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Devices Used (device + used)
Selected AbstractsTranscatheter Mitral Valve Repair for Functional Mitral Regurgitation: Coronary Sinus ApproachJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 6 2007NICOLO PIAZZA M.D. Mitral regurgitation has become recognized as an important health problem. More specifically, functional mitral regurgitation is associated with worse outcomes in heart failure, postmyocardial infarction, and perioperative coronary artery bypass surgery patients. Many patients with severe mitral regurgitation are denied or refused mitral valve surgery. A less invasive procedure with possibly fewer potential complications may thus be attractive for patients with severe mitral regurgitation. Devices used for coronary sinus (CS) mitral annuloplasty are directed toward patients with functional mitral regurgitation. Because of its easy accessibility and close relationship to the posterior mitral annulus (MA), alterations of the CS geometry with percutaneous devices may translate to displacement of the posterior annulus and correct mitral leaflet coaptation. This review will focus on the contemporary CS annuloplasty devices: (1) Edwards MONARC system; (2) Cardiac Dimensions CARILLON; and (3) Viacor Shape Changing Rods system. In addition, important information obtained from recent imaging studies describing the relationship between the CS, MA, and coronary arteries will be reviewed. [source] History and Current Practice of TonsillectomyTHE LARYNGOSCOPE, Issue S100 2002Ramzi T. Younis MD Abstract Objective To review important developments in the history of adenotonsillectomy and describe current methods and results for the operation. Study Design Review. Methods Tonsillectomy practices since antiquity were reviewed, with emphasis on introductions of new surgical tools and procedures, anesthesia methods, and patient care practices. Past and current indications for and complications associated with tonsillectomy were also reviewed. Results Devices used for adenotonsillectomy have included snares, forceps, guillotines, various kinds of scalpels, lasers, ultrasonic scalpels, powered microdebriders, and bipolar scissors. General anesthesia, the Crowe-Davis mouth gag, and methods for controlling bleeding have contributed greatly to success with the operation. Past and current indications for adenotonsillectomy are similar, although the relative importance of some indications has changed. The complication rate has declined, but the problems that do occur remain the same. Currently, cost-effectiveness is a principal concern. Conclusion The instruments and procedures used for adenotonsillectomy have evolved to render it a precise operation. Today, the procedure is a safe, effective method for treating breathing obstruction, throat infections, and recurrent childhood ear disease. [source] A Review of the Biologic Effects, Clinical Efficacy, and Safety of Silicone Elastomer Sheeting for Hypertrophic and Keloid Scar Treatment and ManagementDERMATOLOGIC SURGERY, Issue 11 2007BRIAN BERMAN MD Silicone elastomer sheeting is a medical device used to prevent the development of and improve the appearance and feel of hypertrophic and keloid scars. The precise mechanism of action of silicone elastomer sheeting has not been defined, but clinical trials report that this device is safe and effective for the treatment and prevention of hypertrophic and keloid scars if worn over the scar for 12 to 24 hours per day for at least 2 to 3 months. Some of the silicone elastomer sheeting products currently on the market are durable and adhere well to the skin. These products are an attractive treatment option because of their ease of use and low risk of adverse effects compared to other treatments, such as surgical excision, intralesional corticosteroid injections, pressure therapy, radiation, laser treatment, and cryotherapy. Additional controlled clinical trials with large patient populations may provide further evidence for the efficacy of silicone elastomer sheeting in the treatment and prevention of hypertrophic and keloid scars. The purpose of this article is to review the literature on silicone elastomer sheeting products and to discuss their clinical application in the treatment and prevention of hypertrophic and keloid scars. [source] Randomized comparison of the SLIPA (Streamlined Liner of the Pharynx Airway) and the SS-LM (Soft Seal Laryngeal Mask) by medical studentsEMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2006Cindy Hein Abstract Objective:, The aim of the study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA; Hudson RCI), a new supraglottic airway device, with the Soft Seal Laryngeal Mask (SS-LM; Portex) when used by novices. Methods:, Thirty-six medical students with no previous airway experience, received manikin training in the use of the SLIPA and the SS-LM. Once proficient, the students inserted each device in randomized sequence, in two separate patients in the operating theatre. Only two insertion attempts per patient were allowed. Students were assessed in terms of: device preference; success or failure; success at first attempt and time to ventilation. Results:, Sixty-seven per cent of the students preferred to use the SLIPA (95% confidence interval 49,81%). The SLIPA was successfully inserted (one or two attempts) in 94% of patients (34/36) and the SS-LM in 89% (32/36) (P = 0.39). First attempt success rates were 83% (30/36) and 67% (24/36) in the SLIPA and SS-LM, respectively (P = 0.10). Median time to ventilation was shorter with the SLIPA (40.6 s) than with the SS-LM (66.9 s) when it was the first device used (P = 0.004), but times were similar when inserting the second device (43.8 s vs 42.9 s) (P = 0.75). Conclusions:, In the present study novice users demonstrated high success rates with both devices. The SLIPA group achieved shorter times to ventilation when it was the first device they inserted, which might prove to be of clinical significance, particularly in resuscitation attempts. Although the Laryngeal Mask has gained wide recognition for use by both novice users and as a rescue airway in failed intubation, the data presented here suggest that the SLIPA might also prove useful in these areas. [source] Pre-ICD Illness Beliefs Affect Postimplant Perceptions of Control and Patient Quality of LifePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2010CLAIRE N. HALLAS Ph.D. Background: The implantable cardioverter defibrillator (ICD) is a device used in the treatment of ventricular arrhythmias and the prevention of sudden cardiac death. However, the ICD has been associated with negative psychological outcomes such as anxiety, depression, panic, and poor quality of life (QoL). Recent studies suggest that the preimplantation psychology of patients, combined with their postimplantation perceptions about their cardiac condition, are greater contributory factors than their medical status to a poor outcome. Method: Our study employed an interview-based qualitative grounded theory methodology to explore whether medical history hetereogeneity and illness beliefs impact on the QoL of 13 ICD patients. Results: Perceived control emerged as the core category related to QoL with three subsystem themes related to control: (1) illness beliefs, attributions, and appraisals; (2) coping resources and strategies; and (3) the social world. Patients at risk for the poorest adaptation were younger (<45), unemployed, and with an acute onset cardiac history. These patients interpreted their illness as severe, utilized emotion-focused coping (e.g., avoidance of situations), and believed themselves to be socially excluded. Adjusted patients used proactive problem-focused coping (e.g., normalizing) and minimized consequences of the device. Conclusions: The data developed a theoretical model of QoL, which identified perceived control, illness beliefs, and coping impacting on adjustment. From our study, we have a wider understanding of the combination psychological issues relevant to ICD patients and are able to treat those at risk with interventions to promote adjustment in the context of a society that values health and well-being. (PACE 2010; 33:256,265) [source] Triangular Contests and Caucus Rhetoric at the 1885 General Election*PARLIAMENTARY HISTORY, Issue 2 2008JAMES OWEN This article explores the role played by late-Victorian political associations during parliamentary election campaigns. The central hypothesis is that party organisation, known popularly as the ,caucus', is best understood as a rhetorical device used by politicians and the press to gain legitimacy in the new context created by an expanded and quasi-democratic electorate. The hypothesis is tested by examining the 1885 general election campaigns in Nottingham West and Sheffield Central. Both constituencies witnessed a triangular contest whereby an ,additional' candidate, standing on a radical platform, entered the campaign and pursued a distinctly ,anti-caucus' agenda that was aimed primarily at the local Liberal Party Association. The manner in which the ,caucus' issue was articulated by all sides involved throws new light on the role played by party organisation during this period. While all sides described their association in a way that both defended and asserted its legitimacy, they equally used ,anti-caucus' rhetoric to diminish the credibility of their opponent's organisation, even though they were emulating the deeds they were denouncing. Indeed, it was those within official Liberalism that indulged in the most virulent ,anti-caucus' rhetoric. Thus, it is suggested that, with regard to the attitude of radicals towards official Liberalism, this ,anti-caucus' rhetoric reflected not a real popular resistance against party organisation or ,party', but simply intense competition and imitation between rival ,caucuses'. [source] Second-hand smoking and carboxyhemoglobin levels in children: a prospective observational studyPEDIATRIC ANESTHESIA, Issue 1 2010BRANDEN E. YEE MD Summary Aim:, To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels. Background:, Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable. Patients and Methods:, Parents and their children between the ages of 1,12 were enrolled on the day of elective surgery. The preoperative COHb levels of the children were assessed noninvasively using a CO-Oximeter (Radical-7 Rainbow SET Pulse CO-Oximeter; Masimo, Irvine, CA, USA). The parents were asked to complete an environmental air-quality questionnaire. The COHb levels were tabulated and correlated with responses to the survey in aggregate analysis. Statistical analyses were performed using the nonparametric Mann,Whitney and Kruskal,Wallis tests. P < 0.05 was statistically significant. Results:, Two hundred children with their parents were enrolled. Children exposed to parental smoking had higher COHb levels than the children of nonsmoking controls. Higher COHb values were seen in the youngest children, ages 1,2, exposed to parental cigarette smoke. However, these trends did not reach statistical significance, and confidence intervals were wide. Conclusions:, This study revealed interesting trends of COHb levels in children presenting for anesthesia and surgery. However, the COHb levels measured in our patients were close to the error margin of the device used in our study. An expected improvement in measurement technology may allow screening children for potential