Comparison of two infant cardiopulmonary resuscitation techniques explained by phone in a non-health professionals' population: Two-thumbs encircling hand technique vs. two-fingers technique, a randomised crossover study in a simulation environment.

BACKGROUND: Paediatric out-of-hospital cardiac arrest (OHCA) is the reason for an emergency call in approximately 8/100,000 person-years. Improvement of OHCA resuscitation needs a quality chain of survival and a rapid start of resuscitation. The aim of this study was to compare the efficacy of two resuscitation techniques provided on a mannequin, the two-fingers technique (TFT) and the two-thumbs encircling hand technique (TTHT), explained by a trained emergency call responder on the phone in a population of non-health professionals. METHODS: We conducted a randomised crossover study in the simulation lab of a University Hospital. The participants included in the study were non-health professional volunteers of legal age. The participants were assigned (1:1 ratio) to two groups: group A: TFT then TTHT, group B: TTHT then TFT. Scenario and techniques were discovered during the evaluation. RESULTS: Thirty-five volunteers were randomised before the sessions and 33 ultimately came to the simulation lab. We found a better median QCPR global score during TTHT sessions than during TFT sessions (74 vs. 59, P = 0.046). Linear mixed models showed that the TTHT method was the only variable associated with a better QCPR global score [model 1: ß = 14.3; 95% confidence interval (CI), 2.4-26.2; model 2: ß = 14.5; 95% CI, 2.5-26.6]. CONCLUSION: Our study showed the superiority of TTHT for infant CPR performed by non-health professionals when an emergency call responder advised them over the phone. It seemed to be the best technique for a solo rescuer regardless of previous training.

Benzodiazepines and frail elderly people: how prescribing can be optimized?

In France, benzodiazepine (BZD) is frequently prescribed in elderly people (EP). Long-term efficacy is often questioned, and treatment has to be regularly re-examined, especially in EP. In our Geriatric day-hospital for assessment of frailty, a multidisciplinary team evaluates the patients and gives them preventative measures against the loss of autonomy. Medication evaluation is part of these measures. The aim of our study was to evaluate the impact of a standardized intervention on the optimization of BZD treatment. Setting and method: After a short interview and the delivery of an information booklet about BZD, patients were proposed an optimization of their BZD treatment (dosage reduction, occasional medication, switch to a short half-life BZD, or total discontinuation). Patients were followed up monthly by a phone-interview over a 6-months period. The main outcome measure was the prevalence of BZD optimized treatments after a 6 months follow-up. Results: 18 patients were included. Among them, 50% have been taking a BZD for more than 10 years, and 39% were prescribed a long half-life BZD, which can be qualified as inappropriate in EP. 50% of the subjects were frail and 44% pre-frail, according to the Fried criteria. At the end of the study, 33% of the patients had their BZD treatments optimized, including 17% of total discontinuation. Conclusion: In the frail elderly population, a standardized intervention can be useful to improve BZD treatment. An extension to this intervention would be the creation of an organization tasked with routinely monitoring the patients' withdrawal over a six month period.

DNA nucleic acid sequence-based amplification-based genotyping for polymorphism analysis.

Nucleic acid sequence-based amplification (NASBA) is a sensitive isothermal transcription-based amplification method known to be a suitable tool for RNA research. We demonstrate that NASBA technology can be applied to single nucleotide polymorphism (SNP) analysis using human genomic DNA as a template. Combination of DNA NASBA with multiplex hybridization of specific molecular beacons makes it possible to unambiguously discriminate the presence of the SNP of interest. This protocol is easy-to-use, robust, and makes it possible to rapidly detect single nucleotide substitutions in clinical or cell line DNA sequences using a large range of DNA input. Such a real-time genotyping DNA NASBA assay can find broad application in clinical diagnostics.