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111.
Pascal Meyer Matthieu Henry Eric Maury Jean-Luc Baudel Bertrand Guidet Georges Offenstadt 《Journal of critical care》2009
Purpose
We evaluate a procedure, combining colorimetric capnography with epigastric auscultation, to ensure nasogastric (NG) feeding tube correct position without any radiograph.Methods
We first evaluated the accuracy of colorimetric capnography in detecting tracheal positioning in a control group of 100 mechanically ventilated patients. The procedure was thereafter evaluated in a study group including patients requiring an NG tube. The NG tube was first inserted 30 cm and connected to a colorimetric capnograph (first step). If the capnograph did not detect carbon dioxide, insertion was completed to a total distance of 50 cm. An epigastric auscultation after air insufflation and a second capnography (second step) were performed. A radiograph evaluated correct tube position.Results
In the control group, colorimetric capnograph sensitivity to detect tracheal placement was 100%. In the study group, negative predictive value of first-step capnography to rule out tracheobronchial insertion was 100%. The association of a first-step negative capnography with a positive epigastric auscultation correctly identified all but one gastric insertions, yielding a sensitivity of 98.5% (95% confidence interval, 95.7-100). The positive predictive value of this association to detect gastric placement was 100%.Conclusion
Colorimetric capnography combined with epigastric auscultation is safe and accurate in ensuring correct gastric tube insertion. 相似文献112.
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116.
Masayoshi Sarai Dagmar Hartung Artiom Petrov Jun Zhou Navneet Narula Leo Hofstra Frank Kolodgie Satoshi Isobe Shinichiro Fujimoto Jean-Luc Vanderheyden Renu Virmani Chris Reutelingsperger Nathan D Wong Sudhir Gupta Jagat Narula 《Journal of the American College of Cardiology》2007,50(24):2305-2312
OBJECTIVES: The purpose of this study was to evaluate the role of caspase inhibitors on acute resolution of apoptosis in atherosclerotic lesions as evaluated by imaging with annexin A5. BACKGROUND: Extensive apoptosis of macrophages has been reported at the site of plaque rupture in patients dying of acute coronary syndrome. METHODS: Of 31 New Zealand White atherosclerotic rabbits, 6 received broad caspase, 3 received caspase-1, 3 received caspase-3, 3 received caspase-8, and 4 received caspase-9 inhibitors; 12 animals did not receive any caspase inhibitors (treatment control group). Six unmanipulated rabbits were used for comparison (disease control group). Technetium-99m-labeled annexin A5 was used for imaging atherosclerotic lesions; 6 of the 12 uninhibited atherosclerotic rabbits received (99m)Tc-labeled mutant annexin A5 (radiotracer control group). Gamma images were obtained, and quantitative radiotracer uptake was compared with pathologic findings. RESULTS: Atherosclerotic lesions were best visible in untreated atherosclerotic rabbits. Quantitative annexin uptake, defined as the percent of injected dose per g of abdominal aorta tissue, was significantly higher in untreated atherosclerotic animals (mean +/- SD = 0.0515 +/- 0.0099) compared with the normal rabbits (0.0065 +/- 0.0008; p < 0.0001) or atherosclerotic rabbits receiving mutant annexin (0.014 +/- 0.0024; p < 0.0001). Among all caspase inhibitor-treated rabbits, uptake was 39% lower (0.0314 +/- 0.0151) than in untreated atherosclerotic animals (p < 0.01). Uptake was also significantly lower in rabbits receiving broad caspase (0.0206 +/- 0.0058; p < 0.0001) or caspase-1, -3, or -9 (0.0272 +/- 0.0088, p < 0.01; 0.0286 +/- 0.0095, p < 0.01; 0.0300 +/- 0.0021, p < 0.01, respectively) inhibitors. Caspase-8 inhibitor did not affect apoptosis (0.0618 +/- 0.0047; p = NS). Upon histologic characterization, a substantial decrease in macrophage apoptosis was observed in caspase-inhibited animals. CONCLUSIONS: Molecular imaging, using radiolabeled annexin A5, allows the detection of acute resolution of apoptosis as a result of caspase inhibition in experimental atherosclerosis. If proven clinically, this may allow development of novel intervention strategies in acute vascular events. 相似文献
117.
