Mucosal Erosion of the Cricoid Cartilage After the Use of an i-Gel Supraglottic Airway Device in a Patient with Diffuse Idiopathic Skeletal Hyperostosis.

After standard hip arthroplasty, an 82-year-old patient with previously undiagnosed diffuse idiopathic skeletal hyperostosis of the cervical spine experienced life-threatening side effects after use of a supraglottic airway device (i-gel). Extensive mucosal erosion and denudation of the cricoid cartilage caused postoperative supraglottic swelling and prolonged respiratory failure requiring tracheostomy. In this case report, we highlight the importance of evaluating risk factors for failure of supraglottic airway devices.

Quantification of anandamide and 2-arachidonoylglycerol plasma levels to examine potential influences of tetrahydrocannabinol application on the endocannabinoid system in humans.

The effects of tetrahydrocannabinol (THC) and endogenous cannabinoids (endocannabinoids, ECs) are both mediated by activation of the cannabinoid receptors CB1 and CB2. Exogenous activation of these receptors by THC could therefore alter EC levels. We tested this hypothesis in healthy volunteers (n = 25) who received a large intravenous dose of THC (0.

Stress and addiction.

Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions.

SWIVIT--Swiss video-intubation trial evaluating video-laryngoscopes in a simulated difficult airway scenario: study protocol for a multicenter prospective randomized controlled trial in Switzerland.

Background: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation.

Methods/design: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq™, A.

Reducing self-objectification: are dissonance-based methods a possible approach?

Background: Previous research has documented that self-objectification is associated with numerous negative outcomes including body shame, eating disorder (ED) pathology, and negative affect. This exploratory open study investigated whether or not an evidence-based body image improvement program that targets thin-ideal internalization in university women also reduces self-objectification. A second aim of the study was to determine if previous findings showing that body shame mediated the relationship between self-objectification and eating disorder pathology at a single time point (consistent with self-objectification theory) but did not mediate longitudinally (inconsistent with self-objectification theory) would be replicated in a new sample under novel conditions.

Survey on controversies in airway management among anesthesiologists in the UK, Austria and Switzerland.

Background: While surveys about anesthesia practice appear regularly in the anesthesia literature, they are usually bound to one country. We compared the approach to specific airway management issues among anesthesiologists from three different European countries.

Methods: A questionnaire was distributed during the main session of three anesthesia meetings in Austria (A), the UK, and Switzerland (CH).

i-gel™ supraglottic airway in clinical practice: a prospective observational multicentre study.

Background: The i-gel™ supraglottic airway device has been studied in randomized controlled studies, but it has not been evaluated in a large prospective patient cohort. Therefore, we performed this prospective multicentre observational study to evaluate success rates, airway leak pressure, risk factors for i-gel failure, and adverse events.

Methods: With Ethics Committee approval and waiver of patients' consent, data about anaesthesia providers, patient characteristics, and the performance of the i-gel were recorded in five independent hospitals in Switzerland over a period of 24 months.

Accuracy of prehospital diagnosis and triage of a Swiss helicopter emergency medical service.

Background: Helicopter emergency medical services (HEMSs) have become a standard element of modern prehospital emergency medicine. This study determines the percentage of injured HEMS patients whose injuries were correctly recognized by HEMS physicians.

Methods: A retrospective level III evidence prognostic study using data from the largest Swiss HEMS, REGA (Rettungsflugwacht/Guarde Aérienne), on adult patients with trauma transported to a Level I trauma center (January 2006-December 2007).

Vasectomy reversal with ultrasonography-guided spermatic cord block.

Unlabelled: Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Vasectomy reversal is often performed in general or neuraxial anaesthesia. Even though the site of vasectomy reversal is easily amenable to regional/local anaesthesia, spermatic cord blocks are rarely applied because of their risk of vascular damage within the spermatic cord.

Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders.

