scholarly journals The Effectiveness of Modified Cottle Maneuver in Predicting Outcomes in Functional Rhinoplasty

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Elaine Fung ◽  
Paul Hong ◽  
Corey Moore ◽  
S. Mark Taylor
Keyword(s):  
Surgical Techniques ◽  
Rank Correlation ◽  
Nasal Airflow ◽  
Nasal Valve ◽  
Spearman Rank Correlation ◽  
Nasal Breathing ◽  
Analog Scale ◽  
Outcomes Evaluation ◽  
Postoperative Symptoms ◽  
External Nasal Valve

Objective. To assess the outcomes of functional rhinoplasty for nasal valve incompetence and to evaluate an in-office test used to select appropriate surgical techniques. Methods. Patients with nasal obstruction due to nasal valve incompetence were enrolled. The modified Cottle maneuver was used to assess the internal and external nasal valves to help select the appropriate surgical method. The rhinoplasty outcomes evaluation (ROE) form and a 10-point visual analog scale (VAS) of nasal breathing were used to compare preoperative and postoperative symptoms. Results. Forty-nine patients underwent functional rhinoplasty evaluation. Of those, 35 isolated batten or spreader grafts were inserted without additional procedures. Overall mean ROE score increased significantly (P<0.0001) from 41.9 ± 2.4 to 81.7 ± 2.5 after surgery. Subjective improvement in nasal breathing was also observed with the VAS (mean improvement of 4.5 (95% CI 3.8–5.2) from baseline (P=0.000)). Spearman rank correlation between predicted outcomes using the modified Cottle maneuver and postoperative outcomes was strong for the internal nasal valve (Rho = 0.80; P=0.0029) and moderate for the external nasal valve (Rho = 0.50; P=0.013). Conclusion. Functional rhinoplasty improved subjective nasal airflow in our population. The modified Cottle maneuver was effective in predicting positive surgical outcomes.

An Overview of Computational Fluid Dynamics Preoperative Analysis of the Nasal Airway

2021 ◽  
Author(s):  
Rui Xavier ◽  
Dirk-Jan Menger ◽  
Henrique Cyrne de Carvalho ◽  
Jorge Spratley
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Surgical Techniques ◽  
Virtual Surgery ◽  
Nasal Airway ◽  
Cfd Analysis ◽  
Nasal Airflow ◽  
Nasal Breathing ◽  
Objective Measurements ◽  
Patient Reported

AbstractEvaluation of the nasal airway is crucial for every patient with symptoms of nasal obstruction as well as for every patient with other nasal symptoms. This assessment of the nasal airway comprises clinical examination together with imaging studies, with the correlation between findings of this evaluation and symptoms reported by the patient being based on the experience of the surgeon. Measuring nasal airway resistance or nasal airflow can provide additional data regarding the nasal airway, but the benefit of these objective measurements is limited due to their lack of correlation with patient-reported evaluation of nasal breathing. Computational fluid dynamics (CFD) has emerged as a valuable tool to assess the nasal airway, as it provides objective measurements that correlate with patient-reported evaluation of nasal breathing. CFD is able to evaluate nasal airflow and measure variables such as heat transfer or nasal wall shear stress, which seem to reflect the activity of the nasal trigeminal sensitive endings that provide sensation of nasal breathing. Furthermore, CFD has the unique capacity of making airway analysis of virtual surgery, predicting airflow changes after trial virtual modifications of the nasal airway. Thereby, CFD can assist the surgeon in deciding surgery and selecting the surgical techniques that better address the features of each specific nose. CFD has thus become a trend in nasal airflow assessment, providing reliable results that have been validated for analyzing airflow in the human nasal cavity. All these features make CFD analysis a mainstay in the armamentarium of the nasal surgeon. CFD analysis may become the gold standard for preoperative assessment of the nasal airway.