pulmonary perioperative risk factors in the future. [source] Risk factors for adverse events in children with colds emerging from anesthesia: a logistic regressionPEDIATRIC ANESTHESIA, Issue 2 2007J. RACHEL HOMER BM BCh Summary Background:, Recent upper respiratory infection (URI) in children increases respiratory adverse events following anesthesia for elective surgery. The increased risk continues weeks after resolution of acute URI symptoms. Few systematic analyses have explored specific risk factors. This logistic regression explores the relationship between preoperative URI symptoms and adverse events during emergence from anesthesia. Methods:, Data were combined from control groups of several prospective observational and interventional studies in elective pediatric anesthesia in a tertiary care pediatric hospital. In each study, a blinded observer, distinct from the anesthesia care team, prospectively recorded the presence of stridor, oxygen desaturations (and their duration), coughing and laryngospasm. Parents were subsequently asked about the presence of 10 cold symptoms during the 6 weeks prior to operation. Results:, Our model, based on a dataset of 335 patients, did not demonstrate an association between any particular symptoms and the rate of respiratory adverse events during emergence from anesthesia, with the exception of low-grade fever which appeared to be mildly protective. Respiratory adverse events were affected by the airway management technique (device used and timing of extubation), and adverse events were increased if peak URI symptoms had occurred within the preceding 4 weeks. Conclusions:, Specific preoperative symptoms were not useful in predicting respiratory adverse events during emergence from anesthesia. [source] Randomized controlled trial of salbutamol aerosol therapy via metered dose inhaler-spacer vs. jet nebulizer in young children with wheezingPEDIATRIC PULMONOLOGY, Issue 5 2005J. Deerojanawong MD Abstract The jet nebulizer is a common device used for administering aerosol medication in young children. However, compared to a metered dose inhaler-spacer (MDI-spacer), it takes more time and personnel. This study aimed to compare the efficacy of salbutamol aerosol therapy given via these two devices in young wheezing children. A prospective randomized, double-blind, placebo-controlled trial was performed in children up to 5 years old who had acute wheezing and were admitted to the Department of Pediatrics, King Chulalongkorn Memorial Hospital. Patients were randomly divided into two groups. The first group received 2 puffs of placebo via MDI-spacer, followed by 0.15 mg/kg salbutamol respiratory solution via jet nebulizer. The second group received 2 puffs (100 ,g/puff) of salbutamol via MDI-spacer, followed by placebo via jet nebulizer. Clinical scores and tidal breathing pulmonary function test were evaluated before and after treatment. Pulmonary function parameters included those derived from flow volume loops (volume to peak tidal expiratory flow over total expiratory volume, VPTEF/VE; time to peak tidal expiratory flow over total expiratory time, TPTEF/TE; and ratio of tidal expiratory flow at 25% remaining expiration to peak expiratory flow, 25/PF), compliance (Crs), and resistance (Rrs) of the respiratory system. The efficacy of both methods was compared by using analysis of covariance. Forty-seven wheezing children were studied (24 received salbutamol via MDI-spacer, and 23 received it via jet nebulizer). There was no statistical difference between the two groups regarding clinical scores and all pulmonary function parameters. However, heart rate was significantly increased after treatment in the jet nebulizer group when compared to those in the MDI-spacer group (P,=,0.004). In conclusion, the efficacy of salbutamol aerosol therapy via MDI-spacer compared to jet nebulizer in young wheezing children was not different in terms of clinical score and postbronchodilator pulmonary function parameters. However, salbutamol aerosol therapy via jet nebulizer significantly increased the heart rate when compared to the MDI-spacer. © 2005 Wiley-Liss, Inc. [source] Improvements and new capabilities for the multiple Knudsen cell device used in high-temperature mass spectrometryRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 2 2004M. Heyrman The thermodynamic properties of condensed phases, i.e. the activities of components, can be determined from partial pressures measured by the Knudsen cell mass spectrometric method. Improvements in accuracy and yield of this method are obtained with the use of twin cells, an idea proposed in the 1960s. The multiple cell method was perfected in 1977 in our laboratory. Changes to molecular beam sampling and furnace assemblies were required to make the multiple Knudsen cell technique work properly. This paper summarizes these prerequisites, and presents a new device and the associated method of measurements, as well as the necessary tests performed with a silver sample in each cell. Copyright © 2003 John Wiley & Sons, Ltd. [source] CASE REPORTS: Penile Constriction Devices: Case Report, Review of the Literature, and Recommendations for ExtricationTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2008Jonathan Silberstein ABSTRACT Introduction., Penile constriction devices often present significant challenges to urologic surgeons. Failure to remove such devices can lead to significant ischemia and loss of tissue. Patients often present after several days of ischemia and swelling have developed. Aim., This article reviews previously published data on penile constriction devices and strategies for their removal. Additionally, we present new methodologies for extrication. Methods., A