Non-invasive Detection of Unique Molecular Signatures in Laser-Induced Retinal Injuries.

Unintentional laser exposure is an increasing concern in many operational environments. Determining whether a laser exposure event caused a retinal injury currently requires medical expertise and specialized equipment that are not always readily available. The purpose of this study is to test the feasibility of using dynamic light scattering (DLS) to non-invasively detect laser retinal injuries through interrogation of the vitreous humor (VH). Three grades of retinal laser lesions were studied: mild (minimally visible lesions), moderate (Grade II), and severe (Grade III). A pre-post-treatment design was used to collect DLS measurements in vivo at various time points, using a customized instrument. VH samples were analyzed by liquid chromatography/tandem mass spectrometry (LC-MS/MS) and relative protein abundances were determined by spectral counting. DLS signal analysis revealed significant changes in particle diameter and intensity in laser-treated groups as compared with control. Differences in protein profile in the VH of the laser-treated eyes were noted when compared with control. These results suggest that laser injury to the retina induces upregulation of proteins that diffuse into the VH from the damaged tissue, which can be detected non-invasively using DLS.

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management.

Controlling patient temperature is important for a wide variety of clinical conditions. Cooling to normal or below normal body temperature is often performed for neuroprotection after ischemic insult (e.g. hemorrhagic stroke, subarachnoid hemorrhage, cardiac arrest, or other hypoxic injury). Cooling from febrile states treats fever and reduces the negative effects of hyperthermia on injured neurons. Patients are warmed in the operating room to prevent inadvertent perioperative hypothermia, which is known to cause increased blood loss, wound infections, and myocardial injury, while also prolonging recovery time. There are many reported approaches for temperature management, including improvised methods that repurpose standard supplies (e.g., ice, chilled saline, fans, blankets) but more sophisticated technologies designed for temperature management are typically more successful in delivering an optimized protocol. Over the last decade, advanced technologies have developed around two heat transfer methods: surface devices (water blankets, forced-air warmers) or intravascular devices (sterile catheters requiring vascular placement). Recently, a novel device became available that is placed in the esophagus, analogous to a standard orogastric tube, that provides efficient heat transfer through the patient's core. The device connects to existing heat exchange units to allow automatic patient temperature management via a servo mechanism, using patient temperature from standard temperature sensors (rectal, Foley, or other core temperature sensors) as the input variable. This approach eliminates vascular placement complications (deep venous thrombosis, central line associated bloodstream infection), reduces obstruction to patient access, and causes less shivering when compared to surface approaches. Published data have also shown a high degree of accuracy and maintenance of target temperature using the esophageal approach to temperature management. Therefore, the purpose of this method is to provide a low-risk alternative method for controlling patient temperature in critical care settings.

Disaster medicine training survey results for dental health care providers in Illinois.

BACKGROUND: Ongoing vigilance by governments, public health agencies and health care professionals monitoring potential epidemic and pandemic outbreaks, terrorist threats and ever-present natural disasters requires the continuous evolution of comprehensive disaster response plans and teams, which include the integration of oral health care professionals. METHODS: The authors conducted a study in which oral health care professionals assessed their training in the American Medical Association's (AMA's) National Disaster Life Support (NDLS) courses. At the conclusion of each instructional session, the authors asked participants to complete an anonymous course evaluation form to report their impressions of the training activity. The authors included in the analysis those evaluations associated with sessions attended almost exclusively by dentists and hygienists. RESULTS: The authors derived descriptive statistics from the selected course evaluations. Overall, oral health care professionals believed that the Core Disaster Life Support (CDLS) and Basic Disaster Life Support (BDLS) courses were of great educational value, rating course impact at 9.50 and 9.29, respectively, on a scale from 1 to 10. CONCLUSIONS: Statistical evaluation instruments reveal satisfaction with the all-hazards awareness training received through the AMA's NDLS disaster medicine training curriculum. Licensed oral health care professionals in Illinois accepted the utility and merits of, and benefited from, the four-hour CDLS and eight-hour BDLS certification programs. Practice Implications. Dental professionals in Illinois require minimal additional training for dental emergency responder duties. The AMA's NDLS curriculum provides effective preparation for dental professionals.