McGrath® versus Macintosh laryngoscopes on hemodynamic response to intubation in elderly patients: a randomized clinical trial.

Introduction: laryngoscopy and tracheal intubation induce catecholaminergic release. Our study aimed to evaluate the hemodynamic impact of orotracheal intubation by McGrath® compared to the Macintosh laryngoscope in the elderly. Methods: we conducted a prospective randomized clinical trial that included elderly patients proposed for a scheduled surgery under general anesthesia with orotracheal intubation and divided into 2 groups: patients who were intubated using the McGrath® (group V) and patients who were intubated using the Macintosh direct laryngoscope (group M). Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP), were recorded before induction of anesthesia (baseline), and at 1 min, 3 min, and 5 min after intubation. Our outcomes were the increase of SBP (∆ SBP), MAP (∆ MAP), and HR (∆ HR) between the two groups, during the 5 minutes following the start of the orotracheal intubation, intubation time and the incidence of its related complications. Results: sixty patients were included and randomized into 2 groups of 30. The average age of our sample was 70±6 years with a sex ratio of 1.22. Most of the patients were operated on for orthopedic, urologic, or abdominal surgery. There were no statistically significant differences between the two groups in terms of demographic characteristics and the duration of anesthesia (p> 0.05). The intubation time was significantly increased in group M (p≤0.001). There was a significant difference in SBP, MAP, and HR values at 1 min after orotracheal intubation compared with the baseline values in Group V(P<0,05) and Group M (p < 0.05). There was a significant increase in the first minute after tracheal intubation in terms of SBP (151±42 vs 134.5±26 mmHg, p=0.012), MAP (114±4 vs 102±17 mmHg, p=0.015), DBP (89±32 vs 84±16 mmHg, p=0.01), and HR (99.5±10 vs 94.5±2 b/min, p=0.008) when group M was compared to group V. The ∆SBP was significantly different between group M (∆SBP = 36.2±23.5mmHg) and group V (∆SBP= 30.77±21.6mmHg) (p = 0.005). There were 4 ventricular arrhythmias in group M versus zero in group V (p <0.0001). The postoperative sore throat was significantly decreased in group M vs V (p=0.036). Conclusion: the McGrath® videolaryngoscope decreased the hemodynamic fluctuations due to endotracheal intubation in elderly patients.

Portable impedance-sensing device for microorganism characterization in the field.

A variety of biosensors have been proposed to quickly detect and measure the properties of individual microorganisms among heterogeneous populations, but challenges related to cost, portability, stability, sensitivity, and power consumption limit their applicability. This study proposes a portable microfluidic device based on impedance flow-cytometry and electrical impedance spectroscopy that can detect and quantify the size of microparticles larger than 45 µm, such as algae and microplastics. The system is low cost ($300), portable (5 cm [Formula: see text] 5 cm), low-power (1.2 W), and easily fabricated utilizing a 3D-printer and industrial printed circuit board technology. The main novelty we demonstrate is the use of square wave excitation signal for impedance measurements with quadrature phase-sensitive detectors. A linked algorithm removes the errors associated to higher order harmonics. After validating the performance of the device for complex impedance models, we used it to detect and differentiate between polyethylene microbeads of sizes between 63 and 83 µm, and buccal cells between 45 and 70 µm. A precision of 3% is reported for the measured impedance and a minimum size of 45 µm is reported for the particle characterization.

Recent Advances in CMOS Electrochemical Biosensor Design for Microbial Monitoring: Review and Design Methodology.

Rapid, high-sensitivity, and real-time characterization of microorganisms plays a significant role in several areas, including clinical diagnosis, human healthcare, early detection of outbreaks, and the protection of living beings. Integrating microbiology and electrical engineering promises the development of low-cost, miniaturized, autonomous, and high-sensitivity sensors to quantify and characterize bacterial strains at various concentrations. Electrochemical-based biosensors are receiving particular attention in microbiological applications among the different biosensing devices. Several approaches have been adopted to design and fabricate cutting-edge, miniaturized, and portable electrochemical biosensors to track and monitor bacterial cultures in real time. These techniques differ in their sensing interface circuits and microelectrode fabrication. The goals of this review are (1) to summarize the current state of CMOS sensing circuit designs in label-free electrochemical biosensors for bacteria monitoring and (2) to discuss the material and size of the electrodes used in electrochemical biosensors in microbiological applications. In this paper, we reviewed the latest and most advanced CMOS integrated interface circuits that have recently been used in electrochemical biosensors to identify and characterize bacteria species, such as impedance spectroscopy, capacitive, amperometry, and voltammetry, etc. In addition to the interface circuit design, other crucial factors, such as the material and scale of the electrodes, must be considered to increase the sensitivity of electrochemical biosensors. Surveying the literature in this field improves our knowledge about the impact of electrode designs and materials on sensing precision and will help future designers adapt, design, and fabricate appropriate electrode configurations based on their application. Thus, we summarized the conventional microelectrode designs and materials mainly employed in microbial sensors, including interdigitated electrodes (IDEs), microelectrode arrays (MEAs), paper, and carbon-based electrodes, etc.