Home About us Contact
|
Home About us Contact | ||
|
|
||
One Device (one + device)
Selected AbstractsCatheter-based closure of atrial septal defects in the oval fossa with the Amplatzer® device in patients in their first or second year of life,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 7 2009G. Fischer MD Abstract Objective: To assess feasibility, safety, and efficacy of the use of Amplatzer® occluders in closure of atrial septal defects (ASD) in children in the first 2 years of life. Background: Although scattered reports on such closure have been published, no agreement consists on the policy. Methods: In 654 patients of all ages, closure was achieved in 632 (96.6%). Data were analyzed retrospectively in all 71 children where an attempt had been made to close the ASD before their second birthday. Results: Median age and body weight were 17.2 months (range 3.9,23.8) and 10.0 kg (range 3.8,14.5), respectively. Median fluoroscopy time was 13.6 min and median device size 15 mm. Successful closure was achieved in 68 children (95.8%). Three times the procedure was aborted: in one, the device repeatedly straddled the septum; in the other two, a small left atrium restricted the movement of the left-sided disc. One device embolized and was reimplanted after retrieval. One infant with multiple disorders died 6 days after closure from acute sepsis probably unrelated to the procedure. No other complications occurred. Only trivial shunts closing with time were registered during follow-up. Symptomatic patients profited markedly from closure. Conclusion: The results and complications of ASD closure with the Amplatzer® device in patients in their first 2 years of life compare favorably with procedures in older patients, provided that the size of the septum and the dimensions in the left atrium are taken into consideration when selecting the size of the device. © 2009 Wiley-Liss, Inc. [source] Efficacy and long-term patency of fenestrated amplatzer devices in childrenCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2007Astrid E. Lammers MD Abstract Introduction: Novel transcatheter techniques to control interatrial communications exist. Devices with restrictive fenestrations can be implanted to maintain patency of an atrial septostomy, or reduce an interatrial communication. Experience with these devices in children is limited. Patients and Methods: Fenestrated atrial septal devices were implanted into 10 children (5 male, age 1.5,15.5 years). Devices were modified by the manufacturer (MM, n = 6), or by a modification of an atrial septal occlusion device by the operator (OM, n = 4). Seven devices were implanted after atrial septal puncture and septostomy for severe symptomatic pulmonary hypertension (PHT) [4 heart failure, 3 syncope], according to World Health Organisation Guidelines. Two devices were implanted to reduce left to right shunting through large atrial septal defects with associated PHT. One device was implanted acutely to offload the left atrium during extracorporal circulatory support prior to heart transplantation. Warfarin (n = 5), aspirin (n = 4), or heparin (n = 1) were used for prevention of fenestration thrombosis. Results: Symptoms in all patients with PHT improved after implantation; syncope recurred with fenestration occlusion in one patient. Nine patients were followed up to a mean of 26 months. Five devices (all MM; warfarin n = 4, aspirin n = 1) remained patent on echocardiography. Fenestrations occluded in 4 children after median follow-up of 10 months (MM n = 1, OM n = 3, warfarin n = 1, aspirin n = 3). Conclusions: Implantation of fenestrated atrial devices is feasible and effective; but the occlusion rate is high. Further research on fenestrated atrial septal devices with better long-term patency, and effective antithrombotic drug treatment is necessary. © 2007 Wiley-Liss, Inc. [source] Quantitative gray-scale analysis in skeletal muscle ultrasound: A comparison study of two ultrasound devicesMUSCLE AND NERVE, Issue 6 2009Sigrid Pillen MD Abstract Muscle ultrasound is a useful technique to detect neuromuscular disorders. Quantification of muscle echo intensity (EI) using gray-scale analysis is more reliable and more sensitive compared with visual evaluation of the images. We devised a method to reliably use EI normal values established with one ultrasound device for use with another device. Based on measurements in a dedicated phantom and in 7 healthy subjects, a conversion equation was calculated to convert the mean EI. The reliability of this equation was next evaluated in a follow-up study of 22 healthy children. Mean muscle EI could be reliably converted from one ultrasound device to another. This allows for normal values obtained with one device to be used with other devices, which is an important step forward toward the use of quantitative muscle ultrasound in daily clinical care. Muscle Nerve, 2009 [source] Bronchial blocker compared to double-lumen tube for one-lung ventilation during thoracoscopyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2001C. Bauer Background: Video-assisted thoracoscopic surgery (VATS) requires one-lung ventilation with a properly collapsed lung. This study compared the Broncho-Cath double-lumen endotracheal tube with the Wiruthan bronchial blocker to determine the advantages of one device over the other during anaesthesia with one-lung ventilation for thoracoscopy. Methods: Thirty-five patients undergoing VATS were randomly assigned to one of two groups. Sixteen patients received a left-sided double-lumen tube (DLT) and nineteen a Wiruthan bronchial blocker (BB). The BB group was subdivided in two: BB in the right mainstem bronchus (BBR) for right-sided VATS (9 patients), BB in the left mainstem bronchus (BBL) for left-sided VATS (10 patients). The position of the devices was checked using a fibreoptic bronchoscope. The following variables were measured: 1) number of unsuccessful placement attempts; 2) number of malpositions of the devices; 3) time required to place the device in the