scholarly journals Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection

2019 ◽  
pp. 014556131985934
Author(s):  
Timothy N. Baerg ◽  
Jennifer F. Ha ◽  
Megan Christ ◽  
Glenn E. Green
Keyword(s):  
Social Sciences ◽  
Skin Irritation ◽  
Anastomotic Dehiscence ◽  
Postoperative Management ◽  
Short Term ◽  
Risks And Benefits ◽  
Cricotracheal Resection ◽  
Laryngotracheal Reconstruction ◽  
Neck Control ◽  
Analyze Data

The worst complication of cricotracheal resection (CTR) is anastomotic dehiscence, and to limit it, postoperative management at Michigan Medicine included the use of a modified Minerva cervical-thoracic orthosis (MMCTO). To date, there has been no analysis of the risks and benefits of the brace’s use following CTR. We analyze this with our retrospective study. A search with the keywords “cricotracheal resection” and “laryngotracheal reconstruction” was performed in the Electronic Medical Record Search Engine to identify patients retrospectively. The Statistical Package for Social Sciences was used for analysis; t test, χ2, and Fisher exact tests were used to analyze data. Fifteen males and 13 females with a median age of 4 years were identified, and almost 2/3 had a supra- and/or infrahyoid release performed. Postoperatively, 12 had a Grillo stitch and an MMCTO for a mean of 7 days. Most had no complications, but the most common complications were agitation due to brace discomfort and skin irritation. The worst complication was stroke. Our MMCTO’s design allowed for better head and neck control with relative comfortability, and most patients had no complications with its short-term use. Our modification may be useful adjunct in the postoperative management.

Pediatric Laryngotracheal Stenosis: Where Are We Heading

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P67-P67
Author(s):  
Kishore Sandu
Keyword(s):  
Recurrent Laryngeal Nerve Palsy ◽  
Anastomotic Dehiscence ◽  
Tracheal Resection ◽  
Vocal Cords ◽  
Cricotracheal Resection ◽  
Laryngotracheal Reconstruction ◽  
Grade Ii ◽  
Partial Cricotracheal Resection ◽  
Grade Iii ◽  
Severe Grade

Objective We compare decannulation rates after Laryngotracheal Reconstruction(LTR) and Cricotracheal Resection(CTR) in matched patients. Glottic Stenosis remains a challenge and can be treated by Extended Partial Cricotracheal Resection(PCTR). The objective of the paper is to systematically classify patients to be treated by these different techniques. Methods In 61% of patients, single-stage PCTR with peroperative resection of the tracheostoma was chosen if no more than 5 tracheal rings were resected with the SGS. If the location of the tracheostoma requires the resection of 6 or more tracheal rings, then PCTR was performed in 2 stages. 13% of children in this group sustained an anastomotic dehiscence, compared to 4.5% of children who had a shorter tracheal resection. 17 patients who weighed under 10 kg of body weight and were less than 1 year old underwent CTR and have all been decannulated. Results It is noteworthy that more than a single procedure was necessary in 68% of the cases to reach the aforementioned results with LTRs, whereas only 18% of the cases needed a second open procedure to achieve decannulation with PCTR. Extended PCTR with LT mold for complex frozen larynges has proven to have promise. Complications included anastomotic granulations, minor dehiscence. No patient had a recurrent laryngeal nerve palsy. Conclusions LTR is a less extensive procedure and is preferred for some grade II and less severe grade III stenoses. CTR is reserved for severe grade III and IV stenosis. Stenosis close to the vocal cords remains a challenge and can be treated by extended PCTR.

Religion in the Age of the Anthropocene

2019 ◽  
Author(s):  
Arianne F. Conty
Keyword(s):  
Social Sciences ◽  
Climate Change ◽  
Natural Sciences ◽  
Human Beings ◽  
Risks And Benefits ◽  
Human Exceptionalism ◽  
The Earth ◽  
Contemporary Christian ◽  
Genesis 1 ◽  
Forms Of Life

Though responses to the Anthropocene have largely come from the natural and social sciences, religious responses to the Anthropocene have also been gaining momentum and many scholars have been calling for a religious response to complement scientific responses to climate change. Yet because Genesis 1:28 does indeed tell human beings to ‘subdue the earth’ monotheistic religions have often been understood as complicit in the human exceptionalism that is thought to have created the conditions for the Anthropocene. In distinction to such Biblical traditions, indigenous animistic cultures have typically respected all forms of life as ‘persons’ and such traditions have thus become a source of inspiration for ecological movements. After discussing contemporary Christian efforts to integrate the natural sciences and the environment into their responses to the Anthropocene, this article will turn to animism and seek to evaluate the risks and benefits that could ensue from a postmodern form of animism that could provide a necessary postsecular response to the Anthropocene.

The Phantom at The Opera

2021 ◽  
Author(s):  
Sidney Tarrow
Keyword(s):  
Social Sciences ◽  
Political Development ◽  
American Political Development ◽  
Short Term ◽  
The Social

Movements and parties have given rise to two largely separates specialties in the social sciences. This Element is an effort to link the two literatures, using evidence from American political development. It identifies five relational mechanisms governing movement/party relations: two of them short term, two intermediate term, and one long-term. It closes with a reflection on the role of movement/party relations in democratization and for democratic resilience.

