904 resultados para Surgical instruments and apparatus


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Background: Exhaled nitric oxide has been proposed as a marker for airway inflammation in asthma. The aim of this study was to compare exhaled nitric oxide levels with inflammatory cells and mediators in bronchoalveolar lavage fluid from asthmatic and normal children.

Methods: Children were recruited from elective surgical lists and a non-bronchoscopic bronchoalveolar lavage (BAL) was performed after induction of anaesthesia. Exhaled nitric oxide (parts per billion) was measured by two techniques: tidal breathing and restricted breath.

Results: Median (interquartile range) exhaled nitric oxide measured by restricted breath was increased in asthmatics compared with normal children (24.3 (10.5–66.5) v 9.7 (6.5–16.5), difference between medians 14.6 (95% CI 5.1 to 29.9), p=0.001). In asthmatic children exhaled nitric oxide correlated significantly with percentage eosinophils (r=0.78, p<0.001 (tidal breathing) and r=0.78, p<0.001 (restricted breath)) and with eosinophilic cationic protein (r=0.53, p<0.01 restricted breath)), but not with other inflammatory cells in the BAL fluid. The area under the receiver operator characteristic curves for the prediction of the presence of eosinophilic airways inflammation by exhaled nitric oxide (tidal and restricted) was 0.80 and 0.87, respectively.

Conclusions: Exhaled nitric oxide correlates closely with percentage eosinophils in BAL fluid in asthmatic children and is therefore likely to be a useful non-invasive marker of airway inflammation.

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We report on a study comparing absolute K-alpha yield from Ti foils measured with a calibrated system of an X-ray CCD coupled to a curved LiF Von-Hamos crystal spectrometer to the difference in the signals measured simultaneously with two similar photodiodes fitted with two different filters. Our data indicate that a combination of photodiodes with different filters could be developed into an alternative and inexpensive diagnostic for monitoring single shot pulsed emission in a narrow band of X-ray region.

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El objetivo de este trabajo es analizar la frecuencia con que se utilizan diferentes instrumentos y procedimientos de evaluación desde el punto de vista del profesorado, del alumnado y de los egresados en la formación inicial de maestros y profesores especialistas en Educación Física, así como el grado de coherencia –relación- percibido por cada uno de esos grupos implicados entre dichos instrumentos y procedimientos de evaluación y el desarrollo de las competencias profesionales que se pretende adquieran los estudiantes. La muestra objeto de estudio está compuesta por 199 alumnos, 67 egresados y 53 profesores de las titulaciones de Magisterio (especialidad de Educación Física) y Ciencias de la Actividad Física y el Deporte de las universidades de Valladolid, Salamanca y León. Los resultados muestran una clara discrepancia entre los distintos grupos analizados, tanto en lo referido al tipo de instrumentos de evaluación utilizados, como en la valoración del grado de coherencia entre estos y el desarrollo de las competencias profesionales de los futuros maestros.

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This paper reports the initial response of atomic nitrogen doped diamond like carbon (DLC) to endothelial cells in vitro. The introduction of nitrogen atoms/molecules to the diamond like carbon structures leads to an atomic structural change favorable to the attachment of human micro-vascular enclothelial cells. Whilst the semi-conductivity induced by nitrogen in DLC is thought to play a part, the increase in the inion-bonded N atoms and N-2 molecules in the atomic doped species (with the exclusion of the charged species) seems to contribute to the improved attachment of human microvascular endothelial cells. The increased endothelial attachment is associated with a lower work function and slightly higher water contact angle in the atomic doped films, where the heavy charged particles are excluded. The films used in the study were synthesized by the RF PECVD technique followed by post deposition doping with nitrogen, and afterwards the films were characterized by XPS, Raman spectroscopy, SIMS and Kelvin probe. The water contact angles were measured, and the counts of the adherent endothelial cells on the samples were carried out. This study is relevant and contributory to improving biocompatibility of surgical implants and prostheses.

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The aim of this study was to evaluate the effect of pre-operative visits by theatre nurses on pre- and post-operative levels of anxiety in two groups of general surgical patients, and to see if the outcome was reflected in the level of post-operative pain, nausea, mobility or length of hospitalisation. One group received pre-operative visits while the other group did not. Results of the study showed a significant decrease in anxiety 24 to 72 hours post-operatively for the visited group. A positive relationship between pre-operative anxiety levels and the level of pain, nausea and lack of independence experienced by both groups was also found. Length of hospitalisation was unaffected by the level of anxiety experienced in both groups. The author recommends that all surgical patients should receive a visit from theatre nurses before their operation.

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Background: Laparoscopic surgery requires surgeons to infer the shape of 3-D structures, such as the internal organs of patients, from 2-D displays on a video monitor. Recent evidence indicates that the issue is not resolved by the use of contemporary 3-D camera systems. It is therefore crucial to find ways of measuring differences in aptitude for recovering 3-D structure from 2-D images, and assessing its impact on performance. Our aim was to test empirically for a relationship between laparoscopic ability and the perceptual skill of recovering information about 3-D structures from 2-D monitor displays.

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The zero-range potential model is used to investigate positron collisions and annihilation with molecules. The Kr dimer is considered as an example. It is shown that (i) although positrons do not bind to individual Kr atoms, they do form bound states with Kr. (ii) A sequence of vibrationally excited states of the positron-molecule complex extends into the positron continuum, where it manifests as vibrational Feshbach resonances. (iii) These resonances give a very large contribution to the positron annihilation rate. Even after averaging over the thermal positron energy distribution, the contribution of the lowest Feshbach resonance exceeds that of the non-resonant background by an order of magnitude. © 2002 Elsevier Science B.V. All rights reserved.

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The traditional training of surgeons focused exclusively on developing knowledge, clinical expertise, and technical (surgical) skills. However, analyses of the reasons for adverse events in surgery have revealed that many underlying causes originate from behavioural or non-technical aspects of performance (eg, poor communication among members of the surgical team) rather than from a lack of surgical (ie, technical) skills. Therefore, technical skills appear to be necessary but not sufficient to ensure patient safety. Paying attention to non-technical skills, such as team working, leadership, situation awareness, decision making, and communication, will increase the likelihood of maintaining high levels of error-free performance. Identification and training of non-technical skills has been developed for high-risk careers, such as civil aviation and nuclear power. Only recently, training in non-technical skills has been adopted by the surgical world and anaesthetists. Non-technical skills need to be tailored to the environment where they are used, and eye surgery has some substantial differences compared with other surgical areas, for example, high volume of surgery, use of local anaesthetics, and very sophisticated equipment. This review highlights the need for identification of the non-technical skills relevant to eye surgeons and promotion of their use in the training of eye surgeons.