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https://www.readbyqxmd.com/read/30473960/evaluation-of-an-innovative-bleeding-cricothyrotomy-model
#1
Kate E Hughes, David Biffar, Eze O Ahanonu, Thomas M Cahir, Allan Hamilton, John C Sakles
Objectives Emergency medicine (EM) residents are required to perform a cricothyrotomy during training as per the Accreditation Council for Graduate Medical Education (ACGME) guidelines. Cricothyrotomy is a rare procedure, comprising 0.45% of emergency department airway management procedures. Procedural competence in utilizing a realistic trainer is of utmost importance. We have developed a cricothyrotomy trainer using a fused deposition modeling (FDM) three-dimensional (3D) printer and innovative bleeding tissue to enhance fidelity...
September 18, 2018: Curēus
https://www.readbyqxmd.com/read/30428748/peripheral-tumour-targeting-using-open-source-virtual-bronchoscopy-with-electromagnetic-tracking-a-multi-user-pre-clinical-study
#2
Herman Alexander Jaeger, Fabian Trauzettel, Pietro Nardelli, Federico Daverieux, Erlend Fagertun Hofstad, Håkon O Leira, Marcus P Kennedy, Thomas Langø, Pádraig Cantillon-Murphy
OBJECTIVES: The goal was to demonstrate the utility of open-source tracking and visualisation tools in the targeting of lung cancer. MATERIAL AND METHODS: The study demonstrates the first deployment of the Anser electromagnetic (EM) tracking system with the CustusX image-guided interventional research platform to navigate using an endobronchial catheter to injected tumour targets. Live animal investigations validated the deployment and targeting of peripheral tumour models using an innovative tumour marking routine...
November 15, 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/30300176/emergency-department-airway-management-responsibilities-in-the-united-states
#3
Chukwudi Chiaghana, Christopher Giordano, Danielle Cobb, Terrie Vasilopoulos, Patrick J Tighe, Joshua W Sappenfield
BACKGROUND: In the 1990s, emergency medicine (EM) physicians were responsible for intubating about half of the patients requiring airway management in emergency rooms. Since then, no studies have characterized the airway management responsibilities in the emergency room. METHODS: A survey was sent via the Eastern Association for Surgery and Trauma and the Trauma Anesthesiology Society listservs, as well as by direct solicitation. Information was collected on trauma center level, geographical location, department responsible for intubation in the emergency room, department responsible for intubation in the trauma bay, whether these roles differed for pediatrics, whether an anesthesiologist was available "in-house" 24 hours a day, and whether there was a protocol for anesthesiologists to assist as backup during intubations...
October 8, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/30281884/consensus-based-criterion-standard-for-the-identification-of-pediatric-patients-who-need-emergency-medical-services-transport-to-a-hospital-with-higher-level-pediatric-resources
#4
Jonathan R Studnek, E Brooke Lerner, Manish I Shah, Lorin R Browne, David C Brousseau, Jeremy T Cushman, Peter S Dayan, Patrick C Drayna, Amy L Drendel, Matthew P Gray, Christopher A Kahn, Michael T Meyer, Manish N Shah, Rachel M Stanley
BACKGROUND: Emergency medical services (EMS) providers must be able to identify the most appropriate destination facility when treating children with potentially severe medical illnesses. Currently, no validated tool exists to assist EMS providers in identifying children who need transport to a hospital with higher-level pediatric care. For such a tool to be developed, a criterion standard needs to be defined that identifies children who received higher-level pediatric medical care. OBJECTIVE: The objective was to develop a consensus-based criterion standard for children with a medical complaint who need a hospital with higher-level pediatric resources...
October 3, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/30013701/a-randomized-comparison-of-in-hospital-rescuer-positions-for-endotracheal-intubation-in-a-difficult-airway
#5
COMPARATIVE STUDY
Joanna M Le Parc, Jason J Bischof, Andrew M King, Sarah Greenberger, David P Way, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
Introduction: Emergency endotracheal intubation (ETI) is a common and critical procedure performed in both prehospital and in-hospital settings. Studies of prehospital providers have demonstrated that rescuer position influences ETI outcomes. However, studies of in-hospital rescuer position for ETI are limited. While we adhere to strict standards for the administration of ETI, we posited that perhaps requiring in-hospital rescuers to stand for ETI is an obstacle to effectiveness. Our objective was to compare in-hospital emergency medicine (EM) trainees' performance on ETI delivered from both the seated and standing positions...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29383080/a-novel-approach-to-medical-student-peer-assisted-learning-through-case-based-simulations
#6
Joshua Jauregui, Steven Bright, Jared Strote, Jamie Shandro
Introduction: Peer-assisted learning (PAL) is the development of new knowledge and skills through active learning support from peers. Benefits of PAL include introduction of teaching skills for students, creation of a safe learning environment, and efficient use of faculty time. We present a novel approach to PAL in an emergency medicine (EM) clerkship curriculum using an inexpensive, tablet-based app for students to cooperatively present and perform low-fidelity, case-based simulations that promotes accountability for student learning, fosters teaching skills, and economizes faculty presence...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29383077/development-of-a-novel-ultrasound-guided-peritonsillar-abscess-model-for-simulation-training
#7
Vivienne Ng, Jennifer Plitt, David Biffar
Introduction: Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments.1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical setting, knowing that carotid artery puncture and hemorrhage are serious and devastating complications. While several low-fidelity PTA task trainers have been previously described, none allow for ultrasound image acquisition...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29349680/ultrasound-evaluation-of-the-airway-in-the-ed-a-feasibility-study
#8
Elizabeth A Hall, Ibrahim Showaihi, Frances S Shofer, Nova L Panebianco, Anthony J Dean
BACKGROUND: Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol...
