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The particle detector based on a low concentration 4H-SiC epitaxial layer shows promising properties for the detection of various types of ionizing radiation. The wide bandgap energy of the 4H-SiC semiconductor material (3.23 eV at room temperature) allows the detector to operate reliably at room temperature and at elevated temperatures up to several hundred degrees Celsius. The 80 >m thick 4H-SiC epitaxial layer grown on a 350 >m 4H-SiC substrate was used for detector preparation. The active area of the detector was defined by a 3 mm Schottky contact. The current-voltage measurement shows a reverse current of less than 30 pA up to 1000 V. Capacitance-voltage measurements show that the epitaxial layer is completely depleted at bias voltages above 250 V. The detector has been tested with neutrons of energies from 370 keV up to 14.9 MeV. Neutrons were produced by three nuclear reactions p-T, d-D and d-T. The measured spectra clearly identified the elastic and inelastic scattering at silicon and carbon atoms of detector material.

We compare theoretically predicted, by means of ab-initio calculations, dielectric tensor and related experimental values obtained from Mueller-ellipsometry measurements of an insulating monoclinic (optically biaxial) crystal of Cu(H2O)2(en)SO4, en = C2H8N2. We concentrate on the static limit, → 0. [ABSTRACT FROM AUTHOR]

We compare theoretically predicted, by means of ab-initio calculations, dielectric tensor and related experimental values obtained from Mueller-ellipsometry measurements of an insulating monoclinic (optically biaxial) crystal of Cu(H2O)2(en)SO4, en = C2H8N2. We concentrate on the static limit, → 0. [ABSTRACT FROM AUTHOR]

We report a theoretical ab-initio investigation of the exchange interaction between Cu atoms in Cu(H2O)2(en)SO4, en=C2H8N2(ethylenediamine), an insulating magnetic material. Unlike previous experimental studies which describe the system as a quasi-two-dimensional antiferromagnet, our results, based on the mapping of the system onto an effective Heisenberg model, suggest a quasi-one-dimensional character of magnetism, with the exchange coupling between the Cu atoms being propagated along a zigzag line, lying in the crystal's bc plane and connecting the Cu atoms through the N atoms. Furthermore, we report the calculated positions of the H atoms that have not been provided in experimental papers. [ABSTRACT FROM AUTHOR]

We report a theoretical ab-initio investigation of the exchange interaction between Cu atoms in Cu(H2O)2(en)SO4, en=C2H8N2(ethylenediamine), an insulating magnetic material. Unlike previous experimental studies which describe the system as a quasi-two-dimensional antiferromagnet, our results, based on the mapping of the system onto an effective Heisenberg model, suggest a quasi-one-dimensional character of magnetism, with the exchange coupling between the Cu atoms being propagated along a zigzag line, lying in the crystal's bc plane and connecting the Cu atoms through the N atoms. Furthermore, we report the calculated positions of the H atoms that have not been provided in experimental papers. [ABSTRACT FROM AUTHOR]

We report a theoretical ab-initio investigation of the exchange interaction between Cu atoms in Cu(H2O)2(en)SO4, en=C2H8N2(ethylenediamine), an insulating magnetic material. Unlike previous experimental studies which describe the system as a quasi-two-dimensional antiferromagnet, our results, based on the mapping of the system onto an effective Heisenberg model, suggest a quasi-one-dimensional character of magnetism, with the exchange coupling between the Cu atoms being propagated along a zigzag line, lying in the crystal's be plane and connecting the Cu atoms through the N atoms. Furthermore, we report the calculated positions of the H atoms that have not been provided in experimental papers. [ABSTRACT FROM AUTHOR]

We report a theoretical ab-initio investigation of the exchange interaction between Cu atoms in Cu(H2O)2(en)SO4, en=C2H8N2(ethylenediamine), an insulating magnetic material. Unlike previous experimental studies which describe the system as a quasi-two-dimensional antiferromagnet, our results, based on the mapping of the system onto an effective Heisenberg model, suggest a quasi-one-dimensional character of magnetism, with the exchange coupling between the Cu atoms being propagated along a zigzag line, lying in the crystal's be plane and connecting the Cu atoms through the N atoms. Furthermore, we report the calculated positions of the H atoms that have not been provided in experimental papers. [ABSTRACT FROM AUTHOR]

