Effect of COVID-19 on the prevalence of bystanders performing cardiopulmonary resuscitation: A systematic review and meta-analysis.

BACKGROUND: The importance of bystander cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrests is especially important in the context of coronavirus disease 2029 (COVID-19) because it can significantly influence survival outcomes. The objective of this meta-analysis was to examine the primary outcomes of bystander CPR during the pandemic and pre-pandemic periods. METHODS: A search was conducted in the PubMed Central, Scopus, and EMBASE databases, as well as the Cochrane Central Register of Controlled Trials database, up to December 10, 2023. In cases where the value of I² was greater than or equal to 50% or the Q-test indicated that the p-value was less than or equal to 0.05, the studies were considered to be heterogeneous. Sensitivity assessment was performed using the leave-one-out methodology. The study protocol was registered in PROSPERO with the ID number CRD42023494912. RESULTS: Twenty-five articles were included in this meta-analysis. Pooled analysis showed that bystander CPR frequency during the COVID-19 pandemic was 38.8%, compared to 44.8% for the pre-pandemic period (odds ratio: 1.04; 95% confidence interval: 0.93-1.16; p = 0.48). CONCLUSIONS: The article's conclusions indicate that the COVID-19 pandemic influenced a reduction in bystander CPR compared to the pre-pandemic period, but this difference was not statistically significant. Further research is recommended to understand attitudes, including the fears of witnesses, before performing CPR on patients with suspected or confirmed infectious diseases. The study highlights the importance of bystander intervention in emergency situations and the impact of a pandemic on public health response behaviors.

The role of the neutrophil-lymphocyte ratio in predicting poor outcomes in COVID-19 patients.

BACKGROUND: This study examines how the neutrophil-lymphocyte ratio (NLR) predicts coronavirus disease 2019 (COVID-19) hospitalization, severity, length, and mortality in adult patients. METHODS: A study was done using a retrospective, single-center, observational design. A total of 400 patients who were admitted to the Ziv Medical Center (Safed, Israel) from April 2020 to December 2021 with a confirmed diagnosis of COVID-19 through RT-PCR testing were included in the analysis. Two complete blood count laboratory tests were conducted for each patient. The first test was administered upon admission to the hospital, while the second test was conducted prior to the patient's discharge from the hospital or a few days before their death. RESULTS: Four hundred patients were included in the study, 206 males (51.5%) and 194 females (48.5%). The mean age was 64.5 ± 17.1 years. In the group of cases, there were 102 deaths, and 296 survivors were recorded, with a fatality rate of 25.5%. The median NLR was 6.9 ± 5.8 at the beginning of hospitalization and 15.1 ± 32.9 at the end of hospitalization (p < 0.001). The median length of hospital stay was 9.4 ± 8.8 days. NLR in the fatality group was 34.0 ± 49.9 compared to 8.4 ± 20.4 in the survivor group (p < 0.001). Comparison between the NLR at the time of admission of the patient and before discharge/death was 6.9 ± 5.8 vs. 15.1 ± 32.9 (p < 0.001). CONCLUSIONS: The analyses conducted revealed a statistically significant correlation between the NLR and the severity, mortality rates, and the duration of hospitalization. The consideration of NLR should commence during the initial phases of the disease when assessing individuals afflicted with COVID-19.

Diagnostic performance of point-of-use ultrasound of resuscitation outcomes: A systematic review and meta-analysis of 3265 patients.

BACKGROUND: Echocardiography in the setting of resuscitation can provide information as to the cause of the cardiac arrest, as well as indicators of futility. This systematic review and meta-analysis were performed to determine the value of point-of-care ultrasonography (PoCUS) in the assessment of survival for adult patients with cardiac arrest. METHODS: This meta-analysis was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, EMBASE, Web of Science, Cochrane have been searched from databases inception until March 2nd 2021. The search was limited to adult patients with cardiac arrest and without publication dates or country restrictions. Papers were chosen if they met the required criteria relating to the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of this diagnostic technique concerning resuscitation outcomes. RESULTS: This systematic review identified 20 studies. Overall, for survival to hospital discharge, PoCUS was 6.2% sensitivity (95% confidence interval [CI] 4.7-8.0%) and 2.1% specific (95% CI 0.8-4.2%). PoCUS sensitivity and specificity for return of spontaneous circulation were 23.8% (95% CI 21.4-26.4%) and 50.7% (95% CI 45.8-55.7%) respectively, and for survival to admission 13.8% (95% CI 12.2-15.5%) and 20.1% (95% CI 16.2-24.3%), respectively. CONCLUSIONS: The results do not allow unambiguous recommendation of PoCUS as a predictor of resuscitation outcomes and further studies based on a large number of patients with full standardization of operators, their training and procedures performed were necessary.

Du Bois-Reymond Type Lemma and Its Application to Dirichlet Problem with the p(t)-Laplacian on a Bounded Time Scale.

