VT Group Research Articles

The changes of fungal community and flavor substances in Yunnan-style sausages: A comparative analysis of different drying methods

This study aimed to investigate alterations in the fungal community and flavor substances in Yunnan-style sausages subjected to natural air-dried fermentation (NF), variable-temperature drying (VT), and constant-temperature drying (CT) and analyze the potential relationship between fungal community and flavor substances. The findings revealed that the NF group and VT group were more conducive to enhancing the accumulation of dominant fungi and characteristic flavor substances in Yunnan-style sausages. Glu, Ala, His, and Lys were identified as key taste substances based on their taste activity values (TAV ≥ 1). A total of 272 volatile compounds(VOCS) were detected in the sausage samples, while 28 key aroma compounds were screened based on the odor activity value (OAV ≥ 1). Multivariate statistical analysis showed that 12 key aroma compounds (VIP > 1) could be considered discriminative compounds, including (E,E)-2,4-nonadienal, nonanal, heptanal, benzaldehyde, Dodecanal, cyclohexanol, and hexyl-Benzene, etc. Furthermore, Wickerhamoomyces and Debaryomyces were positively correlated with most of the key flavor substances and physicochemical indices (|r| > 0.6, P < 0.05), which were potential flavor-contributing fungi in Yunnan-style sausages.

Effects of vibration therapy on muscle soreness and athletic performance in wheelchair basketball players

IntroductionVibration therapy (VT) has been widely used to increase performance and rehabilitate injuries in athletes. Delayed onset muscle soreness (DOMS), caused by excessive overload after training and competitions, leads to loss of performance. ObjectiveThe aim of this study was to investigate the effects of wearable local VT on muscle soreness and athletic performance in wheelchair basketball (WCB) players. MethodA non-randomized crossover design was used in this study in which thirteen elite WCB athletes (31.84 ± 12.59 years) participated. A two-week washout period was applied between the measurements of the control and the vibration groups. Muscle soreness, range of motion (ROM), joint position sense, 20-m sprint speed, and shooting percentage were evaluated for all participants pre-exercise, 30 min and 24 h post-exercise for both arms. After eccentric exercise, immediately local wearable VT was applied to both triceps brachii muscles for 10 min in the vibration group. ResultsCompared to baseline, there was a significant increase in muscle soreness and a significant decrease in joint position sense, ROM, sprint speed and shooting percentage in both groups 24 h post-exercise (p < 0.05). No significant differences were observed between the groups for muscle soreness and 20-m sprint speed (p > 0.05). However, there were significant improvements in elbow ROM, elbow joint position sense, and shooting percentage in the VT group (p < 0.05). ConclusionThe local VT may help improve the elbow ROM, elbow joint position sense, and shooting performance but can't contribute to reducing muscle soreness and sprint performance in recovery from exercise.

Rehabilitation of amblyopia using a digital platform for visual training combined with patching in children: a prospective study

PurposeTo assess the possible benefits of the use of perceptual learning and dichoptic therapy combined with patching in children with amblyopia over the use of only patching.MethodsQuasi-experimental multicentric study including 52 amblyopic children. Patients who improved their visual acuity (VA) by combining spectacles and patching were included in patching group (PG: 20 subjects), whereas those that did not improved with patching performed visual training (perceptual learning + dichoptic therapy) combined with patching, being assigned to the visual treatment group (VT: 32 subjects). Changes in VA, contrast sensitivity (CS), and stereopsis were monitored during a 6-month follow-up in each group.ResultsSignificant improvements in VA were found in both groups at 1 month (p < 0.01). The total improvement of VA was 0.18 ± 0.16 and 0.31 ± 0.35 logMAR in PG and VT groups, respectively (p = 0.317). The Wilcoxon effect size was slightly higher in VT (0.48 vs. 0.54) at 6 months. An enhancement in CS was observed in the amblyopic eye of the VT group for all spatial frequencies at 1 month (p < 0.001). Likewise, the binocular function score also increased significantly in VT group (p = 0.002). A prediction equation of VA improvement at 1 month in VT group was obtained by multiple linear regression analysis (p < 0.001, R2 = 0.747).ConclusionsA combined treatment of visual training and patching is effective for obtaining a predictable improvement of VA, CS, and binocularity in patching-resistant amblyopic children.