correct position; 4) number of secondary dislodgements of the devices after turning the patient into the lateral decubitus position. The quality of lung deflation was evaluated by the surgeons who were blinded to the type of tube being used. Results: The number of unsuccessful placement attempts was one in the DLT group (1/16), three in the BBL group (3/10) and none in the BBR group (0/9). The number of malpositions was significantly greater in the BBL group (10/10) compared to the DLT group (2/16) and to the BBR group (1/9) (P<0.001). The time (mean±SD) required to place a BBL was 4.21 min±1.28, significantly longer than the time required to place a DLT (2.26 min±0.55, P<0.0006) or a BBR (2.41 min±0.53, P<0.008). The difference in placement time between DLT and BBR was not significant. The number of secondary dislodgements was one in the DLT group, one in the BBR group and none in the BBL group (NS). The quality of lung deflation was judged excellent or fair in all patients in the DLT and the BBL groups and poor in 44% of the patients in the BBR group. Conclusion: It took significantly longer to place a left BB than a DLT (P<0.0006) or a right BB (P<0.008). The number of initial malpositionings of the left BB was significantly greater than in the other groups (P<0.001). The quality of lung deflation was better in the BBL and in the DLT groups than in the BBR group. We conclude that for routine use during left-sided VATS, the use of a DLT is preferable to a left BB because of its greater ease of placement. For right-sided VATS, DLT and right BB showed the same facility of placement but the DLT provided a better quality of lung deflation. [source] A comparison of McGrath and Macintosh laryngoscopes in novice users: a manikin studyANAESTHESIA, Issue 11 2009D. C. Ray Summary Direct laryngoscopy using the Macintosh laryngoscope is a difficult skill to acquire. Videolaryngoscopy is a widely accepted airway management technique that may be easier for novices to learn. We compared the McGrath® videolaryngoscope and Macintosh laryngoscope by studying the performance of 25 medical students with no previous experience of performing tracheal intubation using an easy intubation scenario in a manikin. The order of device use was randomised for each student. After brief instruction each participant performed eight tracheal intubations with one device and then eight tracheal intubations with the other laryngoscope. Novices achieved a higher overall rate of successful tracheal intubation, avoided oesophageal intubation and produced less dental trauma when using the McGrath. The view at laryngoscopy was significantly better with the McGrath. Intubation times were similar for both laryngoscopes and became shorter with practice. There was no difference in participants' rating of overall ease of use for each laryngoscope. [source] Cell culture monitoring via an auto-sampler and an integrated multi-functional off-line analyzerBIOTECHNOLOGY PROGRESS, Issue 1 2010Gayle E. Derfus Abstract Mammalian cell-based bioprocesses are used extensively for production of therapeutic proteins. Off-line monitoring of such cultivations via manual sampling is often labor-intensive and can introduce operator-dependent error into the process. An integrated multi-functional off-line analyzer, the BioProfile FLEX (NOVA Biomedical, Waltham MA) has been developed, which combines the functionality of three off-line analyzers (a cell counter, an osmometer, and a gas/electrolyte & nutrient/metabolite bio-profile analyzer) into one device. In addition, a novel automated sampling system has also been developed that allows the BioProfile FLEX to automatically analyze the culture conditions in as many as ten bioreactors. This is the first report on the development and function of this integrated analyzer and an auto-sampler prototype for monitoring of mammalian cell cultures. Evaluation of the BioProfile FLEX was conducted in two separate laboratories and involved two BioProfile FLEX analyzers and two sets of reference analyzers (Nova BioProfile 400, Beckman-Coulter Vi-Cell AS, and Advanced Instruments Osmometer 3900), 13 CHO cell lines and over 20 operators. In general, BioProfile FLEX measurements were equivalent to those obtained using reference analyzers, and the auto-sampler did not alter the samples it provided to the BioProfile FLEX. These results suggest that the system has the potential to dramatically reduce the manual labor involved in monitoring mammalian cell bioprocesses without altering the quality of the data obtained, and integration with a bioreactor control system will allow feedback control of parameters previously available only for off-line monitoring. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2010 [source] Leveraging mobile technology for sustainable seamless learning: a research agendaBRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY, Issue 2 2010Chee-Kit Looi Over the next 10 years, we anticipate that personal, portable, wirelessly networked technologies will become ubiquitous in the lives of learners,indeed, in many countries, this is already a reality. We see that ready-to-hand access creates the potential for a new phase in the evolution of technology-enhanced learning, characterised by ,seamless learning spaces' and marked by continuity of the learning experience across different scenarios or contexts, and emerging from the availability of one device or more per student. The challenge is to enable learners to learn whenever they are curious and seamlessly switch between different contexts, such as between formal and informal contexts and between individual and social learning, and by extending the social spaces in which learners interact with each other. In this paper, we review the potential of mobile learning research for designing seamless learning environments that can bridge both formal and informal learning, present a research agenda and discuss important methodological issues that concern research into formal and informal learning. [source] | ||||||||||