scholarly journals Management of Rhinophyma

2016 ◽  
Vol 7 (3) ◽  
pp. 188-191
Author(s):  
Timothy S Lian ◽  
Richard W Thompson
Keyword(s):  
Surgical Techniques ◽  
Surgical Excision ◽  
Definitive Treatment ◽  
Nasal Valve ◽  
Sebaceous Glands ◽  
Tumescent Anesthesia ◽  
Sharp Dissection ◽  
Argon Beam Coagulation ◽  
External Nasal Valve ◽  
Head Neck

ABSTRACT Rhinophyma is a condition that can cause significant disfigurement as well as functional impairment of the nose. It results from hypertrophy and hyperplasia of the sebaceous glands and can be a manifestation of advanced staged rosacea. If left untreated, not only can it cause disfigurement, rhinophyma can also result in nasal airway obstruction by marked ptosis and collapse of the external nasal valve. Surgical excision is the definitive treatment as rhinophyma does not spontaneously regress. Though various surgical techniques are available for the treatment of rhinophyma, a specific technique using tumescent anesthesia, sharp dissection, and argon beam coagulation has been found to be most efficacious. This technique and its advantages are described. How to cite this article Lian TS, Thompson RW. Management of Rhinophyma. Int J Head Neck Surg 2016;7(3):188-191.

Inaccuracy of Standard 2D Photography for the Diagnosis of Cephalic Malposition of Lateral Crural Cartilages

2021 ◽  
Author(s):  
Shahin Bastaninejad ◽  
Ardavan Tajdini ◽  
Yasaman Rezaie
Keyword(s):  
Surgical Techniques ◽  
Accurate Diagnosis ◽  
Alar Cartilage ◽  
Nasal Valve ◽  
Strut Graft ◽  
Primary Rhinoplasty ◽  
The Face ◽  
Medical Photography ◽  
And Function ◽  
External Nasal Valve

AbstractLateral crural cephalic malposition (LCCM) is a well-known deformity of the nasal tip which contributes to functional disturbances of the external nasal valve. Accurate diagnosis of this deformity helps surgeons plan for better outcomes. A total of 176 candidate patients for primary rhinoplasty underwent standard 2D medical photography of the face. Senior authors analyzed photography results and differentiated the patients with LCCM. In addition, we measured the angle between the dorsal septum and lateral end of the long axis of the alar cartilage in the operation room. Ninety-five patients were diagnosed with LCCM on photography. As much as 31.3% (55) of all the patients had LCCM in intraoperative measurements. The sensitivity and specificity of 2D photography for diagnosing LCCM were 0.7924 and 0.5391, respectively. The main surgical techniques for correction of LCCM were alar repositioning (34.3% in total, 56% in LCCM patients) and lateral crural strut graft (43.8% in total, 69% in LCCM patients). LCCM is overdiagnosed via 2D photography, and this method lacks sensitivity. The overall frequency of LCCM seems to be lower than the previously reported frequency. For optimal results in rhinoplasty, surgeons must focus on the best contouring and function rather than solely correcting angles and rotations.

Single-joint Assessment for the Evaluation of Intraarticular Treatment: Responsiveness and Discrimination of the Composite Change Index

2015 ◽  
Vol 42 (9) ◽  
pp. 1672-1676 ◽  
Author(s):  
Caroline J. Aalbers ◽  
Danielle M. Gerlag ◽  
Margriet J. Vervoordeldonk ◽  
Paul P. Tak ◽  
Robert B. Landewé
Keyword(s):  
Effect Size ◽  
Controlled Trial ◽  
Rank Correlation ◽  
Joint Involvement ◽  
Spearman Rank Correlation ◽  
Analog Scale ◽  
Clinical Trial Registration ◽  
Randomized Controlled ◽  
Treatment Responsiveness ◽  
Joint Assessment

Objective.To investigate responsiveness, discrimination, and construct validity of a composite change index (CCI) for the assessment of single-joint involvement in inflammatory arthritis.Methods.Evaluation of standardized response means (SRM), Guyatt effect size, and Spearman rank correlation coefficient in a randomized controlled trial investigating the effect of an intraarticular etanercept injection.Results.The CCI showed a high SRM (1.68) and high Guyatt effect size (2.72). Both visual analog scale of pain and functionality had a moderate Guyatt effect size (2.06, 2.44) and high SRM (0.81, 0.97).Conclusion.This study supports the use of the CCI as a single-joint assessment after single-joint intervention. Clinical trial registration: NTR-1210.

