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1.
J Mol Biol ; 435(1): 167757, 2023 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-35872069

RESUMO

Signal transduction at the synapse is mediated by a variety of protein-lipid interactions, which are vital for the spatial and temporal regulation of synaptic vesicle biogenesis, neurotransmitter release, and postsynaptic receptor activation. Therefore, our understanding of synaptic transmission cannot be completed until the elucidation of these critical protein-lipid interactions. On this front, recent advances in nanodiscs have vastly expanded our ability to probe and reprogram membrane biology in synapses. Here, we summarize the progress of the nanodisc toolbox and discuss future directions in this exciting field.


Assuntos
Metabolismo dos Lipídeos , Proteínas de Membrana , Nanoestruturas , Sinapses , Transmissão Sináptica , Sinapses/fisiologia , Vesículas Sinápticas , Proteínas de Membrana/metabolismo
2.
Ann Emerg Med ; 77(3): 285-295, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33455839

RESUMO

STUDY OBJECTIVE: Extraglottic airway devices are frequently used during cardiac arrest resuscitations and for failed intubation attempts. Recent literature suggests that many extraglottic airway devices are misplaced. The aim of this study is to create a classification system for extraglottic airway device misplacement and describe its frequency in a cohort of decedents who died with an extraglottic airway device in situ. METHODS: We assembled a cohort of all decedents who died with an extraglottic airway device in situ and underwent postmortem computed tomographic (CT) imaging at the state medical examiner's office during a 6-year period, using retrospective data. An expert panel developed a novel extraglottic airway device misplacement classification system. We then applied the schema in reviewing postmortem CT for extraglottic airway device position and potential complications. RESULTS: We identified 341 eligible decedents. The median age was 47.0 years (interquartile range 32 to 59 years). Out-of-hospital personnel placed extraglottic airway devices in 265 patients (77.7%) who subsequently died out of hospital; the remainder died inhospital. The classification system consisted of 6 components: depth, size, rotation, device kinking, mechanical blockage of ventilation opening, and injury. Under the system, extraglottic airway devices were found to be misplaced in 49 cases (14.4%), including 5 (1.5%) that resulted in severe injuries. CONCLUSION: We created a novel extraglottic airway device misplacement classification system. Misplacement occurred in greater than 14% of cases. Severe traumatic complications occurred rarely. Quality improvement activities should include review of extraglottic airway device placement when CT images are available and use the classification system to describe misplacements.


Assuntos
Competência Clínica/estatística & dados numéricos , Intubação Intratraqueal/instrumentação , Máscaras Laríngeas/efeitos adversos , Erros Médicos/classificação , Faringe/lesões , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/métodos , Intubação Intratraqueal/normas , Masculino , Erros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Faringe/diagnóstico por imagem , Garantia da Qualidade dos Cuidados de Saúde , Melhoria de Qualidade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
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