Theoretical and experimental studies of a quasi-two-dimensional quantum antiferromagnet Cu(en)(H2O)2SO4 (en = C2H8N2) were performed. ab initio calculations of exchange interactions confirmed that the system represents a realization of a spatially anisotropic zigzag square lattice. Corresponding quantum Monte Carlo calculations of thermodynamic quantities were realized and the results were applied in the analysis of experimental susceptibility, magnetization, and specific heat studied at temperatures ranging from nominally 300 mK up to 8 K and magnetic fields up to 14 T. The analysis of experimental results provided the estimates of intralayer exchange couplings, J/kB=3.5±0.2 K and J′=0.35J. Theoretical analysis of spin symmetries in Cu(en)(H2O)2SO4 structure predicted the presence of symmetric exchange anisotropies (out-of plane and in-plane spin anisotropy) and a spin-flop transition within the easy plane induced by the magnetic field applied along the easy axis. Isothermal magnetization measurements indicated the expected transition in the field 200 mT applied along the b axis which was finally identified as the easy axis lying within the easy plane bc. Magnetic phase diagrams with saturation fields about 6.5 T show nearly identical behavior in all studied directions. Differences appear only in weak magnetic fields as a result of the presence of weak exchange anisotropies ≈10-3J. The present analysis suggests that Cu(en)(H2O)2SO4 can be a model system for exploring the interplay of quantum fluctuations, exchange anisotropies, and magnetic field in the two-dimensional lattice space. [ABSTRACT FROM AUTHOR]

Background: Advanced Life Support (ALS) during cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) is frequently administered by two-member crews. However, ALS CPR is mostly designed for larger crews, and the feasibility and efficacy of implementing ALS guidelines for only two rescuers remain unclear., Objective: This scoping review aims to examine the existing evidence and identify knowledge gaps in the efficiency of pre-hospital ALS CPR performed by two-member teams., Design: A comprehensive search was undertaken across the following databases: PubMed, Web of Science, SCOPUS, Cochrane Library Trials, and ClinicalTrials.gov. The search covered publications in English or German from January 1, 2005, to November 30, 2023. The review included studies that focused on ALS CPR procedures carried out by two-member teams in adult patients in either simulated or clinical settings., Results: A total of 22 articles were included in the qualitative synthesis. Seven topics in two-person prehospital ALS/CPR delivery were identified: 1) effect of team configuration on clinical outcome and CPR quality, 2) early airway management and ventilation techniques, 3) mechanical chest compressions, 4) prefilled syringes, 5) additional equipment, 6) adaptation of recommended ALS/CPR protocols, and 7) human factors., Conclusion: There is a lack of comprehensive data regarding the adaptation of the recommended ALS algorithm in CPR for two-member crews. Although simulation studies indicate potential benefits arising from the employment of mechanical chest compression devices, prefilled syringes, and automation-assisted protocols, the current evidence is too limited to support specific modifications to existing guidelines., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The authors declare that they have no known financial or personal competing interests that could have influenced this work. The research was carried out at the Third Faculty of Medicine of Charles University in Prague and Emergency Medical Services of the Karlovy Vary region. The work has been supported by the institutional support of Charles University, Prague, Czech Republic (Cooperatio – Intensive Care Medicine)., (© 2024 The Author(s).)

