The association of layperson characteristics with the quality of simulated cardiopulmonary resuscitation performance / 世界急诊医学杂志（英文）

@#BACKGROUND: Few studies have examined the association of layperson characteristics with cardiopulmonary resuscitation (CPR) provision. Previous studies suggested provider characteristics, including age and gender, were associated with CPR quality, particularly chest compression (CC) depth. We sought to determine the association of subject characteristics, including age and gender with layperson CPR quality during an unannounced simulated CPR event. We hypothesized shallower CC depth in females, and older-aged subjects. METHODS: As part of a larger multicenter randomized controlled trial of CPR training for cardiac patients' caregivers, CPR skills were assessed 6 months after training. We analyzed associations between subject characteristics and CC rate, CC depth and no-flow time. Each variable was analyzed independently; significant predictors determined via univariate analysis were assessed in a multivariate regression model. RESULTS: A total of 521 laypersons completed a 6-month CPR skills assessment and were included in the analysis. Mean age was 51.8±13.7 years, 75% were female, 57% were Caucasian. Overall, mean CC rate was 88.5±25.0 per minute, CC depth was 50.9±2.0 mm, and mean no-flow time was 15.9±2.7 sec/min. CC depth decreased significantly in subjects >62 years (P<0.001). Male subjects performed deeper CCs than female subjects (47.5±1.7 vs. 41.9±0.6, P<0.001). CONCLUSION: We found that layperson age >62 years and female gender are associated with shallower CC depth.

Sonographic Measurement of Renal Size in Normal Indian Children.

Objectives: To determine the renal size in normal Indian children by sonography. Settings: Pediatric teaching hospital, Mumbai, India. Duration: 1.5 years. Design: Cross-sectional observational study. Participants: 1000 normal Indian children aged 1 month - 12 years. Methods: Sonographic assessment of renal size (length, width and thickness) was performed using Philips real time mechanical sector scanner of 3.5-5 MHz frequency with electronic caliper. The mean renal dimensions and volume were calculated for each age group with ± 2SD. The renal length and calculated renal volume were correlated with somatic parameters like age, weight, height and body surface area. Regression equations were derived for each pair of dependent and independent variables. Results: No statistical difference was found in renal size between sexes and between right and left kidney. A strong correlation was seen between renal size with various somatic parameters, the best correlation was between renal size length and body height (coefficient of correlation=0.9). Conclusion: This study provides values of renal length (mean ± 2SD) in normal Indian children. Renal length can be easily calculated by derived linear regression equation.

Low axillary sampling in clinically node-negative operable breast cancer.

Background. Targeted sentinel node biopsy has been extensively validated. It has been incorporated into standard guidelines for axillary prediction in women with clinically node-negative operable breast cancer. However, the high cost of the gamma probe and the need for radiocolloid have limited its widespread acceptance in developing countries. We aimed to validate low axillary sampling as a reliable alternative method to sentinel node biopsy in a developing country. Methods. An anatomically guided low axillary sampling removes the lower level I axillary fat with lymph nodes and the method was validated by completing axillary clearance in all women. Results. Three hundred fifty-five women with clinically node-negative operable breast cancer underwent validation of low axillary sampling, with lymph nodes identified in all of them. The median number of nodes identified in low axillary sampling was 5 with overall node-positivity of 32.1% (114 of 355). Ten of these 114 patients were wrongly identified as node-negative by the sampled lymph nodes, i.e. a false-negative rate of 8.8%. Further exploratory analysis showed that 6-node low axillary sampling gave an excellent false-negative rate of 1.5% with 95% sensitivity, which was comparable with the highly targeted sentinel node biopsy technique. Conclusions. With an overall false-negative rate of 8.8% with 5-node low axillary sampling, and even better falsenegative rate of 1.5% with 6-node low axillary sampling, axillary sampling is a low-cost technology, which is a reliable alternative to sentinel node biopsy for axillary nodal prediction in clinically node-negative breast cancer.

An invertase with unusual properties secreted by sucrose-grown cells of Corynebacterium murisepticum.

The mode of sucrose utilisation by Corynebacterium murisepticum cells growing on M9 minimal medium supplemented with 0.4% sucrose as the carbon source was studied. It was observed that during growth of this organism, sucrose in the medium is hydrolysed to glucose and fructose, suggesting the formation of an extracellular invertase. Unlike in other microorganisms (e.g. Saccharomyces cerevisiae) the invertase formation is not repressed by the presence of glucose in the medium. The invertase was found to be the only predominant extracellular protein in the culture broth and could be purified in a single step by precipitation at 90% ammonium sulphate saturation. The purified protein had a molecular mass of 70,000 daltons. It not only showed invertase activity, but also a fructosyltransferase activity as it could convert sucrose to beta-1,2-difructose, as well as to glucose and fructose.