Effects of tidal volume on physiology and clinical outcomes in patients with one‑lung ventilation undergoing surgery: A meta‑analysis of randomized controlled trials.

There is no detailed study on how tidal volume (VT) affects patients during one-lung ventilation (OLV). The present study conducted a meta-analysis to assess the effect of VT on physiology and clinical outcomes in OLV patients. Databases until February 2023 were retrieved from PubMed, Cochrane Library and Web of Science. Randomized controlled trials comparing the application of low and high VT ventilation in adults with OLV were performed. Demographic variables, VT, physiology, and clinical outcomes were retrieved. The random-effects model calculated the summary of odds ratios with 95% confidence intervals (CI) and mean difference with standard deviation. A total of 12 studies involving a total of 876 participants met the inclusion criteria. Low VT ventilation was associated with decreased risk of acute lung injury [relative risk 0.50, 95% CI (0.28, 0.88), P=0.02]. Low VT ventilation decreased the driving pressure (ΔP) and peak pressure (Ppeak) and improved arterial oxygen pressure (PaO2)/fraction of inspired oxygen (FiO2). Furthermore, the present study suggested that a significant difference in blood IL-6 was observed between low and high VT ventilation [mean difference, -35.51 pg/ml, 95% CI (-66.47, -4.54 pg/ml), P=0.02]. A decrease in the length of stay at the hospital occurred in the low VT group when set to 4-5 ml/kg. In the OLV patients, low VT ventilation decreased the risk of acute lung injury, blood IL-6, ΔP and Ppeak, and improved PaO2/FiO2. Furthermore, when low VT was set to 4-5 ml/kg, the length of stay at the hospital decreased.

Factors associated with thrombotic disease in dogs with renal proteinuria: A retrospective of 150 cases.

Knowledge of additional risk factors for thrombotic disease (TD) among dogs with renal proteinuria is limited; these might differ for TD affecting the systemic arterial (AT), systemic venous (VT), and pulmonary circulation (PT). To compare signalment and clinicopathological data between dogs with renal proteinuria with or without TD, and between dogs with AT, VT, and PT. One hundred fifty client-owned dogs with renal proteinuria, 50 of which had TD. Retrospective case-controlled study. A database search (2004-2021) identified proteinuric dogs (UPC > 2) with and without TD. Clinicopathological data were obtained from the records. TD and non-TD (NTD) groups were compared by binary logistic regression, and AT, VT, and PT groups by multinomial regression. Normal data presented as mean ± SD, non-normal data presented as median [25th, 75th percentiles]. Cavalier King Charles Spaniels were overrepresented in the TD group (OR = 98.8, 95% CI 2.09-4671, P = .02). Compared to NTD cases, TD cases had higher concentration of neutrophils (11.06 [8.92, 16.58] × 109 /L vs 7.31 [5.63, 11.06] × 109 /L, P = .02), and lower concentration of eosinophils (0 [0, 0.21] × 109 /L vs 0.17 [0.04, 0.41] × 109 /L, P = .002) in blood, and lower serum albumin (2.45 ± 0.73 g/dL vs 2.83 ± 0.73 g/dL, P = .04). AT cases had higher serum albumin concentrations than VT cases (2.73 ± 0.48 g/dL vs 2.17 ± 0.49 g/dL, P = .03) and were older than PT cases (10.6 ± 2.6 years vs 7.0 ± 4.3 years, P = .008). VT cases were older (9.1 ± 4.2 years vs 7.0 ± 4.3 years, P = .008) and had higher serum cholesterol concentration (398 [309-692 mg/dL] vs 255 [155-402 mg/dL], P = .03) than PT cases. Differences between thrombus locations could reflect differences in pathogenesis.

The adverse effects of vitrification on mouse embryo development and metabolic phenotype in offspring.