This paper is devoted to study the existence of solutions and their regularity in the p(t)-Laplacian Dirichlet problem on a bounded time scale. First, we prove a lemma of du Bois-Reymond type in time-scale settings. Then, using direct variational methods and the mountain pass methodology, we present several sufficient conditions for the existence of solutions to the Dirichlet problem.

The use of high-frequency ultrasonography for the diagnosis of palpable nodules after the administration of dermal fillers.

INTRODUCTION: Esthetic medicine is a buoyant field of medicine. As the number of performed procedures - mainly injections of botulin toxin and dermal fillers - is increasing, the number of complications is rising as well. The most popular dermal filler is hyaluronic acid. Injection of hyaluronic acid dermal fillers is considered a minimally invasive procedure, but complications in the form of skin nodules and lumps are being encountered more and frequently. Esthetic medicine does not currently offer its own diagnostic methods that would allow one to diagnose complications. In these circumstances, the implementation of objective diagnostic methods from other fields of medicine becomes significant. High-frequency ultrasound is one of such methods. AIM OF THE STUDY: The aim of this study was to implement high-frequency ultrasound for the diagnosis of palpable nodules after the administration of dermal fillers. MATERIAL AND METHOD: The study group included 15 women who developed palpable nodules in the region of hyaluronic acid injection. The study includes both early and late complications. An EPIQ 5 (Philips, Bothell, USA) ultrasound machine and a L5-18 transducer were used to examine the nodules. Ultrasound images were evaluated qualitatively by 2 independent investigators. RESULTS: Ultrasound enabled the diagnosis of hyaluronic acid deposition in 9 women, granulomas in 3 women, fibrosis in 2 women and a deposition with inflammation in 1 case. Each of the diagnosed structures presented a typical ultrasound appearance. CONCLUSIONS: High-frequency ultrasound is a useful diagnostic method that has a chance to become a widespread tool to diagnose and treat complications. Because of a low number of study reports in this area, continued research is warranted.

The efficacy of high-frequency ultrasound-guided injection lipolysis in reducing fat deposits located on the inside of the knees.

INTRODUCTION: Many women consider local fat deposits unacceptable for aesthetic reasons as they have negative impact on appearance and thus, contribute to reduced self-esteem. Injection lipolysis (intralipotherapy) may be an alternative for conventional liposuction in reducing fat deposits. AIM: The aim of this paper was to assess the efficacy of high-frequency ultrasound-guided injection of deoxycholic acid (intralipotherapy) to remove fat deposits on the inner side of knees. MATERIALS AND METHODS: The procedure was performed in 7 women (14 inner sides of knees). The formulation was administered under high-frequency ultrasound guidance. The procedure was performed twice at 4-week intervals in each patient. High-frequency ultrasound guidance was used to monitor such parameters as the thickness of the dermis (DermaMed, Draminski S.A.) or the subcutaneous tissue (Philips Epiq 5, USA). Ultrasound was performed both before and after treatment. Additionally, anthropometric measurements were taken, a questionnaire was performed, and a photographic documentation was recorded. RESULTS: Reduction in knee circumference and subcutaneous tissue occurred in 71.42% of patients. CONCLUSIONS: Intralipolysis with deoxycholic acid formulation is an effective method for reducing fat deposits on the inner part of the knees. Ultrasonography proved to be a useful method to monitor the procedure (correct administration of the preparation) and to assess treatment outcomes. A small sample size was a limitation of our study; therefore further studies are needed.

High frequency ultrasound assessment of labial glands simulating small nodules or granulomas after lip augmentation.

AIM OF THE STUDY: The aim of this study is to evaluate the utility of high-frequency ultrasound in the assessment of the nature and differentiation of lumps occurring in the labial mucosa after lip filling procedures. MATERIAL AND METHODS: The study sample included 5 women aged from 28 to 43 years (mean age: 37.4 years) who previously underwent a lip augmentation or rejuvenation procedure. Photographic documentation was taken and high-frequency ultrasound assessment was performed in all the patients. The presence of deposits, foreign body granulomas, fibrosis and labial glands was mainly investigated taking into account the shape of the abnormalities, their margins, surface area, location and echogenicity. In order to confirm the diagnosis, histopathological examination was performed. RESULTS: The examinations performed made it possible to differentiate between granulomas and persistent deposit nodules and to demonstrate the presence of massive fibrosis and of labial glands pushed out by these abnormalities with the glands presenting as hypoechoic oval areas. Histopathological examination confirmed the morphology of labial glands reported by the patients as uncomfortable lumps felt from the side of the mucosa, which clinically simulate persistent deposit nodules or granulomas. CONCLUSIONS: High-frequency ultrasound is a method that is essential for the correct differentiation between complications of tissue filler procedures. This, in turn, makes it possible to apply the right treatment. In this study, it was demonstrated for the first time that the lumps reported by patients who have had a lip filling procedure may be the result of labial glands being pushed out by deposits, granulomas or massive fibrosis, which are complications of such procedures.

Usefulness of Doppler sonography in aesthetic medicine.

