Comparative study of awake endotracheal intubation with Glidescope video laryngoscope versus flexible fiber optic bronchoscope in patients with traumatic cervical spine injury

BackgroundThe Gldiescope video laryngoscope (GVL) as a recent intubating device has gained much popularity in difficult intubation over the last decade. It can be used as a substitute to flexible fiber optic bronchoscope (FOB) in intubating challenges. The object of this study is to compare the utility of GVL and FOB for intubating time, attempts, effects on hemodynamics, adverse effects, patient satisfaction and post intubation neurological outcome during awake intubation in traumatic cervical spine injury.MethodsFifty patients undergoing post traumatic cervical spine fixation under general anesthesia were randomly allocated to two groups in a prospective, controlled non-blinded study. All patients were premedicated with glycopyrrolate 0.2 mg iv and midazolam 1 mg iv that be repeated up to 0.05 mg/kg followed with a bolus dose of remifentanil 1.5 μg/kg then a continuous remifentanil infusion of 0.15 μg/kg/min for 3 min before procedure. Each patient underwent a wake endotracheal intubation with either GVL (G group) or FOB (F group) with manual in line stabilization (MILS). Intubating time, intubating attempts, hear rate (HR), mean arterial pressure (MAP), oxygen desaturation (SO₂ < 90%), sore throat, patient satisfaction and postintubation neurological outcome were recorded.ResultsIntubating time was significantly lower in G group compared with F group (26 ± 5 versus 72 ± 11 respectively), while the percentage of the first successful intubating attempt was insignificantly higher in G group (88%) than in F group (72%). Both HR and MAP were significantly increased only in F group during intubation in comparison with the basal line values. Both devices were safe for post neurological outcome. No significant differences of adverse effects or patient satisfaction were recorded between groups.ConclusionThe GVL is a safe surrogate for FOB during awake intubation for post traumatic cervical spine fixation.     

The reliability and validity of the measurement of lateral trunk motion in two-dimensional video analysis during unipodal functional screening tests in elite female athletes

ObjectiveTo investigate the reliability and validity of the measurement of lateral trunk motion (LTM) in two-dimensional (2D) video analysis of unipodal functional screening tests.DesignObservational study.SettingResearch laboratory.ParticipantsForty-three injury-free female athletes.Main outcome measuresKnee valgus (KV) and lateral trunk motion (LTM) angles were measured with a standard digital camera during the single leg squat and the single leg drop vertical jump (SLDVJ). Three-dimensional motion analysis was used during the SLDVJ to measure peak external knee abduction moment (pKAM). Intraclass correlation coefficients were calculated to assess the intra- and intertester reliability of the LTM angle. Correlations between 2D angles and pKAM were calculated for the SLDVJ.ResultsExcellent intraclass correlation coefficients for the LTM angle were found within (0.99–1.00) and between testers (0.98–0.99). The sum of KV and LTM was significantly correlated with the pKAM during the SLDVJ for the dominant (r = −0.36; p = 0.017) and non-dominant leg (r = −0.32; p = 0.034), while either angle alone was not.ConclusionsLTM can be measured with excellent intra- and intertester reliability. The combination of KV and LTM was moderately associated with pKAM and thus including LTM may aid assessment of movement quality and injury risk.     

General movements in genetic disorders: A first look into Cornelia de Lange syndrome

Abstract

The assessment of General Movements (GMs), i.e. age-specific motor patterns during the first months of life, has repeatedly proven to be a valuable tool to predict neurodevelopmental outcomes. Abnormal spontaneous GMs were found to be among the most reliable markers for cerebral palsy. To add to the knowledge of the abnormal early motor repertoire we analysed prospectively collected video recordings of a boy clinically diagnosed with Cornelia de Lange syndrome. The observed atypical GMs are a further step to disentangle early motor peculiarities in the light of the genetic impact on the developing brain.     

Assessment and management of the predicted difficult airway in babies and children

Although it is essential to take a history and examine every child prior to airway management, preoperative anticipation of a difficult airway is not totally reliable and therefore it is wise to be prepared for the unexpected difficult airway. Information about the airway can be gained from previous medical records, current history, physical examination and other tests. A natural consequence of airway assessment is development of an airway plan. Important anatomical and physiological features may be identified in an airway assessment which can then have a direct influence on the subsequent airway plan. Managing the predicted difficult airway is usually elective. This allows proper preparation of equipment, assistants, expertise and the environment required for the airway plan. This article will discuss paediatric airway assessment, outline those features that contribute to airway difficulty, and identify indications and risk factors associated with various airway techniques. Key objectives for an airway management plan are to maintain oxygenation and avoid trauma. This involves adopting techniques that avoid hypoxia and provide a high success rate with minimum attempts.     

长期服用抗精神病药脑电图异常相关因素分析

〔摘 要〕 目的：观察长期服用抗精神病药物的精神疾病患者的脑电图异常检出率，对其影响因素进行分析，提出预防措施。 方法：选取 2020 年 6 月至 2020 年 12 月期间在泉州市第三医院住院的长期服用抗精神病药物患者 256 例进行脑电图检查， 统计检出异常率；并观察不同药物种类、不同年龄段、不同服药时间患者的脑电异常率，对脑电图异常的危险因素进行分析。 结果：256 例患者中 154 例（60.16 %）出现脑电图异常，其中轻度异常在临床中最常见，重度异常最少见。不同药物种类中， 氯氮平使用者脑电图异常率最高；不同年龄段中，年龄＞ 60 岁脑电图异常率较高。结论：长期服用抗精神病药物患者出现 脑电图异常的影响因素主要为年龄＞ 60 岁、长期服用氯氮平，故临床需结合患者年龄合理选择药物，尽量选择对脑电图影 响较小的药物，且密切监测患者病情变化，适当调整或优化治疗方案。     

Online and offline video game use in adolescents: measurement invariance and problem severity

Background: Despite the increasing popularity of video game playing, little is known about the similarities and differences between online and offline video game players. Objectives: The aims of this study were (i) to test the applicability and the measurement invariance of the previously developed Problematic Online Gaming Questionnaire (POGQ) in both online and offline gamers and to (ii) examine the differences in these groups. Methods: Video game use habits and POGQ were assessed in a sample of 1,964 (71% male) adolescent videogame players. Those gamers who played at least sometimes in an online context were considered “online gamers,” while those who played videogames exclusively offline were considered “offline gamers.” Results: Confirmatory factor analysis supported the measurement invariance across online and offline videogame players. According to the multiple indicators multiple causes (MIMIC) model, online gamers were more likely to score higher on overuse, interpersonal conflict, and social isolation subscales of the POGQ. Conclusion: The results of the present study suggest that online and offline gaming can be assessed using the same psychometric instrument. These findings open the possibility for future research studies concerning problematic video gaming to include participants who exclusively play online or offline games, or both. However, the study also identified important structural features about how online and offline gaming might contribute differently to problematic use. These results provide important information that could be utilized in parental education and the prevention program about the possible detrimental consequences of online vs. offline video gaming.     

Self‐recognition in live videos by young children: does video training help?

The overall aim of the experiment reported here was to establish whether self‐recognition in live video can be facilitated when live video training is provided to children aged 2–2.5 years. While the majority of children failed the test of live self‐recognition prior to video training, more than half exhibited live self‐recognition post video training. Children who failed the live video self‐recognition tasks passed the test of mirror self‐recognition. The findings are discussed in light of a video deficit and the potential role of pre‐test training in facilitating self‐recognition in live video by young children.