Embryo vitrification is a standard procedure in assisted reproductive technology. Previous studies have shown that frozen embryo transfer is associated with an elevated risk of adverse maternal and neonatal outcomes. This study aimed to explore the effects of mouse blastocyst vitrification on the phenotype of vitrified-warmed blastocysts, their intrauterine and postnatal development, and the long-term metabolic health of the derived offspring. The vitrified-warmed blastocysts (IVF + VT group) exhibited reduced mitochondrial activity, increased apoptotic levels, and decreased cell numbers when compared to the fresh blastocysts (IVF group). Implantation rates, live pup rates, and crown-rump length at E18.5 were not different between the two groups. However, there was a significant decrease in fetal weight and fetal/placental weight ratio in the IVF + VT group. Furthermore, the offspring of the IVF + VT group at an age of 36 weeks had reduced whole energy consumption, impaired glucose and lipid metabolism when compared with the IVF group. Notably, RNA-seq results unveiled disturbed hepatic gene expression in the offspring from vitrified-warmed blastocysts. This study revealed the short-term negative impacts of vitrification on embryo and fetal development and the long-term influence on glucose and lipid metabolism that persist from the prenatal stage into adulthood in mice.

Impact of tidal volume strategy at birth on initiating lung injury in preterm lambs.

Tidal ventilation is essential in supporting the transition to air-breathing at birth, but excessive tidal volume (VT) is an important factor in preterm lung injury. Few studies have assessed the impact of specific VT levels on injury development. Here we used a lamb model of preterm birth to investigate the role of different levels of VT during positive pressure ventilation (PPV) in promoting aeration and initiating early lung injury pathways. VT was delivered as; (i) 7ml/kg throughout (VTstatic), (ii) begun at 3ml/kg and increased to a final VT of 7ml/kg over 3-minutes (VTinc) or (iii) commenced at 7ml/kg, decreased to 3ml/kg and the returned to 7ml/kg (VTalt). VT, inflating pressure, lung compliance and aeration were similar in all groups from 4 minutes, as was post-mortem histology and lung lavage protein concentration. However, transient decrease in VT in the VTalt group caused increased ventilation heterogeneity. Following TMT-based quantitative mass spectrometry proteomics, 1610 proteins were identified in the lung. 3-fold more proteins were significantly altered with VTalt compared with VTstatic or VTinc strategies. Gene set enrichment analysis identified VTalt specific enrichment of immune and angiogenesis pathways and VTstatic enrichment of metabolic processes. Our finding of comparable lung physiology and volutrauma across VT groups challenges the paradigm that there is a need to rapidly aerate the preterm lung at birth. Increased lung injury and ventilation heterogeneity was identified when initial VT was suddenly decreased during respiratory support at birth, further supporting the benefit of a gentle VT approach.

Comparing intralesional triamcinolone and verapamil-triamcinolone injections in keloids: A single-blinded randomised clinical trial.

In this clinical trial, we investigated the efficacy of two treatment methods for keloids resulting from surgical incisions: intralesional triamcinolone injections alone versus in combination with verapamil. Patients were divided into two groups: one received triamcinolone alone (Group T) and the other received a triamcinolone-verapamil blend (Group VT). Regular treatments were conducted until the keloids were nearly flat or for a maximum of eight sessions. Both groups showed significant improvements, but Group VT saw quicker resolution of skin redness and needed fewer sessions. Though the Vancouver Scar Scale (VSS) scores were generally similar across both groups, Group VT exhibited greater improvements, leading to lower final scores. The VT group also attained normal scar flexibility faster than the T group. These findings suggest that the combination of verapamil and triamcinolone provides a more effective treatment for keloids, thereby highlighting the potential of verapamil in scar reduction.

Clinical outcomes of vanishing twin syndrome and selective fetal reduction after double embryos transferred in IVF pregnancy: A propensity score matching study