Introduction: Our objective was to conduct an individual patient data meta-analysis (IPDMA) of the two published randomized placebo-controlled trials of mirabegron in people with neurogenic lower urinary tract dysfunction (NLUTD) due to spinal cord injury (SCI) or multiple sclerosis (MS)., Methods: We identified two randomized, placebo-controlled trials. We extracted individual patient data from the trials and evaluated two primary outcomes: change in maximum cystometric capacity and change in the patient perception of bladder condition (PPBC). We also evaluated several secondary outcomes related to urodynamic function and quality of life. We conducted three exploratory analyses to test hypotheses based on our clinical experiences with mirabegron in NLUTD. Analysis of covariance with adjustment for baseline values was used for the statistical analysis., Results: Our IPDMA included 98 patients from the two trials. The results showed that mirabegron was associated with a significant improvement in maximum cystometric capacity (+41 mL, p = 0.04) and in the PPBC (-0.8, p < 0.01) compared to placebo. Secondary outcomes including peak neurogenic detrusor overactivity pressure (-20 cm H 2 O, p < 0.01), incontinence-QOL score (+12, p < 0.01), and 24 h pad weights (-79 g, p = 0.04) also improved significantly compared to placebo. Exploratory analyses found similar improvements in people with MS and SCI; some outcomes improved to a greater degree among people with incomplete SCI, or SCIs that were below T7., Conclusions: Our IPDMA provides evidence supporting the use of mirabegron in patients with NLUTD due to SCI or MS. Further work evaluating differential responses in people with different SCI lesion characteristics may be warranted., (© 2024 The Authors. Neurourology and Urodynamics published by Wiley Periodicals LLC.)

Purpose: To evaluate changes in corneal refractive parameters after implantation of a stromal lenticule of different thickness. We assume that the refractive outcome depends on the optical power of the used lenticule., Methods: We conducted an ex-vivo non-human study on 33 normotonic porcine eyeballs divided into two groups, for 4D and 8D human lenticule implantation. Corneal stromal lenticules were obtained as a by-product from a laser procedure ReLEx SMILE. We evaluated corneal refractive parameters measured on Oculus Pentacam© device before and immediately after the intrastromal lenticule implantation., Results: There was no statistically significant difference in corneal refractive parameters between the eyeball groups before lenticule implantation. In both groups, the intrastromal implantation in the depth of 300um led to a significant increase of central corneal pachymetry and corneal anterior steepening. In the 4D group the average central corneal pachymetry increased from 903 ± 124.59 to 1230 ± 148.99 ( p  = 0.0022) and in 8D group from 733.35 ± 69.60 to 1109 ± 161.64 ( p  = 0.0008). Induced changes in other studied parameters were not statistically significant, Kmax changed from 45.57 ± 2.78 to 72.07 ± 16.83 ( p  = 0.0094) and Km front from 40.72 ± 1.60 to 48.87 ± 5.83 ( p  = 0.0037) in 4D group and in the 8D group average Kmax increased from 42.22 ± 1.54 to 62.95 ± 12.67 ( p  = 0.0001) and K2 front 40.46 ± 1.64 to 51.51 ± 9.63 ( p  = 0.0037). There were no significant differences in refractive changes between the 4D and 8D groups after lenticule implantation., Conclusion: Intrastromal corneal lenticule implantation induces changes in corneal refractive parameters. In both groups, the implantation induced a significant increase of an anterior corneal steepening without any significant influence on posterior corneal flattening. Corneal lenticule implantation did not lead to any significant change of corneal astigmatism. However, in order to have more precise data for future clinical applications we need to continue with the experiments and verify the results on human corneas.

Background: Video emergency calls (VCs) represent a feasible future trend in medical dispatching. Acceptance among callers and dispatchers seems to be good. Indications, potential problems, limitations, and directions of research of adding a live video from smartphones to an emergency call have not been reviewed outside the context of out-of-hospital cardiac arrest (OHCA)., Objective: The main objective of this study is to examine the scope and nature of research publications on the topic of VC. The secondary goal is to identify research gaps and discuss the potential directions of research efforts of VC., Design: Following PRISMA-ScR guidelines, online bibliographic databases PubMed, Web of Science, SCOPUS, Google Scholar, ClinicalTrials.gov, and gray literature were searched from the period of January 1, 2012 through March 1, 2022 in English. Only studies focusing on video transfer via mobile phone to emergency medical dispatch centers (EMDCs) were included., Results: Twelve articles were included in the qualitative synthesis and six main themes were identified: (1) cardiopulmonary resuscitation (CPR) guided by VC; (2) indications of VCs; (3) dispatchers' feedback and perception; (4) technical aspects of VCs; (5) callers' acceptance; and (6) confidentiality and legal issues., Conclusion: Video emergency calls are feasible and seem to be a well-accepted auxiliary method among dispatchers and callers. Some promising clinical results exist, especially for video-assisted CPR. On the other hand, there are still enormous knowledge gaps in the vast majority of implementation aspects of VC into practice.

