UNANTICIPATED DIFFICULT AIRWAY MANAGEMENT IN A TRAUMA PATIENT WITH SEVERE ANKYLOSING SPONDYLITIS

2021 ◽  
pp. 89-90
Author(s):  
T. G. Dissanayakege ◽  
Marie Fernando
Keyword(s):  
Ankylosing Spondylitis ◽  
Soft Skills ◽  
The Body ◽  
Failed Intubation ◽  
Appropriate Use ◽  
Successful Management ◽  
Trauma Victim ◽  
Surgical Tracheostomy ◽  
Airway Anatomy ◽  
Set Up

Ankylosing spondylitis is a chronic debilitating arthropathy affecting multiple joints in the body. Airway implications related to the disease pose a signicant challenge to the anaesthesiologists especially when an unanticipated difcult airway is encountered. A case of 42 year old trauma victim who needed an emergency denitive airway at ward set up, is reported here. Failed intubation due to complex airway anatomy associated with ankylosing spondylitis ensued him being ended up with an emergency surgical tracheostomy. Appropriate use of newer airway adjuncts and workplace soft skills contributed to successful management of an unanticipated difcult airway.

Unanticipated Difficult Airway Management in a Trauma Partient with Severe Ankylosing Spondylitis

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Werner Held ◽  
Marie Fernando
Keyword(s):  
Ankylosing Spondylitis ◽  
Difficult Airway ◽  
Soft Skills ◽  
Difficult Airway Management ◽  
Appropriate Use ◽  
Successful Management ◽  
Trauma Victim ◽  
Surgical Tracheostomy ◽  
Airway Anatomy ◽  
Chronic Arthropathy

Ankylosing Spondylitis is a debilitating chronic arthropathy that affects multiple joints. Anaesthesiologists face significant challenges when dealing with the airway implications of this disease, especially when it is unanticipated that a difficult airway may be encountered. This case describes a 42-year-old trauma victim who required an emergency denitive trachea at his ward. Ankylosing Spondylitis and complex airway anatomy led to his intubation failure. He was eventually given an emergency surgical tracheostomy. The successful management of a difficult airway was possible thanks to the appropriate use of modern airway adjuncts as well as workplace soft skills.

External work in level and grade walking on a motor-driven treadmill

1960 ◽  
Vol 15 (5) ◽  
pp. 759-763 ◽  
Author(s):  
J. W. Snellen
Keyword(s):  
Heat Loss ◽  
Heat Production ◽  
Total Energy Expenditure ◽  
The Body ◽  
External Work ◽  
Thermal Exchange ◽  
Level Walking ◽  
The Subject ◽  
Set Up ◽  
Physical Laws

When studying a walking subject's thermal exchange with the environment, it is essential to know whether in level walking any part of the total energy expenditure is converted into external mechanical work and whether in grade walking the amount of the external work is predictable from physical laws. For this purpose an experiment was set up in which a subject walked on a motor-driven treadmill in a climatic room. In each series of measurements a subject walked uphill for 3 hours and on the level for another hour. Metabolism was kept equal in both situations. Air and wall temperatures were adjusted to the observed weighted skin temperature in order to avoid any heat exchange by radiation and convection. Heat loss by evaporation was derived from the weight loss of the subject. All measurements were carried out in a state of thermal equilibrium. In grade walking there was a difference between heat production and heat loss by evaporation. This difference equaled the caloric equivalent of the product of body weight and gained height. In level walking the heat production equaled heat loss. Hence it was concluded that in level walking all the energy is converted into heat inside the body. Submitted on April 26, 1960

On one-dimensional unsteady flow at infinite Mach number

1968 ◽  
Vol 304 (1478) ◽  
pp. 255-273 ◽  
Keyword(s):  
Asymptotic Expansion ◽  
Blast Wave ◽  
Outer Part ◽  
The Body ◽  
Viscous Boundary Layer ◽  
Outer Flow ◽  
Hypersonic Speeds ◽  
Set Up ◽  
Viscous Boundary ◽  
Infinite Set