ObjectiveThe purpose of this study was to analyze the influence of early vanishing twin syndrome (VTS) and selective fetal reduction (SEFR) on surviving singleton births in in-vitro fertilization (IVF) pregnancy. MethodsWe collected patients who conceived through IVF and delivered singletons over the past six years. The VT group (n = 194) and SEFR group (n = 144) had underwent double embryos transferred (DET) and only one fetus was born, due to the subsequent one birth reduction. The SET group had one embryo transferred (SET) and gave birth to singleton. Using the propensity score matching (PSM) method to reduce confounding, the VT group and SEFR group were matched and compared with 570 and 576 singleton controls, respectively (SET-I/II group). Obstetric complications and neonatal outcomes were compared. In addition, quantity and quality of transferred embryos of VT (n = 194) and singleton groups (born with singleton after DET and matched with VT group by PSM, n = 554) were compared. ResultsCompared with the SET-I group, VT group had increased incidence of severe obstetric complications, including severe preeclampsia (p = 0.031), oligohydramnios (p = 0.038) and polyhydramnios (p = 0.015). VT group was more likely to show more frequent small for gestational age (SGA) (p = 0.046) and very small for gestational age (VSGA) (p = 0.031). Newborns in the SEFR group had a significantly lower birth weight (p = 0.005) and were more likely to manifest as low birthweight (LBW) (p = 0.009) and very low birthweight (VLBW, birth weight < 1500 g) (p = 0.012), and the incidence of very large for gestational age (VLGA) was lower (p = 0.030), compared with the control group. There were more developmental abnormalities in newborns of VTS, for decreased incidence of SGA (OR 0.156, 95% CI 0.036–0.669), VSGA (OR 0.057, 95% CI 0.006–0.553) and VLGA (OR 0.415, 95% CI 0.212–0.815) in SEFR group. The good quality embryo rate was higher in VT group (72.7% vs. 63.3%, p = 0.001) compared with the singleton group. ConclusionsDET with subsequent VTS/SEFR carried a higher rate of adverse clinical outcomes, and the VTS group had worse perinatal outcome compared with SEFR. Therefore, we recommend SET in ART.

Effect of a low versus intermediate tidal volume strategy on pulmonary complications in patients at risk of acute respiratory distress syndrome-a randomized clinical trial.

There is no consensus on whether invasive ventilation should use low tidal volumes (VT) to prevent lung complications in patients at risk of acute respiratory distress syndrome (ARDS). The purpose of this study is to determine if a low VT strategy is more effective than an intermediate VT strategy in preventing pulmonary complications. A randomized clinical trial was conducted in invasively ventilated patients with a lung injury prediction score (LIPS) of >4 performed in the intensive care units of 10 hospitals in Spain and one in the United States of America (USA) from 3 November 2014 to 30 August 2016. Patients were randomized to invasive ventilation using low VT (≤ 6 mL/kg predicted body weight, PBW) (N = 50) or intermediate VT (> 8 mL/kg PBW) (N = 48). The primary endpoint was the development of ARDS during the first 7 days after the initiation of invasive ventilation. Secondary endpoints included the development of pneumonia and severe atelectases; the length of intensive care unit (ICU) and hospital stay; and ICU, hospital, 28- and 90-day mortality. In total, 98 patients [67.3% male], with a median age of 65.5 years [interquartile range 55-73], were enrolled until the study was prematurely stopped because of slow recruitment and loss of equipoise caused by recent study reports. On day 7, five (11.9%) patients in the low VT group and four (9.1%) patients in the intermediate VT group had developed ARDS (risk ratio, 1.16 [95% CI, 0.62-2.17]; p = 0.735). The incidence of pneumonia and severe atelectasis was also not different between the two groups. The use of a low VT strategy did neither affect the length of ICU and hospital stay nor mortality rates. In patients at risk for ARDS, a low VT strategy did not result in a lower incidence of ARDS than an intermediate VT strategy.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02070666.