Purpose: To analyze cardiovascular safety of mirabegron in patients with spinal cord injury (SCI)- and multiple sclerosis (MS)-induced neurogenic detrusor overactivity (NDO) in a prospective, randomized, double-blind, placebo-controlled study., Methods: Seventy-eight patients were enrolled into the study, and 66 of them were included into the final analysis. In 49 (74.2%), NDO developed due to suprasacral SCI, 17 (25.8%) suffered from NDO due to MS. Eleven patients were previously treated for hypertension and one for arrhythmia. All study participants received placebo for 2 weeks run-in period. Subsequently, eligible subjects were randomized for 4 weeks of active treatment with mirabegron 50 mg once daily (Group A; n = 32) or placebo (Group B; n = 34). Data from resting electrocardiography (ECG), 24-h ECG and blood pressure monitoring, and echocardiographic examination, were used for cardiovascular safety assessment. All reported variables were evaluated at time of randomization and at the end of the study. Longitudinal changes of variables within the groups and differences between the groups were assessed using nonparametric Kruskal-Wallis test, and p ≤ 0.05 was considered statistically significant., Results: No statistically significant longitudinal changes were found in safety variables, except for prolongation of QT interval in placebo group (p = 0.0328) recorded by resting ECG. No significant difference between the Groups A and B, in any of the variables, was observed. A single cardiovascular study drug-related adverse event was recorded in a patient with cervical SCI (3.13%)., Conclusions: Our results suggest that mirabegron can be safely used in the treatment of patients with SCI- and MS-induced NDO.

Background: Urethral stricture disease (USD) represents a complex urological problem. Urethroplasty is considered the gold standard for the treatment of USD. Most available studies report outcome data obtained from retrograde urethrography and uroflowmetry. Only a limited number of papers describe the effect of urethroplasty on erectile function and their results are inconsistent. The goal of this prospective study was to evaluate the effect of urethroplasty on both lower urinary tract and erectile function using objective parameters and standardized patient-reported outcome measurement tools. Materials and Methods: A total of 55 consecutive patients with USD were enrolled into the study. Patients underwent ventral onlay urethroplasty, urethroplasty according to the Asopa technique, dorsal onlay urethroplasty, cutaneous flap urethroplasty using the Orandi technique or anastomotic repair. All patients were evaluated using uroflowmetry, urethrography, the PROM-USS questionnaire and the International Index of Erectile Function-5 questionnaire (IIEF-5) pre-operatively and consequently post-op, in 3-month intervals. This study presents the comparison of baseline pre-op parameters and parameters 12 months after the surgery using the Wilcoxon signed rank test, Wilcoxon rank sum test and the Kruskal-Wallis one-way analysis of variance. Results: A significant improvement in uroflowmetry parameters, all domains of the PROM-USS questionnaire, as well as the overall score of the IIEF-5 was observed. No statistically significant differences between sub-groups were found when comparing treatment results in patients with short versus long strictures and patients with penile urethra stricture versus bulbar or membranous urethra stricture. Conclusions: Urethroplasty yielded very good functional results with respect to both lower urinary tract and erectile functions.

