Video-assisted thoracoscopic resection of a small pulmonary nodule after computed tomography-guided localization with a hook-wire system. Experience in 45 consecutive patients.

BACKGROUND: This study is a single-institution validation of video-assisted thoracoscopic (VATS) resection of a small solitary pulmonary nodule (SPN) previously localized by a CT-guided hook-wire system in a consecutive series of 45 patients. METHODS: The records of all patients undergoing VATS resection for SPN preoperatively localized by CT-guided a hook-wire system from January 2002 to December 2004 were assessed with respect to failure to localize the lesion by the hook-wire system, conversion thoracotomy rate, duration of operation, postoperative complications, and histology of SPN. RESULTS: Forty-five patients underwent 49 VATS resections, with simultaneous bilateral SPN resection performed in 4. Preoperative CT-guided hook-wire localization failed in two patients (4%). Conversion thoracotomy was necessary in two patients (4%) because it was not possible to resect the lesion by a VATS approach. The average operative time was 50 min. Postoperative complications occurred in 3 patients (6%), one hemothorax and two pneumonia. The mean hospital stay was 5 days (range: 2-18 days). Histological assessment revealed inflammatory disease in 17 patients (38%), metastasis in 17 (38%), non-small-cell lung cancer (NSCLC) in 4 (9%), lymphoma in 3 (6%), interstitial fibrosis in 2 (4%), histiocytoma in one (2%), and hamartoma in one (2%). CONCLUSIONS: Histological analysis of resected SPN revealed unexpected malignant disease in more than 50% of the patients indicating that histological clarification of SPN seems warranted. Video-assisted thoracoscopic resection of SPN previously localized by a CT-guided hook-wire system is related to a low conversion thoracotomy rate, a short operation time, and few postoperative complications, and it is well suited for the clarification of SPN.

Elaboración de un video sobre calidad, seguridad y medio ambiente en la Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia de la Universidad de Barcelona

La Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia (UB) ha implantado un sistema de gestión de la calidad (SGC) que permite transmitir al estudiante una formación adicional con el objetivo de mejorar sus competencias transversales (siguiendo las directrices del Espacio Europeo de Educación Superior, EEES). Además, en el curso académico 06-07, se instauraron las Buenas Prácticas Ambientales (BPAL) para disponer de un sistema de gestión que incorporase los criterios de calidad, medioambiente y seguridad (sistema de gestión integrada, SGI). Durante el presente curso académico se ha procedido a la grabación y edición de un video sobre calidad, seguridad y medioambiente en la ULD con el objetivo de mejorar la formación transversal de los estudiantes facilitando la integración de los conocimientos y habilidades profesionales. De esta forma, al salir del entorno universitario, los licenciados y graduados de la Facultad de Farmacia dispondrán de un valor añadido en su formación, mejorando así sus competencias para el desarrollo de su futura profesión. En el video se muestra la manera de trabajar correctamente según las normas de calidad, seguridad y medioambiente recogidas además en un tríptico que se entrega a los estudiantes al acceder por primera vez a un laboratorio de prácticas. El video se difundirá a través de la página web de la ULD, de la videoteca de la UB, del canal You Tube Canal UB, así como de las asignaturas que lo soliciten (sirviendo de soporte para el personal docente).

Video analysis software increases the interrater reliability of video gait assessments in children with cerebral palsy.

The aim of this study was to determine the effect of using video analysis software on the interrater reliability of visual assessments of gait videos in children with cerebral palsy. Two clinicians viewed the same random selection of 20 sagittal and frontal video recordings of 12 children with cerebral palsy routinely acquired during outpatient rehabilitation clinics. Both observers rated these videos in a random sequence for each lower limb using the Observational Gait Scale, once with standard video software and another with video analysis software (Dartfish(®)) which can perform angle and timing measurements. The video analysis software improved interrater agreement, measured by weighted Cohen's kappas, for the total score (κ 0.778→0.809) and all of the items that required angle and/or timing measurements (knee position mid-stance κ 0.344→0.591; hindfoot position mid-stance κ 0.160→0.346; foot contact mid-stance κ 0.700→0.854; timing of heel rise κ 0.769→0.835). The use of video analysis software is an efficient approach to improve the reliability of visual video assessments.

Video-assisted thoracic surgery diagnosis of thoracic spinal tuberculosis.

Tuberculous spondylitis is rare in economically well-developed countries. MRI is the most sensitive radiologic method of diagnosis. CT-guided fine needle aspiration can be an appropriate method for obtaining samples for culture, with positive cultures in 25 to 89% of cases. However, it can take >6 weeks for specimens to grow, and it is essential to have adequate culture and sensitivity studies for the diagnosis and treatment of mycobacterial diseases. We propose a minimally invasive diagnostic approach that ensures that adequate surgical specimens are obtained prior to initiating treatment.

