scholarly journals Evaluation of transmitted glow point at a priori chosen depth (1 cm below vocal cords) for lightwand intubation: a prospective observational study

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097424
Author(s):  
Eunyoung Cho ◽  
Hyun-Chang Kim ◽  
Jung-Man Lee ◽  
Ji-Hoon Park ◽  
Najeong Ha ◽  
...  
Keyword(s):  
Observational Study ◽  
Confidence Interval ◽  
Success Rate ◽  
Prospective Observational Study ◽  
Cricoid Cartilage ◽  
A Priori ◽  
Thyroid Cartilage ◽  
Suprasternal Notch ◽  
Vocal Cords ◽  
Laryngeal Injury

Objective When performing lightwand intubation, an improper transmitted glow position before tube advancement can cause intubation failure or laryngeal injury. This study was performed to explore the transmitted glow point corresponding to a priori chosen depth for lightwand intubation. Methods Before lightwand intubation, we marked the transmitted glow point from a bronchoscope on the neck when it reached 1 cm below the vocal cords. Lightwand intubation was then performed using this marking point. The distances from the mark to the upper border of the thyroid cartilage, upper border of the cricoid cartilage, and suprasternal notch were measured. Results In total, 107 patients were enrolled. The success rate of lightwand intubation using the mark was 93.5% (95% confidence interval, 88.7%–99.2%) at the first attempt. The marking point was placed 12.0 mm (95% confidence interval, 10.6–13.4 mm) below the upper border of the cricoid cartilage. Conclusion Anaesthesiologists should be aware of the appropriate point of the transmitted glow on the patient’s neck when performing lightwand intubation. We suggest that this point is approximately 1 cm below the upper border of the cricoid cartilage. Trial registration: ClinicalTrials.gov NCT03480035

scholarly journals Learning Curve for the Acquisition of 20 Standard Two-Dimensional Images in Advanced Perioperative Transesophageal Echocardiography: A Prospective Observational Study

2021 ◽  
Author(s):  
Prasert Sawasdiwipachai ◽  
Sasithorn Thanasriphakdeekul ◽  
Vithaya Chithiraphan ◽  
Kasana Raksamani ◽  
Kamheang Vacharaksa
Keyword(s):  
Observational Study ◽  
Learning Curve ◽  
Transesophageal Echocardiography ◽  
Success Rate ◽  
Prospective Observational Study ◽  
Two Dimensional ◽  
Trainee Group ◽  
Short Course ◽  
Thoracic Anesthesia ◽  
Intraoperative Transesophageal Echocardiography

Abstract Background Learning to perform intraoperative transesophageal echocardiography takes time and practice. We aimed to determine the cumulative success rate in the first 20 intraoperative transesophageal echocardiography cases performed by trainee anesthesiologists with no transesophageal echocardiography experience. Methods This prospective observational study included nine anesthesiologists (four cardiovascular and thoracic anesthesia fellows and five short-course perioperative intraoperative transesophageal echocardiography trainees). Overall, 180 studies self-performed by the trainees were reviewed by certified reviewers. A study was considered successful when at least 15 qualified images were collected within 30 minutes. The cumulative success of each trainee was used as a surrogate of a basic two-dimensional intraoperative transesophageal echocardiography learning curve. Results The participants comprised three male and six female anesthesiologists aged 29–43 years with 2–13 years of work experience. Most studies (146/180, 81.11%) were completed within 30 minutes, and the cumulative success rate was 70–90% (average 82.78 ± 6.71%). The average cumulative success rate in the short-course group (85 ± 7.07%) was higher than that in the official cardiovascular and thoracic fellow trainee group (80 ± 7.07%). The recommended caseload for a 75–80% success rate was 14–18 cases (95% confidence interval, 0.675–0.969). Conclusions We recommended a 14–18 caseload for a target success rate of 75–80% in studies performed by trainees with no previous experience. Our findings will enable the development of programs to train anesthesiologists in intraoperative transesophageal echocardiography.

