Use of the Intubating LMA-Fastrach™  in 254 Patients with Difficult-to-manage Airways

Background The laryngeal mask airway (LMA; LMA North America, Inc., San Diego, CA) has a well-established role in the emergency and elective treatment of patients with difficult-to-manage airways (DA). In this study, the authors report their clinical experience with the intubating LMA (LMA-Fastrach; LMA North America, Inc., San Diego, CA) in 254 patients with different types of DA. Methods The authors reviewed the anesthetic and medical records of patients with DA in whom the LMA-Fastrach was used electively or emergently at four institutions from October 1997 through October 2000. In each case, the number of insertion and intubation attempts was recorded. Success rates for blind and fiber optically guided intubation through the LMA-Fastrach were calculated, up to a maximum of five attempts per patient. Results The LMA-Fastrach was used in 257 procedures performed in 254 patients with DA, including patients with Cormack-Lehane grade 4 views; patients with immobilized cervical spines; patients with airways distorted by tumors, surgery, or radiation therapy; and patients wearing stereotactic frames. Insertion of the LMA-Fastrach was accomplished in three attempts or fewer in all patients. The overall success rates for blind and fiber optically guided intubations through the LMA-Fastrach were 96.5% and 100.0%, respectively. Conclusions The LMA-Fastrach was used successfully in a high percentage of patients who presented with a variety of DA. The clinical experience presented herein indicates that this device may be particularly useful in the emergency and elective treatment of patients in whom intubation with a rigid laryngoscope has failed and in the treatment of patients with immobilized cervical spines.

Download Full-text

OC-0425: Clinical experience with stereotactic MR-guided adaptive radiation therapy for pancreatic tumors

Radiotherapy and Oncology ◽

10.1016/s0167-8140(17)30867-8 ◽

2017 ◽

Vol 123 ◽

pp. S224-S225 ◽

Cited By ~ 3

Author(s):

A. Bruynzeel ◽

F. Lagerwaard ◽

O. Bohoudi ◽

S. Tetar ◽

N. Haasbeek ◽

...

Keyword(s):

Radiation Therapy ◽

Clinical Experience ◽

Adaptive Radiation ◽

Pancreatic Tumors ◽

Adaptive Radiation Therapy

Download Full-text

Early Clinical Experience With Kilovoltage Image-Guided Radiation Therapy for Interfraction Motion Management

Medical Dosimetry ◽

10.1016/j.meddos.2007.06.002 ◽

2008 ◽

Vol 33 (4) ◽

pp. 268-274 ◽

Cited By ~ 15

Author(s):

Joshua D. Lawson ◽

Tim Fox ◽

Eric Elder ◽

Adam Nowlan ◽

Lawrence Davis ◽

...

Keyword(s):

Radiation Therapy ◽

Clinical Experience ◽

Motion Management ◽

Image Guided Radiation Therapy ◽

Image Guided ◽

Early Clinical Experience ◽

Interfraction Motion

Download Full-text

TARGIT-R (Retrospective): 5-Year Follow-Up Evaluation of Intraoperative Radiation Therapy (IORT) for Breast Cancer Performed in North America

Annals of Surgical Oncology ◽

10.1245/s10434-020-09432-3 ◽

2021 ◽

Cited By ~ 1

Author(s):

Stephanie A. Valente ◽

Rahul D. Tendulkar ◽

Sheen Cherian ◽

Chirag Shah ◽

Darrel L. Ross ◽

...

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

North America ◽

Intraoperative Radiation Therapy ◽

Intraoperative Radiation

Download Full-text

Morbidity of in-hospital purulent-septic infections of adults patients after different types of endovascular cardiosurgical operations

Sanitarnyj vrač (Sanitary Inspector) ◽

10.33920/med-08-2008-01 ◽

2020 ◽

pp. 13-19

Author(s):

Viktor Ivanovich Sergevnin ◽

Larisa Gennadievna Kudryavtseva ◽

Anna Igorevna Zolotukhina

Keyword(s):

Medical Records ◽

Heart Surgery ◽

Surgical Intervention ◽

Heart Rhythm ◽

Community Acquired Pneumonia ◽

Short Term ◽

Intervention Community ◽

Duration Of Surgery ◽

Different Types ◽

Low Incidence

An estimate of the incidence of nosocomial purulent-septic infections (GSI) of adult patients after various types of closed heart surgery according to the results of a study of medical records of 3275 patients is presented. It was established that the incidence rate of typical GSI after endovascular cardiac surgery was 3.1, with prenosological forms — 3.9 per 1000 operations. The main clinical options for postoperative GSI were infections in the field of surgical intervention, community-acquired pneumonia, urinary tract infection and bloodstream infection. There were no statistically significant differences between the incidence of GSI after stenting of the coronary arteries, operations for heart rhythm disturbances, stenosis of the carotid artery and other operations. The low incidence of GSI after closed heart surgery is due to the short duration of surgery, as well as the absence or short-term resuscitation of patients.