The use of the blast-wave analogy, as an aid to the interpretation of experimental data on the motion of a fluid past an obstacle at hypersonic speeds, has led to the theoretical study of its role in an asymptotic expansion of the solution to the governing equations at large distances downstream of the body. In all attempts to set up such an expansion it has proved necessary to divide the flow régime into two parts, an outer part dominated by the blast wave and an inner part consisting of streamlines which, originally, pass close by the body. The matching of these two regions is apparently only possible if a certain integral vanishes. In the present paper a numerical integration, in one particular set of circumstances, is carried out to test the validity of the asymptotic expansion proposed. Formally, an unsteady problem is tackled, for ease of computation, but the steady analogue follows immediately and is of exactly the form discussed in the earlier investigations. It is found that the main results are in line with the theory and that the integral in question is indistinguishable from zero. However, a deeper investigation of the asymptotic expansion shows that, for an expansion of the type envisaged, an infinite set of integrals must each vanish. The next integral does not appear to be zero according to our computations but this result is not believed to be conclusive. Assuming that all the integrals do vanish, then it appears that the inner layer, which although inviscid, has many of the characteristics of a viscous boundary layer, has the addi­tional, surprising property that it can exert no direct influence on the outer flow at large distances downstream of the body.

scholarly journals Weavers & Warriors? Gender and Online Identity in 1997 and 2007 V1.0

2008 ◽  
Vol 2 (2) ◽  
Author(s):  
Deirdre Ruane
Keyword(s):  
Preliminary Investigation ◽  
The Body ◽  
Internet Technology ◽  
Online Identity ◽  
Men And Women ◽  
Online Interactions ◽  
And Performance ◽  
And Gender ◽  
Set Up ◽  
Active Exploration

In 1997 the Internet was seen by many as a tool for radical reinterpretation of physicality and gender. Cybertheorists predicted we would leave our bodies behind and interact online as disembodied minds, and that the technology would reshape the way we saw ourselves. However, physicality has proved to be an inextricable part of all our interactions. Changing Internet technology has allowed Net users to find a myriad ways to perform and express their gender online. In this paper I consider attitudes to gender on the Net in 1997, when the main concerns were the imbalance between men and women online and whether it was possible or desirable to bring the body into online interactions. In much of the discourse surrounding gender online, a simple binary was assumed to exist. I go on to consider the extent to which those attitudes have changed today. Through my own experience of setting up a women’s community on Livejournal, and my observations of a men’s community set up in response, I conclude that though traditional attitudes to gender have largely translated to the Net and the binary is still the default view, some shifts have occurred. For example, between 1997 and today there seems to have been a fundamental change in perceptions of women’s attitudes to adversarial debate, and an increase in awareness of genders beyond the binary. In addition, experience and preliminary investigation lead me toward a hypothesis that today’s female-identified Net users are engaged in more conscious and active exploration and performance of their gender online than male-identified users are.

Theorising love in sociological thought: Classical contributions to a sociology of love

2017 ◽  
Vol 18 (1) ◽  
pp. 3-20 ◽  
Author(s):  
Mihai Stelian Rusu
Keyword(s):  
Nuclear Family ◽  
Social World ◽  
The Body ◽  
Talcott Parsons ◽  
Sociological Tradition ◽  
Binding Force ◽  
Social Nature ◽  
External Pressures ◽  
The Social ◽  
Set Up

This article sets out to explore the contributions of classical social thinkers to a sociological understanding of love. It builds on the premise that despite its major relevance and consequential importance in shaping both individual lives and the social world, until recently love was a heavily undertheorised topic in the sociological tradition. Moreover, the body of disparate sociological reflections that have been made on the social nature of love has been largely forgotten in the discipline’s intellectual legacy. The article then proceeds in unearthing the classics’ contributions to a sociology of love. It starts with Max Weber’s view that love promises to be a means of sensual salvation in an increasingly rationalised social world based on impersonal formal relationships. Next, it critically examines Pitirim A. Sorokin’s integral theory of love. It then moves to address Talcott Parsons’ view on love as a binding force whose social function is to integrate the conjugal couple of the modern nuclear family in the absence of the external pressures exerted by the kinship network. The article concludes by showing how these conceptualisations of love were all embedded in wider theoretical constructions set up to account for the modernisation process.

