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Jeffrey Siegler, Melissa Kroll, Susan Wojcik, Hawnwan Philip Moy
INTRODUCTION: In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation)...
October 3, 2016: Prehospital Emergency Care
Agathe Anthierens, Nicolas Olivier, Patrick Mucci, André Thevenon
OBJECTIVE: Low back pain is a pathology associated to a trunk extensors muscles weakness. Studies suggested that it could be associated with an inadequacy between oxygen demand and oxygen utilization by paraspinal muscles (Kell and Bhambhani, 2006). In contrast to chronic low back pain (CLBP) patients, judo athletes are characterized by a great trunk extensors muscles endurance, due to their intensive solicitation within sport practice. Our purpose was to compare aerobic metabolism in those muscles of CLBP patients with judo athletes...
September 2016: Annals of Physical and Rehabilitation Medicine
Daniela Alejandra Quinteros, Emiliano Sebastián López, Juan Lucio Silva Couto, Belkys Angélica Maletto, Daniel Alberto Allemandi, Santiago Daniel Palma, Juan Eduardo Gallo
Suramab (SUM) is a new pharmaceutical combination made up of suramine (SUR) and bevacizumab (BVM), which showed a high synergistic effect when administered jointly. As the pharmaceutical vehicle, poloxamer aqueous dispersions were used since this system is able to maintain their fluidity at low temperatures (<15ºC) but which become gel in the corporal environment (>35ºC).In the present study we aimed at evaluating the effect of Poloxamer to prolong the effect of SUM. These formulations were characterized using rheological, biopharmaceutical (drug release) and morphological (SEM) technique...
August 11, 2016: Current Pharmaceutical Design
Brian E Driver, Matthew E Prekker, Rebecca L Kornas, Ellen K Cales, Robert F Reardon
STUDY OBJECTIVE: Recent data suggest that emergency airway preoxygenation with a bag-valve-mask (BVM) device (held with a tight mask seal but without squeezing the bag) is superior to a nonrebreather (NRB) mask at standard oxygen flow rates. We seek to determine whether preoxygenation with an NRB mask with flush rate oxygen (>40 L/min by fully opening a standard oxygen flowmeter) is noninferior to BVM device with standard-flow oxygen (15 L/min). We also seek to compare the efficacy of preoxygenation with NRB mask at flush rate oxygen with both NRB mask with oxygen at 15 L/min and simple mask at flush rate oxygen...
August 10, 2016: Annals of Emergency Medicine
Baruch Zobrist, Monica Casmaer, Michael D April
OBJECTIVE: To compare tidal volume received during single rescuer ventilation with a modified bag-valve mask (BVM) with integrated internal handle vs standard BVM among healthy volunteers using a manikin model. METHODS: This study was a randomized crossover trial of adult healthcare provider volunteers performing ventilation on a manikin. We randomized participants to perform single rescuer ventilation first using either a modified BVM with integrated internal handle or a standard unmodified BVM...
October 2016: American Journal of Emergency Medicine
Marcel Simon, Christian Wachs, Stephan Braune, Geraldine de Heer, Daniel Frings, Stefan Kluge
BACKGROUND: Critically ill patients with respiratory failure undergoing intubation have an increased risk of hypoxemia-related complications. Delivering oxygen via a high-flow nasal cannula (HFNC) has theoretical advantages and is increasingly used. This study was conducted to compare HFNC with bag-valve-mask (BVM) for preoxygenation and to assess oxygenation during intubation in subjects with hypoxemic respiratory failure. METHODS: This study was a randomized controlled trial including 40 critically ill subjects with hypoxemic respiratory failure who received either HFNC or BVM for preoxygenation before intubation in the ICU...
September 2016: Respiratory Care
Uddhav Timilsina, Dibya Ghimire, Bivek Timalsina, Theodore J Nitz, Carl T Wild, Eric O Freed, Ritu Gaur
Antiretroviral therapy has led to a profound improvement in the clinical care of HIV-infected patients. However, drug tolerability and the evolution of drug resistance have limited treatment options for many patients. Maturation inhibitors are a new class of antiretroviral agents for treatment of HIV-1. They act by interfering with the maturation of the virus by blocking the last step in Gag processing: the cleavage of the capsid-spacer peptide 1 (CA-SP1) intermediate to mature CA by the viral protease (PR)...