Download Full-text

Effectiveness of Truck Rollover Warning Systems

Transportation Research Record Journal of the Transportation Research Board ◽

10.3141/1779-18 ◽

2001 ◽

Vol 1779 (1) ◽

pp. 134-140 ◽

Cited By ~ 4

Author(s):

Derek Baker ◽

Rob Bushman ◽

Curtis Berthelot

Keyword(s):

North America ◽

Warning System ◽

Warning Systems ◽

Commercial Vehicles ◽

Decision Criteria ◽

Warning Messages ◽

System A ◽

Different Types ◽

Rollover Warning

Different types of intelligent rollover system deployed by road agencies across North America are investigated. The importance of weight is addressed for maximum effectiveness of rollover warning messages for commercial vehicles in a potential rollover situation on sharp curves or exit ramps. The type of information that may be used to activate a rollover is discussed to analyze the number of correctly warned vehicles compared with the number of false warnings generated by the rollover warning system. A case study of the effectiveness of an intelligent rollover system is presented. On the basis of this case study, it was found that speed-based rollover warning systems generated anywhere from 44 percent to 49 percent more false rollover warnings for commercial vehicles than did rollover warning systems that employed weight information in the rollover decision criteria.

Download Full-text

A novel technique to prevent the breast implant from exposure after mastectomies

American Journal of Surgical Research and Reviews ◽

10.28933/ajsrr-2021-01-2705 ◽

2021 ◽

pp. 14

Author(s):

Keyword(s):

Radiation Therapy ◽

Soft Tissue ◽

Breast Reconstruction ◽

Breast Implants ◽

Tissue Layer ◽

Dermal Matrix ◽

Implant Exposure ◽

Dermal Flap ◽

Different Types ◽

Dermal Flaps

Introduction After mastectomies, we do our reconstruction, either immediately or delayed. In both ways of reconstruction for post mastectomies defect, the most commonly performed reconstruction is by using breast prosthesis [1]. For many years, surgeons have been trying to find out any solution to reduce the rate of implant exposure and develop some new techniques and modifications. However, once the infection develops or implant expose the only permanent solution is to remove the implant [2-3]. Although there is less evidence found in the literature regarding the salvage of implant once the infection occurs and when implant becomes expose in implant-based reconstruction [4]. Radiation also plays additional role in post-operative complication rates following implant-based breast reconstruction, as it is well documented that the incidence of complications is to be higher in radiated breasts compare to similar non-radiated breasts [5]. With the new advancement in radiation therapy the number of patients have been increasing who are receiving radiation therapy after immediate breast reconstruction [5]. Description of the Technique For more than 15 years we have been reconstructing the breasts deformities after different types of mastectomies, ranging from skin sparing, nipple areola sparing to different types of lumpectomies, by immediate insertion of breast implants. The main problem which we face during post-reconstruction, is the exposure of implant in addition to infection. With the advent of ADM (Artificial Dermal Matrix) [6], serratus anterior muscle [7], rectus fascial flap [7] and inferior dermal flaps [8] although they do an addition to thickness of skin envelop over the implant after mastectomy, but still the rate of implant exposure has not changed noticeably. It has been well understood that of ADM expose in air it dries immediately which later on results in implant exposure. Meanwhile we have developed a novel tech- nique to augment the soft tissue coverage under the incision line over the ADM and implant. By this way, if there is any dehiscence over suture line, there will be no implant exposure as there is additional soft tissue layer of dermal flap. These dermal flaps are actually a de-epithelialized dermal flap from the inferior half of the breast skin, which we used to excise and throw it to the garbage, particularly in skin sparing mastectomies. In this technique we suture the inferior based dermal flap over the artificial dermal matrix in a way that suture lines of skin flaps of mastectomy lie over the de-epithelialized dermal flap, which actually in- crease the survivability of ADM as well as increase the thickness of soft tissue over the implant (figure 1 and 2). By addition of this layer of de-epithelialized dermal flaps over the artificial dermal matrix and breast implants have promising reduction effect over implant exposure as well as it provides the additional vascularized soft tissue layer over the implant. Although we are using dermal flap with ADM frequently in most of our skin spring mastectomies but we did this new technique in 2 patients till now with the mean follow up of 8 weeks till now there is not a single case report of implant exposure in those patients (figure 3).