Age vs. Experience: Evaluation of a Video Feedback Intervention for Newly Licensed Teen Drivers, TPF-5(207), 2013

This project examines the effects of age, experience, and video-based feedback on the rate and type of safety-relevant events captured on video event recorders in the vehicles of three groups of newly licensed young drivers: 1. 14.5- to 15.5-year-old drivers who hold a minor school license (see Appendix A for the provisions of the Iowa code governing minor school licenses); 2. 16-year-old drivers with an intermediate license who are driving unsupervised for the first time; 3. 16-year-old drivers with an intermediate license who previously drove unsupervised for at least four months with a school license. METHODS: The young drivers’ vehicles were equipped with an event-triggered video recording device for 24 weeks. Half of the participants received feedback regarding their driving, and the other half received no feedback at all and served as a control group. The number of safety-relevant events per 1,000 miles (i.e., “event rate”) was analyzed for 90 participants who completed the study. RESULTS: On average, the young drivers who received the video-based intervention had significantly lower event rates than those in the control group. This finding was true for all three groups. An effect of experience was seen for drivers in the control group; the 16-year-olds with driving experience had significantly lower event rates than the 16-year-olds without experience. When the intervention concluded, an increase in event rate was seen for the school license holders, but not for either group of 16-year-old drivers. There is strong evidence that giving young drivers video-based feedback, regardless of their age or level of driving experience, is effective in reducing the rate of safety-relevant events relative to a control group who do not receive feedback. Specific comparisons with regard to age and experience indicated that the age of the driver did not have an effect on the rate of safety-events, while experience did. Young drivers with six months or more of additional experience behind the wheel had nearly half as many safety-relevant events as those without that experience.

Elaboración de un video sobre calidad, seguridad y medio ambiente en la Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia de la Universidad de Barcelona

La Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia (UB) ha implantado un sistema de gestión de la calidad (SGC) que permite transmitir al estudiante una formación adicional con el objetivo de mejorar sus competencias transversales (siguiendo las directrices del Espacio Europeo de Educación Superior, EEES). Además, en el curso académico 06-07, se instauraron las Buenas Prácticas Ambientales (BPAL) para disponer de un sistema de gestión que incorporase los criterios de calidad, medioambiente y seguridad (sistema de gestión integrada, SGI). Durante el presente curso académico se ha procedido a la grabación y edición de un video sobre calidad, seguridad y medioambiente en la ULD con el objetivo de mejorar la formación transversal de los estudiantes facilitando la integración de los conocimientos y habilidades profesionales. De esta forma, al salir del entorno universitario, los licenciados y graduados de la Facultad de Farmacia dispondrán de un valor añadido en su formación, mejorando así sus competencias para el desarrollo de su futura profesión. En el video se muestra la manera de trabajar correctamente según las normas de calidad, seguridad y medioambiente recogidas además en un tríptico que se entrega a los estudiantes al acceder por primera vez a un laboratorio de prácticas. El video se difundirá a través de la página web de la ULD, de la videoteca de la UB, del canal You Tube Canal UB, así como de las asignaturas que lo soliciten (sirviendo de soporte para el personal docente).

Elaboración de un video sobre calidad, seguridad y medio ambiente en la Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia de la Universidad de Barcelona

La Unidad de Laboratorios Docentes (ULD) de la Facultad de Farmacia (UB) ha implantado un sistema de gestión de la calidad (SGC) que permite transmitir al estudiante una formación adicional con el objetivo de mejorar sus competencias transversales (siguiendo las directrices del Espacio Europeo de Educación Superior, EEES). Además, en el curso académico 06-07, se instauraron las Buenas Prácticas Ambientales (BPAL) para disponer de un sistema de gestión que incorporase los criterios de calidad, medioambiente y seguridad (sistema de gestión integrada, SGI). Durante el presente curso académico se ha procedido a la grabación y edición de un video sobre calidad, seguridad y medioambiente en la ULD con el objetivo de mejorar la formación transversal de los estudiantes facilitando la integración de los conocimientos y habilidades profesionales. De esta forma, al salir del entorno universitario, los licenciados y graduados de la Facultad de Farmacia dispondrán de un valor añadido en su formación, mejorando así sus competencias para el desarrollo de su futura profesión. En el video se muestra la manera de trabajar correctamente según las normas de calidad, seguridad y medioambiente recogidas además en un tríptico que se entrega a los estudiantes al acceder por primera vez a un laboratorio de prácticas. El video se difundirá a través de la página web de la ULD, de la videoteca de la UB, del canal You Tube Canal UB, así como de las asignaturas que lo soliciten (sirviendo de soporte para el personal docente).

Evaluation of the Video Intubation Unit in morbid obese patients.