2016: Scientific Reports
David A Pearson, R Darrell Nelson, Lisa Monk, Clark Tyson, James G Jollis, Christopher B Granger, Claire Corbett, Lee Garvey, Michael S Runyon
BACKGROUND: Team-focused CPR (TFCPR) is a choreographed approach to cardiopulmonary resuscitation (CPR) with emphasis on minimally interrupted high-quality chest compressions, early defibrillation, discourages endotracheal intubation and encourages use of the bag-valve-mask (BVM) and/or blind-insertion airway device (BIAD) with a ventilation rate of 8-10 breaths/min to minimize hyperventilation. Widespread incorporation of TFCPR in North Carolina (NC) EMS agencies began in 2011, yet its impact on outcomes is unknown...
August 2016: Resuscitation
Zheng Liu, Jacob J Swidorski, Beata Nowicka-Sans, Brian Terry, Tricia Protack, Zeyu Lin, Himadri Samanta, Sharon Zhang, Zhufang Li, Dawn D Parker, Sandhya Rahematpura, Susan Jenkins, Brett R Beno, Mark Krystal, Nicholas A Meanwell, Ira B Dicker, Alicia Regueiro-Ren
A series of C-3 phenyl- and heterocycle-substituted derivatives of C-3 deoxybetulinic acid and C-3 deoxybetulin was designed and synthesized as HIV-1 maturation inhibitors (MIs) and evaluated for their antiviral activity and cytotoxicity in cell culture. A 4-subsituted benzoic acid moiety was identified as an advantageous replacement for the 3'3'-dimethylsuccinate moiety present in previously disclosed MIs that illuminates new aspects of the topography of the pharmacophore. The new analogs exhibit excellent in vitro antiviral activity against wild-type (wt) virus and a lower serum shift when compared with the prototypical HIV-1 MI bevirimat (1, BVM), the first MI to be evaluated in clinical studies...
April 15, 2016: Bioorganic & Medicinal Chemistry
Vijay Singh, Mudit Dixit, Monica Kosa, Dan Thomas Major, Elena Levi, Doron Aurbach
The most intriguing feature of metal-metal bonds in inorganic compounds is an apparent lack of correlation between the bond order and the bond length. In this study, we combine a variety of literature data obtained by quantum chemistry and our results based on the empirical bond valence model (BVM), to confirm for the first time the existence of a normal exponential correlation between the effective bond order (EBO) and the length of the metal-metal bonds. The difference between the EBO and the formal bond order is attributed to steric conflict between the (TM)n cluster (TM=transition metal) and its environment...
April 4, 2016: Chemistry: a European Journal
Troy E Reihsen, Laszlo Alberti, Jason Speich, Lauren H Poniatowski, Danielle Hart, Robert M Sweet
BACKGROUND: Training health care providers to manage common life-threatening traumatic injuries is an important endeavor. A fresh perfused cadaveric model with high anatomic and tissue fidelity was developed to assess performance of hemorrhage and airway management skills during a simulated polytrauma scenario. METHODS: Fresh human cadavers were obtained within 96 hours of death. Hemorrhage from a right traumatic amputation and left inguinal wound was simulated using cannulation of the right popliteal and left femoral artery, respectively...
May 2016: Journal of Trauma and Acute Care Surgery
Konggrapun Srisuwan, Nattaporn Hongsawong, Adisorn Lumpaopong, Prapaipim Thirakhupt, Yupapin Chulamokha
OBJECTIVE: Volume overload from an incorrect assessment of dry weight leads to cardiovascular diseases in chronic hemodialysis patients. Dry weight assessment in pediatric is difficult for a number of reasons including growth. Blood volume monitoring (BVM) has been proposed as an accurate method of estimating dry weight in adult. However, there is very scant data regarding B VM assessment in pediatric. Therefore, the authors conducted a study to compare dry weight, postdialytic body weight, predialytic blood pressure, intradialytic blood pressure, and intra dialytic symptoms between clinical adjustment and B VM method...
