Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health
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Hawaii J Med Public Health · Oct 2013
Comparative StudyIntubation methods by novice intubators in a manikin model.
Tracheal Intubation is an important yet difficult skill to learn with many possible methods and techniques. Direct laryngoscopy is the standard method of tracheal intubation, but several instruments have been shown to be less difficult and have better performance characteristics than the traditional direct method. We compared 4 different intubation methods performed by novice intubators on manikins: conventional direct laryngoscopy, video laryngoscopy, Airtraq® laryngoscopy, and fiberoptic laryngoscopy. ⋯ In the difficult airway scenario video laryngoscopy maintained a significantly higher success rate (91% vs 71% P=0.04) and likelihood of success (3.2 ± 1.0 95%CI [2.9-3.5] vs 2.4 ± 0.9 95%CI [2.1-2.7]) when compared to direct laryngoscopy. Participants also reported significantly higher rates of self-confidence (3.5 ± 0.6 95%CI [3.3-3.7]) and ease of use (1.5 ± 0.7 95%CI [1.3-1.8]) with video laryngoscopy compared to all other methods. We found no correlation between videogame playing and intubation methods.
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Hawaii J Med Public Health · Aug 2013
Case ReportsTreatment of median arcuate ligament syndrome via traditional and robotic techniques.
Median arcuate ligament syndrome (MALS) is a rare entity characterized by extrinsic compression of the celiac artery and symptoms of postprandial epigastric pain, nausea, vomiting, and weight loss mimicking mesenteric ischemia. We present two patients diagnosed with MALS, the first treated with an open laparotomy by a vascular surgeon and the second using a robot assisted laparoscopic approach by a general surgeon with a vascular surgeon on standby. ⋯ Both patients recovered without complications and experienced resolution of their symptoms. A discussion of the pathophysiology, literature review, and multispecialty treatment approach are presented.
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Hawaii J Med Public Health · Jun 2013
Randomized Controlled TrialThe importance of communication in the management of postoperative pain.
This study investigates the importance of communication in surgery and how delivering preoperative patient education can lead to better health outcomes postoperatively, via promoting tolerable pain scores and minimizing the use of narcotics after surgery. Patients who underwent outpatient surgery were randomly divided into groups to compare the pain scores of those who received preoperative patient education, the experimental group, and those who did not receive any form of patient education, the control group. Two weeks before surgery, the experimental group subjects received oral and written forms of patient education consisting of how the body responds to pain, and how endorphins cause natural analgesia. ⋯ Patients in both groups were offered and received gabapentin and celecoxib preoperatively for prophylaxis of postoperative pain unless they declined. The control groups were found to have average pain scores significantly greater (P <.05) than the experimental groups and also a significantly longer (P <.005) duration of pain. This study illustrates the power of patient education via oral, written and visual communication, which can serve as an effective means to minimize narcotic analgesia after surgery.
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Hawaii J Med Public Health · Jun 2013
ReviewThe role of eosinophils in angiostrongyliasis: multiple roles for a versatile cell?
Human infection with the rat lungworm, Angiostrongylus cantonensis, is characterized by a vigorous eosinophil response that gives the disease its name, eosinophilic meningitis. The actual role eosinophils play, both protective and destructive, in this infectious process is still largely a mystery. Research since 2002 has indicated that eosinophils are a multifaceted granulocyte that contributes to a wide range of physiological and pathological processes depending on their location and activation status. This article suggests an expanded role for eosinophils as both classic antiparasitic effector cells and as immune regulatory cells in eosinophilic meningitis caused by Angiostrongylus cantonensis.