The generative role of curiosity in soft skills development for contemporary VUCA environments

2020 ◽  
Vol 33 (5) ◽  
pp. 737-751
Author(s):  
Alison Horstmeyer
Keyword(s):  
Design Methodology ◽  
Soft Skills ◽  
The Body ◽  
Skills Development ◽  
Soft Skill ◽  
Content Type ◽  
A Value ◽  
Skill Gaps ◽  
Practical Implications

PurposeThis paper examines the role of curiosity in volatile, uncertain, complex and ambiguous (VUCA) work contexts.Design/methodology/approachThis conceptual article relied upon an examination of literature about curiosity, VUCA and soft skills.FindingsCuriosity, when encouraged and supported within the workforce, may aid organizations in closing soft skill gaps and better navigating ambiguity, perpetually changing business landscapes, and rapidly advancing technology.Research limitations/implicationsEmpirical research is needed to validate, confirm and further explicate the specific mechanisms and value of curiosity within VUCA environments.Practical implicationsOrganizations need to move beyond espousing a value of curiosity to deliberately and effectively cultivating and supporting it within their employees.Originality/valueAlthough ample research and literature has examined curiosity, soft skills and VUCA environments independently, the body of literature on the specific role of curiosity in such environments is limited.

Selling the role of salvage: Cell salvage past and present

2020 ◽  
Vol 30 (11) ◽  
pp. 336-339
Author(s):  
Lucy Godfrey
Keyword(s):  
Large Scale ◽  
Emergency Situation ◽  
Cost Effective ◽  
The Body ◽  
Cell Salvage ◽  
Autologous Transfusion ◽  
Allogenic Transfusion ◽  
Set Up ◽  
Meta Analyses

The use of transfused blood, be it from an allogenic (donor) or autologous (same patient) source, is not a new treatment and in fact has been experimented with since the mid 1800s. The role of cell salvage and re-infusion of a patient’s own blood, however, has only begun to gain real popularity in the last 20 years, after the undertaking of several large scale meta-analyses which have shown that not only is autologous transfusion no less efficacious when compared to allogenic transfusion, but also potentially safer for a number of reasons. Autologous transfusion is also more cost effective overall and potentially quicker to initiate in an emergency situation. Despite the body of evidence to support the use of salvaged blood for transfusion, hesitation around its use still persists, with staff apprehension around set up of cell salvage equipment and general underestimation of intraoperative blood loss being key factors in its underuse.

scholarly journals Effectiveness of Echinochrome on HFD-Induced Hyperlipidemia in Rats

2019 ◽  
Vol 9 (5) ◽  
pp. 337-344
Author(s):  
Sohair R. Fahmy ◽  
Nashwah Ismail Zaki ◽  
Shaimaa Zakaria Eid ◽  
Ayman Saber Mohamed ◽  
Sarah S. Hassanein
Keyword(s):  
High Fat Diet ◽  
The Body ◽  
Control Group ◽  
High Fat ◽  
Obese Rats ◽  
Liver Functions ◽  
Set Up ◽  
Antioxidant Markers ◽  
Kidney Functions ◽  
Group 1