Integration of Web-Based Learning into Higher Education Institutions in Uganda

2018 ◽  
Vol 13 (3) ◽  
pp. 33-50
Author(s):  
Baguma Asuman ◽  
Md. Shahadat Hossain Khan ◽  
Che Kum Clement
Keyword(s):  
Social Sciences ◽  
Higher Education ◽  
Teaching And Learning ◽  
Educational Institutions ◽  
Web Based ◽  
Web Based Learning ◽  
Learning Contexts ◽  
New Knowledge ◽  
Quantitative And Qualitative Methods ◽  
Analyze Data

This article reports on the barriers encountered by teachers and the possible solutions to the integration of web-based learning (WBL) into higher educational institutions in Uganda. A total of 50 teachers in the departments of ICT, management, and social sciences from five different universities were purposively selected. A self-designed questionnaire was adapted to collect participants responses. Both quantitative and qualitative methods were used to analyze data. The findings indicate that teachers had a positive attitude to incorporate WBL into teaching and learning process, but they encountered some difficulties which were identified as slow internet speeds, insufficient web-based tools, lack of technical support, etc. It further identified possible enablers to overcome these difficulties and provides empirical evidence of incorporating new knowledge in the existing literature. It also provides recommendations in terms of overcoming difficulties to enhance and incorporate WBL in teaching and learning contexts of higher education in Uganda particularly and developing countries in general

Arytenoid Prolapse as a Consequence of Cricotracheal Resection in Children

2001 ◽  
Vol 110 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Michael J. Rutter ◽  
Benjamin E. J. Hartley ◽  
Dana Thompson Link ◽  
Robin T. Cotton
Keyword(s):  
Positive Airway Pressure ◽  
Incidental Finding ◽  
Anastomotic Dehiscence ◽  
Poor Sleep ◽  
Arytenoid Cartilage ◽  
Laryngotracheal Stenosis ◽  
Shortness Of Breath ◽  
Rigid Endoscopy ◽  
Cricotracheal Resection ◽  
Endoscopic Laser

Cricotracheal resection (CTR) is a technique introduced comparatively recently for treating severe laryngotracheal stenosis in children. The recognized complications of CTR include recurrent laryngeal nerve damage, anastomotic dehiscence, and restenosis. We describe a further complication of CTR, namely, prolapse of the arytenoid cartilage. The presentation may be late, with symptoms of shortness of breath on exertion and nocturnal stertor with a poor sleep pattern, or the prolapse may be an asymptomatic incidental finding. The diagnosis is performed with flexible nasopharyngoscopy with the patient unanesthetized, or with rigid endoscopy with the patient lightly anesthetized and spontaneously ventilating. The affected arytenoid cartilage is noted to prolapse anteriorly and medially with inspiration, partly obstructing the airway. If treatment is required, endoscopic laser partial arytenoidectomy is effective. In a series of 44 children who underwent CTR, 20 were noted to develop arytenoid prolapse after operation. Twelve were asymptomatic, and 8 required laser arytenoidectomy, 2 of whom now require continuous positive airway pressure for moderate supraglottic collapse.

scholarly journals Dynamical Evolutionary Psychology: Mapping the Domains of the New Interactionist Paradigm

2002 ◽  
Vol 6 (4) ◽  
pp. 347-356 ◽  
Author(s):  
Douglas T. Kenrick ◽  
Jon K. Maner ◽  
Jon Butner ◽  
Norman P. Li ◽  
D. Vaughn Becker ◽  
...  
Keyword(s):  
Social Sciences ◽  
Dynamical Systems ◽  
Social Goals ◽  
Cultural Norms ◽  
Evolutionary Models ◽  
Evolutionary Time ◽  
Short Term ◽  
Evolutionary Theories ◽  
Interactionist Paradigm ◽  
Systems Models

Dynamical systems and evolutionary theories have both been proposed as integrative approaches to psychology. These approaches are typically applied to different sets of questions. Dynamical systems models address the properties of psychological systems as they emerge and change over time; evolutionary models address the specific functions and contents of psychological structures. New insights can be achieved by integrating these two paradigms, and we propose a framework to begin doing so. The framework specifies a set of six evolutionarily fundamental social goals that place predictable constraints on emergent processes within and between individuals, influencing their dynamics over the short-term, and across developmental and evolutionary time scales. These social goals also predictably influence the dynamic emergence and change of cultural norms. This framework has heuristic as well as integrative potential, generating novel hypotheses within a number of unexplored areas atpsychology's interface with the other biological and social sciences.

scholarly journals Teaching Sustainable Development in a Sensory and Artful Way—Concepts, Methods, and Examples

2021 ◽  
Vol 13 (24) ◽  
pp. 13619
Author(s):  
Harald Heinrichs
Keyword(s):  
Social Sciences ◽  
Higher Education ◽  
Sustainable Development ◽  
Present Article ◽  
Sustainable Development Goals ◽  
Course Design ◽  
Sustainability Science ◽  
Short Term ◽  
Major Threat ◽  
Development Goals

Despite significant short-term pressures such as the recent Coronavirus pandemic with its economic and social disruptions, longer-term environmental un-sustainability and its projected intergenerational consequences remain a major threat for the future of mankind. More and new efforts are required in all social spheres with regard to the universal Sustainable Development Goals. In this context, the present article makes the argument for teaching sustainable development in higher education with a more sensory and artful approach, in order to raise students’ awareness of the multisensory reality of human existence and develop skills to engage creatively for sustainability transformations. Rooted in the perspective of sensory and arts-based sustainability science, three experimental bachelor courses—designed and conducted by the author of this article in collaboration with artists—with twenty to twenty-five students in each course from diverse disciplinary backgrounds in environmental studies, cultural studies, and social sciences are presented and discussed. It is argued that the specific course design and the scientific-artistic co-teaching provide an innovative way to teach sustainability topics in a more sensory way. The article ends with an outlook on potentials and challenges of this approach.

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