Laryngeal Dysfunction following Prolonged Intubation

1979 ◽  
Vol 88 (4) ◽  
pp. 474-478 ◽  
Author(s):  
Robert E. Whited
Keyword(s):  
Vocal Cord ◽  
Medical Center ◽  
Recovery Phase ◽  
Clinical Findings ◽  
Posterior Commissure ◽  
Prolonged Intubation ◽  
Vocal Cord Paresis ◽  
The Many ◽  
The University

Prolonged endotracheal intubation in the adult is becoming more popular with the advent of “soft” tubes and cuffs. The many deleterious effects of such long-term intubation on the laryngotrachea have been extensively discussed in the literature. However, only sporatic attention has been given to vocal cord paresis or paralysis. The University of Cincinnati Medical Center experience with postintubation patients has shown that cord mobility disturbances are relatively common. Sixteen patients are presented who have had similar clinical findings and course following extubation. The clinical picture is that of a symmetrical vocal cord paresis or paralysis associated with arytenoid and posterior commissure edema and erythema. Vocal cord position is most often median or paramedian. A spontaneous recovery over days to weeks is the usual course. During the recovery phase cord movement most often remains symmetrical; however, full motion may occur in one cord before the other. In all patients abduction was most limited and slowest to return. In this series the most significant effect has been aspiration. Two patients developed a posterior commissure stenosis. This entity is believed to be due to inflammation initiated by the tube and its movement against the posterior half of the endolarynx. In particular, inflammatory involvement of the cricoarytenoid joints and interarytenoid region best explain the clinical course. When mucosal ulcerations and granulation tissue are superimposed on the immobilized cords interarytenoid scarring may lead to chronic stenosis.

scholarly journals Liquid materials for biomedical research: a highly IT-integrated and automated biobanking solution

2019 ◽  
Vol 43 (6) ◽  
pp. 347-354 ◽  
Author(s):  
Daniela Popp ◽  
Romanus Diekmann ◽  
Lutz Binder ◽  
Abdul R. Asif ◽  
Sara Y. Nussbeck
Keyword(s):  
Life Cycle ◽  
Medical Center ◽  
Research Results ◽  
Long Term Storage ◽  
Medical Centers ◽  
It Systems ◽  
Complete Life Cycle ◽  
The University ◽  
Term Storage

Abstract Various information technology (IT) infrastructures for biobanking, networks of biobanks and biomaterial management are described in the literature. As pre-analytical variables play a major role in the downstream interpretation of clinical as well as research results, their documentation is essential. A description for mainly automated documentation of the complete life-cycle of each biospecimen is lacking so far. Here, the example taken is from the University Medical Center Göttingen (UMG), where the workflow of liquid biomaterials is standardized between the central laboratory and the central biobank. The workflow of liquid biomaterials from sample withdrawal to long-term storage in a biobank was analyzed. Essential data such as time and temperature for processing and freezing can be automatically collected. The proposed solution involves only one major interface between the main IT systems of the laboratory and the biobank. It is key to talk to all the involved stakeholders to ensure a functional and accepted solution. Although IT components differ widely between clinics, the proposed way of documenting the complete life-cycle of each biospecimen can be transferred to other university medical centers. The complete documentation of the life-cycle of each biospecimen ensures a good interpretability of downstream routine as well as research results.

scholarly journals The First Quarter of SARS-CoV-2 Testing: the University of Washington Medicine Experience

2020 ◽  
Vol 58 (8) ◽  
Author(s):  
Alexander L. Greninger ◽  
Keith R. Jerome
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Real Time ◽  
Real Time Pcr ◽  
Medical Center ◽  
Rt Pcr ◽  
University Of Washington ◽  
Clinical Laboratories ◽  
To Come ◽  
The Many ◽  
The University

ABSTRACT In early March 2020, the University of Washington Medical Center clinical virology laboratory became one of the first clinical laboratories to offer testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). When we first began test development in mid-January, neither of us believed there would be more than 2 million confirmed SARS-CoV-2 infections nationwide or that we would have performed more than 150,000 real-time PCR (RT-PCR) tests, with many more to come. This article will be a chronological summary of how we rapidly validated tests for SARS-CoV-2, increased our testing capacity, and addressed the many problems that came up along the way.