Factors associated with frovatriptan response in patients with migraine: A prospective, observational study

Cephalalgia ◽  
2015 ◽  
Vol 36 (5) ◽  
pp. 493-498 ◽  
Author(s):  
Jong-Geun Seo ◽  
Sung-Pa Park
Keyword(s):  
Major Depressive Disorder ◽  
Risk Factor ◽  
Observational Study ◽  
Confidence Interval ◽  
Depressive Disorder ◽  
Odds Ratio ◽  
Prospective Observational Study ◽  
Major Depressive ◽  
Factors Associated ◽  
Headache Clinic

Background Almost one-third of patients with migraine do not adequately respond to triptans. We examined factors contributing to frovatriptan response in patients with migraine. Methods We enrolled new patients with migraine who consecutively visited our headache clinic. Eligible patients were instructed to take 2.5 mg of frovatriptan as soon as possible after migraine attack. The responsiveness was determined by whether headache was relieved or absent within 4 hours after the intake of frovatriptan. We assessed frovatriptan to be efficacious when headache responded to its administration in at least one of two successive migraine attacks and inefficacious when headache was not relieved in either attack. We included demographic, clinical and psychiatric variables in the analysis of factors associated with frovatriptan response. Results Of 128 eligible patients, 28 (21.9%) experienced frovatriptan inefficacy. In 24 patients with current major depressive disorder, 12 (50.0%) had frovatriptan inefficacy. Only current major depressive disorder was identified as a risk factor for inefficacy (odds ratio = 5.500, 95% confidence interval 2.103–14.382, p = 0.001). Conclusions Depression may be a risk factor of frovatriptan inefficacy in patients with migraine, even though half of patients with major depressive disorder respond to frovatriptan.

scholarly journals OUTCOMES OF CIRCUMFERENTIAL V/S ANTERIOR TUCKING TYMPANOPLASTY TECHNIQUE IN INACTIVE MUCOSAL CHRONIC OTITIS MEDIA WITH SUBTOTAL PERFORATIONS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 95-98
Author(s):  
Sultan Singh Rulania ◽  
Sushma Mahich ◽  
Rekha Harshvardhan
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Otitis Media ◽  
Uptake Rate ◽  
Prospective Observational Study ◽  
Chronic Otitis Media ◽  
Hearing Gain ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: The objective of the study is to compare circumferential versus anterior tucking underlay tympanoplasty technique. Methods: In this prospective observational study, 100 patients with chronic otitis media (Inactive mucosal type) were included, who were randomly allocated in two groups; Group I which comprised of 50 patients in which tympanoplasty with anterior tucking was done, and Group II comprised of 50 patients in which circumferential flap tympanoplasty was done. Improvement in the hearing gain and graft uptake success rate was compared. Results: The mean air-bone gap (ABG) changed from 28.74 dB to 11.52 dB after anterior tucking with a mean change of 17.22 dB and this change was found to be statistically significant (p<0.001). Similarly, the mean ABG changed from 28.92 dB to 11.86 dB after a circumferential flap with a mean change of 17.06 dB and this change was also found to be statistically significant (p<0.001). There was a slightly better improvement (17.22 dB) in the anterior tucking group as compared to the circumferential flap (17.06 dB). This difference was, however, not found to be statistically significant (p=0.830). Three-month graft uptake rate in the anterior tucking group was found 92% and in the circumferential group was 94%. (p>0.05). Conclusions: Our study concluded that both techniques have almost the same results with good graft uptake. Results of hearing improvements in both techniques were also comparable.

Platelet/Lymphocyte Ratio and Risk of In-Hospital Mortality in Patients with ST-Elevated Myocardial Infarction - A Prospective Observational Study from KIMS, Hubli, Karnataka

2021 ◽  
Vol 8 (41) ◽  
pp. 3528-3533
Author(s):  
Uday Subhash Bande ◽  
Kalinga Bommanakatte Eranaik ◽  
Basawantrao Kailash Patil ◽  
Manjunath Shivalingappa Hiremani ◽  
Sushma Shankaragouda Biradar
Keyword(s):  
Myocardial Infarction ◽  
Observational Study ◽  
Confidence Interval ◽  
Hospital Mortality ◽  
Atherosclerotic Plaque ◽  
Prospective Observational Study ◽  
Receiver Operating Curve ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Platelet Lymphocyte Ratio

