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https://www.readbyqxmd.com/read/28325539/n2-gas-egress-from-patients-airways-during-ln2-spray-cryotherapy
#1
John P O'Connor, Brian M Hanley, Thomas I Mulcahey, Ellen E Sheets, Kacey W Shuey
Spray cryotherapy using liquid nitrogen (LN2) is a general surgical tool used to ablate benign or malignant lesions. Adequate egress of the gaseous nitrogen (N2) generated during this process must be provided for safe use when LN2 is used within the body rather than topically. When delivered to either the gastrointestinal tract (requiring active venting via a suction tube) or body cavities open to room barometric pressure (such as lung airways) allowing for passive venting, the N2 gas generated from the boiling process must be evacuated...
March 18, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28323084/integration-of-in-hospital-cardiac-arrest-contextual-curriculum-into-a-basic-life-support-course-a-randomized-controlled-simulation-study
#2
Elizabeth A Hunt, Jordan M Duval-Arnould, Nnenna O Chime, Kareen Jones, Michael Rosen, Merona Hollingsworth, Deborah Aksamit, Marida Twilley, Cheryl Camacho, Daniel P Nogee, Julianna Jung, Kristen Nelson-McMillan, Nicole Shilkofski, Julianne S Perretta
OBJECTIVE: To compare resuscitation performance on simulated in-hospital cardiac arrests after traditional American Heart Association (AHA) Healthcare Provider Basic Life Support course (TradBLS) versus revised course including in-hospital skills (HospBLS). DESIGN: Prospective, randomized, controlled curriculum evaluation. SETTING: Johns Hopkins Medicine Simulation Center. SUBJECTS: One hundred twenty-two first year medical students divided into fifty-nine teams...
March 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28322599/dissolvit-an-in-vitro-method-for-simulating-the-dissolution-and-absorption-of-inhaled-dry-powder-drugs-in-the-lungs
#3
Per Gerde, Maria Malmlöf, Lina Havsborn, Carl-Olof Sjöberg, Pär Ewing, Stefan Eirefelt, Katarina Ekelund
The main purpose of this work was to develop an in vitro method for simulating the dissolution and absorption of inhaled dry powder drugs that also mimics systemic pharmacokinetic data. A second purpose was to evaluate this method. DissolvIt(®) was developed as a simulation of the air-blood barrier of the upper airways, constituting: "airborne" particles deposited on a glass cover slip, a mucus simulant, a polycarbonate (basal) membrane, and a pumped albumin buffer simulating the pulmonary blood flow. The PreciseInhale(®) exposure system was used to aerosolize and deposit test formulations onto cover slips...
February 2017: Assay and Drug Development Technologies
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#4
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28303275/modeling-pathological-hemodynamic-responses-to-the-valsalva-maneuver
#5
Leszek Pstras, Karl Thomaseth, Jacek Waniewski, Italo Balzani, Federico Bellavere
The Valsalva maneuver consisting in a forced expiration against closed airways is one of the most popular clinical tests of the autonomic nervous system function. When properly performed by a healthy subject, it features four characteristic phases of arterial blood pressure and heart rate variations, based on the magnitude of which the autonomic function may be assessed qualitatively and quantitatively. In patients with some disorders or in healthy patients subject to specific conditions, the pattern of blood pressure and heart rate changes during the execution of the Valsalva maneuver may, however, differ from the typical sinusoidal-like pattern...
March 17, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28303104/mathematical-modeling-of-streptococcus-pneumoniae-colonization-invasive-infection-and-treatment
#6
Elisa Domínguez-Hüttinger, Neville J Boon, Thomas B Clarke, Reiko J Tanaka
Streptococcus pneumoniae (Sp) is a commensal bacterium that normally resides on the upper airway epithelium without causing infection. However, factors such as co-infection with influenza virus can impair the complex Sp-host interactions and the subsequent development of many life-threatening infectious and inflammatory diseases, including pneumonia, meningitis or even sepsis. With the increased threat of Sp infection due to the emergence of new antibiotic resistant Sp strains, there is an urgent need for better treatment strategies that effectively prevent progression of disease triggered by Sp infection, minimizing the use of antibiotics...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28300726/a-computational-comparison-of-the-multiple-breath-washout-and-forced-oscillation-technique-as-markers-of-bronchoconstriction
#7
Brody H Foy, David Kay
Many types of lung disease lead to constriction of airways within the conducting zone, causing increases in airway resistance and ventilation heterogeneity (VH). The multiple-breath washout (MBW) and forced oscillation technique (FOT) are two clinical measures of small airway bronchoconstriction. Within this study computational modelling of the MBW and FOT was applied to the analysis of thousands of bronchoconstriction scenarios in the conducting zone of the lungs. The simulations show that MBW indices primarily respond to the severity of constriction, while FOT indices may be able to distinguish between constrictions at differing airway depths...