PO-03-094 IMAGE INTEGRATION IN VENTRICULAR TACHYCARDIA (VT) ABLATION USING SENSE2 PROTOCOL MAPPING

We have previously developed the sense protocol functional substrate mapping technique for VT ablation. This involves targeting areas of decremental signal delay during single extra pacing at short coupling interval. However, functional substrate characterization can involve protracted mapping time. We incorporated the MRI and CT data using ADAS-3D software into the mapping workflow to integrate structural mapping information into the functional mapping substrate characterization to improve procedural efficiency. Cardiac MRI/CTs were performed on 33 patients with ischemia-related VT (group A). These were processed with the ADAS-3D software to characterize the extent of ventricular scars. Focused substrate maps were then performed in patients, guided by the extent of ADAS scar and corridors, looking at the scar substrate in intrinsic rhythm and then functional channels using single extra pacing from the RV apex. Following the delineation of functional channels pace mapping and entrainment mapping were used to confirm targets for ablation. Group A was then compared to a matched cohort who underwent sense protocol mapping without MRI (group B) and an institutional cohort who underwent conventional mapping and ablation using entrainment or pace mapping (group C). 33 patients (mean age 68 years; 31 male subjects, mean EF 32%) underwent ablation. Median procedure time was 175 minutes compared with 305 and 246 minutes in groups B and C(p=<0.001) Mean substrate mapping time was 17 mins vs 80 and 63 mins in groups B and C (p=<0.001). 85% of patients were free from symptomatic VT/ anti-tachycardia pacing or implantable cardioverter defibrillator shocks at a median follow-up of 171 days. The mean VT burden was reduced from 22 events per patient in the six months pre-ablation to 1 event per patient in the median follow-up period of 171 days post-ablation (p=0.02). Sense2 protocol showed a reduced probability of device therapy compared with institutional and sense protocol (Log-rank p=0024 in the figure). The Sense2 protocol integrated structural MRI findings into functional signal ablation of VT. It shortened procedure times by enabling focused substrate maps to be performed without requiring complete geometry. Outcomes compare favourably with our previous data from sense protocol but with significantly shorter procedure times. There were improved outcomes compared to our institutional standard ablation cohort.

Comparing the Effects of Differential and Visuo-Motor Training on Functional Performance, Biomechanical, and Psychological Factors in Athletes after ACL Reconstruction: A Randomized Controlled Trial.

Variation during practice is widely accepted to be advantageous for motor learning and is, therefore, a valuable strategy to effectively reduce high-risk landing mechanics and prevent primary anterior cruciate ligament (ACL) injury. Few attempts have examined the specific effects of variable training in athletes who have undergone ACL reconstruction. Thereby, it is still unclear to what extent the variations in different sensor areas lead to different effects. Accordingly, we compared the effects of versatile movement variations (DL) with variations of movements with emphasis on disrupting visual information (VMT) in athletes who had undergone ACL reconstruction. Forty-five interceptive sports athletes after ACL reconstruction were randomly allocated to a DL group (n = 15), VT group (n = 15), or control group (n = 15). The primary outcome was functional performance (Triple Hop Test). The secondary outcomes included dynamic balance (Star Excursion Balance Test (SEBT)), biomechanics during single-leg drop-landing task hip flexion (HF), knee flexion (KF), ankle dorsiflexion (AD), knee valgus (KV), and vertical ground reaction force (VGRF), and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)) assessed before and after the 8 weeks of interventions. Data were analyzed by means of 3 × 2 repeated measures ANOVA followed by post hoc comparison (Bonferroni) at the significance level of p ≤ 0.05. Significant group × time interaction effects, main effect of time, and main effect of group were found for the triple hop test and all eight directions, SEBT, HF, KF, AD, KV, VGRF, and TSK. There was no significant main effect of group in the HF and triple hop test. Additionally, significant differences in the triple hop test and the seven directions of SEBT, HF, KF, KV, VGRF, and TSK were found between the control group and the DL and VMT groups. Between group differences in AD and the medial direction of SEBT were not significant. Additionally, there were no significant differences between VMT and the control group in the triple hop test and HF variables. Both motor learning (DL and VMT) programs improved outcomes in patients after ACL reconstruction. The findings suggest that DL and VMT training programs lead to comparable improvements in rehabilitation.

PD11-08 THE EFFECT OF VAGINAL TESTOSTERONE ON SEXUAL FUNCTION AND VAGINAL HEALTH: INTERIM ANALYSIS FOR PIVOT (PREVENTION OF RECURRENT URINARY TRACT INFECTION USING VAGINAL TESTOSTERONE)