scholarly journals Marine algal flora of São Miguel Island, Azores

2021 ◽  
Vol 9 ◽  
Author(s):  
Ana I Neto ◽  
Ignacio Moreu ◽  
Edgar Rosas Alquicira ◽  
Karla León-Cisneros ◽  
Eva Cacabelos ◽  
...  
Keyword(s):  
Marine Algae ◽  
New Records ◽  
Algal Flora ◽  
Eastern Group ◽  
The Past ◽  
Presence Data ◽  
Marine Algal ◽  
The Many ◽  
The University

The macroalgal flora of the Island of São Miguel (eastern group of the Azores Archipelago) has attracted the interest of many researchers in the past, the first publications going back to the nineteenth century. Initial studies were mainly taxonomic, resulting in the publication of a checklist of the Azorean benthic marine algae. Later, the establishment of the University of the Azores on the Island permitted the logistic conditions to develop both temporal studies and long-term research and this resulted in a significant increase on research directed at the benthic marine algae and littoral communities of the Island and consequent publications. Prior to the present paper, the known macroalgal flora of São Miguel Island comprised around 260 species. Despite this richness, a significant amount of the research was never made public, notably Masters and PhD theses encompassing information regarding presence data recorded at littoral and sublittoral levels down to a depth of approximately 40 m around the Island and the many collections made, which resulted in vouchers deposited in the AZB Herbarium Ruy Telles Palhinha and the LSM- Molecular Systematics Laboratory at the Faculty of Sciences and Technology of the University of the Azores. The present publication lists the macroalgal taxonomic records, together with information on their ecology and occurrence around São Miguel Island, improving the knowledge of the Azorean macroalgal flora at local and regional scales. A total of 12,781 specimens (including some identified only to genus) belonging to 431 taxa of macroalgae are registered, comprising 284 Rhodophyta, 59 Chlorophyta and 88 Ochrophyta (Phaeophyceae). Of these, 323 were identified to species level (212 Rhodophyta, 48 Chlorophyta and 63 Ochrophyta), of which 61 are new records for the Island (42 Rhodophyta, 9 Chlorophyta and 10 Ochrophyta), one an Azorean endemic (Predaea feldmannii subsp. azorica Gabriel), five are Macaronesian endemisms (the red algae Botryocladia macaronesica Afonso-Carrillo, Sobrino, Tittley & Neto, Laurencia viridis Gil-Rodríguez & Haroun, Millerella tinerfensis (Seoane-Camba) S.M.Boo & J.M.Rico, Phyllophora gelidioides P.Crouan & H.Crouan ex Karsakoff and the green alga Codium elisabethiae O.C.Schmidt), 19 are introduced species (15 Rhodophyta, two Chlorophyta and two Ochrophyta) and 32 are of uncertain status (21 Rhodophyta, five Chlorophyta and six Ochrophyta).

Coordination of long-term data management in the Gulf of Mexico: Lessons learned and recommendations from two years of cross-agency collaboration

Shore & Beach ◽  
2020 ◽  
pp. 17-22
Author(s):  
Kathryn Keating ◽  
Melissa Gloekler ◽  
Nancy Kinner ◽  
Sharon Mesick ◽  
Michael Peccini ◽  
...  
Keyword(s):  
Gulf Of Mexico ◽  
Data Management ◽  
Management Practices ◽  
Collaborative Work ◽  
Lessons Learned ◽  
The Many ◽  
Diverse Data ◽  
The University ◽  
Term Data

This paper presents a summary of collaborative work, lessons learned, and suggestions for next steps in coordinating long-term data management in the Gulf of Mexico in the years following the Deepwater Horizon oil spill (DWH). A decade of increased research and monitoring following the DWH has yielded a vast amount of diverse data collected from response and assessment efforts as well as ongoing restoration efforts. To maximize the benefits of this data through proper management and coordination, a cross-agency and organization Long-Term Data Management (LTDM) working group was established in 2017 with sponsorship from NOAA’s Office of Response and Restoration (OR&R) and NOAA’s National Marine Fisheries Service Restoration Center (NMFS RC) and facilitated by the University of New Hampshire’s Coastal Response Research Center. This paper will describe the LTDM working group’s efforts to foster collaboration, data sharing, and best data management practices among the many state, federal, academic and non-governmental entities working to restore and improve the coastal environment in the Gulf following the DWH. Through collaborative workshops and working groups, participants have helped to characterize region-specific challenges, identify areas for growth, leverage existing connections, and develop recommended actions for stakeholders at all organizational levels who share an interest in data coordination and management activities.