March 12, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28292973/evaluation-of-functional-characteristics-of-4-oscillatory-positive-pressure-devices-in-a-simulated-cystic-fibrosis-model
#8
Hillary Van Fleet, Diane K Dunn, Neil L McNinch, Teresa A Volsko
BACKGROUND: Oscillatory positive expiratory pressure (OPEP) is an airway clearance therapy that delivers positive pressure and air-flow oscillations during exhalation. This study described functional characteristic differences of 4 OPEP devices during an active exhalation in a simulated model. We hypothesized peak pressure (Ppeak), positive expiratory pressure (PEP), oscillatory frequency (f), and pressure amplitude will differ, depending upon the device used, device resistance setting, and time (repeated consecutive active exhalations through the device)...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#9
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28290929/advanced-trauma-life-support-time-standards
#10
Andrew B Hall, Felix S Boecker, Joseph M Shipp, Dennis Hanseman
INTRODUCTION: Trauma readiness is critical to military medicine. Without medical centers that include persistent volumes of trauma, simulation has become the means to maintain and practice those skills. To create those simulations, standards for both design and metrics to evaluate practitioners are required. MATERIALS AND METHODS: Forty-four traumas were monitored and times to completion of the various steps of Advanced Trauma Life Support were recorded and tabulated...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28278356/computational-fluid-dynamics-and-trigeminal-sensory-examinations-of-empty-nose-syndrome-patients
#11
Chengyu Li, Alexander A Farag, James Leach, Bhakthi Deshpande, Adam Jacobowitz, Kanghyun Kim, Bradley A Otto, Kai Zhao
OBJECTIVE: The precise pathogenesis of empty nose syndrome (ENS) remains unclear. Various factors such as nasal aerodynamics and sensorineural dysfunction have been suspected, although evidence is limited. This study reported the first examination of both nasal aerodynamics and trigeminal sensory factors in actual ENS patients. STUDY DESIGN: Prospective case control. METHODS: We enrolled six patients diagnosed with ENS. Three patients had pre- and post-inferior turbinate (IT) reduction computed tomography scans, which allowed comparison of their nasal aerodynamics changes through computational fluid dynamic (CFD) simulation...
March 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28277892/development-of-optimized-inhalable-gemcitabine-loaded-gelatin-nanocarriers-for-lung-cancer
#12
Susanne R Youngren-Ortiz, David B Hill, Peter R Hoffmann, Kenneth R Morris, Edward G Barrett, M Gregory Forest, Mahavir B Chougule
BACKGROUND: Aerosol delivery of chemotherapeutic nanocarriers represents a promising alternative for lung cancer therapy. This study optimized gemcitabine (Gem)-loaded gelatin nanocarriers (GNCs) cross-linked with genipin (Gem-GNCs) to evaluate their potential for nebulized lung cancer treatment. METHODS: Gem-GNCs were prepared by two-step desolvation and optimized through Taguchi design and characterized for physicochemical properties. Particle size and morphology were confirmed by scanning and transmission electron microscopy...
March 9, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28277885/regional-ventilation-is-the-main-determinant-of-alveolar-deposition-of-coarse-particles-in-the-supine-healthy-human-lung-during-tidal-breathing
#13
Rui Carlos Sá, Kirby L Zeman, William D Bennett, G Kim Prisk, Chantal Darquenne
BACKGROUND: To quantify the relationship between regional lung ventilation and coarse aerosol deposition in the supine healthy human lung, we used oxygen-enhanced magnetic resonance imaging and planar gamma scintigraphy in seven subjects. METHODS: Regional ventilation was measured in the supine posture in a 15 mm sagittal slice of the right lung. Deposition was measured by using planar gamma scintigraphy (coronal scans, 40 cm FOV) immediately postdeposition, 1 hour 30 minutes and 22 hours after deposition of (99m)Tc-labeled particles (4...
March 9, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28275141/cutting-edge-targeting-epithelial-ormdl3-increases-rather-than-reduces-airway-responsiveness-and-is-associated-with-increased-sphingosine-1-phosphate
#14
Marina Miller, Arvin B Tam, James L Mueller, Peter Rosenthal, Andrew Beppu, Ruth Gordillo, Matthew D McGeough, Christine Vuong, Taylor A Doherty, Hal M Hoffman, Maho Niwa, David H Broide
In this study, we used cre-lox techniques to generate mice selectively deficient in ORMDL3 in airway epithelium (Ormdl3(Δ2-3/Δ2-3)/CC10) to simulate an inhaled therapy that effectively inhibited ORMDL3 expression in the airway. In contrast to the anticipated reduction in airway hyperresponsiveness (AHR), OVA allergen-challenged Ormdl3(Δ2-3/Δ2-3)/CC10 mice had a significant increase in AHR compared with wild-type mice. Levels of airway inflammation, mucus, fibrosis, and airway smooth muscle were no different in Ormdl3(Δ2-3/Δ2-3)/CC10 and wild-type mice...