Abstract Obesity has been identified with an expanded danger of a progression of illnesses that include different organ-frameworks of the body. In the present examination, we evaluated the hypolipidemic properties of Echinochrome (Ech) pigment in a high-fat diet (HFD) induced hyperlipidemia in rats. After the hyperlipidemic model was set up, rats were haphazardly separated into five groups as follows: normal control group, HFD group, Atorvastatin (ATOR) group (80 mg/kg), Ech group (1 mg/kg) and combined group ATOR + Ech. The outcomes demonstrated that Ech improves lipid profile, liver functions, kidney functions and antioxidant markers of obese rats. The findings of the present investigation indicated that the Ech possesses hypolipidemic potential in obese rats.

scholarly journals Clinicopathological Characteristics and Non-Adhesive Organ Culture of Insulinomas

2008 ◽  
Vol 97 (1) ◽  
pp. 42-49 ◽  
Author(s):  
D. Hoem ◽  
D. Jensen ◽  
S. Steine ◽  
T. E. Thorsen ◽  
A. Viste ◽  
...  
Keyword(s):  
Organ Culture ◽  
Ct Scan ◽  
Endoscopic Ultrasonography ◽  
Cell Biology ◽  
Age Of Onset ◽  
Clinicopathological Characteristics ◽  
The Body ◽  
University Hospital ◽  
Rare Type ◽  
Set Up

Background and Aims: Insulinoma is a very rare type of islet cell tumour, but nevertheless the most common endocrine tumour of the pancreas. We aimed at reviewing our clinical experience with this tumour type and to assess whether organ culture could be obtained from surgically resected insulinoma material. Material and Methods: All patients with insulinomas (6 men and 10 women) referred to Haukeland University Hospital between 1986 and 2006 were included in the study. Median age of onset was 53 years (range 21–74). Biochemical diagnosis was established during a 72 h fast test. Imaging and localization of the tumours were performed with intra-operative ultrasonography, endoscopic ultrasonography, CT-scan and/or transcutaneous ultrasonography. For six patients, organ cultures were set up from tumour tissue fragments. Results: The annual incidence of insulinoma was 0.8 per million. The patients generally presented with non-specific, episodic symptoms, which often were mistaken for cardiovascular, neurological or diabetic disease and in some cases delayed the diagnosis with several years. Two patients had diabetes prior to the diagnosis of insulinoma. Patient weight gain was probably due to increased food intake, compensating for the hypoglycemia. Intra-operative ultrasonography detected all tumours correctly, whereas 73% were detected by endoscopic ultrasonography and 38% by CT scan. Five insulinomas were located in the head, eight in the body and three in the tail of the pancreas. All were removed by open-access surgery, eleven cases by resection and five by enucleation. One tumour was malignant with liver metastases and two patients had tumours defined as borderline. Insulinoma tissue fragments developed into spheroids during the first week of culturing and insulin secretion into the media was demonstrated. Conclusions: Insulinomas are rare and diagnostically challenging tumours. Intra-operative ultrasonography was superior to other imaging modalities to locate the lesion. In organ culture, insulinomas readily form spheroids which may be used to yield insight into beta-cell biology.

Anaesthesia of the patient with chronic kidney disease

2020 ◽  
Vol 25 (11) ◽  
pp. 268-276
Author(s):  
Oscar Bautista Díaz-Delgado ◽  
Briony Alderson
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Renal Failure ◽  
Cardiac Output ◽  
Kidney Disease ◽  
The Body ◽  
Renal Physiology ◽  
Successful Management ◽  
Emergency Procedures ◽  
Routine Procedures

Chronic kidney disease is common, particularly in geriatric animals. General anaesthesia is usually required for routine procedures (dental prophylaxis, ovariohysterectomy or castration) and emergency procedures, which may have profound effects on the body, especially on cardiac output, subsequent blood pressure and on the perfusion of different vital organs. It is essential to understand the effects of renal dysfunction on the patient, as well as the effects that anaesthesia and surgery may have on the kidneys. The understanding of renal physiology, along with the effect of drug choices, is key to successful management of chronic renal failure.

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