comprehensive review of the English language literature was performed using MEDLINE. "Penile incarceration" and "penile strangulation" were used as search terms, and a manual bibliographic review of cross-referenced items was performed. Publications prior to 1970 were excluded from our search. Main Outcome Measures., Review of published literature on penile constriction devices and their removal. Results., Penile incarceration is frequently described in the literature as an isolated case report or small series describing the approach of a single physician or group of physicians for dealing with these problems. Penile incarceration has been reported in a wide spectrum of age groups, with the incarcerating object most frequently placed for erotic or autoerotic purposes. While the most commonly reported devices causing incarceration are metal rings, higher-grade penile injuries are more frequently sustained by nonmetallic objects. Patients who present with incarceration after 72 hours are more likely to sustain higher-grade injuries than those who seek more timely treatment. Strategies for extrication depend on the type of device used, the length of time of incarceration, the patient's ability to remain calm, and the tools available to the presenting physicians. Conclusion., Penile incarceration is a urologic emergency with potentially severe clinical consequences. With rapid intervention and removal of the foreign body, most patients do extremely well and need no further intervention. Removal of such devices can be challenging and often requires resourcefulness and a multidisciplinary approach. Silberstein J, Grabowski J, Lakin C, and Goldstein I. Penile constriction devices: Case report, review of the literature, and recommendations for extrication. J Sex Med 2008;5:1747,1757. [source] A study of airway management using the ProSeal LMA® laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgeryANAESTHESIA, Issue 9 2007M. Hohlrieder Summary In a randomised double blind prospective study, we tested the hypothesis that postoperative pain is lower in patients who receive an ProSeal LMAÔ laryngeal mask airway compared with a tracheal tube. One hundred consecutive female patients (ASA I,II, 18,75 years) undergoing laparoscopic gynaecological surgery were divided into two equal-sized groups for airway management with the ProSeal LMA or tracheal tube. Anaesthesia management was identical for both groups and included induction of anaesthesia using propofol/fentanyl, and maintenance with propofol/remifentanil, muscle relaxation with rocuronium, positive pressure ventilation, gastric tube insertion, dexamethasone/tropisetron for anti-emetic prophylaxis, and diclofenac for pain prophylaxis. All types of postoperative pain were treated using intravenous patient-controlled analgesia (PCA) morphine. Patients and postoperative staff were unaware of the airway device used. Data were collected by a single blinded observer. We found that pain scores were lower for the ProSeal LMA at 2 h and 6 h but not at 24 h. Morphine requirements were lower for the ProSeal LMA by 30.4%, 30.6% and 23.3% at 2, 6 and 24 h, respectively. Nausea was less common with the ProSeal LMA than with the tracheal tube at 2 h and 6 h but not at 24 h. There were no differences in the frequency of vomiting, sore throat, dysphonia or dysphagia. We conclude that postoperative pain is lower for the ProSeal LMA than the tracheal tube in females undergoing gynaecological laparoscopic surgery. [source] A Comparison of GlideScope Video Laryngoscopy Versus Direct Laryngoscopy Intubation in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 9 2009Timothy F. Platts-Mills MD Abstract Objectives:, The first-attempt success rate of intubation was compared using GlideScope video laryngoscopy and direct laryngoscopy in an emergency department (ED). Methods:, A prospective observational study was conducted of adult patients undergoing intubation in the ED of a Level 1 trauma center with an emergency medicine residency program. Patients were consecutively enrolled between August 2006 and February 2008. Data collected included indication for intubation, patient characteristics, device used, initial oxygen saturation, and resident postgraduate year. The primary outcome measure was success with first attempt. Secondary outcome measures included time to successful intubation, intubation failure, and lowest oxygen saturation levels. An attempt was defined as the introduction of the laryngoscope into the mouth. Failure was defined as an esophageal intubation, changing to a different device or physician, or inability to place the endotracheal tube after three attempts. Results:, A total of 280 patients were enrolled, of whom video laryngoscopy was used for the initial intubation attempt in 63 (22%) and direct laryngoscopy was used in 217 (78%). Reasons for intubation included altered mental status (64%), respiratory distress (47%), facial trauma (9%), and immobilization for imaging (9%). Overall, 233 (83%) intubations were successful on the first attempt, 26 (9%) failures occurred, and one patient received a cricothyrotomy. The first-attempt success rate was 51 of 63 (81%, 95% confidence interval [CI] = 70% to 89%) for video laryngoscopy versus 182 of 217 (84%, 95% CI = 79% to 88%) for direct laryngoscopy (p = 0.59). Median time to successful intubation was 42 seconds (range, 13 to 350 seconds) for video laryngoscopy versus 30 seconds (range, 11 to 600 seconds) for direct laryngoscopy (p < 0.01). Conclusions:, Rates of successful intubation on first attempt were not significantly different between video and direct laryngoscopy. However, intubation using video laryngoscopy required significantly more time to complete. [source] Recent