A New Deal for California

2014 ◽  
Vol 4 (4) ◽  
pp. 64-70
Author(s):  
Gray Brechin
Keyword(s):  
New Deal ◽  
The United States ◽  
Public Works ◽  
University Of California ◽  
The Great Depression ◽  
Inventory Map ◽  
The Many ◽  
The University ◽  
Work Relief

This essay explains the genesis and explosive growth of the online Living New Deal, an unprecedented team effort to inventory, map, and interpret the immense public works legacy of Franklin Roosevelt’s work relief programs designed to extricate the United States from the Great Depression. Based at the University of California Berkeley Department of Geography, the project has both preservation and public policy components, demonstrating the many immediate and long-term benefits of Roosevelt’s stimulus programs in contrast to the damage wrought by neoliberal austerity.

scholarly journals Liver Replacement for Pediatric Patients

PEDIATRICS ◽  
1979 ◽  
Vol 63 (6) ◽  
pp. 825-829
Author(s):  
Thomas E. Starzl ◽  
Lawrence J. Koep ◽  
Gerhard P.J. Schröter ◽  
Charles G. Halgrimson ◽  
Kendrick A. Porter ◽  
...  
Keyword(s):  
Medical Center ◽  
Common Cause ◽  
University Of Colorado ◽  
Native Liver ◽  
One Year ◽  
Liver Replacement ◽  
The University ◽  
Long Term Survivors

Between March 1963 and January 1978, 74 patients 18 years of age or younger have had liver replacements at the University of Colorado Medical Center, Denver. The most common cause of native liver failure was biliary atresia (48/74, 65%); the second most common cause was chronic aggressive hepatitis (12/74, 16%). Twenty-nine patients (39%) lived for at least one year, and 16 are still alive one to nine years after transplantation. Technical surgical problems, rejection, and infection were the main causes of death. Improved immunosuppression is needed; nevertheless, the quality of life in the long-term survivors has encouraged continuation of this difficult work.

scholarly journals A practical workflow for organizing clinical intraoperative and long-term iEEG data in BIDS

2020 ◽  
Author(s):  
Matteo Demuru ◽  
Dorien van Blooijs ◽  
Willemiek Zweiphenning ◽  
Dora Hermes ◽  
Frans Leijten ◽  
...  
Keyword(s):  
Data Structure ◽  
The Netherlands ◽  
Epilepsy Surgery ◽  
Medical Center ◽  
Imaging Data ◽  
Neuroimaging Data ◽  
Brain Imaging Data ◽  
The University ◽  
The Brain

