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991.
992.
OBJECTIVE: To determine the practical value of the new pediatric disposable ETCO2 detector Pedi-CAP in verifying endotracheal tube placement in neonatal resuscitation. METHODS: Infants who required endotracheal intubation in the delivery room or the neonatal intensive care unit (NICU) were included in a prospective study in which the endotracheal tube placement was determined clinically and simultaneously by the Pedi-CAP and confirmed by chest radiograph. The Pedi-CAP and clinical evaluation determination times of the endotracheal tube placement were measured and compared. The accuracy and ease of the Pedi-CAP use were tested. RESULTS: Forty-five newborns (450 to 4620 gm) who needed endotracheal intubation were included in the study. Twenty-four (53.3%) were intubated in the delivery room and 21 (46.7%) in the NICU. The Pedi-CAP color indicator correlated with the clinical evaluation and radiograph findings of proper intubation in 30 of 33 patients (sensitivity 91%, specificity 100%, positive predictive value 100%, and negative predictive value 80%). There were three false-negative results in patients with severe cardiorespiratory depression. The Pedi-CAP color indicator correlated with the clinical evaluation for the ET-tube being in the esophagus in 12 of 12 patients (sensitivity, specificity, and positive and negative predictive value were all 100%). The time required to determine the tube position by clinical evaluation was 0 to 90 seconds (mean = 39.7 seconds; SD +/- 15.3 seconds). The time required with the disposable ETCO2 detector was 4 to 12 seconds (mean = 8.1 seconds; SD +/- 2.9 seconds; p < 0.001). CONCLUSION: The use of a disposable pediatric endotracheal CO2 detector significantly reduces the time spent in verifying the endotracheal tube position (trachea versus esophagus) in newborns, including premature babies with body weight < 1000 gm. This is of particular benefit to babies who are erroneously intubated in the esophagus, because using the device allows much faster detection of this problem and much earlier reintubation. 相似文献
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Differential patterns of striatal activation in young children with and without ADHD. 总被引:14,自引:0,他引:14
Sarah Durston Nim T Tottenham Kathleen M Thomas Matthew C Davidson Inge-Marie Eigsti Yihong Yang Aziz M Ulug B J Casey 《Neuropsychopharmacology》2003,53(10):871-878
BACKGROUND: Cognitive control, defined as the ability to suppress inappropriate thoughts and actions, is compromised in attention-deficit/hyperactivity disorder (ADHD). This study examines the neural basis of this deficit. METHODS: We used a paradigm that incorporates a parametric manipulation within a go/nogo task, so that the number of go trials preceding a nogo trial is varied to tax the neural systems underlying cognitive control with increasing levels of interference. RESULTS: Using this paradigm in combination with event-related functional magnetic resonance imaging (fMRI), we show that children without ADHD have increased susceptibility to interference with increasing numbers of go trials preceding a nogo trial, but children with ADHD have difficulty even with a single go trial preceding a nogo trial. In addition, children with ADHD do not activate frontostriatal regions in the same manner as normally developing children, but rather rely on a more diffuse network of regions, including more posterior and dorsolateral prefrontal regions. CONCLUSIONS: Normal immature cognition may be characterized as being susceptible to interference and supported by the maturation of frontostriatal circuitry. ADHD children show a slightly different cognitive profile at 6 to 10 years of age that is paralleled by a relative lack of or delay in the maturation of ventral frontostriatal circuitry. 相似文献
995.
A 12-year-old girl had an orbital lymphangioma and ipsilateral persistent hyperplastic primary vitreous (recently termed persistent fetal vasculature). Persistent fetal vasculature, orbital combined venous lymphatic vascular malformations, and noncontiguous intracranial vascular malformations may reflect the same defect in embryonal vascular maturation occurring in different tissues. Physicians caring for patients with orbital lymphangiomas should search for subtle signs of ipsilateral microphthalmos and should consider neuroimaging to evaluate for intracranial vascular malformations. 相似文献
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997.
Ann-Maree Kennedy Abdul Aziz Sameena Khalid David Hurman 《European archives of oto-rhino-laryngology》2012,269(5):1509-1512
We adapted the 2002 Scottish Referral Guidelines for suspected squamous cell carcinoma of the head and neck (SCCHN) as a set of “alarm symptoms.” These were then incorporated into a new Suspected Cancer Urgent Referral Electronically (SeCURE) system enabling immediate electronic referral from primary care to the appropriate hospital-based multi-disciplinary cancer team. All referrals made via the SeCURE system during the first year of its implementation were reviewed retrospectively. One hundred and ninety patients were urgently referred, of whom 15 (8%) were ultimately diagnosed with SCCHN. This audit demonstrated overall poor compliance with the referral guidelines. Although the electronic referral system helped for speedy clinic appointments, there was a low pick up rate of positive head and neck cancer cases. Continuing education for GPs is important and following discussion with colleagues in primary care, steps have been taken to reinforce awareness and more appropriate use of the SeCURE system. 相似文献
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999.
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Nik Daliana Nik Farid Sulaiman Che' Rus Maznah Dahlui Nabilla Al-Sadat Norlaili Abdul Aziz 《BMC public health》2014,14(Z3):S9