BACKGROUND Cardiovascular disease is a significant health problem in India with an estimate 3.7 million deaths each year. Mechanisms of myocardial ischemia include inflammation, endothelial dysfunction, platelet aggregation and coagulation. Acute coronary syndrome occurs due to rupture of atherosclerotic plaque. Platelets play a role in both development and rupture of the atherosclerotic plaque. Lymphocytes play a role in chronic inflammation of atherosclerosis. Lower lymphocyte count has increased mortality after acute myocardial infarction. METHODS The study was conducted in Department of General Medicine, Karnataka Institute of Medical Sciences, Hubli from February 2019 to December 2020. It is a prospective observational study. Patients aged ≥ 18 years with ST-elevated myocardial infarction (STEMI) were included in the study. Total 156 cases were selected based on inclusion and exclusion criteria. Cardiovascular events during the in-hospital period were noted. The study population was divided into tertiles based on the platelet-lymphocyte ratio (PLR) values. The low PLR group (n = 104) was defined as having values in the lower 2 tertiles (PLR ≤ 148.4) and the high PLR group (n = 52) was defined as having values in the highest tertile (PLR > 148.4). A ‘P’ value < 0.05 was considered statistically significant. RESULTS Out of 156 patients, 103 (66 %) were males and 53 (34 %) cases were female. Mean age group was 59 ± 10 years. Percentage of patients who underwent thrombolysis was higher in high PLR group (65.38 % vs. 48.07 %, P = 0.041). Death rate was higher in high PLR group (28.84 % vs. 8.65 %, P = 0.001). PLR > 148.4 was found to be an independent predictor of in-hospital cardiovascular mortality in multivariate analyses (hazard ratio: 13.222 (2.113-21.749) P = 0.006 with 95 % confidence interval). Receiver operating curve (ROC) analyses, a PLR value of 148.4 for in-hospital mortality rate had sensitivity of 62.5 % and a specificity of 72 % (area under the curve = 0.627, 95% confidence interval 0.485 – 0.769). CONCLUSIONS In our study, higher PLR had significant association with in-hospital mortality in patients with STEMI. KEYWORDS ST Elevation Myocardial Infarction (STEMI), Platelet/Lymphocyte Ratio (PLR), Ischemic Heart Disease (IHD)

Ultrasound-Guided Cannulation of the Brachiocephalic Vein in Neonates and Preterm Infants: A Prospective Observational Study

2017 ◽  
Vol 35 (05) ◽  
pp. 503-508 ◽  
Author(s):  
Paula Alonso-Quintela ◽  
Sandra Terroba-Seara ◽  
Aquilina Jiménez-González ◽  
Silvia Rodríguez-Blanco ◽  
José Vázquez-Martínez ◽  
...  
Keyword(s):  
Observational Study ◽  
Success Rate ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Venous Catheter ◽  
Late Complications ◽  
Brachiocephalic Vein ◽  
Success Rates ◽  
Low Weight

Introduction Percutaneous central venous catheter (CVC) insertion is a challenging procedure in neonates, especially in preterm infants. Objective This study aims to describe the technical success and safety profile of ultrasound (US)-guided brachiocephalic vein (BCV) cannulation in neonates. Methods Prospective observational study. Neonates admitted to the neonatal intensive care unit (NICU) in whom US-guided cannulation of the BCV was attempted were eligible. Outcomes included first attempt success rate, the overall success rate, the number of attempts, the cannulation time, immediate mechanical complications, catheter indwelling days, and late complications. Results A total of 40 procedures in 37 patients were included. Median weight and age at the time of cannulation were 1.85 kg (0.76–4.8) and 13 days (3–31), respectively. First attempt and overall success rates were 29 (72.5%) and 38 (95%), respectively. No major complications were observed. Catheter-associated infection rate was 2.4/1,000 catheter days. There were no difference in outcomes between low weight preterm infants (<1.5 kg) and the rest of the cohort. There was no linear relationship between weight at time of insertion and the number of puncture attempts (r = 0.250; p = 0.154) or cannulation time (r = 0.257; p = 0.142). Conclusion US-guided cannulation of the BCV may be considered in acutely ill neonates, including small preterm infants, who need a large bore CVC.

Thyroid cartilage at the suprasternal notch with low situated thyroid gland

1988 ◽  
Vol 102 (5) ◽  
pp. 476-478 ◽  
Author(s):  
Soliman M. Soliman
Keyword(s):  
Congenital Anomaly ◽  
Thyroid Gland ◽  
Hyoid Bone ◽  
Cricoid Cartilage ◽  
Thyroid Cartilage ◽  
Suprasternal Notch ◽  
Cervical Trachea

AbstractThe thyroid cartilage and thyroid gland forming a lump at the suprasternal notch is a surprising congenital anomaly which I believe has not been previously reported.A case with co-existent low hyoid bone, pharyngo-oesophageal junction and intrathoracic cricoid cartilage with no cervical trachea is presented. Its pathogenesis is suggested and its surgical importance is discussed.

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