Report of the National Commission on Nurse Anesthesia Education. Current and future perspectives regarding the framework for nurse anesthesia education: nurse anesthesia curriculum in the College of Pharmacy and Allied Health Professions, Wayne State University.

The nurse anesthesia educational program at Wayne State University, Detroit, is one of four allied health programs that offers a master's degree from the College of Pharmacy and Allied Health Professions. The program itself is housed in a teaching hospital, where CRNAs control and deliver the coursework. Advantages and limitations of this arrangement are analyzed and discussed.     

Asthmatherapie bei Kindern und Erwachsenen

Ohne Zusammenfassung     

Multicenter Experience of Hematopoietic Stem Cell Transplantation in WHIM Syndrome

Journal of Clinical Immunology - WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome is a rare disease, caused by CXCR4 gene mutations, which incorporates features of...     

Comparing MDI and DPI Aerosol Deposition Using In Vitro Experiments and a New Stochastic Individual Path (SIP) Model of the Conducting Airways

Pharmaceutical Research - Deposition characteristics of MDI and DPI aerosols were compared throughout the conducting airways for the first time using a combination of in vitro experiments and a...     

Characterization of Respiratory Drug Delivery with Enhanced Condensational Growth using an Individual Path Model of the Entire Tracheobronchial Airways

The objective of this study was to evaluate the delivery of inhaled pharmaceutical aerosols using an enhanced condensational growth (ECG) approach in an airway model extending from the oral cavity to the end of the tracheobronchial (TB) region. The geometry consisted of an elliptical mouth-throat (MT) model, the upper TB airways extending to bifurcation B3, and a subsequent individual path model entering the right lower lobe of the lung. Submicrometer monodisperse aerosols with diameters of 560 and 900 nm were delivered to the mouth inlet under control (25 °C with subsaturated air) or ECG (39 or 42 °C with saturated air) conditions. Flow fields and droplet characteristics were simulated using a computational fluid dynamics model that was previously demonstrated to accurately predict aerosol size growth and deposition. Results indicated that both the control and ECG delivery cases produced very little deposition in the MT and upper TB model (approximately 1%). Under ECG delivery conditions, large size increases of the aerosol droplets were observed resulting in mass median aerodynamic diameters of 2.4–3.3 μm exiting B5. This increase in aerosol size produced an order of magnitude increase in aerosol deposition within the TB airways compared with the controls, with TB deposition efficiencies of approximately 32–46% for ECG conditions. Estimates of downstream pulmonary deposition indicted near full lung retention of the aerosol during ECG delivery. Furthermore, targeting the region of TB deposition by controlling the inlet temperature conditions and initial aerosol size also appeared possible.     

Neurostimulators in epilepsy

A review of electrical stimulation in patients with refractory epilepsy, including animal and human data, shows that there is anatomic and physiologic evidence supporting the role of the thalamus in epilepsy. The most recent reports in patients with refractory epilepsy suggest that deep brain stimulation and cortical electrical stimulation of the anterior thalamic nucleus and hippocampus may reduce seizure frequency in patients with refractory partial and secondarily generalized seizures. This has led to a multicenter, prospective randomized trial called the Stimulation of the Anterior Nucleus of the Thalamus for Epilepsy (SANTE trial) that is currently being conducted at several centers in the United States. There is also a multicenter clinical trial for patients with refractory partial epilepsy treated with a cranially implanted responsive neurostimulator (RNS) system. Preliminary reports from the RNS system feasibility trial (the NeuroPace trial) suggest that electrographic seizures can be detected before they evolve into clinical seizures, and that electrical stimulation of the epileptogenic zone can then terminate the electrographic seizures. The preliminary data in patients using deep brain stimulation of the anterior thalamic nucleus and hippocampus, and cortical stimulation studies of the epileptogenic zone are promising and suggest a reduction in seizure frequency in some patients with refractory partial and secondarily generalized seizures. The exact mechanism of action and the best parameters used during electrical stimulation remain unknown and are the subject of ongoing research.