INTRODUCTION: In recent years, ultrasonography has been used in an increasing number of fields, such as dermatology, aesthetic medicine and cosmetology. For skin imaging, research has shown the usefulness of both classic scanners equipped with linear transducers, and high-frequency scanners with mechanical transducers. An increasing number of reports indicating high usefulness of Doppler sonography have been published recently. The aim of this study was to assess the usefulness of high-frequency Doppler imaging in the diagnosis of vascular complications after aesthetic procedures using tissue fillers. MATERIALS AND METHODS: A total of 12 women aged 19-48 years (mean age 36.08 years) who had undergone hyaluronic acid treatment were included in the study group. Ultrasound scans were performed using standard ultrasound scanners, i.e. Philips Epiq 5 with a linear transducer and Samsung RS85 with linear transducers and Doppler Microflow Imaging option. Ultrasound scans were performed to assess the presence of blood flow using Color Power Doppler (CPA). Pulsed-Wave Doppler was used only for arteries. If no blood flow was recorded with Color Power Doppler, Microflow Imaging was used. RESULTS: Doppler ultrasound showed normal blood flow despite reported symptoms in 3 cases. Vascular stenosis was found in 2 patients. In the other 7 patients, Doppler ultrasound showed no blood flow at the sites where complications developed. CONCLUSIONS: Skin ultrasound with Doppler options is a useful tool in the diagnosis of aesthetic medicine complications.

Granuloma as a complication of polycaprolactone-based dermal filler injection: ultrasound and histopathology studies.

In aesthetic medicine, there has been an ongoing search for an ideal dermal filler to offer zero complication rate. Polycaprolactone-based dermal filler (PCL) has been available since 2009. The purpose of the paper was to present a case of granuloma as a complication of PCL injection, which has not been reported so far by other researchers. A 68-year-old female was injected with PCL. One year later, nodules accompanied by bluish skin discoloration developed within the injection site. Ultrasound and histopathology studies were performed. The examinations confirmed the presence of foreign body granuloma after PCL, which makes it the first reported case worldwide. The published data analyses showed general lack of studies and case reports to address this issue. The PCL, like an injection of any soft tissue filler, may lead to serious complications, such as granuloma formation. This makes further research legitimate and necessary.

Reconstruction method for extended depth-of-field optical diffraction tomography.

In the paper we present a novel method of extended depth-of-field limited-angle optical diffraction tomography, in which the change of a focal plane position is performed with a liquid focus-tunable lens. One sinogram is acquired for each state of a focus-tunable lens. After acquisition process is complete, all sinograms are independently reconstructed and stitched to form the final tomographic reconstruction. The presented solution effectively extends the applicability of the Rytov approximation to relatively thick samples and provides uniform resolution of 3D tomographic reconstructions. The method is also combined with Generalized Total Variation Iterative Constraint algorithm, which minimizes distortion of the results due to the limited angular range of acquired projections. The combined solution is dedicated to investigation of transparent and semi-transparent biological micro-structures, like cells and tissue slices.

Low dose of GRP78-targeting subtilase cytotoxin improves the efficacy of photodynamic therapy in vivo.

Photodynamic therapy (PDT) exerts direct cytotoxic effects on tumor cells, destroys tumor blood and lymphatic vessels and induces local inflammation. Although PDT triggers the release of immunogenic antigens from tumor cells, the degree of immune stimulation is regimen-dependent. The highest immunogenicity is achieved at sub-lethal doses, which at the same time trigger cytoprotective responses, that include increased expression of glucose-regulated protein 78 (GRP78). To mitigate the cytoprotective effects of GRP78 and preserve the immunoregulatory activity of PDT, we investigated the in vivo efficacy of PDT in combination with EGF-SubA cytotoxin that was shown to potentiate in vitro PDT cytotoxicity by inactivating GRP78. Treatment of immunocompetent BALB/c mice with EGF-SubA improved the efficacy of PDT but only when mice were treated with a dose of EGF-SubA that exerted less pronounced effects on the number of T and B lymphocytes as well as dendritic cells in mouse spleens. The observed antitumor effects were critically dependent on CD8+ T cells and were completely abrogated in immunodeficient SCID mice. All these results suggest that GRP78 targeting improves in vivo PDT efficacy provided intact T-cell immune system.

A case of child death caused by intestinal volvulus following magnetic toy ingestion.

An 8-year boy was admitted to the ER of one of Warsaw's pediatric hospitals with a history of having bloody vomiting the day before. During admission the boy collapsed and lost consciousness. CPR was unsuccessful. On medico-legal autopsy, two foreign objects (small magnetic spheres--0.5 cm in diameter) were found in two different places in the small and large intestines and were notably attracted magnetically one to another. A loop of approximately 1-m length with features of small intestinal hemorrhagic necrosis and small intestinal mechanical obstruction was found. The cause of death was intestinal volvulus and small intestinal mechanical obstruction caused by ingestion of foreign objects (two neodymium magnets). Most likely these small magnetic spheres were part of a popular toy, the safety of which, lately, has been widely discussed.