Application of a video laryngoscope combined with a fiberoptic bronchoscope in emergency endotracheal intubation and its effects on pulmonary infection in patients with craniocerebral trauma / 中国基层医药

Objective:To investigate the application of a video laryngoscope combined with a fiberoptic bronchoscope in emergency endotracheal intubation and its effects on pulmonary infection in patients with craniocerebral trauma.Methods:A total of 105 patients with craniocerebral trauma who received treatment in Yiwu Central Hospital from January 2020 to December 2020 were included in this study. They were randomly allocated to undergo endotracheal intubation with a video laryngoscope (control group, n = 50) or a video laryngoscope combined with a fiberoptic bronchoscope (observation group, n = 55). Glottic exposure, intubation, vital signs, lung infection rate during hospitalization, and incidence of complications were monitored/determined in each group. Results:Glottic exposure in the observation group was superior to that in the control group ( Z = 4.29, P < 0.001). First-pass success rate was significantly higher in the observation group than in the control group [96.36% (53/55) vs. 82.00% (41/50), χ2 = 5.76, P < 0.05]. The number of intubation attempts and the time to successful intubation were (1.07 ± 0.53) times and (85.12 ± 15.36) seconds, respectively in the observation group, which were significantly less or shorter than those in the control group [(1.92 ± 0.74) times, (106.13 ± 16.34) seconds, t = 6.81, 6.79, both P < 0.001). The changes in mean arterial pressure and heart rate during intubation were less in the observation group than in the control group (both P < 0.05). The amplitude of increase in blood oxygen saturation after intubation was greater in the observation group than in the control group ( P < 0.05). Lung infection rate was significantly lower in the observation group than in the control group [10.91% (6/55) vs. 30.00% (15/50), χ2 = 5.96, P < 0.05]. The incidence of complications was significantly lower in the observation group than in the control group [5.45% (3/55) vs. 18.00% (9/50), χ2 = 4.07, P < 0.05]. Conclusion:Application of a video laryngoscope combined with a fiberoptic bronchoscope in emergency endotracheal intubation can increase the first-pass success rate, reduce repeated intubation attempts, shorten time to successful intubation, help to maintain stable vital signs, prevent lung infection and complication. Therefore, the combined method is of clinical application value.

Intubación traqueal a ciegas con dispositivo supraglótico Air-Q: serie prospectiva de casos en pediatría / Blind tracheal intubation with Air-Q supraglottis device: prospective case series in pediatrics

Abstract Introduction: Airway management in children is one of the challenges faced by physicians in the different care settings. Unlike the adult population, there is no standard-of-reference device for blind intubation in pediatrics. Our group has already conducted a case series study using the I-Gel device for this purpose, but with no acceptable rates of blind intubation. As part of our search for an appropriate device for this purpose, we examined the use of the Air-Q which comes in pediatric sizes but lacks studies for blind intubation in this population. Objective: The main objective of this study was to assess the percentage of successful blind tracheal intubations through the Air-Q supraglottic device. Materials and methods: Prospective sample of 45 pediatric patients weighing between 7 and 50 kg. Besides assessing the percentage of successful blind tracheal intubations, sealing pressures, and fiberoptic visualization through the device were also evaluated and reported, together with the complications associated with the procedure. Results and conclusion: The overall percentage of blind intubation through the Air-Q mask in this study was 55.5%, found to be not acceptable to warrant a recommendation of use for blind intubation; on the other hand, ideal fiberoptic visualiza tion was acceptable, making this method advisable for fiberoptic-guided intubation through the supraglotting device.

Resumen Introducción: El manejo de la vía aérea en el niño hace parte de los desafíos a los cuales debe enfrentarse el médico en los diferentes servicios de atención. A diferencia de la población adulta, en pediatría no existe un dispositivo estándar de referencia para la intubación a ciegas; nuestro grupo ya realizo una serie de casos con el dispositivo I-gel para este propósito, el cual no mostró tasas aceptables de intubación a ciegas; buscando un dispositivo idóneo para este fin, se plantea el dispositivo Air-Q el cual viene en tamaños pediátricos y no tiene estudios en esta población para intubación a ciegas. Objetivo: El objetivo principal de este estudio fue evaluar el porcentaje de éxito en la intubación traqueal a ciegas a través del dispositivo supraglótico Air-Q. Materiales y métodos: Se recogió una muestra prospectiva en una población pediátrica de 45 pacientes con peso entre 7 y 50Kg, además de evaluar el porcentaje de éxito de la intubación traqueal a ciegas, se evaluó la presión de sello, visión fibroscópica a través del dispositivo y se reportaron las complicaciones asociadas al procedimiento. Resultados y conclusiones: El porcentaje global de intuba ción a ciegas a través de la máscara Air-Q en este estudio fue del 55,5%, encontrándolo como un porcentaje no aceptable para recomendar la intubación a ciegas a través de este dispositivo; por otra parte la visión fibroscópica ideal fue aceptable, pudiéndose aconsejar como método para guiar la intubación fibroscópica a través de dispositivo supraglótico.

