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https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#1
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28617149/comparison-of-airway-deposition-distributions-of-particles-in-healthy-and-diseased-workers-in-an-egyptian-industrial-site
#2
Péter Füri, Werner Hofmann, Ágnes Jókay, Imre Balásházy, Mona Moustafa, Blanka Czitrovszky, Gábor Kudela, Árpád Farkas
The objective of this study is the prediction and comparison of airway deposition patterns of an industrial aerosol in healthy workers and workers suffering from silicosis. Mass concentrations and related size distributions of particulate matter were measured in the industrial area of Samalut in Minia, Egypt. A novel stochastic lung deposition model, simulating the symptoms of silicosis by chronic bronchial (Br) obstruction and emphysema in the acinar (Ac) region, was applied to compute mass deposition fractions, deposition density, deposition rate and deposition density rate distributions in healthy and diseased workers...
June 15, 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28616613/comparison-of-the-airway-access-skills-of-prehospital-staff-in-moving-and-stationary-ambulance-simulation-a-randomized-crossover-study
#3
Onur Karaca, Basak Bayram, Nese Colak Oray, Asli Acerer, Zeynep Sofuoglu
OBJECTIVES: We aimed to compare the procedural success and intervention durations regarding various airway access skills in moving and stationary ambulance simulations. MATERIAL AND METHODS: An ambulance simulator was used to simulate the moving ambulance environment, and a standard manikin was used for airway simulation. The study included 38 paramedics and paramedic students. In stationary and moving environments, a classical endotracheal intubation with a stylet, an intubation with a gum elastic bougie (GEB), a laryngeal mask airway (LMA), and a laryngeal tube (LT) were applied randomly...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#4
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28609480/an-automated-and-reliable-method-for-breath-detection-during-variable-mask-pressures-in-awake-and-sleeping-humans
#5
Chinh D Nguyen, Jason Amatoury, Jayne C Carberry, Danny J Eckert
Accurate breath detection is crucial in sleep and respiratory physiology research and in several clinical settings. However, this process is technically challenging due to measurement and physiological artifacts and other factors such as variable leaks in the breathing circuit. Recently developed techniques to quantify the multiple causes of obstructive sleep apnea, require intermittent changes in airway pressure applied to a breathing mask. This presents an additional unique challenge for breath detection...
2017: PloS One
https://www.readbyqxmd.com/read/28603907/a-randomised-controlled-trial-evaluating-a-low-cost-3d-printed-bronchoscopy-simulator
#6
T H Pedersen, J Gysin, A Wegmann, M Osswald, S R Ott, L Theiler, R Greif
Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering complex procedural skills. We developed a cost-effective bronchial tree simulator based on a human thorax computed tomography scan using rapid-prototyping (3D-print) technology. This randomised, single-blind study evaluated how realistic our 3D-printed simulator would mimic human anatomy compared with commercially available bronchial tree simulators (Laerdal(®) Airway Management Trainer with Bronchial Tree and AirSim Advance Bronchi, Stavanger, Norway)...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28603412/in-vitro-dose-comparison-of-respimat-%C3%A2-inhaler-with-dry-powder-inhalers-for-copd-maintenance-therapy
#7
Anna-Maria Ciciliani, Peter Langguth, Herbert Wachtel
BACKGROUND: Combining in vitro mouth-throat deposition measurements, cascade impactor data and computational fluid dynamics (CFD) simulations, four different inhalers were compared which are indicated for chronic obstructive pulmonary disease (COPD) treatment. METHODS: The Respimat inhaler, the Breezhaler, the Genuair, and the Ellipta were coupled to the idealized Alberta throat model. The modeled dose to the lung (mDTL) was collected downstream of the Alberta throat model using either a filter or a next generation impactor (NGI)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28594858/factors-associated-with-delayed-defibrillation-in-cardiopulmonary-resuscitation-a-prospective-simulation-study
#8
Christoph Castan, Alexander Münch, Moritz Mahling, Leopold Haffner, Jan Griewatz, Anne Hermann-Werner, Reimer Riessen, Jörg Reutershan, Nora Celebi
INTRODUCTION: Early defibrillation is an important factor of survival in cardiac arrest. However, novice resuscitators often struggle with cardiac arrest patients. We investigated factors leading to delayed defibrillation performed by final-year medical students within a simulated bystander cardiac arrest situation. METHODS: Final-year medical students received a refresher lecture and basic life support training before being confronted with a simulated cardiac arrest situation in a simulation ambulance...
