The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform

Masayoshi Kikuchi - One of the best experts on this subject based on the ideXlab platform.

Anthony J Dean - One of the best experts on this subject based on the ideXlab platform.

  • Ultrasound evaluation of the airway in the ED: a feasibility study
    Critical Ultrasound Journal, 2018
    Co-Authors: Elizabeth A. Hall, Ibrahim Showaihi, Nova L. Panebianco, Frances S Shofer, Anthony J Dean
    Abstract:

    Background Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol. Objectives This study seeks to determine the feasibility of ultrasound measurements of the upper airway performed in the ED by emergency physicians, the inter-rater reliability of such measurements, and their relationship with Mallampati score and BMI. Methods A convenience sample of volunteer ED patients and healthy volunteers with no known airway issues, aged > 18 years, had images taken of their airway using a standardized ultrasound scanning protocol by two EM ultrasound fellowship trained physicians. Measurements consisted of tongue base, tongue base-to-skin, epiglottic width and thickness, and pre-epiglottic space. Mean and standard deviation (SD) were used to summarize measurements. Inter-rater reliability was assessed by intraclass correlation coefficients (ICCs). Analysis of variance with linear contrasts was used to compare measurements with Mallampati scores and linear regression with BMI. Results Of 39 participants, 50% were female, 50% white, 42% black, with median age 32.5 years (range 19–90), and BMI 26.0 (range 19–47). Mean ± SD for each measurement (mm) was as follows: tongue base (44.6 ± 5.1), tongue base-to-skin (60.9 ± 5.3), epiglottic width (15.0 ± 2.8) and thickness (2.0 ± 0.37), and pre-epiglottic space (11.4 ± 2.4). ICCs ranged from 0.76 to 0.88 for all measurements except Epiglottis thickness (ICC = 0.57). Tongue base and tongue base-to-skin thickness were found to increase with increasing Mallampati score ( p  = .04, .01), whereas only tongue-to-skin thickness was loosely correlated with BMI ( r  = .38). Conclusions A standardized ultrasound scanning protocol demonstrates that the airway can be measured by emergency sonologists with good inter-operator reliability in all but epiglottic thickness. The measurements correlate with Mallampati score but not with BMI. Future investigation might focus on ultrasound evaluation of the airway in patients receiving airway management to determine whether ultrasound can predict challenging or abnormal airway anatomy prior to laryngoscopy.

  • Ultrasound evaluation of the airway in the ED: a feasibility study.
    Critical Ultrasound Journal, 2018
    Co-Authors: Elizabeth A. Hall, Ibrahim Showaihi, Nova L. Panebianco, Frances S Shofer, Anthony J Dean
    Abstract:

    Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol. This study seeks to determine the feasibility of ultrasound measurements of the upper airway performed in the ED by emergency physicians, the inter-rater reliability of such measurements, and their relationship with Mallampati score and BMI. A convenience sample of volunteer ED patients and healthy volunteers with no known airway issues, aged > 18 years, had images taken of their airway using a standardized ultrasound scanning protocol by two EM ultrasound fellowship trained physicians. Measurements consisted of tongue base, tongue base-to-skin, epiglottic width and thickness, and pre-epiglottic space. Mean and standard deviation (SD) were used to summarize measurements. Inter-rater reliability was assessed by intraclass correlation coefficients (ICCs). Analysis of variance with linear contrasts was used to compare measurements with Mallampati scores and linear regression with BMI. Of 39 participants, 50% were female, 50% white, 42% black, with median age 32.5 years (range 19–90), and BMI 26.0 (range 19–47). Mean ± SD for each measurement (mm) was as follows: tongue base (44.6 ± 5.1), tongue base-to-skin (60.9 ± 5.3), epiglottic width (15.0 ± 2.8) and thickness (2.0 ± 0.37), and pre-epiglottic space (11.4 ± 2.4). ICCs ranged from 0.76 to 0.88 for all measurements except Epiglottis thickness (ICC = 0.57). Tongue base and tongue base-to-skin thickness were found to increase with increasing Mallampati score (p = .04, .01), whereas only tongue-to-skin thickness was loosely correlated with BMI (r = .38). A standardized ultrasound scanning protocol demonstrates that the airway can be measured by emergency sonologists with good inter-operator reliability in all but epiglottic thickness. The measurements correlate with Mallampati score but not with BMI. Future investigation might focus on ultrasound evaluation of the airway in patients receiving airway management to determine whether ultrasound can predict challenging or abnormal airway anatomy prior to laryngoscopy.

