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Purpose Extracorporeal membrane oxygenation (ECMO) use for severe coronavirus disease 2019 (COVID-19) patients has increased during the course of the pandemic. As uncertainty existed regarding patient's outcomes, early guidelines recommended against establishing new ECMO centers. We aimed to explore the epidemiology and outcomes of ECMO for COVID-19 related cardiopulmonary failure in five countries in the Middle East and India and to evaluate the results of ECMO in 5 new centers. Methods This is a retrospective, multicenter international, observational study conducted in 19 ECMO centers in five countries in the Middle East and India from March 1, 2020, to September 30, 2020. We included patients with COVID-19 who received ECMO for refractory hypoxemia and severe respiratory acidosis with or without circulatory failure. Data collection included demographic data, ECMO-related specific data, pre-ECMO patient condition, 24 h post-ECMO initiation data, and outcome. The primary outcome was survival to home discharge. Secondary outcomes included mortality during ECMO, survival to decannulation, and outcomes stratified by center type. Results Three hundred and seven COVID-19 patients received ECMO support during the study period, of whom 78 (25%) were treated in the new ECMO centers. The median age was 45 years (interquartile range IQR 37-52), and 81% were men. New center patients were younger, were less frequently male, had received higher PEEP, more frequently inotropes and prone positioning before ECMO and were less frequently retrieved from a peripheral center on ECMO. Survival to home discharge was 45%. In patients treated in new and established centers, survival was 55 and 41% (p = 0.03), respectively. Multivariable analysis retained only a SOFA score < 12 at ECMO initiation as associated with survival (odds ratio, OR 1.93 (95% CI 1.05-3.58), p = 0.034), but not treatment in a new center (OR 1.65 (95% CI 0.75-3.67)). Conclusions During pandemics, ECMO may provide favorable outcomes in highly selected patients as resources allow. Newly formed ECMO centers with appropriate supervision of regional experts may have satisfactory results., Author(s): Ahmed A. Rabie [sup.1], Mohamed H. Azzam [sup.2], Abdulrahman A. Al-Fares [sup.3], Akram Abdelbary [sup.4], Hani N. Mufti [sup.5] [sup.6], Ibrahim F. Hassan [sup.7], Arpan Chakraborty [sup.8], Pranay Oza [...]

Background: Preterm premature rupture of membranes (PPROM) increases risk for early neonatal sepsis causing neonatal morbidity and mortality. This study was carried out to assess fetal thymus measure by ultrasound as a predictor of subclinical chorioamnionitis in PROM. Methods: This prospective analytical study included 206 pregnant women who fulfilled the inclusion criteria in emergency obstetric hospital and outpatient antenatal care unit faculty of medicine Zagazig University. Patients were divided into 2 groups; Control group formed of 103 cases of uncomplicated pregnancy between 24-36 weeks gestational age, and Study group formed of 103 cases of preterm premature rupture of membrane between 24-36 weeks gestational age. All patients had a detailed sonographic assessment to evaluate fetal biometry, fetal thymus measurement, amniotic fluid volume and major structural fetal anomalies. Results: 68.9% of studied cases had positive histological examination for chorioamnionitis versus 0% of their controls. The ability of small thymus transverse diameter to detect subclinical chorioamnionitis occurrence among PROM females was 100%, while it could exclude 91.5% negative cases among truly negatives examined. With accuracy as a predictor tool of 94.2%. Conclusion: Assessment of the decrease in fetal thymus diameter by serial ultrasonographic examinations is a promising prenatal method in the prediction of intraamniotic infection and subclinical chorioamnionitis in cases of PPROM. [ABSTRACT FROM AUTHOR]

This paper provides a comprehensive exploration of float current analysis in lithium-ion batteries, a promising new testing method to assess calendar aging. Float currents are defined as the steady-state trickle charge current after a transient part. In the literature, a correlation to capacity loss was reported. Assuming the float current compensates for the voltage decay over time and is linked to calendar aging, effects from voltage slippery must be considered. The dU/dQ analysis suggests solely a loss of active lithium. Therefore, we investigate the solid electrolyte interphase (SEI) growth as the general aging mechanism to explain the origin of float currents. Our results show that the voltage slippery theory holds true within the low to middle test voltage ranges. However, the theory's explanatory power begins to diminish at higher voltage ranges, suggesting the existence of additional, yet unidentified, factors influencing the float current. A shuttle reaction or lithiation of the cathode by electrolyte decomposition are the most promising alternative aging mechanisms at high voltages. The paper proposes a unique voltage slippery model to check for correlations between aging mechanisms, the float current test and the check-up test. For a better understanding, test strategies are proposed to verify/falsify the aging mechanisms beyond SEI. [ABSTRACT FROM AUTHOR]

Background Achalasia is a motility disorder characterized by the lower esophageal sphincter’s inability to relax in absence of peristalsis. It causes dysphagia, undigested food regurgitation, chest pain, weight loss, and respiratory symptoms such as nocturnal cough, recurrent aspiration, and pneumonia. Patients and methods This study included 46 patients who were admitted with symptoms of achalasia in Cairo University hospitals. Laparoscopic Heller’s cardiomyotomy (LHM) was performed for 23 patients and peroral endoscopic myotomy (POEM) was done for other 23 patients. Clinical assessment using the Eckardt score was done for all patients preoperatively and 3 months postoperatively. Results The operative time ranged from 90 to 160 min in LHM patients (group 1) (mean, 125.7 min), whereas it ranged from 75 to 180 min in POEM patients (group 2) (mean, 123.8 min). BMI postoperatively ranged from 25.2 to 30.9 kg/m² (mean, 26.9 kg/m² ) in group 1, whereas in group 2, it ranged from 16.02 to 43.36 kg/m² (mean, 26.8 kg/m² ). Conclusion There was no significant difference between LHM and POEM in terms of their resolution or improvement of symptoms of achalasia in our research, but there was a significant difference regarding gastroesophageal reflux symptoms postoperatively between both groups, in which gastroesophageal reflux symptoms postoperatively occurred with POEM and did not occur with LHM. [ABSTRACT FROM AUTHOR]