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Background: Therapeutic hypothermia can improve neurological status in cardiac arrest survivors. Objectives: We investigated the association between the timing of inducing therapeutic hypothermia and neurological outcomes in patients who experienced out-of-hospital cardiac arrest. Methods: We evaluated data from 116 patients who were comatose after return of spontaneous circulation and those who received therapeutic hypothermia between January 2013 and April 2017. The primary endpoint was good neurological outcomes during index hospitalization, defined as a cerebral performance category score of 1 or 2. Therapeutic hypothermia timing was defined as the duration from the return of spontaneous circulation to hypothermia initiation. We analyzed the effect of early hypothermia induction on neurological results. Results: In total, 112 patients were enrolled. The median duration to hypothermia initiation was 284 min (25th–75th percentile, 171–418 min). Eighty-two (69.5%) patients underwent hypothermia within 6 h, and 30 (25.4%) had good neurological outcomes. The rates of good neurological outcomes by hypothermia initiation time quartile (shortest to longest) were 28.3%, 34.5%, 14.8%, and 28.6% (p = 0.401). The good neurologic outcomes did not differ between hypothermia patients within 6 h or after (26.5% vs 26.7%, p = 0.986). Short low-flow time and bystander resuscitation were associated with good neurological outcomes (p = 0.044, confidence interval: 0.027–0.955), but the timing of hypothermia initiation was not (p = 0.602, confidence interval: 0.622–1.317). Conclusion: A shorter low-flow time was associated with good neurological outcomes in out-of-hospital cardiac arrest patients who experienced hypothermia. However, inducing hypothermia sooner, even within 6 h, did not improve the neurological outcomes. Thus, as current guidelines recommend, initiating hypothermia within 6 h of recovery of spontaneous circulation is reasonable.

We report the first detection of Y280-lineage H9N2 avian influenza viruses in live bird markets in Korea during July 2020. The viruses were isolated from domestic ducks and chickens traded in three markets in two different provinces, indicating dispersal of the newly introduced viruses. Complete genome sequencing and comparative phylogenetic analyses of all eight gene segments of the viruses showed high nucleotide homology to a Y280-lineage H9N2 avian influenza virus isolated in a chicken farm in China, which belongs to one of the most prevalent H9N2 genotypes in China. Increasing human cases of the same genotype H9N2 infection in China and the mammalian specific markers present in the viruses isolated suggest potential implications for public health.

Highly pathogenic avian influenza viruses (HPAIVs) and low pathogenic avian influenza viruses (LPAIVs) represent important threats to the poultry industry and global human health. Due to the high rates of avian influenza virus (AIV) transmission, controlling AIV outbreaks is challenging. HPAIV is known to be transmitted from wild birds to domestic ducks, from which it can be transmitted to layer and broiler chickens. Therefore, surveillance of AIV in domestic ducks and chickens in advance of outbreaks can prevent its spread and enable timely implementation of disease control measures. Certain molecular diagnostic tools can be applied in the field for faster AIV detection. In this study, we evaluated the AIV-detection ability of two insulated isothermal PCR (iiPCR) devices, POCKIT™Micro DUO Nucleic Acid Analyzer (POCKIT DUO) and POCKIT™ Central Nucleic Acid Analyzer (POCKIT Central). We found that the analytical, in vivo and clinical performances of the two POCKIT devices were comparable to those of real-time reverse transcription PCR. Due to their brief protocols and short detection times, POCKIT DUO and POCKIT Central represent promising molecular diagnostic devices for the reliable detection of AIV.

Currently, no vaccine or established therapeutic agents are available for coronavirus disease 2019. The sharp increase in demand for personal protective equipment (PPE) necessitates an improvement in the protective efficacy of PPE. We evaluated the potential antimicrobial and antiviral effects of a surface-coating disinfectant (3-(trimethoxysilyl)propyldimethyl octadecyl ammonium chloride, Si-QAC) when applied onto PPE. Si-QAC-pre-coated PPE was artificially contaminated with either influenza virus or Salmonella. The results showed significantly reduced influenza and Salmonella titers in Si-QAC-coated PPE; these antimicrobial effects lasted 7 days. This suggests that this surface-coating disinfectant effectively reduces pathogen contamination of PPE, enabling their safe and long-term use.

