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
Angiostrongylus cantonensis and rat lungworm disease in Brazil.
The metastrongyloid nematode genus Angiostrongylus includes 18 species, two of which are relevant from a medical standpoint, Angiostrongylus costaricensis and Angiostrongylus cantonensis. The first was described from Costa Rica in 1971 and causes abdominal angiostrongyliasis in the Americas, including in Brazil. Angiostrongylus cantonensis, first described in 1935 from Canton, China, is the causative agent of eosinophilic meningitis. ⋯ In Brazil seven human cases have been reported since 2007 from the southeastern and northeastern regions. Epidemiological studies found infected specimens of Rattus norvegicus and Rattus rattus as well as many species of molluscs, including the giant African land snail, Achatina fulica, from various regions of Brazil. The spread of angiostrongyliasis is currently a matter of concern in Brazil.
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Hawaii J Med Public Health · Jun 2013
Biology, systematics, life cycle, and distribution of Angiostrongylus cantonensis, the cause of rat lungworm disease.
Angiostrongylus cantonensis is a metastrongyloid nematode in the family Angiostrongylidae. It is the cause of angiostrongyliasis (rat lungworm disease), which manifests as eosinophilic meningitis. First described in 1935 from rats in China, A. cantonensis was placed in the genus Parastrongylus in 1986, but most workers have not adopted this treatment. ⋯ The natural life cycle involves rats as the definitive host and snails or slugs as the intermediate host. Human infection, as accidental hosts, results in worms maturing in the brain, but dying there instead of moving back into the bloodstream, as in rats, thereby leading to eosinophilic meningitis. The disease is an emerging infectious disease; Angiostrongylus cantonensis continues to be reported in new regions beyond its native range.