2017: PloS One
https://www.readbyqxmd.com/read/28576759/competitive-dominance-within-biofilm-consortia-regulate-the-relative-distribution-of-pneumococcal-nasopharyngeal-density
#9
Xueqing Wu, Nate T Jacobs, Catherine Bozio, Preston Palm, Santiago M Lattar, Christiane R Hanke, David M Watson, Fuminori Sakai, Bruce R Levin, Keith P Klugman, Jorge E Vidal
Streptococcus pneumoniae is a main cause of child mortality worldwide, but strains also asymptomatically colonize the upper airways of most children forming biofilms. Recent studies have demonstrated that ∼50% of colonized children carry at least two different serotypes (i.e., strains) in the nasopharynx; however, studies of how strains coexist are limited. In this work, we investigated the physiological, genetics, and ecological requirements for the relative distribution of densities, and spatial localization, of pneumococcal strains within biofilm consortia...
June 2, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28566046/are-all-manikins-created-equal-a-pilot-study-of-simulator-upper-airway-anatomic-fidelity
#10
Jennifer A Woo, Sonya Malekzadeh, Kelly M Malloy, Ellen S Deutsch
This study evaluates the anatomic fidelity of several commercially available pediatric and adult manikins, including airway task trainers, which could be used in aerodigestive procedure training. Twenty-three experienced otolaryngologists assessed the aerodigestive anatomy of 5 adult and 5 pediatric manikins in a passive state, using rigid and flexible endoscopy. Anatomic fidelity was rated on a 5-point scale for the following: nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, trachea, esophagus, and neck...
June 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28562401/using-a-standardized-patient-to-improve-collaboration-and-problem-solving-skills-with-cpap-usage-in-the-home
#11
Margaret G Williams, Joan Ruhs
A review of literature revealed a lack of research pertaining to nurses' or student nurses' knowledge of continuous positive airway pressure (CPAP) and the ability to troubleshoot CPAP malfunction. This study sought to answer the following questions: What are associate degree nursing (ADN) students' knowledge, interdisciplinary communication, and problem-solving skills regarding patients' home use of CPAP? Is there a change after participation in a simulation with a patient on CPAP in home setting? Twenty-one ADN students enrolled in small Midwest college participated...
June 2017: Home Healthcare Now
https://www.readbyqxmd.com/read/28559463/development-and-testing-of-a-bubble-bi-level-positive-airway-pressure-system
#12
Stephen C John, Joseph D Barnett, Nickolas D Habben, Hoa T Le, Eric Cheng, Sunil P John, Peter A Gustafson
BACKGROUND: Neonatal respiratory distress results in > 1 million annual deaths worldwide. Bubble CPAP is a simple, effective, and widely used therapy for infants in respiratory distress. In low-resource settings, more advanced respiratory support is limited by cost, technical expertise, and sporadic electricity. We sought to develop a safe, inexpensive, and simple solution to provide further respiratory support for these infants. METHODS: A standard bubble CPAP system was modified to provide 2 levels of positive airway pressure (bi-level positive airway pressure) by attaching a novel device...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28550740/multi-resolution-classification-of-exhaled-aerosol-images-to-detect-obstructive-lung-diseases-in-small-airways
#13
Jinxiang Xi, Weizhong Zhao, Jiayao Eddie Yuan, Biwei Cao, Linlin Zhao
Exhaled aerosol patterns have been used to detect obstructive respiratory diseases in the upper airways. Signals from small airway diseases are weak and may not manifest themselves in the exhaled aerosol patterns. Therefore, it will be more challenging to detect abnormalities in small airways. The objective of this study is to develop a simulation-based classification model that can accurately classify small airway diseases. The model performance was evaluated in five obstructed models that are located in lung bifurcations G7-9...
May 20, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28536796/development-and-evaluation-of-a-family-of-human-face-and-upper-airway-models-for-the-laboratory-testing-of-orally-inhaled-products
#14
Mark W Nagel, Jason A Suggett, Dominic P Coppolo, Jolyon P Mitchell
Many orally inhaled products are supplied with a facemask instead of a mouthpiece, enabling aerosolized medication to be transferred from the inhaler to the lungs when the user lacks the capability to use a mouthpiece. Until recently, laboratory evaluation of an orally inhaled product-facemask was frequently undertaken by removing the facemask, treating the facemask adapter as being equivalent to a mouthpiece. Measurements of delivered drug mass were therefore subject to bias arising from the absence of dead volume, had the facemask been present...