January 18, 2018: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29236684/cryo-em-structures-of-the-tmem16a-calcium-activated-chloride-channel
#9
Shangyu Dang, Shengjie Feng, Jason Tien, Christian J Peters, David Bulkley, Marco Lolicato, Jianhua Zhao, Kathrin Zuberbühler, Wenlei Ye, Lijun Qi, Tingxu Chen, Charles S Craik, Yuh Nung Jan, Daniel L Minor, Yifan Cheng, Lily Yeh Jan
Calcium-activated chloride channels (CaCCs) encoded by TMEM16A control neuronal signalling, smooth muscle contraction, airway and exocrine gland secretion, and rhythmic movements of the gastrointestinal system. To understand how CaCCs mediate and control anion permeation to fulfil these physiological functions, knowledge of the mammalian TMEM16A structure and identification of its pore-lining residues are essential. TMEM16A forms a dimer with two pores. Previous CaCC structural analyses have relied on homology modelling of a homologue (nhTMEM16) from the fungus Nectria haematococca that functions primarily as a lipid scramblase, as well as subnanometre-resolution electron cryo-microscopy...
December 21, 2017: Nature
https://www.readbyqxmd.com/read/28558796/systems-based-approach-to-examine-the-cytokine-responses-in-primary-mouse-lung-macrophages-infected-with-low-pathogenic-avian-influenza-virus-circulating-in-south-east-asia
#10
Biruhalem Taye, Hui Chen, Myint Zu Myaing, Boon Huan Tan, Sebastian Maurer-Stroh, Richard J Sugrue
BACKGROUND: Influenza A virus (IAV) is a major public health concern, being responsible for the death of approximately half a million people each year. Zoonotic transmissions of the virus from swine and avian origin have occurred in the past, and can potentially lead to the emgergence of new IAV stains in future pandemics. Pulmonary macrophages have been implicated in disease severity in the lower airway, and understanding the host response of macrophages infected with avian influenza viruses should provide new therapeutic strategies...
May 30, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28454596/opioids-cause-central-and-complex-sleep-apnea-in-humans-and-reversal-with-discontinuation-a-plea-for-detoxification
#11
Shahrokh Javaheri, Sanjiv Patel
Central sleep apnea (CSA) and continuous positive airway pressure (CPAP) emergent CSA are common in patients for whom opioids have been prescribed for chronic pain management. It is not known if opioids are the potential cause of CSA. We report the case of a patient who underwent multiple full nights of polysomnography testing while on opioids, off opioids, and with various positive airway pressure devices. While on opioids, the patient had severe CSA that persisted during both CPAP and bilevel titration but was eliminated with adaptive servoventilation therapy...
June 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28368678/functional-characterization-of-a-novel-3d-model-of-the-epithelial-mesenchymal-trophic-unit
#12
Fabio Bucchieri, Alessandro Pitruzzella, Alberto Fucarino, Antonella Marino Gammazza, Celeste Caruso Bavisotto, Vito Marcianò, Massimo Cajozzo, Giorgio Lo Iacono, Roberto Marchese, Giovanni Zummo, Stephen T Holgate, Donna E Davies
BACKGROUND/AIM: Epithelial-mesenchymal communication plays a key role in tissue homeostasis and abnormal signaling contributes to chronic airways disease such as COPD. Most in vitro models are limited in complexity and poorly represent this epithelial-mesenchymal trophic unit. We postulated that cellular outgrowth from bronchial tissue would enable development of a mucosal structure that recapitulates better in vivo tissue architecture. MATERIALS AND METHODS: Bronchial tissue was embedded in Matrigel and outgrowth cultures monitored using time-lapse microscopy, electrical resistance, light and electron microscopy...