This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum of eating disorders, and the strengths and challenges of this approach, including its suitability for youth. Finally, we report a case study of an adolescent female with eating disorder not otherwise specified (EDNOS) for whom FBT was effective.

Standard vs. point-of-care measurement of fibrinogen: potential impact on clinical decisions.

Background: Intraoperative major bleeding is a common complication during surgery and can lead to the transfusion of blood products and/or procoagulant drugs. This is a therapeutic challenge, and adherence to guidelines is desirable to preserve blood product resources. The intraoperative administration of fibrinogen concentrate, a pro-coagulant drug, in bleeding patients might reduce the use and therefore the risks associated with blood products.

Airway research: the current status and future directions.

We highlight the areas we think important for future development of the subspeciality. The ultimate goal is to improve patient care and safety and to do this, we need to identify how and where episodes of harm arise. Simply continuing with current practice does not represent the best path towards our ultimate goal; objective evidence is needed to inform changes in practice.

Eating disorders in youth: diagnostic variability and predictive validity.

Objective: The primary aim was to examine the utility of DSM-IV criteria in predicting treatment outcome in a sample of adolescents with eating disorders.

Method: We (a) descriptively compared the baseline rates of anorexia nervosa (AN) and bulimia nervosa (BN) across multiple reference points for diagnostic criteria, (b) using ROC curve analyses, assessed the sensitivity and specificity of each diagnostic criterion in predicting clinical outcome, and (c) with logistic regression analyses, examined the incremental predictive value of each criterion.

Results: Results show a high degree of variability in the baseline diagnostic profiles as a function of the information used to inform each DSM-IV criterion.

Point-of-care prothrombin time testing in paediatric intensive care: an observational study of the ease of use of two devices.

Background: Two major difficulties arise when taking blood samples in children: the challenge of venous access and the comparatively large amount of blood required.

Objective: To assess the value of point-of-care prothrombin time testing in paediatric intensive care patients. We evaluated two point-of-care devices, CoaguChek XS Plus and CoaLine, assessing ease of use in clinical practice and correlation with the standard prothrombin time measurement of the haematology laboratory.

Randomized trial comparing the i-gel™ and Magill tracheal tube with the single-use ILMA™ and ILMA™ tracheal tube for fibreoptic-guided intubation in anaesthetized patients with a predicted difficult airway.

Background: The i-gel™ is a single-use supraglottic airway device (SAD) that allows fibreoptic-guided tracheal intubation through the device. Until now, no prospective data for this procedure are available. Therefore, in a prospective randomized controlled trial, we evaluated fibreoptic-guided tracheal intubation with a standard Rüsch™ PVC tracheal tube (TT) through the i-gel™ compared with the single-use ILMA™ (sILMA™) TT through the sILMA™ in patients with a predicted difficult airway.

Randomized clinical trial of the i-gel™ and Magill tracheal tube or single-use ILMA™ and ILMA™ tracheal tube for blind intubation in anaesthetized patients with a predicted difficult airway.

Background: The single-use supraglottic airway device i-gel™ has been described in several case reports as a conduit for intubation, but no prospective data about success rates of blind intubation are available. Therefore, we performed this prospective randomized controlled trial to compare the success rate of blind tracheal intubation with a Magill PVC tube through the i-gel™ with intubation using an sILMA™ PVC tube through the single-use intubating laryngeal mask airway (sILMA™).

Methods: With ethics committee approval and written informed consent, 80 patients with predictors of a difficult airway were computer randomized to either supraglottic airway device (SAD).

Performance of the pediatric-sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children.

Background: This prospective, randomized, controlled trial compares the performance of the pediatric i-gel (Intersurgical Ltd., Wokingham, United Kingdom) with the Ambu AuraOnce laryngeal mask (Ambu A/S, Ballerup, Denmark) in anesthetized and ventilated children.

Methods: With ethics committee approval and written informed consent, the authors included 208 children, aged 0-17 yr, scheduled for elective day-surgery under general anesthesia.