Tooth decay detection using a fiber optic sensor / Detección de caries dental usando un sensor de fibra óptica

ABSTRACT Introduction: tooth decay has become one of the most prevalent diseases worldwide, but ironically it is one of the most neglected. Currently, adequate and effective caries treatment is based on early diagnosis and procedures such as sealants, crowns, and root canal treatment. Methods: This study examined the behavior of carious and non-carious areas of critical dental units (premolars and molars) subjecting them to a wavelength of 830 nm in adult humans who agreed to a dental exam and had at least one tooth affected by dental caries. Underage persons and patients in medical treatment were excluded. After finding a behavior that helped differentiate decayed tissue from healthy areas, the used experimental system was characterized and tested in volunteers. The implemented system contains a fiber optic sensor comprised of a trifurcated fiber and a photodetector to perform optical power measurements. Results: This sensor detected 100% of dental caries samples on premolar and molar occlusal surfaces. It also showed the ability to diagnose buccal cavities. Conclusions: The results showed that caries can be identified in dental units by means of a fiber optic sensor and infrared light at 830 nm.

RESUMEN. Introducción: la caries se ha manifestado como una de las enfermedades con mayor prevalencia mundial, pero paradójicamente es una de las más desatendidas. En la actualidad, el tratamiento adecuado y eficaz contra la caries se basa en el diagnóstico temprano y en procedimientos como obturaciones, coronas y tratamiento de conductos. Métodos: esta investigación se centró en examinar el comportamiento de zonas cariadas y no cariadas de piezas dentales vitales (premolares y molares) al someterlas a una longitud de onda de 830 nm en seres humanos mayores de edad que aceptasen una revisión odontológica y que presentaran al menos un caso de caries dental. Fueron excluidos menores de edad y personas bajo tratamientos médicos. Tras encontrar un comportamiento que permitió diferenciar entre zonas cariadas y sanas, se caracterizó el sistema experimental usado y se probó en voluntarios. El sistema implementado se basa en un sensor de fibra óptica compuesto por una fibra trifurcada y un fotodetector para realizar mediciones de potencia óptica. Resultados: este sensor detectó el 100% de las muestras de caries dental en superficies oclusales de premolares y molares. Asimismo, exhibió indicios de la capacidad de diagnosticar caries vestibulares. Conclusiones: los resultados mostraron que se puede establecer la presencia de caries en piezas dentales mediante la implementación de un sensor de fibra óptica y luz infrarroja de 830 nm.

Flexible bronchoscopy and mechanical ventilation in managing Mounier-Kuhn syndrome: a case report / Broncoscopia flexível e ventilação mecânica no tratamento da síndrome de Mounier-Kuhn: relato de caso

ABSTRACT CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT) scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis. Flexible bronchoscopy was performed, which revealed enlarged airways with expiratory collapse. Furthermore, orifices of tracheal diverticulosis were also detected. Non-invasive positive pressure ventilation (NPPV) was added, along with long-term oxygen therapy. At control visits, the patient's clinical and laboratory findings were found to have improved. CONCLUSION: Flexible bronchoscopy can be advocated for establishing the diagnosis and non-invasive mechanical ventilation can be used with a high success rate, for clinical wellbeing in Mounier-Kuhn syndrome.

RESUMO CONTEXTO: A síndrome de Mounier-Kuhn é uma condição congênita rara com dilatação e diverticulação distintas da parede traqueal. Os sintomas podem ser variáveis ​e o tratamento geralmente é de suporte. RELATO DE CASO: Paciente do sexo masculino, de 60 anos, com internação hospitalar recorrente, foi internado neste caso devido a dispneia, tosse e produção de expectoração. A amostra de sangue arterial revelou acidose respiratória descompensada, com hipoxemia moderada. A tomografia computadorizada de tórax mostrou dilatação da traqueia e brônquios, divertículos traqueais e bronquiectasias. Realizou-se broncoscopia flexível, que revelou aumento das vias aéreas com colapso expiratório. Além disso, também foram detectados orifícios de diverticulose traqueal. Foi adicionada ventilação com pressão positiva não invasiva (NPPV) juntamente com a oxigenoterapia a longo prazo. Foram verificadas melhoras dos resultados clínicos e laboratoriais do doente nas visitas de controle. CONCLUSÃO: A broncoscopia flexível pode ser defendida para estabelecer o diagnóstico, e a ventilação mecânica não invasiva pode ser utilizada com alta taxa de sucesso, para bem-estar clínico, na síndrome de Mounier-Kuhn.

Intelligent interface for data acquisition and transmission from a neutron generator to a computer through an optical fibre / Interfase inteligente para adquirir y transmitir desde un generador de neutrones a un computador a través de una fibra óptica

The present paper shows the design, construction and application of an interface developed on the base of the microcontroller usage. The aim is to reestablish the communication exchange among the basic modules that constitute the Neutron Generator belonging to the CEADEN Physics Department. Original interface design is upgraded by the automation of the data acquisition on the Neutron Generator exploitation parameters. The data acquisition card, optoelectronic converters, a PC-user interface using Lab VIEW environment, the indispensable firmware for interface functioning were developed for that purpose. The use of PC in the Neutron Generator is introduced, thus setting a precedent for the further automation of other subsystems.

Se presenta el diseño, construcción y aplicación de una interfase desarrollada utilizando microcontroladores, con el fin de restablecer la comunicación entre los módulos básicos que componen el generador de neutrones del Departamento de Física del Centro de Aplicaciones Tecnológicas y Desarrollo Nuclear. Se moderniza la interfase original automatizando la adquisición de la información sobre los parámetros de explotación del generador de neutrones. Se desarrolló la tarjeta de adquisición de las señales de interés, los conversores opto electrónicos, la interfase PC-usuario en ambiente LabView y los códigos indispensables para el funcionamiento de la interfase. Se introdujo el uso de la PC en el generador de neutrones y se estableció el antecedente para extender la automatización a otros subsistemas de la instalación.