November 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Dong Han, Jeffrey V Siebers, Jeffrey F Williamson
PURPOSE: To evaluate the accuracy and robustness of a simple, linear, separable, two-parameter model (basis vector model, BVM) in mapping proton stopping powers via dual energy computed tomography (DECT) imaging. METHODS: The BVM assumes that photon cross sections (attenuation coefficients) of unknown materials are linear combinations of the corresponding radiological quantities of dissimilar basis substances (i.e., polystyrene, CaCl2 aqueous solution, and water)...
January 2016: Medical Physics
Christopher Groombridge, Cheau Wern Chin, Bernard Hanrahan, Anna Holdgate
OBJECTIVES: Preoxygenation prior to intubation aims to increase the duration of safe apnea by causing denitrogenation of the functional residual capacity, replacing this volume with a reservoir of oxygen. In the operating room (OR) the criterion standard for preoxygenation is an anesthetic circuit and well-fitting face mask, which provide a high fractional inspired oxygen concentration (FiO2 ). Outside of the OR, various strategies exist to provide preoxygenation. The objective was to evaluate the effectiveness of commonly used preoxygenation strategies outside of the OR environment...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Kyung Kang, Taeyun Kim, Young Sun Ro, Yu Jin Kim, Kyung Jun Song, Sang Do Shin
PURPOSE: Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway. METHODS: We used the Korean nationwide OHCA cohort database from 2010 to 2013...
February 2016: American Journal of Emergency Medicine
Dane B Nenadić, Miloš D Pavlović, Tatjana Motrenko
BACKGROUND/AIM: The Nugent's score is still the gold standard in the great majority of studies dealing with the assessment of vaginal flora and the diagnosis of bacterial vaginosis (BV). The aim of this study was to show that the analysis of Gram-stained vaginal samples under microscope at the magnification of x200 (a novel microscopic method--NMM), as a fast and simple tool, easily applicable in everyday practice, better reflects complexity of vaginal microflora than the Nugent's methodology (x1000)...
August 2015: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Michael Thomas Steuerwald, Bryce R H Robinson, Dennis J Hanseman, Amy Makley, Timothy A Pritts
BACKGROUND: The relationship between the prehospital airway device used and later development of ventilator-associated pneumonia (VAP) is unknown. We sought to determine if the prehospital airway device choice is associated with an increased risk of VAP in risk-adjusted critically injured patients. METHODS: We performed a retrospective analysis of all trauma patients requiring definitive airway placement before intensive care unit admission at a Level I trauma center from 2008 to 2012...
February 2016: Journal of Trauma and Acute Care Surgery
Susanne Kron, Daniel Schneditz, Til Leimbach, Jutta Czerny, Sabine Aign, Joachim Kron
The reduction of blood volume below a critical threshold is assumed to trigger intradialytic morbid events (IME). Recently, we presented a simple method to determine the absolute blood volume during routine hemodialysis (HD) carried out without blood sampling and without injection of dyes or radiolabeled markers. Such information could be used to detect excessive volume reduction during HD and to prevent IME. Therefore, we performed a pilot study in IME-prone patients to identify the absolute blood volume at which they developed clinical symptoms...
April 2016: Hemodialysis International
Douglas R Dixon, Darren Braude
In airway procedures, preparation is 90% of success. For obese patients, positioning is 90% of this preparation. Other considerations include utilizing NIPPV and nasal cannula apneic oxygenation, utilizing multiple providers and airway adjuncts for BVM ventilation, correctly dosing medications based upon ideal, lean or total body weight, and having backup airway devices ready.
August 2015: JEMS: a Journal of Emergency Medical Services
Anita Saxena, R K Sharma, Amit Gupta, Manns Manohar John
Intradialytic hypotension (IDH) is a life-threatening condition. We evaluated the feasibility of blood volume monitoring (BVM) and blood temperature monitoring (BTM) in preventing IDH in patients prone to the same. Fourteen hemodynamically unstable end-stage renal disease patients who were prone to IDH and unable to achieve dry weight were given BVM treatment twice weekly for two weeks. Forty patients who were not on BVM treatment served as controls. Patients were anemic, had low serum albumin (3.4 ± 0.43 g/dL) and fluid overload and were edematous...
September 2015: Saudi Journal of Kidney Diseases and Transplantation
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