BACKGROUND: Tracheal intubation may be more difficult in morbidly obese (MO) patients than in the non-obese. The aim of this study was to evaluate clinically if the use of the Video Intubation Unit (VIU), a video-optical intubation stylet, could improve the laryngoscopic view compared with the standard Macintosh laryngoscope in this specific population. METHODS: We studied 40 MO patients (body mass index >35 kg/m(2)) scheduled for bariatric surgery. Each patient had a conventional laryngoscopy and a VIU inspection. The laryngoscopic grades (LG) using the Cormack and Lehane scoring system were noted and compared. Thereafter, the patients were randomised to be intubated with one of the two techniques. In one group, the patients were intubated with the help of the VIU and in the control group, tracheal intubation was performed conventionally. The duration of intubation, as well as the minimal SpO(2) achieved during the procedure, were measured. RESULTS: Patient characteristics were similar in both groups. Seventeen patients had a direct LG of 2 or 3 (no patient had a grade of 4). Out of these 17 patients, the LG systematically improved with the VIU and always attained grade 1 (P<0.0001). The intubation time was shorter within the VIU group, but did not attain significance. There was no difference in the SpO(2) post-intubation. CONCLUSION: In MO patients, the use of the VIU significantly improves the visualisation of the larynx, thereby improving the intubation conditions.

Video Evaluation of Highway Drainage Systems, HR-317, 1991

Since 1978 the concept of longitudinal edge drains along Iowa primary and Interstate highways has been accepted as a cost-effective way of prolonging pavement life. Edge-drain installations have increased over the years, reaching a total of nearly 3,000 mi by 1989. With so many miles of edge drain installed, the development of a system for inspection and evaluation of the drains became essential. Equipment was purchased to evaluate 4-in.-diameter and geocomposite edge drains. Initial evaluations at various sites supported the need for a postconstruction inspection program to ensure that edge-drain installations were in accord with plans and specifications. Information disclosed by video inspections in edge drains and in culverts was compiled on videotape to be used as an informative tool for personnel in the design, construction, and maintenance departments. Video evaluations have influenced changes in maintenance, design, and construction inspection for highway drainage systems in Iowa.

Evaluation of errors in alpine skiing video analysis

INTRODUCTION: Video records are widely used to analyze performance in alpine skiing at professional or amateur level. Parts of these analyses require the labeling of some movements (i.e. determining when specific events occur). If differences among coaches and differences for the same coach between different dates are expected, they have never been quantified. Moreover, knowing these differences is essential to determine which parameters reliable should be used. This study aimed to quantify the precision and the repeatability for alpine skiing coaches of various levels, as it is done in other fields (Koo et al, 2005). METHODS: A software similar to commercialized products was designed to allow video analyses. 15 coaches divided into 3 groups (5 amateur coaches (G1), 5 professional instructors (G2) and 5 semi-professional coaches (G3)) were enrolled. They were asked to label 15 timing parameters (TP) according to the Swiss ski manual (Terribilini et al, 2001) for each curve. TP included phases (initiation, steering I-II), body and ski movements (e.g. rotation, weighting, extension, balance). Three video sequences sampled at 25 Hz were used and one curve per video was labeled. The first video was used to familiarize the analyzer to the software. The two other videos, corresponding to slalom and giant slalom, were considered for the analysis. G1 realized twice the analysis (A1 and A2) at different dates and TP were randomized between both analyses. Reference TP were considered as the median of G2 and G3 at A1. The precision was defined as the RMS difference between individual TP and reference TP, whereas the repeatability was calculated as the RMS difference between individual TP at A1 and at A2. RESULTS AND DISCUSSION: For G1, G2 and G3, a precision of +/-5.6 frames, +/-3.0 and +/-2.0 frames, was respectively obtained. These results showed that G2 was more precise than G1, and G3 more precise than G2, were in accordance with group levels. The repeatability for G1 was +/-3.1 frames. Furthermore, differences among TP precision were observed, considering G2 and G3, with largest differences of +/-5.9 frames for "body counter rotation movement in steering phase II", and of 0.8 frame for "ski unweighting in initiation phase". CONCLUSION: This study quantified coach ability to label video in term of precision and repeatability. The best precision was obtained for G3 and was of +/-0.08s, which corresponds to +/-6.5% of the curve cycle. Regarding the repeatability, we obtained a result of +/-0.12s for G1, corresponding to +/-12% of the curve cycle. The repeatability of G2 and G3 are expected to be lower than the precision of G1 and the corresponding repeatability will be assessed soon. In conclusion, our results indicate that the labeling of video records is reliable for some TP, whereas caution is required for others. REFERENCES Koo S, Gold MD, Andriacchi TP. (2005). Osteoarthritis, 13, 782-789. Terribilini M, et al. (2001). Swiss Ski manual, 29-46. IASS, Lucerne.

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. P. Advance?, King Vision?) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC?, GlideScope?, McGrath?) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt. DISCUSSION: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway. TRIAL REGISTRATION: NCT01692535.

Teaching Video NeuroImages: Micronystagmus of oculopalatal tremor.

Three months after brainstem hemorrhage, MRI revealed a hyperintense lesion of the left inferior olivary nucleus of a 45-year-old man (figure). The patient was completely asymptomatic, but exhibited oculopalatal tremor (OPT), rhythmic palatal oscillations, and small-amplitude vertical pendular nystagmus of the right eye, best visualized on fundus examination (see video).