Introduction of a Warming Bundle to Reduce Hypothermia in Neonatal Surgical Patients.

INTRODUCTION: Hypothermia in the neonatal surgical population has been linked with significant morbidity and mortality. Our goal was to decrease intra and postoperative hypothermia. INTERVENTION: In November 2021, a radiant warmer and hat were included along with standard warming methods prior to the start of General Surgery procedures to minimize episodes of hypothermia. PRIMARY OUTCOME: Core body temperature was measured pre, intra and post-operatively. METHODS: Data were prospectively collected from electronic medical records from July 2021 to March 2023. A retrospective analysis was performed. Hypothermia was defined as a temperature <36.5C. Control charts were created to analyze the effect of interventions. RESULTS: A total of 277 procedures were identified; 226 abdominal procedures, 31 thoracic, 14 skin/soft tissue and 6 anorectal. The median post-natal age was 36.1 weeks (IQR: 33.2-39.2), with a pre-surgical weight of 2.3 kg (IQR: 1.6-3.0) and operative duration of 181 min (IQR: 125-214). Hat and warmer data were unavailable for 59 procedures, both hat and warmer were used for 51 % procedures, hat alone for 29 %, warmer alone for 10 % and neither for 10 % of procedures. Over time there was a significant increase in hat utilization while warmer usage was unchanged. There was a significant increase in the mean lowest intra-operative temperature and decrease in proportion of hypothermic patients intra-operatively and post-operatively. CONCLUSIONS: The inclusion of a radiant warmer and hat decreased the proportion of hypothermic patients during and after surgery. Further studies are necessary to analyze the impact on surgical outcomes. LEVEL OF EVIDENCE: III.

Two new day-flying species of Agrotis Ochsenheimer (Lepidoptera: Noctuidae) from the alpine summit of the Maunakea Volcano.

Two new endemic Hawaiian species of Agrotis Ochsenheimer (Noctuidae) are described: A. helela and A. kuamauna. Both species are day-flying and occur at high-elevations. Observations of adult and larval morphology and biology are included, as well as illustrations of adult moths and genitalia for both sexes.

Update on Minimal Standards for Electroencephalography in Canada: A Review by the Canadian Society of Clinical Neurophysiologists.

Surface electroencephalogram (EEG) recording remains the gold standard for noninvasive assessment of electrical brain activity. It is the most efficient way to diagnose and classify epilepsy syndromes as well as define the localization of the epileptogenic zone. The EEG is useful for management decisions and for establishing prognosis in some types of epilepsy. Electroencephalography is an evolving field in which new methods are being introduced. The Canadian Society of Clinical Neurophysiologists convened an expert panel to develop new national minimal guidelines. A comprehensive evidence review was conducted. This document is organized into 10 sections, including indications, recommendations for trained personnel, EEG yield, paediatric and neonatal EEGs, laboratory minimal standards, requisitions, reports, storage, safety measures, and quality assurance.

Prostate imaging: evaluation of a reusable two-channel endorectal receiver coil for MR imaging at 1.5 T.

PURPOSE: To prospectively compare image quality with use of a two-channel solid reusable phased-array endorectal receiver coil (SPAC) with that of the single-channel inflatable endorectal balloon coil currently in widespread use for 1.5-T magnetic resonance (MR) imaging of the prostate. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. Multiparametric prostate MR imaging at 1.5 T was performed in patients who were suspected of having cancer. Thirty consecutive patients were included (mean age, 66.1 years; range, 49-76 years). The first 15 patients were imaged by using a balloon coil and an eight-channel external array, and the remaining 15 were imaged with a SPAC alone. One patient was imaged with both techniques. Axial T2-weighted images acquired at both standard and high spatial resolution were used to compare image quality between coils. Qualitative assessments of image quality were made separately by three radiologists. Signal-to-noise ratio (SNR) profiles were determined on a pixel-by-pixel basis in a 1-cm central band in the prostate by using T1-weighted axial images at the apex, midgland, and base. Interrater reliability was determined by using a two-way intraclass correlation coefficient, qualitative scores were compared by using the Student t test for independent samples, and SNR profiles were plotted by using a Biot-Savart curve approximation. RESULTS: SNR of the SPAC was significantly better compared with that of the balloon coil at distances up to 3.0 cm at the apex and 3.5 cm at the base and midgland (P < .001). There was a 7% improvement in SNR at the mean maximal anteroposterior prostate dimension in this cohort and a 96% improvement at half this distance. At both standard and high spatial resolution, significant improvements in overall image quality (P = .015 and P < .001, respectively), visibility of the anterior gland (P = .009 and P < .001, respectively), and noise (P < .001 and P < .001, respectively) were seen when the SPAC was used. Interrater reliability was 0.536 (95% confidence interval: 0.461, 0.603). CONCLUSION: Both SNR and image quality were significantly improved with use of the SPAC at 1.5 T compared with use of the single-channel inflatable endorectal balloon coil.