Another method to maintain positive-pressure ventilation through the Montgomery® T tube

We describe airway management in a patient who had a Montgomery® T tube in situ. The main concern pertaining to these patients is the inadequate depth of anaesthesia and ventilation, in view of loss of volume of air and gases, as well as dilution through the proximal end of the Montgomery®  T tube. To circumvent these problems, we describe another method of providing ventilation, through the extraluminal horizontal limb of the Montgomery®  T tube by introducing an uncuffed endotracheal tube and minimising the loss of carrier gases to the larynx, together with a review of literature for the same.Keywords: Montgomery® T tube, positive-pressure ventilationSouth Afr J Anaesth Analg 2013;19(5):274-27

Delays in Liquidated and Resolved Firms

The ultimate objective of the Indian bankruptcy reform is to get up to plausible recovery rates and change the behavior of borrowers. The key tool for achieving these objectives is reducing the delay. In the existing literature, we know that there are large delays, particularly for large firms (Bhatia et. al. 2019, Felman et. al. 2019, Shah 2018). The most important proximate objective of the Indian bankruptcy reform is to reduce delays in the bankruptcy process (Shah and Thomas, 2018)

Innovations in Radiotherapy Technology.

Many low- and middle-income countries, together with remote and low socioeconomic populations within high-income countries, lack the resources and services to deal with cancer. The challenges in upgrading or introducing the necessary services are enormous, from screening and diagnosis to radiotherapy planning/treatment and quality assurance. There are severe shortages not only in equipment, but also in the capacity to train, recruit and retain staff as well as in their ongoing professional development via effective international peer-review and collaboration. Here we describe some examples of emerging technology innovations based on real-time software and cloud-based capabilities that have the potential to redress some of these areas. These include: (i) automatic treatment planning to reduce physics staffing shortages, (ii) real-time image-guided adaptive radiotherapy technologies, (iii) fixed-beam radiotherapy treatment units that use patient (rather than gantry) rotation to reduce infrastructure costs and staff-to-patient ratios, (iv) cloud-based infrastructure programmes to facilitate international collaboration and quality assurance and (v) high dose rate mobile cobalt brachytherapy techniques for intraoperative radiotherapy

Multiple Pregnancy after Gonadotropin-Intrauterine Insemination: An Unavoidable Event?

Objective. Determine which factors predict multiple pregnancy in gonadotropin-intrauterine insemination cycles so that cancellation criteria might be developed. Study Design. Retrospective chart review of all patients undergoing gonadotropin-intrauterine insemination over a continuous 36 month period. Results. No factors examined were able to predict the occurrence of multiple pregnancy. Conclusion. Multiple pregnancy is an unavoidable complication of gonadotropin-intrauterine insemination treatment

Structural Genomic Variation as Risk Factor for Idiopathic Recurrent Miscarriage

Peer reviewe

Association of Central Arterial Stiffness and Pressure Pulsatility with Mild Cognitive Impairment and Dementia: The Atherosclerosis Risk in Communities Study-Neurocognitive Study (ARIC-NCS)

The association of central arterial stiffness and pressure pulsatility with mild cognitive impairment and dementia is not well characterized in the population-based setting

The association of sport and exercise activities with cardiovascular disease risk: The Atherosclerosis risk in Communities (ARIC) study

Background: This study assessed the independent associations between participation in self-reported sport and exercise activities and incident cardiovascular disease (CVD). Methods: Data were from 13,204 participants in the Atherosclerosis Risk in Communities Study cohort (1987–2015). Baseline sport and exercise activities were assessed via the modified Baecke questionnaire. Incident CVD included coronary heart disease, heart failure, or stroke. Multivariable-adjusted Cox proportional hazard models assessed the association of participation in specific sport and exercise activities at enrollment with risk of CVD. Results: During a median follow-up time of 25.2 years, 30% of the analytic sample (n = 3966) was diagnosed with incident CVD. In fully adjusted models, participation in racquet sports (hazard ratio [HR] 0.75; 95% confidence interval [CI], 0.61–0.93), aerobics (HR 0.75; 95% CI, 0.63–0.88), running (HR 0.68; 95% CI, 0.54–0.85), and walking (HR 0.89; 95% CI, 0.83–0.95) was significantly associated with a lower risk of CVD. There were no significant associations for bicycling, softball/baseball, gymnastics, swimming, basketball, calisthenics exercises, golfing with cart, golfing with walking, bowling, or weight training. Conclusions: Participation in specific sport and exercises may substantially reduce the risk for CVD

Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134882/1/mp4244.pd

Validation of the severity index by cardiac catheterization and Doppler echocardiography in patients with aortic sclerosis and stenosis

The severity index is a new echocardiographic measure that is thought to be an accurate indicator of aortic leaflet pathology in patients with AS. However, it has not been validated against cardiac catheterization or Doppler echocardiographic measures of AS severity nor has it been applied to patients with aortic sclerosis. The purposes of this study were to compare the severity index to invasive hemodynamics and Doppler echocardiography across the spectrum of calcific aortic valve disease, including aortic sclerosis and AS. 48 patients with aortic sclerosis and AS undergoing echocardiography and cardiac catheterization comprised the study population. The aortic valve leaflets were assessed for mobility (scale 1 to 6) and calcification (scale 1 to 4) and the severity index was calculated as the sum of the mobility and calcification scores according to the methods of Bahler et al. The severity index increased with increasing severity of aortic valve disease; the severity indices for patients with aortic sclerosis, mild to moderate AS and severe AS were 3.38 ± 1.06, 6.45 ± 2.16 and 8.38 ± 1.41, respectively. The aortic jet velocity by echocardiography and the square root of the maximum aortic valve gradient by cardiac catheterization correlated well with the severity index (r = 0.84, p < 0.0001; r = 0.84, p < 0.0001, respectively). These results confirm that the severity index correlates with hemodynamic severity of aortic valve disease and may prove to be a useful measure in patients with aortic sclerosis and AS