Developments and Applications of Haptic DevicesCOMPUTER GRAPHICS FORUM, Issue 2 2003S. D. Laycock Abstract Over recent years a variety of haptic feedback devices have been developed and are being used in a number of important applications. They range from joysticks used in the entertainment industry to specialised devices used in medical applications. This paper will describe the recent developments of these devices and show how they have been applied. It also examines how haptic feedback has been combined with visual display devices, such as virtual reality walls and workbenches, in order to improve the immersive experience. ACM CSS: H.5.2 Information Interfaces and Presentation,Haptic I/O; I.3.8 Computer Graphics,Applications; I.6 Simulation and Modelling,Applications [source] The Utility of Heart Sounds and Systolic Intervals Across the Care ContinuumCONGESTIVE HEART FAILURE, Issue 2006W. Frank Peacock MD Acoustic cardiography is an exciting, new, easy-to-use, modernized technology that incorporates already proven techniques of phonocardiography. Application of acoustic cardiography to clinical practice can improve diagnosis and management of heart failure patients. Its clinical use should help address some of the need for robust, inexpensive, and widely accessible technology for proactive heart failure diagnosis and management. Acoustic cardiographically recorded measurements have been correlated with both cardiac catheterization and echocardiographically determined hemodynamic parameters. Heart sounds captured by acoustic cardiograms have proven to assist clinicians in assessing dyspneic patients in the emergency department by utilizing the strong specificity of an S3 for detecting acute decompensated heart failure. Acoustic cardiography offers a cost-efficient, easy-to-use method to optimize the devices used in cardiac resyncronization therapy. The rapidly and easily obtainable information gathered by acoustic cardiography should foster its more widespread use in diagnosis and treatment of heart failure, including cardiac resyncronization therapy device optimization. [source] The Utility of Heart Sounds and Systolic Intervals Across the Care ContinuumCONGESTIVE HEART FAILURE, Issue 2006W. Frank Peacock MD Acoustic cardiography is an exciting, new, easy-to-use, modernized technology that incorporates already proven techniques of phonocardiography. Application of acoustic cardiography to clinical practice can improve diagnosis and management of heart failure patients. Its clinical use should help address some of the need for robust, inexpensive, and widely accessible technology for proactive heart failure diagnosis and management. Acoustic cardiographically recorded measurements have been correlated with both cardiac catheterization and echocardiographically determined hemodynamic parameters. Heart sounds captured by acoustic cardiograms have proven to assist clinicians in assessing dyspneic patients in the emergency department by utilizing the strong specificity of an S3 for detecting acute decompensated heart failure. Acoustic cardiography offers a cost-efficient, easy-to-use method to optimize the devices used in cardiac resyncronization therapy. The rapidly and easily obtainable information gathered by acoustic cardiography should foster its more widespread use in diagnosis and treatment of heart failure, including cardiac resyncronization therapy device optimization. [source] Design of bilinear hysteretic isolation systemsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 9 2003M. Fragiacomo Abstract This paper concerns the design of passive base isolation systems characterized by a bilinear hysteretic behaviour. The study refers to the case where the structure to be isolated (superstructure) vibrates according to the first mode. In this case the whole isolated structure can be modelled by a two-degree-of-freedom system. The base isolation effectiveness has been evaluated for different characteristics of the device, namely mass, strength, elastic and plastic stiffness, by using mainly energetic quantities. The optimum values for the base device have been obtained by minimizing the input energy and the displacement of the superstructure. Conclusions are drawn for superstructures with a fundamental period of 0.5s, a damping ratio of 5% and for three different kinds of earthquake ground motions. The study showed that the seismic input greatly affects the behaviour of the isolated structure, and therefore the design ground motion must be carefully chosen, dependent on the characteristics of the site. A simple procedure that involves mainly linear dynamic analyses is proposed for the design of base devices used in conjunction with superstructures of any fundamental vibration period. The procedure produces good results in spite of its simplicity, and therefore it is suitable for practical use by design engineers. Copyright © 2003 John Wiley & Sons, Ltd. [source] An Evaluation of a Blind Rotational Technique for Selective Mainstem IntubationACADEMIC EMERGENCY MEDICINE, Issue 10 2004Aaron E. Bair MD Abstract Objectives: Although rare, massive hemoptysis and major bronchial disruptions are associated with high mortality. Selective ventilation of the uninvolved lung can increase the likelihood of survival. Specialized devices used for single lung ventilation are often not readily available and can be difficult to place in the emergency department. The authors evaluated a blind rotational technique for selective mainstem intubation using either a standard endotracheal tube (ET) or a directional-tip endotracheal tube (DTET). Methods: This was a prospective, randomized trial on 25 human cadavers. The desired side of mainstem intubation was determined