HUBUNGAN BEBAN KERJA PERAWAT DENGAN KELENGKAPAN PENGISIAN DOKUMENTASI ASUHAN KEPERAWATAN

2020 ◽  
Vol 5 (2) ◽  
pp. 588
Author(s):  
Etlida Wati ◽  
Ulva Arini
Keyword(s):  
Nursing Care ◽  
Rank Correlation ◽  
Bivariate Analysis ◽  
Spearman Rank Correlation ◽  
Cross Sectional ◽  
Weight Category ◽  
Spearman Rank ◽  
Hospital Room ◽  
Analysis Technique ◽  
Nurse Workload

<p>Documentation is an activity of recording, reporting or recording an event and activities carried out in the form of providing services that are considered important and valuable. One factor that can influence documentation is the nurse's workload. The purpose of this study is to identify the relationship between nurses' workload and the application of documentation in the Hj. Anna Lasmanah Banjarnegara. This  research is quantitative with a cross sectional approach descriptive correlation design. Samples were taken with a total sampling of 65 nurses. Instruments to measure documentation using observation sheets. While the nurse workload instrument uses a questionnaire sheet. The analysis technique uses Spearman Rank correlation. Based on the research results of the workload of a nurse in the hospital room , most of them are in the weight category, as many as 46 respondents (70.8%). Application of nursing care documentation in the hospital room Hj. Anna Lasmanah Banjarnegara, most of them are respondents in the incomplete category as many as 63 respondents (96.9%). There is a significant relationship between nurse workload with the application of documentation, this is evidenced by the results of the Spearman Rank correlation bivariate analysis, which is r = 0.688 with p = 0.000 &lt;0.05. It is hoped that management will motivate nurses to complete the documentation of nursing care</p>

Efektivitas Komunikasi Pendamping Corporate Social Responsibility (CSR)

2020 ◽  
Vol 4 (6) ◽  
pp. 894
Author(s):  
Yara Falmira Dianira
Keyword(s):  
Statistical Tests ◽  
Rank Correlation ◽  
Communication Effectiveness ◽  
Message Content ◽  
Sources Of Information ◽  
Source Information ◽  
Spearman Rank Correlation ◽  
Level Of Understanding ◽  
Corporate Social