March 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28230230/bronchoscopic-lung-volume-reduction-procedures-for-chronic-obstructive-pulmonary-disease
#13
REVIEW
Joseph Em van Agteren, Khin Hnin, Dion Grosser, Kristin V Carson, Brian J Smith
BACKGROUND: In the recent years, a variety of bronchoscopic lung volume reduction (BLVR) procedures have emerged that may provide a treatment option to participants suffering from moderate to severe chronic obstructive pulmonary disease (COPD). OBJECTIVES: To assess the effects of BLVR on the short- and long-term health outcomes in participants with moderate to severe COPD and determine the effectiveness and cost-effectiveness of each individual technique. SEARCH METHODS: Studies were identified from the Cochrane Airways Group Specialised Register (CAGR) and by handsearching of respiratory journals and meeting abstracts...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27812636/gel-pillow-designed-specifically-for-obstructive-sleep-apnea-treatment-with-continuous-positive-airway-pressure
#14
Adriana Salvaggio, Anna Lo Bue, Serena Iacono Isidoro, Salvatore Romano, Oreste Marrone, Giuseppe Insalaco
Objective: To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Methods: Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27812633/lung-volumes-and-airway-resistance-in-patients-with-a-possible-restrictive-pattern-on-spirometry
#15
Kenia Schultz, Luiz Carlos D'Aquino, Maria Raquel Soares, Andrea Gimenez, Carlos Alberto de Castro Pereira
Objective: Many patients with proportional reductions in FVC and FEV1 on spirometry show no reduction in TLC. The aim of this study was to evaluate the role that measuring lung volumes and airway resistance plays in the correct classification of patients with a possible restrictive pattern on spirometry. Methods: This was a prospective study involving adults with reduced FVC and FEV1, as well as an FEV1/FV(C) ratio within the predicted range. Restrictive lung disease (RLD) was characterized by TLC below the 5th percentile, as determined by plethysmography...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27812632/effects-of-passive-inhalation-of-cigarette-smoke-on-structural-and-functional-parameters-in-the-respiratory-system-of-guinea-pigs
#16
Thiago Brasileiro de Vasconcelos, Fernanda Yvelize Ramos de Araújo, João Paulo Melo de Pinho, Pedro Marcos Gomes Soares, Vasco Pinheiro Diógenes Bastos
Objective: To evaluate the effects of passive inhalation of cigarette smoke on the respiratory system of guinea pigs. Methods: Male guinea pigs were divided into two groups: control and passive smoking, the latter being exposed to the smoke of ten cigarettes for 20 min in the morning, afternoon and evening (30 cigarettes/day) for five days. After that period, inflammatory parameters were studied by quantifying mesenteric mast cell degranulation, as well as oxidative stress, in BAL fluid...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27811534/performance-in-trauma-resuscitation-at-an-urban-tertiary-level-i-pediatric-trauma-center
#17
Payal Kadia Gala, Kevin Osterhoudt, Sage R Myers, Mariel Colella, Aaron Donoghue
BACKGROUND: The role of the surveyor in trauma resuscitations is to identify life-threatening injuries and is meant to be conducted by a set protocol for every patient. Optimal performance of the trauma survey is known to be a challenge in pediatric trauma resuscitation. A postulated reason for this observation is that many trainees, such as pediatric residents, who perform the trauma survey have minimal experience and do not have formal advanced trauma life support training. The assessment of factors that may be obstacles in performing the trauma survey has not been studied robustly...
November 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27739074/lung-volume-reduction-surgery-for-diffuse-emphysema
#18
REVIEW
Joseph Em van Agteren, Kristin V Carson, Leong Ung Tiong, Brian J Smith
BACKGROUND: Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten years have passed since the last version of this review was prepared, prompting us to perform an update...
October 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27383929/evaluating-bronchodilator-response-in-pediatric-patients-with-post-infectious-bronchiolitis-obliterans-use-of-different-criteria-for-identifying-airway-reversibility
#19
Rita Mattiello, Paula Cristina Vidal, Edgar Enrique Sarria, Paulo Márcio Pitrez, Renato Tetelbom Stein, Helena Teresinha Mocelin, Gilberto Bueno Fischer, Marcus Herbert Jones, Leonardo Araújo Pinto
OBJECTIVE: Post-infectious bronchiolitis obliterans (PIBO) is a clinical entity that has been classified as constrictive, fixed obstruction of the lumen by fibrotic tissue. However, recent studies using impulse oscillometry have reported bronchodilator responses in PIBO patients. The objective of this study was to evaluate bronchodilator responses in pediatric PIBO patients, comparing different criteria to define the response. METHODS: We evaluated pediatric patients diagnosed with PIBO and treated at one of two pediatric pulmonology outpatient clinics in the city of Porto Alegre, Brazil...
May 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27325238/pre-clinical-validation-of-virtual-bronchoscopy-using-3d-slicer
#20
Pietro Nardelli, Alexander Jaeger, Conor O'Shea, Kashif A Khan, Marcus P Kennedy, Pádraig Cantillon-Murphy
PURPOSE: Lung cancer still represents the leading cause of cancer-related death, and the long-term survival rate remains low. Computed tomography (CT) is currently the most common imaging modality for lung diseases recognition. The purpose of this work was to develop a simple and easily accessible virtual bronchoscopy system to be coupled with a customized electromagnetic (EM) tracking system for navigation in the lung and which requires as little user interaction as possible, while maintaining high usability...
January 2017: International Journal of Computer Assisted Radiology and Surgery
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