by randomization. Each cadaver was used for four ET, four DTET, and four control intubations. In the ET group, the trachea was intubated. The tube was then rotated 90° in the direction of the desired placement and advanced until resistance was met. In the DTET group, the technique was identical, except the trigger was activated to flex the tip during advancement. In the control group, an ET was advanced in neutral alignment until resistance was met. A bronchoscopist blinded to the desired placement determined tube position. Comparison testing was performed using Pearson's chi-square test. Results: When attempting to intubate the left mainstem, use of the ET with the rotational technique was successful 72.3% of the time (95% confidence interval [95% CI] = 57% to 84%). Intubation of the left mainstem using the DTET was successful 68.5% of the time (95% CI = 54% to 81%; p = 0.67). Attempts to selectively intubate the right mainstem using the rotational technique were highly successful in both groups: 94% for the ET (95% CI = 84% to 99%) versus 97.8% for the DTET (95% CI = 89% to 100%). Among controls, the right mainstem was intubated 93% of the time (95% CI = 86% to 97%). Conclusions: In a cadaveric model, the left mainstem bronchus can be selectively intubated with moderate reliability using this rotational technique. Use of a DTET confers no significant advantage. The ability to generalize these findings to living subjects is unknown. [source] Discursive constructions of terrorism in Spain: Anglophone and Spanish media representations of EtaINTERNATIONAL JOURNAL OF APPLIED LINGUISTICS, Issue 1 2009Roberto A. Valdeón separatista; terrorista; medios de comunicación; noticias; enfoque crítico This paper studies the use of the terms ,separatist' and ,terrorist' in the aftermath of Madrid's 3/11 attacks and their discursive implications from a critical perspective, and attempts to throw some light on whether there are sufficient grounds to substantiate the voices against ,separatist' when reporting on attacks carried out by the militant group Eta that involved killings. The study is divided into three sections, which examine, first, the choice(s) made by Spanish news websites and the intratextual cohesion devices used by the authors, and, secondly, the terms and devices used in British and American news websites. Finally, we shall discuss the ideological implications that might lie beneath the preference for ,separatist' in Anglophone media, and comment on the problems derived from it. En este artículo se analiza el uso de las palabras ,terrorist' y ,separatist' tras los atentados terroristas que tuvieron lugar en Madrid en marzo de 2004, así como sus implicaciones discursivas desde un enfoque crítico. Se comprobará si existen razones para justificar las críticas al uso del término ,separatista' para definir los atentados perpetrados por la banda Eta. El trabajo se divide en tres secciones. En la primera se estudian medios de noticias españoles en internet para establecer qué elementos léxicos se utilizan así como las estrategias de cohesión intratextual presentes. En el segundo se analizan medios de noticias de habla inglesa, tanto británicos como americanos. Por último se comentarán las implicaciones ideológicas del uso de ,separatist' en los medios de habla inglesa así como los problemas que ocasiona. [source] Children's prescription medicines: parents' perceptions on dosing intervals, dosing devices and prescription adviceINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 1 2007Dr. Therése Kairuz senior lecturer, pharmacy practice Objective To gather information on devices used to administer liquid medicines, dosing intervals for antibiotic administration, and parents' perceptions of the advice received from pharmacists about prescription medicines, for children up to the age of six years. Setting Six schools from different socio-economic areas were selected within the Auckland area of New Zealand. To facilitate distribution and collection of questionnaires, the headmaster or a teacher was known to the researchers. Method An anonymous questionnaire was distributed to year 1 and 2 students (aged five and six years) to take home for completion by a parent or primary caregiver. Respondents were asked to refer to their youngest child and/or to the last time they had given medicines or received a prescription for a child. Key findings A total of 299 completed questionnaires were received (48.2%); 60 questionnaires had not been distributed by school teachers in error, and the overall return rate was thus adjusted to 53.4%. The device used most frequently to administer medicines to younger children up to the age of three years was an oral medicine syringe, while nearly one-third of children aged three to six years received medicine in a ,teaspoon'. Almost half the respondents (48.8%) indicated they would be most likely to forget the midday dose of antibiotics, and dosing deviated from recommended intervals. Most respondents had received advice from a pharmacist on how to take the medicine, and had understood instructions and had the opportunity to ask questions. Conclusion This study highlights areas that pharmacists can include when advising parents and guardians about children's medicines, such as ideal dosing intervals of antibiotics and the use of accurate dosing devices. [source] Recent developments in nonlinear network design: Overview of integrated nonlinear microwave and millimeter-wave circuits workshopINTERNATIONAL JOURNAL OF RF AND MICROWAVE COMPUTER-AIDED ENGINEERING, Issue 5 2002Adalbert BeyerArticle first published online: 27 AUG 200 Abstract In the 1960s and 1970s the design of microwave networks containing nonlinear elements often consisted of trial and error routines. The required circuit performance was then achieved iteratively. With the knowledge of the physical property of the materials at microwave frequencies and its influence on active devices used in microwave networks, it is possible to reduce the time required to analyze new nonlinear circuits for microwave purposes. Advanced tools are necessary, which can analyze the network very quickly for a short development time. The basic requirements are a fast and accurate nonlinear measurement system and descriptions that match the real counterpart. This article shows the development of the nonlinear microwave network design for the last decade as a reflection of the workshop entitled Integrated Nonlinear Microwave and Millimeterwave Circuits. © 2002 Wiley Periodicals, Inc. Int J RF and Microwave CAE 12, 388,417, 2002. Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mmce10041 [source] Review on the effects of exposure to spilled oils on human healthJOURNAL OF APPLIED TOXICOLOGY, Issue 4 2010Francisco Aguilera Abstract Harmful effects of oil spills on diverse flora and fauna species have been extensively studied. Nevertheless, only a few studies have been compiled in the literature dealing with the repercussions of oil exposure on human health; most of them have focused on acute effects and psychological symptoms. The objective of this work was to gather all these studies and to analyze the possible consequences of this kind of complex exposure in the different aspects of human health. Studies found on this topic were related to the disasters of the Exxon Valdez, Braer, Sea Empress, Nakhodka, Erika, Prestige and Tasman Spirit oil tankers. The majority of them were cross-sectional; many did not include control groups. Acute effects were evaluated taking into account vegetative-nervous symptoms, skin and mucous irritations, and also psychological effects. Genotoxic damage and endocrine alterations were assessed only in individuals exposed to oil from Prestige. The results of the reviewed articles clearly support the need for biomonitoring human populations exposed to spilled oils, especially those individuals involved in the cleanup, in order to evaluate not only the possible immediate consequences for their health but also the medium- and long-term effects, and the effectiveness of the protective devices used. Copyright © 2010 John Wiley & Sons, Ltd. [source] New Devices for Chronic Ventricular SupportJOURNAL OF CARDIAC SURGERY, Issue 3 2001F.A.C.S., F.C.C.P., Kenneth L. Franco M.D. Congestive heart failure affects 5 million people in the United States with 500,000 new cases diagnosed each year. Medical and surgical therapy have helped many patients but when these options fail, heart transplantation remains the only other treatment available to help improve their condition. Heart transplantation suffers from the lack of a sufficient number of suitable donor organs, the complications of chronic immunosuppression, and many patients die while on the waiting list. A number of pulsatile and nonpulsatile cardiac assist devices are being developed to provide chronic support for patients with heart failure and to be an alternative to heart transplantation. It is estimated that as many as 60,000 patients with heart failure could be helped by mechanical devices used for chronic support. For these devices to be effective they must provide sufficient cardiac output to allow patients to perform their daily activities, have a low risk of thromboemboli, be fully implantable thereby reducing the risk of infection, and have a low incidence of device malfunction requiring part or all of the device to be replaced. In this article, we will review several new devices which have been developed over the past 5 years or so and will be in human clinical trials in the United States soon, either as a bridge or as an alternative to heart transplantation. [source] Email Copies in Workplace InteractionJOURNAL OF COMPUTER-MEDIATED COMMUNICATION, Issue 1 2006Karianne Skovholt This study examines how employees in a distributed work group use email copies in networks of collaboration. It studies the audience design of messages with multiple recipients, analyzing explicit and implicit addressing devices used to appoint recipients as primary and secondary participants in the interaction. Copying in recipients serves to share knowledge of ongoing projects and to build up a common information pool. Furthermore, it is used to facilitate multi-party interaction and to build personal identity and alliances. Copies to third parties may also be used for reasons of social control, for instance in order to gain compliance or to put pressure on the addressee to conform to social norms of conduct. [source] Oral mucosal versus cutaneous sensory testing: a review of the literatureJOURNAL OF ORAL REHABILITATION, Issue 10 2002R. Jacobs summary, The innervation of skin and oral mucosa plays a major physiological role in exteroception. It also has a clinical interest as illustrated by sensory changes after neurosurgical procedures. These sensory changes often rely only on the patients' subjective reports, although objective assessments are possible. This review compares the neurophysiological features of the trigeminal sensory pathways with those of cutaneous sensory innervation. In this review, three receptor groups will be discussed: mechanoreceptors, thermoreceptors and nociceptors. Differences between receptors in the glabrous skin, the hairy skin and the oral mucosa will be highlighted. Sensory testing devices have been developed to quantify psychophysiological parameters such as the threshold level for receptor activation upon mechanical stimulation, but such devices have been