IGO Medical Group

Introduction & Aim: Sudden cardiac arrest remains a leading cause of mortality, with global survival rates remaining low. High-quality CPR characterized by adequate depth and minimal interruptions, is the cornerstone of survival. Manual CPR quality often declines due to rescuer fatigue and challenging environments. Mechanical chest compression devices (MCCDs) offer a potential solution to ensure consistent quality. This study aims to provide an overview of MCCDs available in the Polish Emergency Medical System, highlighting their advantages, limitations and applications, while evaluating their clinical effectiveness compared to manual CPR. Material and methods: The study consisted of a descriptive and comparative literature review, focusing on the technical data and clinical evidence (up to 2025) for the AutoPulse, LUCAS, and Corpuls CPR systems used in Poland. Data analysis included RCTS, cohort studies, systematic reviews, and meta-analyses evaluating MCCDs, utilizing PubMed, Scopus, and Google Scholar. Results: MCCDs ensure high-quality, uninterrupted compressions, particularly in challenging transport or specific scenarios, freeing up personnel for other tasks. Large-scale randomized controlled trials (RCTs) and recent meta-analyses demonstrate that MCCDs provide comparable survival outcomes to high-quality manual CPR, with survival rates ranging from 6.0% to 9.4%. However, MCCDs show a significant advantage in specialized scenarios - prolonged transport, catheterization labs, or as a bridge to advanced therapies like eCPR and extracorporeal life support. Conclusions: MCCDs are reliable alternatives for specific clinical situations. Although they involve higher costs and different injury patterns, the benefits of maintaining consistent CPR quality in conditions where manual compressions fail are measurable. Current guidelines recommend their use as a viable alternative in specific, difficult circumstances, rather than as a routine replacement for manual CPR.

Background. The use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) has been shown to be effective in removing nonviable tissue, reducing bioburden, and promoting granulation tissue formation in acute and chronic infected wounds. Objective. To illustrate the clinical efficacy of the use of pure hypochlorous acid (pHA) antimicrobially preserved wound cleansing solution as the instillation fluid for NPWTi-d (NPWTi-d/pHA) in wound bed preparation in patients with complex wounds. Case Report. The treatment protocol for use of NPWTi-d/pHA in preparing wound beds for final closure is demonstrated in 3 illustrative cases of patients with complex wounds resulting from necrotizing infection and trauma with heavy contamination. All 3 patients developed a healthy-appearing wound bed deemed suitable for primary closure an average of approximately 1 month following initial surgical debridement. Conclusion. The cases presented demonstrate the ability of a pHA antimicrobially preserved wound cleansing solution used as the instillation fluid with NPWTi-d to aid in bacterial reduction, mechanical debridement, and promotion of wound healing. Use of NPWTi-d/pHA in these cases of extensive necrotizing infection and posttraumatic injury with heavy contamination allowed for final closure an average of 1 month after initial surgical debridement.

Abstract Background: Patients who develop severe side-effects when taking high-risk drugs may have a significantly reduced health-related quality of life (QOL); therefore, it is important to identify changes in health-related QOL in these patients. This study aimed to determine health-related QOL in community pharmacy outpatients taking high-risk drugs.Methods: This prospective observational study was conducted at 29 pharmacies in 12 regions and cities in Japan from October to December 2020. Using descriptive questionnaires of EuroQOL-5-dimensions-5-levels (EQ-5D-5L), community pharmacists obtained health-related QOL data from outpatients taking high-risk drugs.Results: In total, 760 outpatients were enrolled. The mean health-related QOL of all outpatients was 0.869. Health-related QOL decreased with increasing age. Outpatient health -related QOL was 0.700, 0.763, 0.785, and 0.817 when taking antiepileptic, antidepressant, digitalis, and antiarrhythmic drugs, respectively, which was lower than the average health-related QOL of all outpatients. Mobility and pain/discomfort accounted for a large proportion of the decline in health-related QOL with increasing age. No difference was found concerning personal care in relation to age; however, the number of outpatients with mobility, normal activity, and pain challenges decreased with age. In contrast, outpatients aged <65 years with anxiety/depression showed lower than overall average health-related QOL.Conclusion: Community pharmacists determined the health-related QOL of outpatients taking high-risk drugs. We clarified the contributions of the 5-dimensions.Trial registration: UMIN-CTR Study Design: trial Number UMIN 000041942. Registered 30 September 2020, https://www.umin.ac.jp