AbstractThe neuroscience community increasingly uses the Brain Imaging Data Structure (BIDS) to organize data, extending from MRI to electrophysiology data. While automated tools and workflows are developed that help organize MRI data from the scanner to BIDS, these workflows are lacking for clinical intracranial EEG (iEEG data). We present a practical guideline on how to organize full clinical iEEG epilepsy data into BIDS. We present electrophysiological datasets recorded from twelve subjects who underwent intracranial monitoring followed by resective epilepsy surgery at the University Medical Center Utrecht, the Netherlands, and became seizure-free after surgery. These data include intraoperative electrocorticography recordings from six patients, long-term electrocorticography recordings from three patients and stereo-encephalography recordings from three patients. We describe the 6 steps in the pipeline that are essential to structure the data from these clinical iEEG recordings into BIDS and the challenges during this process. These guidelines enable centers performing clinical iEEG recordings to structure their data to improve accessibility, reusability and interoperability of clinical data.Background & SummaryToday’s era of big data and open science has highlighted the importance of organizing and storing data in keeping with the FAIR Data Principles of Findable, Accessible, Interoperable and Reusable Data to the neuroscientific community1,2. Over the past five years, a community-driven effort to develop a simple standardized method of organizing, annotating and describing neuroimaging data has resulted in the Brain Imaging Data Structure (BIDS). BIDS was originally developed for magnetic resonance imaging data (MRI3), but now also has extensions for magnetoencephalography (MEG4), electroencephalography (EEG5), and intracranial encephalography (iEEG6). BIDS prescribes rules about the organization of the data itself, with a formalized file/folder structure and naming conventions, and provides standardized templates to store associated metadata in human and machine readable, text-based, JSON and TSV file formats. Software packages analyzing neuroimaging data increasingly support data organized using the BIDS format (https://bids-apps.neuroimaging.io/apps/). However, a major challenge in the use of BIDS is to curate the data from their source format into a BIDS validated set. Several tools exist to convert MRI source data into BIDS datasets7–11, but to our knowledge, there is currently no tool or protocol for iEEG.The University Medical Center in Utrecht, the Netherlands, is a tertiary referral center performing around 150 epilepsy surgeries per year. The success of surgery for treating focal epilepsy depends on accurate prediction of brain tissue that needs to be removed or disconnected to yield full seizure control. People referred for epilepsy surgery undergo an extensive presurgical work-up, starting with MRI and video-EEG and, if needed, PET or ictal SPECT. This noninvasive phase is followed directly by a resection, possibly guided by intraoperative ECoG, or by long-term electrocorticography (ECoG) or stereo-encephalography (SEEG) with electrodes placed on or implanted in the brain12. From January 2008 until December 2019, 560 of the epilepsy surgeries in our center were guided by intraoperative ECoG; 163 surgeries followed after long-term ECoG or SEEG investigation. These iEEG data offer a unique combination of high spatial and temporal resolution measurements of the living human brain and it is important to curate these data in a way such that they can be used by many people in the future to study epilepsy and typical brain dynamics.As part of RESPect (Registry for Epilepsy Surgery Patients, ethical committee approval (18-109)), we started to retrospectively convert raw, unprocessed, clinical iEEG data of patients that underwent epilepsy surgery from January 2008 onwards, to the iEEG-BIDS format and identified 6 critical steps in this process. With this paper, we give a practical workflow of how we collected iEEG data in the UMC Utrecht and converted these data to BIDS. We share our entire pipeline and provide practical examples of six patients with intraoperative ECoG, three patients with long-term ECoG and three patients with SEEG data, demonstrating how BIDS can be used for intraoperative as well as long-term recordings.

Psychological Issues in Bone Marrow Transplantation

PEDIATRICS ◽  
1977 ◽  
Vol 60 (4) ◽  
pp. 625-631
Author(s):  
G. Gail Gardner ◽  
Charles S. August ◽  
John Githens
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Medical Center ◽  
Underlying Disease ◽  
Medical Procedures ◽  
Psychological Issues ◽  
University Of Colorado ◽  
The Many ◽  
The University

We studied the psychological and emotional problems experienced by seven children and their families who underwent bone marrow transplantation at the University of Colorado Medical Center from 1973 to 1975. These problems included (1) anxiety and depression relating to isolation, fear of death, and painful procedures; (2) an overdependence associated with a feeling of helplessness; (3) anger directed toward both the staff and the parents; (4) a reduced tolerance for medical procedures; and (5) periodic refusal to cooperate. Initially we had been concerned that patients might become agitated, psychotic, or even suicidal. These did not occur. Severe anxiety over bodily changes was not a problem. We did not encounter prolonged refusal to cooperate, refusal to remain in isolation, or drug addiction. Important aspects in management included an honest, straightforward, and direct discussion of all aspects of transplantation, including the potential complications and the risks of death from the underlying disease or from complications of transplantation. A firm but understanding approach to the patients appeared to be the most effective method to develop their continuing cooperation. The opportunity for patients to express verbally their fears of procedures and of death was essential. The donors needed help in working through their feelings of guilt if a transplant was not successful. The parents needed continuing psychological support for the many personal, social, and psychological difficulties which they had to face.

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