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Artigo em Inglês | MEDLINE | ID: mdl-34360379


Although the use of audio feedback with devices such as metronomes during cardiopulmonary resuscitation (CPR) is a simple method for improving CPR quality, its effect on the quality of pediatric CPR has not been adequately evaluated. In this study, 64 healthcare providers performed CPR (with one- and two-handed chest compression (OHCC and THCC, respectively)) on a pediatric resuscitation manikin (Resusci Junior QCPR), with and without audio feedback using a metronome (110 beats/min). CPR was performed on the floor, with a compression-to-ventilation ratio of 30:2. For both OHCC and THCC, the rate of achievement of an adequate compression rate during CPR was significantly higher when performed with metronome feedback than that without metronome feedback (CPR with vs. without feedback: 100.0% (99.0, 100.0) vs. 94.0% (69.0, 99.0), p < 0.001, for OHCC, and 100.0% (98.5, 100.0) vs. 91.0% (34.5, 98.5), p < 0.001, for THCC). However, the rate of achievement of adequate compression depth during the CPR performed was significantly higher without metronome feedback than that with metronome feedback (CPR with vs. without feedback: 95.0% (23.5, 99.5) vs. 98.5% (77.5, 100.0), p = 0.004, for OHCC, and 99.0% (95.5, 100.0) vs. 100.0% (99.0, 100.0), p = 0.003, for THCC). Although metronome feedback during pediatric CPR could increase the rate of achievement of adequate compression rates, it could cause decreased compression depth.

Reanimação Cardiopulmonar , Criança , Retroalimentação , Retroalimentação Sensorial , Humanos , Manequins , Pressão
PLoS One ; 15(3): e0230687, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32208443


AIM: This study was conducted to investigate the effect of resuscitation guideline terminology on the performance of infant cardiopulmonary resuscitation (CPR). METHODS: A total of 40 intern or resident physicians conducted 2-min CPR with the two-finger technique (TFT) and two-thumb technique (TT) on a simulated infant cardiac arrest model with a 1-day interval. They were randomly assigned to Group A or B. The participants of Group A conducted CPR with the chest compression depth (CCD) target of "approximately 4 cm" and those of Group B conducted CPR with the CCD target of "at least one-third the anterior-posterior diameter of the chest". Single rescuer CPR was performed with a 15:2 compression to ventilation ratio on the floor. RESULTS: In both chest compression techniques, the average CCD of Group B was significantly deeper than that of Group A (TFT: 41.0 [range, 39.3-42.0] mm vs. 36.5 [34.0-37.9] mm, P = 0.002; TT: 42.0 [42.0-43.0] mm vs. 37.0 [35.3-38.0] mm, P < 0.001). Adequacy of CCD also showed similar results (Group B vs. A; TFT: 99% [82-100%] vs. 29% [12-58%], P = 0.001; TT: 100% [100-100%] vs. 28% [8-53%], P < 0.001). CONCLUSIONS: Using the CCD target of "at least one-third the anterior-posterior diameter of the chest" resulted in deep and adequate chest compressions during simulated infant CPR in contrast to the CCD target of "approximately 4 cm". Therefore, changes in the terminology used in the guidelines should be considered to improve the quality of CPR. TRIAL REGISTRATION: Clinical Research Information Service; (Registration number: KCT0003486).

Reanimação Cardiopulmonar/métodos , Médicos/psicologia , Adulto , Feminino , Dedos/fisiologia , Guias como Assunto , Humanos , Lactente , Internato e Residência , Masculino , Manequins , Parada Cardíaca Extra-Hospitalar/patologia , Parada Cardíaca Extra-Hospitalar/prevenção & controle , Pressão , Estudos Prospectivos , Tórax/fisiologia
Spine J ; 17(12): 1837-1845, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28645673