Jan F Hawkins - One of the best experts on this subject based on the ideXlab platform.

  • respiratory diseases of the horse a problem oriented approach to diagnosis and management
    Respiratory diseases of the horse: a problem-oriented approach to diagnosis and management., 2013
    Co-Authors: Laurent L Couetil, Jan F Hawkins
    Abstract:

    Anatomy of the equine respiratory tract Introduction Extrathoracic airways Overview nares and rostral nasal passages nasal septum conchae and paranasal sinuses guttural pouches nasopharynx hard and soft palate Epiglottis larynx cervical trachea Intrathoracic airways and the lungs Tracheobronchial tree pulmonary circulation bronchial circulation Pulmonary function Ventilation Respiratory muscles lung volumes and ventilation regional differences in ventilation Diffusion Respiratory gases laws of diffusion diffusion limitation transport of gases in blood Ventilation-perfusion relationship Mechanics of breathing Airflow resistance lung elasticity pulmonary inertance Clinical examination General inspection Signalment history breathing pattern nasal discharge Physical examination Extrathoracic airways: nose to extrathoracic trachea intrathoracic airways and chest wall: intrathoracic trachea to alveoli Diagnostic tests and therapeutic procedures Endoscopy Dynamic endoscopy Diagnostic imaging Radiography computed tomography nuclear imaging ultrasonography Sampling of respiratory secretions Tracheal wash bronchoalveolar lavage airway brushing Airway and lung biopsy Endobronchial biopsy percutaneous lung biopsy thoracoscopic lung biopsy Thoracocentesis Sinus trephination Sinoscopy Thoracoscopy Lung function tests Arterial blood gases lung mechanics Allergy tests Aerosol therapy Principles of aerosol therapy aerosol delivery devices aerolization of anti-microbials The coughing horse Introduction Definition characteristics pathophysiology Acute cough Viral respiratory infections pneumonia Chronic cough Heaves (recurrent airway obstruction) inflammatory airway disease parasitic pneumonitis The horse with nasal discharge Introduction Seromucoid nasal discharge Rhinitis viral infections Mucopurulent nasal discharge Sinus diseases guttural pouch empyema strangles Epistaxis Exercise-induced pulmonary hemorrhage ethmoid hematoma guttural pouch mycosis miscellaneous causes of epistaxis Milk Cleft palate dorsal displacement of the soft palate The horse with increased respiratory effort Introduction Pleuropneumonia/pneumonia heaves (recurrent airway obstruction) interstitial lung diseases proximal airway obstruction Abnormal respiratory sounds Introduction Stridor Nasal diseases: atheroma alar fold obstruction nasal septum obstruction nasal polyps. Pharyngeal and laryngeal diseases: dorsal displacement of the soft palate epiglottic entrapment epiglottic retroversion axial deviation of the aryepiglottic folds epiglottitis rostral displacement of the palatopharyngeal arch laryngeal hemiplegia arytenoid chondritis. Tracheal diseases: collapsing trachea tracheal trauma tracheal neoplasia Abnormal lung sounds Congenital abnormalities Wry nose choanal atresia palatoschisis (cleft palate) cysts branchial arch defects guttural pouch tympany Further reading Index

  • Respiratory Diseases of the Horse: A Problem-Oriented Approach to Diagnosis and Management - Respiratory Diseases of the Horse : A Problem-Oriented Approach to Diagnosis and Management
    2013
    Co-Authors: Laurent L Couetil, Jan F Hawkins
    Abstract:

    Anatomy of the equine respiratory tract Introduction Extrathoracic airways Overview nares and rostral nasal passages nasal septum conchae and paranasal sinuses guttural pouches nasopharynx hard and soft palate Epiglottis larynx cervical trachea Intrathoracic airways and the lungs Tracheobronchial tree pulmonary circulation bronchial circulation Pulmonary function Ventilation Respiratory muscles lung volumes and ventilation regional differences in ventilation Diffusion Respiratory gases laws of diffusion diffusion limitation transport of gases in blood Ventilation-perfusion relationship Mechanics of breathing Airflow resistance lung elasticity pulmonary inertance Clinical examination General inspection Signalment history breathing pattern nasal discharge Physical examination Extrathoracic airways: nose to extrathoracic trachea intrathoracic airways and chest wall: intrathoracic trachea to alveoli Diagnostic tests and therapeutic procedures Endoscopy Dynamic endoscopy Diagnostic imaging Radiography computed tomography nuclear imaging ultrasonography Sampling of respiratory secretions Tracheal wash bronchoalveolar lavage airway brushing Airway and lung biopsy Endobronchial biopsy percutaneous lung biopsy thoracoscopic lung biopsy Thoracocentesis Sinus trephination Sinoscopy Thoracoscopy Lung function tests Arterial blood gases lung mechanics Allergy tests Aerosol therapy Principles of aerosol therapy aerosol delivery devices aerolization of anti-microbials The coughing horse Introduction Definition characteristics pathophysiology Acute cough Viral respiratory infections pneumonia Chronic cough Heaves (recurrent airway obstruction) inflammatory airway disease parasitic pneumonitis The horse with nasal discharge Introduction Seromucoid nasal discharge Rhinitis viral infections Mucopurulent nasal discharge Sinus diseases guttural pouch empyema strangles Epistaxis Exercise-induced pulmonary hemorrhage ethmoid hematoma guttural pouch mycosis miscellaneous causes of epistaxis Milk Cleft palate dorsal displacement of the soft palate The horse with increased respiratory effort Introduction Pleuropneumonia/pneumonia heaves (recurrent airway obstruction) interstitial lung diseases proximal airway obstruction Abnormal respiratory sounds Introduction Stridor Nasal diseases: atheroma alar fold obstruction nasal septum obstruction nasal polyps. Pharyngeal and laryngeal diseases: dorsal displacement of the soft palate epiglottic entrapment epiglottic retroversion axial deviation of the aryepiglottic folds epiglottitis rostral displacement of the palatopharyngeal arch laryngeal hemiplegia arytenoid chondritis. Tracheal diseases: collapsing trachea tracheal trauma tracheal neoplasia Abnormal lung sounds Congenital abnormalities Wry nose choanal atresia palatoschisis (cleft palate) cysts branchial arch defects guttural pouch tympany Further reading Index

J H Hwang - One of the best experts on this subject based on the ideXlab platform.

  • estimation of the nares to Epiglottis distance and the nares to vocal cords distance in young children
    BJA: British Journal of Anaesthesia, 2012
    Co-Authors: Sunghoon Kim, D H Kim, H Kang, J J Park, S H Seong, Eun Ha Suk, J H Hwang
    Abstract:

    Background Estimation of the nares-to-Epiglottis and nares-to-vocal cords distances would facilitate the selection of properly sized nasopharyngeal airways and appropriate positioning of a fibreoptic bronchoscope in young children. The purposes of this study were to measure the nares-to-Epiglottis and nares-to-vocal cords distances and to create an algorithm to predict these distances based on anatomical landmarks and paediatric characteristic data. Methods Two hundred and eleven children, aged 1–10 yr, undergoing elective surgery were investigated. After induction of general anaesthesia, the distances from the nares to the Epiglottis/vocal cords were measured using a nasogastric tube. After intubation, the distances from the lateral border of the nose to the ipsilateral mandible angle (nares-to-mandible distance) and the tragus of the ear (nares-to-tragus distance) were measured using a tape measure. Results The nares-to-Epiglottis and nares-to-vocal cords distances were significantly correlated with the age, weight, height, and external measurements (P Conclusions The nares-to-Epiglottis and nares-to-vocal cords distances can be predicted using the height and the nares-to-mandible distance in young children. Clinical Trial Registration number: Clinical Research Information Service KCT0000150.

Stefanie Ritztimme - One of the best experts on this subject based on the ideXlab platform.

  • estimation of age at death based on aspartic acid racemization in elastic cartilage of the Epiglottis
    International Journal of Legal Medicine, 2014
    Co-Authors: Christian Matzenauer, Alexandra Reckert, Stefanie Ritztimme
    Abstract:

    Age estimation based on aspartic acid racemization (AAR) has been applied successfully to various tissues. For routine uses, AAR is analyzed in dentine. For cases in which teeth are unavailable, analyzing AAR in purified elastin has been shown to be an alternative method. The suitability of elastic cartilage from the Epiglottis as an elastin source for age estimation based on AAR was tested. A total of 65 tissue samples (cartilage) of Epiglottis and 45 samples of elastin purified from the elastic cartilage of Epiglottis samples were analyzed. While the d-aspartic acid content of total tissue samples increased with age only slowly, its increase with age in purified elastin samples was similar to that in purified elastin from other tissues. The relationship between the d-aspartic acid content and age was shown to be close enough for age estimation based on AAR in purified elastin from the elastic cartilage of the Epiglottis, provided a sufficient quality of elastin purification. Age estimation based on AAR in purified elastin from the Epiglottis might serve as a valuable alternative in cases in which other tissues (e.g., teeth) are unavailable.