ABSTRACT An important factor for the success of a CSR program is effective communication. Communication will be effective if it has an impact. If the information is conveyed based on the needs, then the communication will be effective. This study aims to analyze the factors which are related to the effectiveness of CSR communication. This study used a census method to approach 37 participants who received CSR programs. The Data analysis used the Spearman rank correlation for the statistical tests. The results showed that there was a correlation between factors that have the strength of CSR companion communication (level of attractiveness of the companion, quality of message content, and sources of information) which have real communication at the level of understanding of the participants of the Kertajaya Creative Destination (KCD) CSR program. In addition, there is a real correlation the factors that have the strength of CSR companion communication (the level of credibility of the companion, the source information, and the level of the recipient) and having communication at the level of attitudes of participants in the Kertajaya Creative Destination (KCD) CSR program. However, there is no real correlation between CSR companion communication factors and participant actions.Keywords :communication effectiveness, CSR, elements of communication. ABSTRAK Faktor penting dari keberhasilan program CSR adalah komunikasi yang efektif. Komunikasi dikatakan efektif jika menimbulkan dampak. Bila informasi tersampaikan sesuai dengan kebutuhan, maka komunikasi yang dijalankan efektif. Penelitian ini bertujuan untuk menganalisis efektivitas komunikasi pendamping CSR. Penelitian ini menggunakan pendekatan sensus terhadap 37 orang peserta penerima program CSR. Analisis data menggunakan uji statistik korelasi rank Spearman. Hasil penelitian menunjukkan bahwa terdapat hubungan nyata antara faktor efektivitas komunikasi pendamping CSR (derajat daya tarik pendamping, kualaitas isi pesan, dan sumber informasi)  dengan efektivitas komunikasi pada tingkat pemahaman peserta program CSR Kertajaya Creative Destination (KCD). Selain itu, terdapat hubungan nyata antara faktor efektivitas komunikasi pendamping CSR (tingkat kredibilitas pendamping, sumber informasi, dan tingkat penerima) dengan efektivitas komunikasi pada tingkat sikap peserta program CSR Kertajaya Creative Destination (KCD). Namun, tidak terdapat hubungan nyata antara faktor efektivitas komunikasi pendamping CSR dengan tindakan peserta. Kata Kunci : CSR, efektivitas komunikasi, unsur-unsur komunikasi.

scholarly journals Costal Cartilage Lateral Crural Strut Graft for Correction of External Nasal Valve Dysfunction in Primary and Revision Rhinoplasty

2021 ◽  
pp. 014556132098394
Author(s):  
Mohamed A. Taha ◽  
Christian A. Hall ◽  
Harry E. Zylicz ◽  
William T. Barham ◽  
Margaret B. Westbrook ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Primary Group ◽  
Nasal Valve ◽  
Lateral Crus ◽  
Valve Dysfunction ◽  
Score Improvement ◽  
Revision Rhinoplasty ◽  
Final Score ◽  
Sinonasal Outcome Test ◽  
External Nasal Valve

Objective: To evaluate and compare the costal cartilage lateral crural strut graft’s (LCSG) ability to support a weak lateral crus in patients with external nasal valve dysfunction (EVD) undergoing primary versus revision functional rhinoplasty. Methods: This is a prospective cohort study of 26 patients (mean [SD]: 40.23 [6.75] years of age; 10 [38%] females) with clinically diagnosed EVD, who underwent primary versus revision functional rhinoplasty with the use of a costal cartilage LCSG (10 [38%] primary functional rhinoplasty patients and the 16 [62%] revision patients). Preoperative and 12-month postoperative subjective and objective functional measurements along with statistical analysis were performed. Results: While all baseline demographic and preoperative functional measurement scores were similar between the 2 groups, the primary cohort’s preoperative scores were higher overall. Follow-up was a mean of 14.58 months. The primary group demonstrated a greater difference in score improvement postoperatively in all categories. All patients had significantly improved visual analog scale (VAS), Nasal Obstruction Symptom Evaluation Scale, 22-Item Sinonasal Outcome Test, and nasal peak inspiratory flow (NPIF) scores. When comparing the overall score outcome and surgical efficacy of the LCSG, both groups had near equal final score outcomes with the exception of VASL and NPIF. Conclusion: The LCSG is a viable and versatile option in the management of EVD for both primary and revision rhinoplasty patients.

scholarly journals Does continuity in nursing staff matter? A pilot study on correlation of central line-associated bloodstream infections and employee turnover

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Thomas Scheier ◽  
Stefan P. Kuster ◽  
Mesida Dunic ◽  
Christian Falk ◽  
Hugo Sax ◽  
...  
Keyword(s):  
Nursing Staff ◽  
Employee Turnover ◽  
Rank Correlation ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Rates ◽  
Nursing Personnel ◽  
Care Hospital ◽  
Spearman Rank Correlation ◽  
Spearman Rank