Background: Nuss et al introduced a less invasive method for inserting a stainless steel bar through the small incision on the lateral chest wall into the pectus excavatum. This study was undertaken to assess the effect of the Nuss operation on lung mechanics, CT-Index and hemodynamics. Methods: Twenty patients (age 4 to 17 years) with severe pectus excavatum underwent the Nuss operation. CT-Index (the internal transverse distance of the thorax/the vertebral-sternal distance at greatest depression) was evaluated before operation. Lung mechanics (dynamic compliance [], static compliance [] and airway resistance []), hemodynamic changes (heart rate [HR], systolic blood pressure [SBP], and diastolic blood pressure [DBP]), and gas exchange (arterial oxygen tension [], arterial carbon dioxide tension [], pulse oximeter saturation [] and end-tidal carbon dioxide tension[PET]) were measured before and after the operation. Results: and decreased significantly (P ＜ 0.05), but did not change. and decreased significantly (P ＜ 0.05), and SBP and DBP increased significantly (P ＜ 0.05) postoperatively. Conclusions: It is concluded that decreased compliance after the Nuss operation may result from reduced thoracic elastance, not to a change of lung parenchyma.

Background: This study was undertaken in order to investigate any cardiopulmonary changes caused by the surgical procedure during a Nuss operation in patients with pectus excavatum. Methods: Thirty patients undergoing the Nuss operation were divided into two groups. The patients were randomly assigned to either Group-V (n 15) which volume controlled ventilation was applied, or to Group-P (n = 15) where pressure controlled ventilation was applied. Mechanical ventilation provided a tidal volume to be set at approximately 10 ml/kg and a frequency set to keep ETCO. In range, between 32 mmHg and 38 mmHg. During the surgical procedure, we recorded expired volume (VE) and inspired maximal pressure (Pmax) changes according to the ventilator mode, and then also recorded changes in vital signs. Results: Heart rate and blood pressure had no significant changes in either groups. In Group-V, during rotation of the metal bar, there was a significant decrease in expired volume (P < 0.001), changes of inspired maximal pressure gradually increased with the operation (P < 0.001). In Group-P, rotation of the metal bar caused a significant decrease in expired volume (P < 0.001). Conclusions: During the Nuss operation, there should be careful observation of changes in the vital signs, expired volume and maximal pressure during insertion and rotation of the metal bar. (Korean J Anesthesiol 2001; 41: 178-183)

Background: During ophthalmologic surgery, a variety of anesthetic induction techniques are used in an attempt to prevent the rise of intraocular pressure (IOP). This study compared the effects of etomidate, a new intravenous anesthetic agent, on the changes in IOP with those of thiopental sodium and propofol. Methods: Forty-five patients were randomly allocated and divided into three groups to be injected intravenously with etomidate 0.2 0.3 mg/kg (E-group, n = 15), propofol 2 3 mg/kg (P-group, n = 15) or thiopental sodium 4 - 5 mg/kg (T-group, n = 15). Systolic arterial pressure (SAP), heart rate (HR) and intraocular pressure (IOP) were measured at 1, 2 and 3 minutes after the administration of the induction agents. During the induction of anesthesia, the incidence of IV injection pain, myoclonus, hiccup and a decrease in SAP of more than 30% were investigated. Results: At 1, 2 and 3 min following the induction of anesthesia, the SAP in the P-Group decreased significantly more than that in the other two groups (P < 0.05). After the induction, heart rate in the T-Group increased significantly more than that in the other two groups (P < 0.05). The three intravenous agents induced a significant decrease in IOP after an injection (P < 0.05). Comparing the three groups, the IOP in the E- and P-Group decreased significantly more than that in the T-Group (P < 0.05). Conelusions: Etomidate may be used as a choice of intravenous induction agent to reduce intraocular pressure in ophthalmologic operations especially in an emergency situation, geriatric and hypovolemic patients.