Cervical Auscultation for the Identification of Swallowing Difficulties

Swallowing difficulties, commonly referred to as dysphagia, affect thousands of Americans every year. They have a multitude of causes, but in general they are known to increase the risk of aspiration when swallowing in addition to other physiological effects. Cervical auscultation has been recently applied to detect such difficulties non-invasively and various techniques for analysis and processing of the recorded signals have been proposed. We attempted to further this research in three key areas. First, we characterized swallows with regards to a multitude of time, frequency, and time-frequency features while paying special attention to the differences between swallows from healthy adults and safe dysphagic swallows as well as safe and unsafe dysphagic swallows. Second, we attempted to utilize deep belief networks in order to classify these states automatically and without the aid of a concurrent videofluoroscopic examination. Finally, we sought to improve some of the signal processing techniques used in this field. We both implemented the DBSCAN algorithm to better segment our physiological signals as well as applied the matched complex wavelet transform to cervical auscultation data in order to improve its quality for mathematical analysis

Noninvasive Dynamic Characterization of Swallowing Kinematics and Impairments in High Resolution Cervical Auscultation via Deep Learning

Swallowing is a complex sensorimotor activity by which food and liquids are transferred from the oral cavity to the stomach. Swallowing requires the coordination between multiple subsystems which makes it subject to impairment secondary to a variety of medical or surgically related conditions. Dysphagia refers to any swallowing disorder and is common in patients with head and neck cancer and neurological conditions such as stroke. Dysphagia affects nearly 9 million adults and causes death for more than 60,000 yearly in the US. In this research, we utilize advanced signal processing techniques with sensor technology and deep learning methods to develop a noninvasive and widely available tool for the evaluation and diagnosis of swallowing problems. We investigate the use of modern spectral estimation methods in addition to convolutional recurrent neural networks to demarcate and localize the important swallowing physiological events that contribute to airway protection solely based on signals collected from non-invasive sensors attached to the anterior neck. These events include the full swallowing activity, upper esophageal sphincter opening duration and maximal opening diameter, and aspiration. We believe that combining sensor technology and state of the art deep learning architectures specialized in time series analysis, will help achieve great advances for dysphagia detection and management in terms of non-invasiveness, portability, and availability. Like never before, such advances will enable patients to get continuous feedback about their swallowing out of standard clinical care setting which will extremely facilitate their daily activities and enhance the quality of their lives

Lectures on internal medicine propaedeutics

Курс лекцій для студентів третіх курсів медичних факультетів з пропедевтики внутрішньої медицини за англійською формою навчання на англійській мові. Розглядаються підхід, методи обстеження та основні клінічні синдроми пацієнтів з захворюваннями дихальної, серцево-судинної, травної, видільної, кістково-м’язової, сполучної, кров’яної та ендокринної систем.Lecture 1 Propaedeutics as an introduction to the clinic of internal medicine Lecture 2 Approach to the patient Lecture 3 Approach to the patient with disease of the respiratory system Lecture 4 Approach to the patient with disease of the cardiovascular system Lecture 5 Approach to the patient with gastrointestinal tract diseases Lecture 6 Approach to the Patient with diseases of the hepatobiliary tract and pancreas Lecture 7 Approach to the patient with affection and disease of the kidneys Lecture 8 Approach to the patient with affection and disease of the musculoskeletal system and connective tissue Lecture 9 Approach to the patient with affection and disease of the blood Lecture 10 Approach to the patient with affection and disease of the endocrine system Lecture 11 Syndromes of respiratory system diseases Lecture 12 Syndromes of cardiovascular system diseases Lecture 13 Syndromes of gastrointestinal tract diseases Lecture 14 Syndromes of hepatobiliary tract and exocrine pancreas diseases Lecture 15 Syndromes of kidneys diseases Lecture 16 Syndromes of the musculoskeletal system and connective tissue diseases Lecture 17 Syndromes of the blood system diseases Lecture 18 Syndromes of the endocrine system disease

PRELIMINARY FINDINGS OF A POTENZIATED PIEZOSURGERGICAL DEVICE AT THE RABBIT SKULL

The number of available ultrasonic osteotomes has remarkably increased. In vitro and in vivo studies have revealed differences between conventional osteotomes, such as rotating or sawing devices, and ultrasound-supported osteotomes (Piezosurgery®) regarding the micromorphology and roughness values of osteotomized bone surfaces. Objective: the present study compares the micro-morphologies and roughness values of osteotomized bone surfaces after the application of rotating and sawing devices, Piezosurgery Medical® and Piezosurgery Medical New Generation Powerful Handpiece. Methods: Fresh, standard-sized bony samples were taken from a rabbit skull using the following osteotomes: rotating and sawing devices, Piezosurgery Medical® and a Piezosurgery Medical New Generation Powerful Handpiece. The required duration of time for each osteotomy was recorded. Micromorphologies and roughness values to characterize the bone surfaces following the different osteotomy methods were described. The prepared surfaces were examined via light microscopy, environmental surface electron microscopy (ESEM), transmission electron microscopy (TEM), confocal laser scanning microscopy (CLSM) and atomic force microscopy. The selective cutting of mineralized tissues while preserving adjacent soft tissue (dura mater and nervous tissue) was studied. Bone necrosis of the osteotomy sites and the vitality of the osteocytes near the sectional plane were investigated, as well as the proportion of apoptosis or cell degeneration. Results and Conclusions: The potential positive effects on bone healing and reossification associated with different devices were evaluated and the comparative analysis among the different devices used was performed, in order to determine the best osteotomes to be employed during cranio-facial surgery

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Occupational diseases: a guide to their recognition

Revised edition."Occupational diseases are discussed in terms of occupational health hazards. The purpose of the text is to make available information needed for timely recognition of symptoms of occupational diseases. The text covers routes of entry and modes of action, biological hazards, dermatoses, diseases of the airways, plant and wood hazards, chemical hazards, chemical carcinogens, pesticides, and such physical hazards as radiation, atmospheric variations, and oscillatory vibrations. Sources of consultation and references are included." - NIOSHTIC-2Edition for 1964 by the Institute under its earlier name, Division of Occupational Health.editors, Marcus M. Key ... [et al.] manuscript editor, Lorice Ede.Includes index.Bibliography: p. 534-556