You have accessJournal of UrologyCME1 Apr 2023PD11-08 THE EFFECT OF VAGINAL TESTOSTERONE ON SEXUAL FUNCTION AND VAGINAL HEALTH: INTERIM ANALYSIS FOR PIVOT (PREVENTION OF RECURRENT URINARY TRACT INFECTION USING VAGINAL TESTOSTERONE) Mariela Martinez, Arshia Sandozi, Jeffrey Lee, Liliya Vafina, Claire Yin, Cassandra Pond, Robert Adelson, Annette Lee, and Allison Polland Mariela MartinezMariela Martinez More articles by this author , Arshia SandoziArshia Sandozi More articles by this author , Jeffrey LeeJeffrey Lee More articles by this author , Liliya VafinaLiliya Vafina More articles by this author , Claire YinClaire Yin More articles by this author , Cassandra PondCassandra Pond More articles by this author , Robert AdelsonRobert Adelson More articles by this author , Annette LeeAnnette Lee More articles by this author , and Allison PollandAllison Polland More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003251.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: During menopause, declining estrogen levels can lead to vaginal atrophy and changes in vaginal flora. Vaginal estrogen treats atrophy thereby restoring flora, which prevents UTIs and improves sexual function in post-menopausal women. While estrogen is effective, some patients have contraindications or are unwilling to use it. Vaginal testosterone cream (VT) has been shown to improve vaginal atrophy, however, its effects on overall vaginal health, urinary tract infections and sexual function have not been fully described. METHODS: This is a randomized, double-blind study that enrolled postmenopausal women with rUTIs. Patients were randomized to VT or placebo. Vaginal health index (VHI), Female Sexual Function Index (FSFI), and vaginal swab to assess flora via DNA sequencing were collected at baseline and at one, four and nine month follow up. RESULTS: A total of 52 women have been enrolled to date (25 placebo arm, 27 VT arm). Average VHI at enrollment was 14.52 +/- 0.67. The baseline VHI for the VT group was 15 +/- 4.39 while the VHI for the placebo arm was 14.03 +/- 4.30. There was no significant difference in mean VHI scores for either group at one month. The VT group experienced a steady increase in VHI starting at the four month time point. By 9 months, women in the VT arm had experienced statistically significant increase in VHI (15.00+/-4.39 to 17.50 +/- 4.43, p = 0.04) (Table 1). Both groups experienced improvement in FSFI scores compared to baseline (Table 2). With respect to microbiome, there were significant differences between groups at baseline; with treatment although statistically significant trends were seen, the clinical significance of these trends remains unknown. Data on urinary tract infections is still being collected in this ongoing study. CONCLUSIONS: Interim analysis showed greater long term improvement in VHI scores with VT as compared to placebo, while FSFI improved in both groups. Longer treatment follow up and increased patient enrollment will be valuable in determining the effects of VT on vaginal microbiome and recurrent UTI. Source of Funding: AUA Urology Care Foundation, Maimonides Research and Development Grant © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e335 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mariela Martinez More articles by this author Arshia Sandozi More articles by this author Jeffrey Lee More articles by this author Liliya Vafina More articles by this author Claire Yin More articles by this author Cassandra Pond More articles by this author Robert Adelson More articles by this author Annette Lee More articles by this author Allison Polland More articles by this author Expand All Advertisement PDF downloadLoading ...

The predictive value of Tp-Te interval, Tp-Te/QT ratio, and QRS-T angle of idiopathic ventricular tachycardia in patients with ventricular premature beats.

Identify idiopathic ventricular tachycardia in patients with ventricular premature beats was required to have effectively treatment. The aim of this study is to investigate the predictive value of Tp-Te interval, Tp-Te/QT ratio, and QRS-T angle of idiopathic ventricular tachycardia in patients with idiopathic ventricular premature beats. One hundred and seventy-eightpatients who had undergone premature ventricular complex/ventricular tachycardia (PVC/VT) ablation between January 1,2020 and August 30, 2022 constituted our study population as ventricular arrhythmia group. Seventy-fivehealthy people were selected as control group. Patients with no episode of VT were classified as PVC group, while with any episode of VT that has the same morphology with PVC were classified as PVC with VT group. Patients in PVC with VT group were divided into two groups: nonsustained VT group (duration of any episode of VT below 30 s) and sustained VT group (duration of any episode of VT over 30 s). Tp-Te interval, Tp-Te/QT ratio and QRS-T angle were compared in groups. Tp-Te interval, Tp-Te/QT ratio and patients with increased QRS-T angle in PVC with VT group were higher or more than those in PVC group (p < .001). The value of combined diagnosis of these indexes was higher. Tp-Te interval was longer in the sustained VT group compared to the nonsustained VT group (p = .009). Tp-Te interval, Tp-Te/QT ratio, and QRS-T angle may have a predictive value of presence of idiopathic VTin patients with premature beats and the combined prediction of these indexes is more valuable. Tp-Te interval maybe helpful for prediction of sustained idiopathic VT.