Jean-Yves Jenny Eug��ne Ciobanu Philippe Clavert Jean-Henri Jaeger Jean-Luc Kahn Jean-Fran?ois Kempf 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2011,21(6):391-396
We wanted to test the following hypothesis: the location of the tibial and femoral ACL attachments measured by a navigation
system differs from their actual anatomic location. A total of 10 gross specimens were studied. The standard navigated procedure
was used. Metallic reference pins were implanted around the tibial and femoral ACL attachments and palpated with a navigated
stylus. Their position was recorded in comparison with the same tibial or femoral reference point. All measurements were repeated
with a caliper. Caliper and navigated measurements were compared with appropriate statistical tests at a 0.05 level of significance.
There was a significant difference between caliper and navigated measurements at the tibia in absolute value (maximal range
of 4 mm, mean difference about 2 mm), but the difference ratio was low (about 3%); there was no significant difference between
caliper and navigated measurements at the femur. There was a strong correlation and a good agreement between caliper and navigated
measurements. It is likely that these differences have few, if any, clinical relevance. We demonstrated that the navigation
system used during the present study has the potential to enhance the precision of the intra-operative measurement of the
tunnel placement during ACL replacement. 相似文献
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119.
Damien Riquet Nicolas Houel Jean-Luc Bodnar 《Journal of medical engineering & technology》2016,40(6):307-314
Every human injury leads to a scar formation. The healing process leads to the formation of new tissue: the scar, which is different from the original tissue. This process is influenced by mechanical strength and the local vasculature is modified. The purpose of this study is to show that there are various temperatures between the scar and the peri-scar area associated with the healing process that can be estimated using the thermal infrared camera. In the study, 12 scars were stimulated by cold. Several changes of temperature were observed between scar and peri-scar area for 10?min. Scars appeared significantly colder with a Wilcoxon test (p?=?0.01). Results showed that stimulated infrared thermography can be used to monitor the temperature difference between the scar and peri-scar tissue. 相似文献
120.
A. Alanio J.‐L. Beretti B. Dauphin E. Mellado G. Quesne C. Lacroix A. Amara P. Berche X. Nassif M.‐E. Bougnoux 《Clinical microbiology and infection》2011,17(5):750-755
New Aspergillus species have recently been described with the use of multilocus sequencing in refractory cases of invasive aspergillosis. The classical phenotypic identification methods routinely used in clinical laboratories failed to identify them adequately. Some of these Aspergillus species have specific patterns of susceptibility to antifungal agents, and misidentification may lead to inappropriate therapy. We developed a matrix‐assisted laser desorption ionization time‐of‐flight (MALDI‐TOF) mass spectrometry (MS)‐based strategy to adequately identify Aspergillus species to the species level. A database including the reference spectra of 28 clinically relevant species from seven Aspergillus sections (five common and 23 unusual species) was engineered. The profiles of young and mature colonies were analysed for each reference strain, and species‐specific spectral fingerprints were identified. The performance of the database was then tested on 124 clinical and 16 environmental isolates previously characterized by partial sequencing of the β‐tubulin and calmodulin genes. One hundred and thirty‐eight isolates of 140 (98.6%) were correctly identified. Two atypical isolates could not be identified, but no isolate was misidentified (specificity: 100%). The database, including species‐specific spectral fingerprints of young and mature colonies of the reference strains, allowed identification regardless of the maturity of the clinical isolate. These results indicate that MALDI‐TOF MS is a powerful tool for rapid and accurate identification of both common and unusual species of Aspergillus. It can give better results than morphological identification in clinical laboratories. 相似文献