Aim: We aimed to systematically assess the evidence on the efficacy and safety of alpha-blockers in patients with multiple sclerosis (MS) suffering from neurogenic lower urinary tract dysfunction (NLUTD)., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to perform this systematic review. An electronic search of Cochrane register, Embase, Medline, Scopus (last search 3 March 2018) and screening of reference lists as well as reviews were used to identify the studies. Articles were included if they reported on efficacy/safety of alpha-blockers for the treatment of NLUTD in patients with MS., Results: After screening of 7'015 abstracts, three studies enrolling a total of 50 patients were included: one randomized, placebo-controlled, single-blind trial and two prospective cohort studies. Alpha-blocker treatment was successful in 50% to 96% of the patients. Pooling data from the three included studies, the relative risk for successful alpha-blocker treatment was 3.89 (95% confidence interval 2.7-7.0). The general safety profile of alpha-blockers was favorable with 8% of the patients reporting adverse events., Conclusions: Alpha-blockers may be effective and safe for treating NLUTD in female and male patients with MS but the studies were small and the overall quality of evidence was low. To make definitive conclusions, well designed randomized controlled trials are highly warranted., (© 2019 Wiley Periodicals, Inc.)

The density functional theory was used to calculate elastic tensor for the quasi-one-dimensional antiferromagnetic compound Cu(en)(H₂O)₂SO₄, with en = C₂H 8 N₂. The bulk, shear, Young moduli, Poisson ratio, and elastic anisotropy were determined for the polycrystalline Cu(en)(H₂O)₂SO₄ by employing the Hill averaging of the single crystal elastic constants. They were compared to the respective quantities for other low-dimensional magnetic systems. The Cu(en)(H₂O)₂SO₄ compound is predicted to be soft and ductile. We have also estimated the Debye temperature for the Cu(en)(H₂O)₂SO₄ single crystal by using the sound velocities obtained from the calculated elastic constants.

Aims: To assess the efficacy and safety of mirabegron in the treatment of neurogenic detrusor overactivity., Methods: This prospective, multicenter, randomized, double-blind, placebo-controlled study was conducted in three tertiary centers, and included 78 patients suffering from spinal cord injury or multiple sclerosis. Patients were randomized for Mirabegron 50 mg (Group A) or placebo (Group B). Urodynamic parameters, the 24 h pad-weight test, and patient-reported outcomes were assessed. Safety assessments included monitoring the incidence and severity of adverse events. Changes in time and differences between groups were assessed with nonparametric Kruskal-Wallis one-way analysis of variance; P ≤ 0.05 was considered statistically significant., Results: In total, 66 patients were eligible for inclusion in the final analysis. There was a significant increase of volume at the first detrusor contraction (P = 0.00047) and an improvement in bladder compliance (P = 0.0041) in the mirabegron group compared with the placebo-treated group, whereas the increase in cystometric capacity did not reach statistical significance (P = 0.061). There was a clear tendency to reduced urine leakage (P = 0.056) in Group A. There were significant changes in all the patient-reported outcomes, favoring the mirabegron group. The incidence of drug-related adverse events was 3.13%., Conclusions: Mirabegron (50 mg) improved both urodynamic variables and patient-reported outcomes in patients with NDO. The treatment was tolerated well., (© 2018 Wiley Periodicals, Inc.)

Elastic moduli, hardness (both at room temperature) and thermal expansion (4.2-670 K) have been experimentally determined for polycrystalline CePt 3 Si and its prototype compound CePt 3 B as well as for single-crystalline CePt 3 Si. Resonant ultrasound spectroscopy was used to determine elastic properties (Young's modulus E and Poisson's ratio ν) via the eigenfrequencies of the sample and the knowledge of sample mass and dimensions. Bulk and shear moduli were calculated from E and ν, and the respective Debye temperatures were derived. In addition, ab initio DFT calculations were carried out for both compounds. A comparison of parameters evaluated from DFT with those of experiments revealed, in general, satisfactory agreement. Positive and negative thermal expansion values obtained from CePt 3 Si single crystal data are fairly well explained in terms of the crystalline electric field model, using CEF parameters derived recently from inelastic neutron scattering. DFT calculations, in addition, demonstrate that the atomic vibrations keep almost unaffected by the antisymmetric spin-orbit coupling present in systems with crystal structures having no inversion symmetry. This is opposite to electronic properties, where the antisymmetric spin-orbit interaction has shown to distinctly influence features like the superconducting condensate of CePt 3 Si.