Abstract Background Understaffing has been previously reported as a risk factor for central line-associated bloodstream infections (CLABSI). No previous study addressed the question whether fluctuations in staffing have an impact on CLABSI incidence. We analyzed prospectively collected CLABSI surveillance data and data on employee turnover of health care workers (HCW) to address this research question. Methods In January 2016, a semiautomatic surveillance system for CLABSI was implemented at the University Hospital Zurich, a 940 bed tertiary care hospital in Switzerland. Monthly incidence rates (CLABSI/1000 catheter days) were calculated and correlations with human resources management-derived data on employee turnover of HCWs (defined as number of leaving HCWs per month divided by the number of employed HCWs) investigated. Results Over a period of 24 months, we detected on the hospital level a positive correlation of CLABSI incidence rates and turnover of nursing personnel (Spearman rank correlation, r = 0.467, P = 0.022). In more detailed analyses on the professional training of nursing personnel, a correlation of CLABSI incidence rates and licensed practical nurses (Spearman rank correlation, r = 0.26, P = 0.038) or registered nurses (r = 0.471, P = 0.021) was found. Physician turnover did not correlate with CLABSI incidence (Spearman rank correlation, r =  −0.058, P = 0.787). Conclusions Prospectively determined CLABSI incidence correlated positively with the degree of turnover of nurses overall and nurses with advanced training, but not with the turnover of physicians. Efforts to maintain continuity in nursing staff might be helpful for sustained reduction in CLABSI rates.

scholarly journals FRI0177 MULTI-MODALITY IMAGING TO EVALUATE LUPUS NEPHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 672.2-673
Author(s):  
C. Dykas ◽  
B. H. Rovin ◽  
M. Boesen ◽  
O. Kubassova ◽  
P. Lipsky
Keyword(s):  
Image Analysis ◽  
Renal Function ◽  
Rank Correlation ◽  
Renal Perfusion ◽  
Imaging Data ◽  
Spearman Rank Correlation ◽  
Dce Mri ◽  
Analysis Group ◽  
Multi Center Study ◽  
Mean Time

Background:Lupus nephritis (LN) remains a significant cause of morbidity and mortality in subjects with Systemic Lupus Erythematosus (SLE). The gold standard for evaluation of LN remains the kidney biopsy, whereas renal function is usually evaluated by eGFR and urinary protein:creatinine ratio. More effective and sensitive methodology is needed to assess LN and also the response to treatment. Functional imaging of the kidney using quantitative techniques has great potential, as it can assess kidney function and pathologic changes non-invasively by evaluating perfusion, oxygenation, cellular density and fibrosis.Objectives:The objective of this study was to develop a multi-modality imaging approach for the evaluation of the spectrum of pathologic changes in LN and to determine when imaging data correlated with renal functionMethods:In this multi-center study (NCT03180021), subjects who were having a standard of care renal biopsy for LN were asked to participate in the imaging evaluation. Local Institutional Review Board approval was obtained, and subjects signed an Informed Consent Form. Dynamic contrast enhanced MRI (DCE-MRI) was employed to detect changes in vascularization and perfusion, Diffusion Weighted Imaging (DWI) to assess interstitial diffusion, T2*Map/BOLD to evaluate tissue oxygenation and T1rho to evaluate fibrosis (Figure 1). Regions of interest were identified in the imaged kidneys and imaging parameters were correlated with measures of renal function, including eGFR and urinary protein: creatinine ratio. In DCE-MRI, we specifically focused on mean Maximum Enhancement (ME), mean Time to Peak Enhancement (TTP) and mean Time of Washout (Twashout) as indicators of renal perfusion.Results:Nine subjects have been evaluated to date and their imaging data assessed for quality. Evaluation of mean data from DCE-MRI has shown a significant correlation between renal perfusion and renal function. For example, as shown in the figure, the 24 hour protein concentration negatively correlated with ME (rs=-0.81, p=0.015), TTP (rs=-0.83, p=0.01) and Twashout (rs=-0.81.p=0.01, Spearman rank correlation). In addition, the protein:creatinine ratio also negatively correlated with ME (rs=-0.79, p=0.02), TTP (rs=-0.74, p=0.04) and Twashout (rs=-0.79, p=0.02, Spearman rank correlation).Conclusion:These initial results have established the feasibility of multi-modality imaging as a tool to evaluate LN in a multi-center study. Moreover, changes in perfusion detected by DCE-MRI significantly correlate with proteinuria and urinary protein:creatinine ratio. These results suggest that multiparameter imaging may contribute useful data in the evaluation of subjects with LN.Figure:Disclosure of Interests:Claire Dykas: None declared, Brad H Rovin Grant/research support from: GSK, Consultant of: GSK, Mikael Boesen Consultant of: AbbVie, AstraZeneca, Eli Lilly, Esaote, Glenmark, Novartis, Pfizer, UCB, Paid instructor for: IAG, Image Analysis Group, AbbVie, Eli Lilly, AstraZeneca, esaote, Glenmark, Novartis, Pfizer, UCB (scientific advisor)., Speakers bureau: Eli Lilly, Esaote, Novartis, Pfizer, UCB, Olga Kubassova Shareholder of: IAG, Image Analysis Group, Consultant of: Novartis, Takeda, Lilly, Employee of: IAG, Image Analysis Group, Peter Lipsky Consultant of: Horizon Therapeutics