"Objetivo: Valorar la asociación de las mediciones tridimensionales (3D) derivadas de la absorciometría de rayos X de energía dual (DXA) lumbar con las fracturas osteoporóticas en las vértebras dorsales.Material y métodos: Analizamos retrospectivamente 32 mujeres postmenopáusicas: 16 con fracturas incidentes en las vértebras dorsales y 16 controles sin ningún tipo de fractura. Las DXA lumbares se adquirieron en la visita inicial (es decir, antes del evento de fractura) y se midió la densidad mineral ósea de área (DMOa) en las vértebras L1 a L4. Las mediciones 3D derivadas de la DXA se evaluaron utilizando un software de modelado 3D (3DSHAPER). La densidad mineral ósea volumétrica (DMOv) se calculó en el hueso trabecular, cortical e integral. También se midió el grosor cortical y la DMO superficial (DMOs) cortical. Las diferencias en las mediciones derivadas de la DXA entre los grupos de fracturados y controles se evaluaron utilizando una prueba t de Student no pareada. También se calculó la razón de probabilidades (OR) y el área bajo la curva característica operativa del receptor (AUC).Resultados: En el presente estudio casocontrol ajustado por edad no se encontraron diferencias significativas entre los grupos de fracturados y controles en términos de peso (=0,44), altura (=0,25) y DMOa (=0,11). Sin embargo, sí se encontraron diferencias significativas (<0,05) en la DMOv integral y trabecular y en la DMOs cortical. La DMOv trabecular en el cuerpo vertebral fue la medida que mejor discriminó entre ambos grupos, con un AUC de 0,733, respecto a 0,682 para la DMOa.Conclusión: Este estudio muestra la capacidad de los modelos 3D derivados de la DXA lumbar para discriminar entre sujetos con fracturas incidentes en las vértebras dorsales y controles. Es necesario analizar cohortes mayores para determinar si estas mediciones podrían mejorar la predicción del riesgo de fractura en la práctica clínica."

SummaryThe Andromeda Zn-Cu-Au-Ag prospect is a geophysical discovery that represents the first VMS prospect of significance in the Albany-Fraser Orogenic belt, Western Australia. The prospect was first identified following a ground Transient Moving Loop Electromagnetic survey over a structural ellipse that is recognised in aeromagnetic data and has similarities to the Nova “eye”. A conductive plate, 450 m from surface was drilled, but it was the subsequent Down Hole Transient Electromagnetic survey that ultimately led to the intersection of 29.9 m @ 2.5% Zn, 1.4% Cu from 548 m and confirmed the discovery.Andromeda is classified as a strongly deformed Besshistyle, VMS deposit that has been metamorphosed at low granulite grade conditions. Ore lenses reach ~20 m true width and comprise coarse‐grained pyrrhotite, pyrite, sphalerite and chalcopyrite. This paper outlines the geophysical methods used to identify and discover Andromeda and describes our current understanding of the geology, mineralogy and representative geochemistry.

A recent study found that combat amputees had a reduced prevalence of posttraumatic stress disorder (PTSD) compared with nonamputees with serious extremity injuries. We hypothesized that an extended period of impaired consciousness or early treatment with morphine could prevent consolidation of traumatic memory and the development of PTSD. To examine this hypothesis, we retrospectively reviewed 258 combat casualty records from the Iraq or Afghanistan conflicts from 2001-2008 in the Expeditionary Medical Encounter Database, including medications and Glasgow Coma Scale (GCS) scores recorded at in-theater facilities within hours of the index injury. All patients sustained amputations from injuries. Psychological diagnoses were extracted from medical records for 24 months postinjury. None of 20 patients (0%) with GCS scores of 12 or lower had PTSD compared to 20% of patients with GCS scores of 12 or greater who did have PTSD. For patients with traumatic brain injury, those treated with intravenous morphine within hours of injury had a significantly lower prevalence of PTSD (6.3%) and mood disorders (15.6%) compared to patients treated with fentanyl only (prevalence of PTSD = 41.2%, prevalence of mood disorder = 47.1%). GCS scores and morphine and fentanyl treatments were not significantly associated with adjustment, anxiety, or substance abuse disorders.

Abstract The Clean Air Act (CAA) requires that the United States (U.S.) Environmental Protection Agency (EPA) set National Ambient Air Quality Standards (NAAQS) for pollutants considered harmful to human health and the environment. Previous research has shown that high ambient ozone levels are harmful to human health (e.g., Bell ML, Dominici F, Samet JM, Epidemiology, 16(4):436–445, 2005; Ito K, De Leon SF, Lippmann M, Epidemiology, 16(4):446–457, 2005, [4]). While ozone is not directly emitted, the formation of ozone is driven by chemical interactions in the presence of sunlight involving nitrogen oxides (NOx) and volatile organic compounds. Prevailing weather conditions in the Northeastern U.S. transport the relatively long-lived NOx (NO and NO2) and the secondarily-formed ozone downwind, contributing to pollutant levels at locations much farther from the emission source regions. In this study, we investigate associations between polluted air parcels transported from the Ohio River Valley (ORV) in the Midwestern U.S. and respiratory-related hospital admissions in New York State (NYS). We also examine whether better characterization of exposure in an epidemiology model would improve the discernment of this health signal.KeywordsAccountabilityOzoneHealth effectsTransport

Air quality surfaces representing pollutant concentrations across space and time are needed for many applications, including tracking trends and relating air quality to human and ecosystem health. The spatial and temporal characteristics of these surfaces may reveal new information about the associations between emissions, pollution levels, and human exposure and health outcomes that may not have been discernable before. This paper presents four techniques, ranging from simple to complex, to statistically combine observed and modeled daily maximum 8-hr ozone concentrations for a domain covering the greater New York State area for the summer of 2001. Cross-validation results indicate that, for the domain and time period studied, the simpler techniques (additive and multiplicative bias adjustment) perform as well as or better than the more complex techniques. However, the spatial analyses of the resulting ozone concentration surfaces revealed some problems with these simpler techniques in limited areas where the model exhibits difficulty in simulating the complex features such as those observed in the New York City area.