May 23, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28527873/comparison-of-xenon-with-led-illuminant-in-difficult-and-inhalation-injury-airway-scenario-a-randomized-crossover-manikin-study
#15
Andreas Moritz, Johannes Prottengeier, Joachim Schmidt
PURPOSE: The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. METHODS: We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526471/-comparison-of-different-stylets-used-for-intubation-with-the-c-mac-d-blade-%C3%A2-videolaryngoscope-a-randomized-controlled-study
#16
Dilek Ömür, Başak Bayram, Şule Özbilgin, Volkan Hancı, Bahar Kuvaki
OBJECTIVE: The angle of the C-MAC D-Blade(®) videolaryngoscope, which is used for difficult airway interventions, is not compatible with routinely used endotracheal tubes. METHODS: A prospective randomized crossover study was performed comparing five intubation methods for use with standardized airways, including using different stylets or no stylet: Group HS, hockey-stick stylet; Group DS, D-blade type stylet; Group CS, CoPilot(®) videolaryngoscope rigid stylet(®); Group GEB, gum elastic bougie; and Group NS, no stylet...
May 17, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28523829/the-prediction-of-viscous-losses-and-pressure-drop-in-models-of-the-human-airways
#17
A K Wells, I P Jones, S Hamill, R Bordas
This paper examines the viscous flow resistance in branching tubes as applied to simplified models of the lungs, and compares the results of Computational Fluid Dynamics (CFD) simulations for a range of conditions with measurement data. The results are in good agreement with the available measurement data for both inspiration and expiration. A detailed sensitivity analysis of the dissipation and viscous resistance in a branch then examines the ratio of the viscous resistance to that for a fully developed Poiseuille flow, Z...
May 18, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28516728/increased-heterogeneity-of-airway-calibre-in-adult-rats-after-hypoxia-induced-intrauterine-growth-restriction
#18
Kimberley C W Wang, Jude S Morton, Sandra T Davidge, Alexander N Larcombe, Alan L James, Graham M Donovan, Peter B Noble
BACKGROUND AND OBJECTIVE: Intrauterine growth restriction (IUGR) is associated with asthma development. We hypothesized that IUGR disrupts airway development leading to postnatal structural abnormalities of the airway that predispose to disease. This study therefore examined structural changes to the airway and lung in a rat model of maternal hypoxia-induced IUGR. METHODS: Pregnant rats were housed under hypoxic conditions (11.5% O2 ) from gestational days (GDs) 13 to 20 (pseudoglandular-canalicular stages, i...
May 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28498063/preliminary-evaluation-of-a-novel-rigid-bronchoscopy-simulator
#19
Grace E Hsiung, Ben Schwab, Ellen K O'Brien, Colin D Gause, Ferdynand Hebal, Katherine A Barsness, Deborah M Rooney
PURPOSE: Emergent retrieval of airway foreign bodies (AFBs) in children remains a priority skill set for pediatric surgeons. In the setting of low procedural volume, simulation-based education with deliberate practice is essential to ensure trainees reach expected surgical competency. The purposes of this work were to (1) create a realistic rigid bronchoscopy for AFB retrieval simulation model and (2) to evaluate preliminary validity evidence of a novel simulator for the use of training and assessing pediatric surgical trainees' rigid bronchoscopy skills...
May 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28487171/an-in-vitro-study-examining-the-duration-between-deep-inspirations-on-the-rate-of-renarrowing
#20
Samuel Mailhot-Larouche, Katherine Lortie, David Marsolais, Nicolas Flamand, Ynuk Bossé
The factors altering the bronchodilatory response to a deep inspiration (DI) in asthma are important to decipher. In this in vitro study, we investigated the effect of changing the duration between DIs on the rate of force recovery post-DI in guinea pig bronchi. The airway smooth muscle (ASM) within the main bronchi were submitted to length oscillation that simulated tidal breathing in different contractile states during 2, 5, 10 or 30min prior to a larger length excursion that simulated a DI. The contractile states of ASM were determined by adding either methacholine or isoproterenol...
May 6, 2017: Respiratory Physiology & Neurobiology
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