merely developed to determine the threshold of skin receptors (tactile, thermal). Later on, some have been adapted to suit the particularities of the oral environment. This review attempts to compare the available literature on test devices for oral versus cutaneous tactile function. It summarizes what is common or rather particular to the devices used to study either cutaneous or oral receptors. [source] Infant bath seats, drowning and near-drowningJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5-6 2004RW Byard Objective: To investigate the possible role of infant bathtub seats in drowning and near-drowning episodes in infants. Methods: A review was conducted of the files of the Forensic Science Centre and Child Protection Unit, Women's and Children's Hospital, Adelaide, South Australia, for significant immersion incidents in infants involving bathtub seats from January 1998 to December 2003. Results: A total of six cases of drowning occurred over the 6-year period of the study in children under 2 years of age, including two infants. One of these cases, a 7-month-old boy, had been left unattended for some time in an adult bath in a bathtub seat. He was found drowned, having submerged after slipping down and becoming trapped in the seat. Three near-drowning episodes occurred in children under the age of 2 years, including two boys aged 7 and 8 months, both of whom had been left for some time in adult baths in bath seats. Both were successfully resuscitated and treated in hospital. Conclusions: These cases demonstrate the vulnerability of infants to immersion incidents when left unattended in bathtubs. Bathtubs are particularly dangerous for infants as the slippery and smooth surfaces predispose to loss of balance and make escape from water difficult. Infant bathtub seats may give parents and child carers a false sense of security leading to infants being left unattended. Unfortunately, however, infants may fall out of, or slip and become trapped in, such seats. Infants and young children cannot be left unsupervized in water, and devices used as bathing aids such as bathtub seats may contribute to immersion incidents. [source] Influence of single versus multiple actuations on the particle size distribution of beclometasone dipropionate metered-dose inhalersJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 8 2003M. R. Feddah The particle size distributions of beclometasone dipropionate delivered from Becotide and Respocort inhalers after single and multiple actuations were investigated using the Andersen Mark II Cascade impactor and the drug was quantified using high performance liquid chromatography. The fine particle mass and the mass median aerodynamic diameter were calculated. An apparent increase in mass median aerodynamic diameter was observed when the number of actuations increased. In addition, the fine particle mass decreased as the number of actuations increased. When performing and analysing cascade impaction study data differences between single versus multiple actuations must be considered. Regulatory guidelines should be amended to stipulate the number of actuations to be loaded into devices used to evaluate the particle size distribution of inhaled aerosol products. [source] Film and Early Medieval LiteratureLITERATURE COMPASS (ELECTRONIC), Issue 1 2004Stuart D Lee ,Lights, camera, action!' These are hardly the words one would normally associate with the study of medieval literature, but this article suggests that the study of films can be a major asset to English lecturers. Using Old English literature as an example, this short article demonstrates how portrayals of the Anglo-Saxons in films can stimulate an interesting class discussion on their place in history and relevance to modern culture. Moreover, the article shows that one can draw similarities between the devices used by film directors and editors and those employed by the Old English poets, thus allowing teachers to introduce films into the classroom to illustrate the complexity of Old English literature. [source] An overview on the development of a bio-artificial pancreas as a treatment of insulin-dependent diabetes mellitusMEDICINAL RESEARCH REVIEWS, Issue 2 2006Ana Isabel Silva Abstract This paper presents the concept and most of the research undertaken all over the world for the development of a bio-artificial pancreas (BAP) device over the last 30 years. The devices studied, meant to mimic the insulin secretion of the natural organ, were diverse and have been reviewed. Allogeneic or xenogeneic cells or cell clusters have been separated from the host's immune system by synthetic biocompatible semipermeable membranes to prevent the need, of the host, for immune-suppressing regimens. The biocompatible polymer used as a barrier and its intrinsic characteristics, the cell immobilization or suspension media, the existence or not of co-immobilized molecules or cells, the number of devices used and the implantation site, were addressed. © 2005 Wiley Periodicals, Inc. Med Res Rev [source] THE VACUITY OF POSTMODERNIST METHODOLOGYMETAPHILOSOPHY, Issue 3 2005Nicholas Shackel Abstract: Many of the philosophical doctrines purveyed by postmodernists have been roundly refuted, yet people continue to be taken in by the dishonest devices used in proselytizing for postmodernism. I exhibit, name, and analyse five favourite rhetorical manoeuvres: Troll's Truisms, Motte and Bailey Doctrines, Equivocating Fulcra, the Postmodernist Fox Trot, and Rankly Relativising Fields. Anyone familiar with postmodernist writing will recognise their pervasive hold on the dialectic of postmodernism and come to judge that dialectic as it ought to be judged. [source] | |||||||||||||||||||||||||||||||||||||