrhage (aSAH). Transluminal balloon angioplasty (BA) and super‐selective intra‐arterial (IA) infusion of vasodilators are considered for refractory vasospasm. We examined the safety and efficacy of repeated daily IA treatment in vasospasm. Methods : We reviewed records a single center of vasospasm treatment for aSAH from 2016 through 2019. Primary endpoints were rate of cerebral infarctions and safety related to daily treatments. Secondary endpoints were mortality and favorable clinical outcome at hospital discharge defined as modified Rankin scale of scores 0–2. Results : Of 426 patients with SAH, 197 were aneurysmal with 79 with DCI. Forty‐five out of 79 underwent IA treatment, of which 14 underwent 1 or 2 treatments (Group 1) and 31 underwent ≥3 treatments (Group2). Incidence of CI were similar (Group 1: 42.8%; Group 2: 54.8%, p = 0.45) Good clinical outcomes at discharge were seen in 36% in Group 1 and 16% in Group 2 (p = 0.15). Mortality was 7% in group 1 and 26% in group 2 (p = 0.17). Conclusions : Complications including vessel dissection, systemic hypotension and seizures did not increase with repeated treatments. CI was not noted to differ, but the outcomes were worse in group 2 which may relate to severity of SAH rather than DCI.

Conventional and contrast-enhanced ultrasound features in sclerosing adenosis and correlation with pathology

2020 ◽  
pp. 1-9
Author(s):  
Sihui Shao ◽  
Minghua Yao ◽  
Xin Li ◽  
Chunxiao Li ◽  
Jing Chen ◽  
...  
Keyword(s):  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Exact Test ◽  
Contrast Enhanced ◽  
Chi Squared ◽  
Group 2 ◽  
Student’S T ◽  
Sensitivity Specificity ◽  
Sclerosing Adenosis ◽  
Group 1

OBJECTIVES: To evaluate the efficacy of conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) in differential diagnosis of sclerosing adenosis (SA) from malignance and investigate the correlated features with pathology. METHODS: We retrospectively enrolled 103 pathologically confirmed SA. All lesions were evaluated with conventional US while 31 lesions with CEUS. Lesions were divided into SA with or without benign lesions (Group 1, n = 81) and SA with malignancy (Group 2, n = 22). Performance of two methods were analyzed. The ultrasonographic characteristics were compared between two groups with Student’s t-test for measurement and chi-squared or Fisher’s exact test for count data. RESULTS: There were 22 lesions complicated with malignancy, and the mean age of Group 2 was higher than Group 1 (55.27 vs. 41.57, p <  0.001). The sensitivity, specificity and accuracy of conventional US and CEUS were 95.45%, 46.91%, 57.28% and 100%, 62.5%, 70.97%. Angularity (p <  0.001), spicules (p = 0.023), calcification (p = 0.026) and enlarged scope (p = 0.012) or crab claw-like enhancement (p = 0.008) in CEUS were more frequent detected in SA with malignancy. CONCLUSIONS: Though CEUS showed an improved accuracy, the performance of ultrasound in the diagnosis of SA was limited. Awareness and careful review of the histopathologically related imaging features can be helpful in the diagnosis of SA.

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