Programmed ventricular stimulation in structural heart disease: Implications of patterns of ventricular arrhythmias induced to long-term outcomes

IntroductionCurrently available data gives some credence to utility of VT induction studies in patients with stable ischemic cardiomyopathy, there are some unresolved questions as to define sensitive threshold for low-risk and the prognostic relevance of ill sustained or non-specific tachycardia on induction study. We evaluated potential ability of VT inducibility to predict likelihood of SHD (Structural heart disease) patients for subsequent arrhythmic or adverse cardiac events. Material and MethodsAll consecutive patients with syncope/documented arrhythmia who had VT induction done were included and patients with VT storm, ACS,uncontrolled HF were excluded. We studied in 4 groups-monomorphic VT, sustained polymorphicVT, ill sustainedVT/VF and no VT/VF induced. The primary-endpoints were – Sudden death, all-cause mortality and secondary-endpoints were – MACE (AICD shock, death,HF, recurrence of VT). We screened 411 patients and included 169 within inducible (n = 79) and non-inducible group (n = 90). ResultsThere were a higher number of patients with coronary artery disease, LV dysfunction, patients on amiodarone in inducible group and no difference in usage of beta-blockers. Recurrence of VT, composite of MACE was significantly higher in inducible group (p < 0.05). Mortality was not different in 3 groups compared with no VT/VF group. We found that monomorphic VT group had significantly higher MACE as compared to others and also predicted recurrence of VT and AICD shock and showed a trend towards significance for prediction of mortality. Inducible patients on AICD had mortality similar to non-inducible group. ConclusionInduction of monomorphicVT/polymorphicVT with ≤3extrastimuli is associated with a higher number of MACE events on follow up. Induction of monomorphicVT predicts recurrence of VT/ICD shock.

Which Surgery for Stage II-III Empyema Patients? Observational Single-Center Cohort Study of 719 Consecutive Patients.

Recent guidelines support the use of thoracoscopic surgery in stage II-III empyema; however, there is still debate regarding the best surgical approach. The aim of our study is to compare postoperative outcomes of VATS and open surgical approaches for the treatment of post-pneumonic empyema. Observational cohort study on prospectively collected cases of post-pneumonic empyema surgically treated in a single center (2000-2020). Patients were divided into an open group (OT, posterolateral muscle sparing thoracotomy) and VATS group (VT, 2 or 3 port ± utility incision). The primary outcome of the study was empyema resolution, assessed by the recurrence rate. Secondary outcomes were mortality, complications, pain and return to daily life. All patients were followed up at 1, 3 and 6 months after surgery in the outpatient clinic with a chest radiograph/CT scan. In total, 719 consecutive patients were surgically treated for stage II-III empyema, with 644 belonging to the VT group and 75 to the OT group. All patients had a clinical history of pneumonia lasting no more than 6 months before surgery, and 553 (76.9%) had stage II empyema. Operative time was 92.7 ± 6.8 min for the OT group and 112.2 ± 7.4 for the VT group. The conversion rate was 8.4% (46/545) for stage II and 19.2% (19/99) for stage III. Twelve patients (1.86%) in the VT group and four patients (5.3%) in the OT group underwent additional surgery for bleeding. Postoperative mortality was 1.25% (9/719): 5.3% (4/75) in OT and 0.77% (5/644) in VT. Postoperative stay was 10 ± 6.5 days in OT and 8 ± 2.4 in VT. Overall morbidity was 14.7% (106/719): 21.3% (16/75) in OT and 13.9% (90/644) in VT. In VT, six patients (0.93%) showed recurrent empyema: five were treated with chest drainage and one with additional open surgery. Our findings suggest that the VATS approach, showing a 99% success rate, shorter length of stay and lower postoperative morbidity, should be considered the treatment of choice for thoracic empyema.

