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Signa Vitae

A Journal In Intensive Care And Emergency Medicine

Tag: survival (Page 1 of 2)

Genetic determinants of survival

Abstract

The human genome comprises some 20,000 genes, or 3 billion base pairs. Variation in this genetic sequence is common and some of these variants affect gene function or the protein transcribed from it. Human characteristics are determined by the interaction of the genome with environmental challenges, and differences between us thus result from variation in those challenges and in the genome itself. This is true of human susceptibility to disease, and survival from it. Genetic variation influences human behaviours which may predispose to health or disease; the risk of contracting an infectious disease, or of suffering diseases such as cancer or myocardial infarction; the development of complications; the response to any treatment administered; and thus the outcome of the disease state. Genetic studies can help shed light on the mechanisms which underpin disease processes, whilst perhaps suggesting ways in which treatment might be ‘personalised’, and novel therapeutic targets for drug development.

More sophisticated approaches to such endeavours are required, given the failure to identify the bulk of gene variants of influence using conventional strategies.

Key words: gene, polymorphism, survival, genome

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Genetic determinants of survival

Abstract

The human genome comprises some 20,000 genes, or 3 billion base pairs. Variation in this genetic sequence is common- and some of these variants affect gene function or the protein transcribed from it. Human characteristics are determined by the interaction of the genome with environmental challenges- and differences between us thus result from variation in those challenges and in the genome itself. This is true of human susceptibility to disease, and survival from it. Genetic variation influences human behaviours which may predispose to health or disease; the risk of contracting an infectious disease, or of suffering diseases such as cancer or myocardial infarction; the development of complications; the response to any treatment administered; and thus the outcome of the disease state. Genetic studies can help shed light on the mechanisms which underpin disease processes, whilst perhaps suggesting ways in which treatment might be ‘personalised’, and novel therapeutic targets for drug development.

More sophisticated approaches to such endeavours are required, given the failure to identify the bulk of gene variants of influence using conventional strategies.

Key words: Gene, polymorphism, survival, genome

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Automated external defibrillator skills among lay people in the region of Koroska: a pilot study

Abstract

Background. In the region of Koroška, there are more and more public spaces equipped with automated external defibrillators which can be used by a witnessed bystander. The aim of this study was to gain insight into the skills required for using automated external defibrillators.

Methods. This was a cross-sectional survey conducted in two family medicine practices. We included volunteers who visited their family doctor during a period of four days. Skills were assessed in a virtual setting using a plastic manikin.

Results. There were 107 participants in the sample, 60.0% were women. Average age of the sample was 47.6±16.8 years. In the practical part (skills testing), the participants earned 2.7 points from a total of 5 points. Younger participants and those who attended a course in basic life support, in the past 10 years, had a significantly higher score.

Conclusion. Lay people need more education regarding skills for using automated external defibrillators.

Key words: automated external defibrillator, basic life support, lay people, survival, cardiac arrest

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Veno-venous two-site cannulation versus veno-venous double lumen ECMO: complications and survival in infants with respiratory failure

Abstract

Objective. To compare complications and survival between the two-site veno-venous versus the veno-venous double lumen extracorporeal membrane oxygenation (ECMO) in infants with respiratory failure.
Methods. The Extracorporeal Life Support Organization (ELSO, Ann Arbor, Michigan) provided the registry database, collected between 1999-2009 for this research project. During this period, 9086 infants ≤ 7 kg birth weight (BW) were treated with ECMO. From these children, those who were older than 32 days and received veno-venous extracorporeal membrane oxygenation (VV ECMO), were extracted for analysis. From a total of 270 infants who met the inclusion criteria, 236 infants were treated with veno-venous double lumen (VVDL) ECMO and 34 infants received VV two-site ECMO. ELSO records were reviewed for the following information: demographic data, type of ventilation, ventilator days and settings during ECMO, complications during ECMO and survival.
Results. Eighty-seven percent (n=236) of infants were cannulated with VVDL and 13% (n=34) with VV two-site cannulation. Twenty-four hours after ECMO onset, ventilator settings were significantly higher in the VV two-site group. Median ECMO duration was significantly shorter in the VV two-site group (137(90/208) vs. 203(128/336) hours, p=0.01). Total complication rate and survival rates (71% in the VVDL group and 56% in the VV two-site group) were not significantly different.
Conclusion. Both cannulation modes for ECMO are safe for use in infants with respiratory failure. The decision regarding which technique should be used for this group of patients depends mainly on best practice experience of the individual ECMO center and on the technical equipment routinely used by the center.

 

Key words: ECMO, infants, respiratory failure, complications, survival

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Epidemiology of cardiac arrest outside and inside hospital – Experiences from registries in Sweden

Abstract

Cardiac arrest is a dramatic condition leading to sudden death if someone cannot perform two interventions, basic life support and early defibrillation, that have been proved to improve long-term survival. The ‘Utstein style’, recently introduced, represents a standard of practice both inside and outside hospital with recommended guidelines for the uniform reporting of clinical data from the patient suffering cardiac arrest. In Sweden the vast majority of patients suffering from cardiac arrest regardless whether inside or outside hospital are included in webbased national registers (one for out-of-hospital cardiac arrest (OHCA) and one for in-hospital-cardiac arrest (IHCA)). In this article we will present our experiences from OHCA and IHCA separately.

Keywords: cardiac arrest outside and inside hospital, epidemiology, The Swedish register, survival, cerebral function

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