scholarly journals In vivo calibration of the T2* cardiovascular magnetic resonance method at 1.5 T for estimation of cardiac iron in a minipig model of transfusional iron overload

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Peter Diedrich Jensen ◽  
Asbjørn Haaning Nielsen ◽  
Carsten Wiberg Simonsen ◽  
Ulrik Thorngren Baandrup ◽  
Svend Eggert Jensen ◽  
...  
Keyword(s):  
Rank Correlation ◽  
Calibration Data ◽  
Iron Loading ◽  
Spearman Rank Correlation ◽  
Calibration Equation ◽  
Spearman Rank ◽  
Cardiac Iron ◽  
In Vivo Calibration ◽  
Spearman Rank Correlation Coefficient

Abstract Background Non-invasive estimation of the cardiac iron concentration (CIC) by T2* cardiovascular magnetic resonance (CMR) has been validated repeatedly and is in widespread clinical use. However, calibration data are limited, and mostly from post-mortem studies. In the present study, we performed an in vivo calibration in a dextran-iron loaded minipig model. Methods R2* (= 1/T2*) was assessed in vivo by 1.5 T CMR in the cardiac septum. Chemical CIC was assessed by inductively coupled plasma-optical emission spectroscopy in endomyocardial catheter biopsies (EMBs) from cardiac septum taken during follow up of 11 minipigs on dextran-iron loading, and also in full-wall biopsies from cardiac septum, taken post-mortem in another 16  minipigs, after completed iron loading. Results A strong correlation could be demonstrated between chemical CIC in 55 EMBs and parallel cardiac T2* (Spearman rank correlation coefficient 0.72, P < 0.001). Regression analysis led to [CIC] = (R2* − 17.16)/41.12 for the calibration equation with CIC in mg/g dry weight and R2* in Hz. An even stronger correlation was found, when chemical CIC was measured by full-wall biopsies from cardiac septum, taken immediately after euthanasia, in connection with the last CMR session after finished iron loading (Spearman rank correlation coefficient 0.95 (P < 0.001). Regression analysis led to the calibration equation [CIC] = (R2* − 17.2)/31.8. Conclusions Calibration of cardiac T2* by EMBs is possible in the minipig model but is less accurate than by full-wall biopsies. Likely explanations are sampling error, variable content of non-iron containing tissue and smaller biopsies, when using catheter biopsies. The results further validate the CMR T2* technique for estimation of cardiac iron in conditions with iron overload and add to the limited calibration data published earlier.

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