Intermediate tidal volume is an acceptable option for ventilated patients with acute respiratory distress syndrome

ObjectiveEvidence only proves low surpasses high tidal volume (VT) for acute respiratory distress syndrome (ARDS). Intermediate VT is a common setting for ARDS patients and has been demonstrated as effective as low VT in non-ARDS patients. The effectiveness of intermediate VT in ARDS has not been studied and is the objective of this study. DesignA retrospective cohort study. SettingFive ICUs with their totally 130 beds in Taiwan. Patients or participantsARDS patients under invasive ventilation. InterventionsNo. Main variables of interest28-D mortality. ResultTotally 382 patients, with 6958 ventilator settings eligible for lung protection, were classified into low (mean VT=6.7ml/kg), intermediate (mean VT=8.9ml/kg) and high (mean VT=11.2ml/kg) VT groups. With similar baseline ARDS and ICU severities, intermediate and low VT groups did not differ in 28-D mortality (47% vs. 63%, P=0.06) or other outcomes such as 90-D mortality, ventilator-free days, ventilator-dependence rate. Multivariate analysis revealed high VT was independently associated with 28-D and 90-D mortality, but intermediate VT was not significantly associated with 28-D mortality (HR 1.34, CI 0.92–1.97, P=0.13) or 90-D mortality. When the intermediate and low VT groups were matched in propensity scores (n=66 for each group), their outcomes were also not significantly different. ConclusionIntermediate VT, with its outcomes similar to small VT, is an acceptable option for ventilated ARDS patients. This conclusion needs verification through clinical trials.

This Month in Anesthesiology

This Month in Anesthesiology

Extended aseptic handling and anaesthetic efficacy of propofol preserved under different conditions

Twenty-seven vials of propofol and 20 Albino rats were used in this study to determine the effect of refrigeration and aseptic handling on contamination and anaesthesia of propofol. The vials were assigned to three groups of nine (9) vials per group in 3 replicates. They were opened aseptically and the contents transferred to sterile bottles. VR group were stored in a refrigerator at 40C, VS in an infrared hood chamber, and VT stored on a bench. Propofol was aseptically aspirated from each vial immediately after opening and at 8, 10, 12, 24, 48 and 168 hours for culture on nutrient and McConkey agar. Qualitative and quantitative analysis of the isolates were carried out. Twenty adult Albino Wistar rats were assigned to 4 groups of 5 rats per group. One group (VF) of rats was anaesthetized with fresh propofol, while the remaining 3 groups were anaesthetized with the preserved propofol from each drug group, stored at the longest duration at which contamination was not evident at culture. Durations of anaesthesia, corneal reflex loss, and abdominal twitch and tail sensation loss, were measured. Data was analyzed using ANOVA and Duncan Multiple Range Test using SPSS version 22. Values of p &lt; 0.05 were considered significant. Contamination occurred in the VS, VR and VT groups at 168, 48 and 12 hours respectively. This contravenes the opinion that opened propofol vials become contaminated after 8 hours. Bacillus subtilis, Streptococcus pneumonia, Lactobacillus spp, Klebsiella pneumonia and Staphylococcus epidermidis were isolated from the various groups. The indices of anaesthesia did not differ significantly among the groups. Therefore, following strict adherence to aseptic techniques, propofol may be safely used for up to 24 hours if stored either in a refrigerator or in a sterile environment, without any significant alterations in its anaesthetic characteristics.

Role of Mitophagy-based TLR9 Signal Pathway in Neonatal Ventilator-induced Lung Injury

The study focused on the role of mitophagy in neonatal ventilator-induced lung injury (VILI). Immunoassays were used to study the TLR9 signaling pathway of neonatal VILI, expected to provide a feasible solution for neonatal VILI. The mice were randomly divided into four groups, group A: spontaneous breathing group; group B: normal tidal volume (VT) group (VT=9mL/kg); group C: high VT group (VT=39mL/kg); and group D: ODN2088 (400μg/ Only) intervention + high VT group. The four groups were compared for the expression of inflammatory factors. It was found that as the culture time increased, the expression of TLR9, MyD88, and NF-κBp65 in the lung tissue of the large VT group was significantly higher than those in the spontaneous breathing group and normal VT group, and the differences were statistically significant; and TLR9 inhibitors could activate the TLR9-MyD88 signaling pathway to up-regulate the expression of NF-κB, mediating the release of inflammatory factors to cause VILI.