We present a method based on graph theory for the evaluation of the inelastic propensity rules for molecules exhibiting complete destructive quantum interference in their elastic transmission. The method uses an extended adjacency matrix corresponding to the structural graph of the molecule for calculating Green's function between the sites with attached electrodes and consequently states the corresponding conditions the electron-vibration coupling matrix must meet for the observation of an inelastic signal between the terminals. The method can be fully automated and we provide a functional website running a code using Wolfram Mathematica, which returns a graphical depiction of destructive quantum interference configurations together with the associated inelastic propensity rules for a wide class of molecules.

Objectives: To evaluate the accuracy of sonouroflowmetry in recording urinary flow parameters and voided volume., Methods: A total of 25 healthy male volunteers (age 18-63 years) were included in the study. All participants were asked to carry out uroflowmetry synchronous with recording of the sound generated by the urine stream hitting the water level in the urine collection receptacle, using a dedicated cell phone. From 188 recordings, 34 were excluded, because of voided volume <150 mL or technical problems during recording. Sonouroflowmetry recording was visualized in a form of a trace, representing sound intensity over time. Subsequently, the matching datasets of uroflowmetry and sonouroflowmetry were compared with respect to flow time, voided volume, maximum flow rate and average flow rate. Pearson's correlation coefficient was used to compare parameters recorded by uroflowmetry with those calculated based on sonouroflowmetry recordings., Results: The flow pattern recorded by sonouroflowmetry showed a good correlation with the uroflowmetry trace. A strong correlation (Pearson's correlation coefficient 0.87) was documented between uroflowmetry-recorded flow time and duration of the sound signal recorded with sonouroflowmetry. A moderate correlation was observed in voided volume (Pearson's correlation coefficient 0.68) and average flow rate (Pearson's correlation coefficient 0.57). A weak correlation (Pearson's correlation coefficient 0.38) between maximum flow rate recorded using uroflowmetry and sonouroflowmetry-recorded peak sound intensity was documented., Conclusions: The present study shows that the basic concept utilizing sound analysis for estimation of urinary flow parameters and voided volume is valid. However, further development of this technology and standardization of recording algorithm are required., (© 2015 The Japanese Urological Association.)

We present results of ab initio transport calculations for epitaxial magnetic tunnel junctions Fe/GaAs/Ag(001). The electronic structure is calculated by means of the tight-binding linear muffin-tin orbital method and the ballistic conductances are evaluated within the Kubo-Landauer formalism which includes the effect of the spin-orbit interaction. Particular attention is paid to the dependence of the conductances on the orientation of magnetization direction of the Fe electrode with respect to the crystal lattice and on the thickness of the tunneling barrier. We have found that the in-plane tunneling anisotropic magnetoresistance (TAMR) exhibits a non-monotonic thickness dependence with a maximum around 7.5 nm of GaAs. This behavior is ascribed to a hybridization of interface resonances formed on both sides of the junction and manifested as hot spots in k[]-resolved conductances. For thicker GaAs barriers, the relative intensity of the hot spots is reduced on account of the contribution from a narrow central region of the two-dimensional Brillouin zone which leads to the final decrease of the TAMR effect.