March 8, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28268756/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#15
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28260232/generative-anatomy-modeling-language-gaml
#16
Doga Demirel, Alexander Yu, Seth Baer-Cooper, Tansel Halic, Coskun Bayrak
BACKGROUND: This paper presents the Generative Anatomy Modeling Language (GAML) for generating variation of 3D virtual human anatomy in real-time. This framework provides a set of operators for modification of a reference base 3D anatomy. The perturbation of the 3D models is satisfied with nonlinear geometry constraints to create an authentic human anatomy. METHODS: GAML was used to create 3D difficult anatomical scenarios for virtual simulation of airway management techniques such as Endotracheal Intubation (ETI) and Cricothyroidotomy (CCT)...
March 5, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28258595/transgenic-expression-of-human-leukocyte-antigen-e-attenuates-galko-hcd46-porcine-lung-xenograft-injury
#17
Christopher T Laird, Lars Burdorf, Beth M French, Natalia Kubicki, Xiangfei Cheng, Gheorghe Braileanu, Wenji Sun, Natalie A O'Neill, Arielle Cimeno, Dawn Parsell, Edward So, Andrea Bähr, Nikolai Klymiuk, Carol J Phelps, David Ayares, Agnes M Azimzadeh, Richard N Pierson
BACKGROUND: Lung xenografts remain susceptible to loss of vascular barrier function within hours in spite of significant incremental advances based on genetic engineering to remove the Gal 1,3-αGal antigen (GalTKO) and express human membrane cofactor protein (hCD46). Natural killer cells rapidly disappear from the blood during perfusion of GalTKO.hCD46 porcine lungs with human blood and presumably are sequestered within the lung vasculature. Here we asked whether porcine expression of the human NK cell inhibitory ligand HLA-E and β2 microglobulin inhibits GalTKO...
March 3, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28250924/cellular-crosstalk-between-airway-epithelial-and-endothelial-cells-regulates-barrier-functions-during-exposure-to-double-stranded-rna
#18
Cornelia Blume, Riccardo Reale, Marie Held, Matthew Loxham, Timothy M Millar, Jane E Collins, Emily J Swindle, Hywel Morgan, Donna E Davies
INTRODUCTION: The epithelial and endothelial barriers of the airway mucosa are critical for regulation of tissue homeostasis and protection against pathogens or other tissue damaging agents. In response to a viral infection, epithelial cells must signal to the endothelium to initiate immune cell recruitment. This is a highly temporal regulated process; however, the mechanisms of this cross-talk are not fully understood. METHODS: In a close-contact co-culture model of human airway epithelial and endothelial cells, cellular crosstalk was analyzed using transepithelial electrical resistance (TER) measurements, immunofluorescence, electron microscopy, and ELISA...
March 2017: Immunity, Inflammation and Disease
https://www.readbyqxmd.com/read/28235993/a-novel-two-step-sequential-bioaccessibility-test-for-potentially-toxic-elements-in-inhaled-particulate-matter-transported-into-the-gastrointestinal-tract-by-mucociliary-clearance
#19
Jawad Ali Hussein Alpofead, Christine M Davidson, David Littlejohn
A novel two-step sequential extraction has been developed to assess the bioaccessibility of As, Cd, Cr, Cu, Fe, Mn, Ni, Pb and Zn in airborne particulate matter following inhalation and transport into the human gastrointestinal tract by mucociliary clearance. A new artificial mucus fluid (AMF) was used to determine the bioaccessible potentially toxic element (PTE) fraction in the upper airways, in sequence with the simplified bioaccessibility extraction test (SBET) or the stomach phase of the unified bioaccessibility method (gastric fluid only) (UBMG)...
February 24, 2017: Analytical and Bioanalytical Chemistry
https://www.readbyqxmd.com/read/28226944/3d-force-torque-characterization-of-emergency-cricothyroidotomy-procedure-using-an-instrumented-scalpel
#20
Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Adam Ryason, Ganesh Sankaranarayanan, Kathryn L Butler, Marc DeMoya, Suvranu De, Suvranu De, Marc DeMoya, Kathryn L Butler, Ganesh Sankaranarayanan, Adam Ryason
Emergency Cricothyroidotomy (CCT) is a surgical procedure performed to secure a patient's airway. This high-stakes, but seldom-performed procedure is an ideal candidate for a virtual reality simulator to enhance physician training. For the first time, this study characterizes the force/torque characteristics of the cricothyroidotomy procedure, to guide development of a virtual reality CCT simulator for use in medical training. We analyze the upper force and torque thresholds experienced at the human-scalpel interface...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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