Download Full-text

Off-Label Prescribing in Pediatric Inpatients With Pneumonia in a Children's Hospitaal

JURNAL ILMU KEFARMASIAN INDONESIA ◽

10.35814/jifi.v16i1.433 ◽

2018 ◽

Vol 16 (1) ◽

pp. 25

Author(s):

Hesty Utami Ramadaniati ◽

Heni Safarini ◽

Aishah A Regine

Keyword(s):

Clinical Trials ◽

Medical Records ◽

Product Information ◽

Drug Label ◽

Off Label ◽

National Drug ◽

Different Types ◽

Pediatric Use ◽

Official Information ◽

Study Hospital

Off-label is a term used in which a drug prescribed outside the official information of the marketing authorization. Off-label prescribing may occur as the result of several factors including lack of clinical trials data involving pediatrics and suitable formulations for medicines commonly prescribed to this fragile population. Objective: This study aimed to estimate the nature and prevalence of off-label prescribing in pediatric inpatients with pneumonia. Material and Methods: a retrospective study was conducted in a study hospital using medical records from pediatric inpatients with pneumonia during the period of January-December 2015. Patient and prescribing data were collected, and drugs were classified as on-label or off-label based on the Indonesia National Drug Information (IONI) and British National Formulary for Children (BNFC). Thereafter, off-label drugs were categorized with a hierarchical system of age, indication, route of administration and dosage. Results: There were 1141 drugs with 77 different types of drug were administered to 207 patient during the study period. The data uncovered that 405 (35,5%) of the drug prescriptions were used off-label based on IONI, and 319 (28%) of the drug were used off-label based on BNFC. Based on IONI and BNFC, most off-label drugs were from anti infection drugs. Conclusion: The prevalence of off-label use in pediatric inpatients with pneumonia is not high. The off-label prescribing may not be necessarily be considered irrational, yet this fact reveals that the use of drugs does not comply with the drug label. Clinical trials for pediatric drugs are essential to provide complete product information for pediatric use.

Download Full-text

Success rates of botulinum toxin in different types of strabismus and dose effect

Canadian Journal of Ophthalmology ◽

10.1016/j.jcjo.2021.12.002 ◽

2022 ◽

Author(s):

Leyla Niyaz ◽

Volkan Yeter ◽

Cihangir Beldagli

Keyword(s):

Botulinum Toxin ◽

Dose Effect ◽

Success Rates ◽

Different Types

Download Full-text

Artifacts at Work

International Journal of Sociotechnology and Knowledge Development ◽

10.4018/ijskd.2014040104 ◽

2014 ◽

Vol 6 (2) ◽

pp. 53-66

Author(s):

Thomas Winman

Keyword(s):

Nursing Students ◽

Medical Records ◽

Practical Knowledge ◽

Nursing School ◽

Approach To Learning ◽

Video Recordings ◽

Use Of Technology ◽

Different Types ◽

Second Year ◽

Source Of Information

This study focuses on nursing students' internships and how the students are handling the tension created by expectations and dilemmas when using medical records (MRs) in practice. The overall aim of this study is to develop knowledge about what is required by nursing students in order to coordinate and sustain knowledge through the use of MRs. The theoretical approach to learning that has been adopted implies that learning takes place in social activities, and empirically this means that the study of learning and professional knowledge is a matter of studying activities where, for example, technologies are put into practical use, where experience and knowledge are brought to life. The data consists of observations of five nursing students during their second year in nursing school, interviews and ten video-recordings from shift reports. The result shows that nursing students regularly use MRs as a source of information and that they are struggling with transforming that information into action-oriented knowledge. The conclusion is that information systems such as MRs need to be understood and defined by teachers as materials and devices created or adapted to solving practical problems, and should be treated thereafter. Providers of education need to take into account the different types of intellectual or practical knowledge that professionals like nurses are expected to have, where the use of technology cannot be separated from, but need to be integrated into other aspects of knowledge.

Download Full-text