Neuropeptide Y (NPY), a potent vasoconstrictor released from the sympathetic nerves, has been suggested to counterbalance sepsis-induced vasodilation. Thus, the changes in plasma and tissue NPY concentrations in relation to hemodynamic variables and inflammatory markers in a porcine model of moderate septic shock were investigated. Susceptibility of NPY to be removed by continuous hemofiltration in two settings has been also studied. Thirty-four domestic pigs were divided into five groups: (i) control group; (ii) control group with conventional hemofiltration; (iii) septic group; (iv) septic group with conventional hemofiltration; and (v) septic group with high-volume hemofiltration. Sepsis induced by fecal peritonitis continued for 22 h. Hemofiltration was applied for the last 10 h. Hemodynamic and inflammatory parameters (heart rate, mean arterial pressure, cardiac output, systemic vascular resistance, plasma concentrations of tumor necrosis factor-α, interleukin-6, and NPY) were measured before and at 12 and 22 h of peritonitis. NPY tissue levels were determined in the left ventricle and mesenteric and coronary arteries. Sepsis induced long-lasting increases in the systemic NPY levels without affecting its tissue concentrations. Continuous hemofiltration at any dose did not reduce sepsis-induced elevations in NPY plasma concentrations, nor did it affect the peptide tissue levels. The increases in NPY systemic levels were significantly correlated with changes in the systemic vascular resistance. The results support the hypothesis of NPY implication in the regulation of the vascular resistance under septic conditions and indicate that NPY clearance rate during hemofiltration does not exceed the capacity of perivascular nerves to release it., (© 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Therapeutic hypothermia is currently recommended neuroprotective therapeutic measure for comatose patients after cardiac arrest. Hypothermia has been proven not only to affect the neurological outcomes but also the survival of patients after cardiac arrest. This communication summarizes the issue of early infectious complications in patients after cardiac arrest undergoing therapeutic hypothermia. Diagnosis of infectious events is complicated in patients after cardiac arrest not only by the physiological effects of therapeutic hypothermia but also by the consequences of reperfusion injury and development of postresuscitation disease associated with systemic inflammatory response syndrome. Furthermore, there are discussed limited diagnostic options of infectious complications. The significance of the usual symptoms of infections is reduced, as well as the value of laboratory markers such as procalcitonin and C-reactive protein. Finally, the possibility of antibiotic treatment and eventual antibiotic prophylaxis during therapeutic hypothermia in patients after cardiac arrest outside hospitals is mentioned.

Introduction and Aims: Therapeutic hypothermia is a standard part of post-resuscitation care. Here we present cohort patients after non-traumatic cardiac arrest and their neurological outcomes who underwent 12 hours of therapeutic hypothermia. Moreover, we focused on examining the results of particular subgroup of patients with initial ventricular fibrillation (VF) with acute myocardial infarction with ST-elevation (STEMI) who underwent coronary intervention (PCI)., Methods: We evaluated retrospectively the patients with non-traumatic out-of- and in-hospital cardiac arrest (IHCA, OHCA), admitted to our intensive care unit (ICU) in 2006-2009. Therapeutic hypothermia was induced in all patients with persistent coma after restoration of spontaneous circulation (ROSC). We maintained the target temperature (32-34 degrees C) for 12 hours. Then, passive rewarming followed. Intravascular cooling device was not used. A good neurological outcome was considered to be cerebral performance category (CPC) 1 or 2 at hospital discharge., Results: Total number of patients was 88 (OHCA n = 63; IHCA n = 25), average age 58 (+/- 16) years, average APACHE II was 29 (+/- 6). Men were in 65%. Target temperature was achieved and maintained in 76% of patients. ICU mortality was 32%, hospital mortality 53%. Initial ECG rhythm was VF in 59%, asystoly in 32% and pulsless electrical activity in 9%. Coronary angiography was performed in 57% and PCI in 42% patients. We did not observe severe arrhythmias, minor gastrointestinal bleeding occurred in 2%. The infectious complications were recorded: early pneumonia in 7%, tracheobronchitis in 10% and bacteraemia in 1% patients. In the group of 23 patients with VF/STEMI/PCI target temperature was achieved and maintained in 91%, ICU and hospital survival rates were 87% and 78%. CPC 1 and 2 was observed in 83% among survivors (n = 15)., Conclusions: We achieved similar results in patients after non-traumatic cardiac arrest who underwent a protocol with 12 hours of therapeutic hypothermia as in studies reporting 24 hours of hypothermia, particularly in patients with VF/STEMI/PCI. Twelve hours of therapeutic hypothermia was associated with a low incidence of infectious complications.