BACKGROUND CONTEXT: The aim of spinal deformity correction is to restore the spine's functional alignment by balancing it in both the sagittal and coronal planes. Regardless of posture, the ideal coronal profile is straight, and therefore readily assessable. PURPOSE: This study compares two radiological methods to determine which better predicts postoperative standing coronal balance. STUDY DESIGN/SETTING: We conducted a single-center, radiographic comparative study between 2011 and 2015. PATIENT SAMPLE: A total of 199 patients with a mean age of 55.1 years were studied. Ninety patients with degenerative lumbar scoliosis (DLS) and 109 ankylosing spondylitis (AS) were treated with posterior surgery during this period. OUTCOME MEASURES: Baseline clinical and radiographic parameters (sagittal and coronal) were recorded. Comparison was performed between the new supra-acetabular line (central sacral vertical line [CSVL1]) and conventional supra-iliac line (CSVL2) perpendicular methods of coronal balance assessment. These methods were also compared with the gold standard standing C7 plumb line. METHODS: Each patient underwent standardized operative procedures and had perioperative spine X-rays obtained for assessment of spinal balance. Adjusted multivariate analysis was used to determine predictors of coronal balance. RESULTS: Significant differences in baseline characteristics (age, gender, and radiographic parameters) were found between patients with DLS and AS. CSVL1, CSVL2, and C7 plumb line differed in all the perioperative measurements. These three radiological methods showed a mean right coronal imbalance for both diagnoses in all pre-, intra-, and postoperative radiographs. The magnitude of imbalance was the greatest for CSVL2 followed by CSVL1 and subsequently the C7 plumb line. A larger discrepancy between CSVL and C7 plumb line measurements intraoperatively than those postoperatively suggests a postural effect on these parameters, which is greater for CSVL2. Multivariate analysis identified that in DLS, the preoperative C7 plumb line was predictive of its postoperative value. CSVL1, but not CSVL2, was predictive of the postoperative C7 plumb line in patients with AS. CONCLUSIONS: The supra-acetabular line (CSVL1) is better, although not ideal, as compared with the supra-iliac line (CSVL2) in determining coronal balance. Because CSVL1 still cannot be relied on with a high predictive value, it is imperative that future studies continue to identify better intraoperative markers for achieving coronal balance.

Região Lombossacral/diagnóstico por imagem , Procedimentos Neurocirúrgicos/métodos , Radiografia/métodos , Escoliose/cirurgia , Espondilite Anquilosante/cirurgia , Idoso , Feminino , Humanos , Região Lombossacral/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/normas , Posicionamento do Paciente/métodos , Posicionamento do Paciente/normas , Período Perioperatório , Postura , Radiografia/normas , Padrões de Referência , Escoliose/diagnóstico por imagem , Espondilite Anquilosante/diagnóstico por imagem
J Back Musculoskelet Rehabil ; 30(4): 801-809, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28372312


BACKGROUND: Posterior lumbar surgery can lead to damage on paraspinal muscles. OBJECTIVE: Our study aimed to examine the recovery in the denervated paraspinal muscles by posterior lumbar surgery and to determine that of improvement in the lower back pain (LBP). METHODS: Depending on surgical treatments, the patients were divided into two groups: The group I (interspinous implantation with decompression) and II (posterior lumbar interbody fusion with decompression). The paraspinal mapping score was recorded for individual muscle. RESULTS: In the group I, there was reinnervation in the denervated multifidus and erector spinae at the upper, surgical and lower levels at 12 months. In the group II, there was reinnervation in the denervated erector spinae at the upper, surgical and lower levels at 12 months. There was significant aggravation in the LBP in both groups at immediate postoperative. But there was significant improvement in it at 6 months in the group I and at 12 months in the group II. CONCLUSION: There was reinnervation in not only denervated multifidus and erector spinae at 12 months following interspinous ligament stabilization but also in denervated erector spinae at 12 months following pedicle screw fixation with fusion.

Descompressão Cirúrgica/efeitos adversos , Dor Lombar/cirurgia , Vértebras Lombares/cirurgia , Regeneração Nervosa , Músculos Paraespinais/fisiologia , Fusão Vertebral/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Eletromiografia , Feminino , Humanos , Região Lombossacral , Masculino , Pessoa de Meia-Idade , Músculos Paraespinais/lesões , Músculos Paraespinais/inervação , Recuperação de Função Fisiológica , Adulto Jovem
J Occup Environ Med ; 59(4): 384-388, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28157765


OBJECTIVE: The aim of this study was to investigate the prevalence of metabolic syndrome (MS) and its relationships with socio-demographic and lifestyle-related factors in firefighters comparing it to general workers. METHODS: Data from 257 Korean men career firefighters and 1064 Korean men workers were analyzed. RESULTS: There was no significant difference in the prevalence of MS between firefighters (21.4%) and general workers (25.6%). We found that age and obesity were independent risk factors for MS in both firefighters and general workers. After adjusting for age and obesity, the risk for MS in firefighters was not significantly different from that in the most of occupational groups except sales workers. CONCLUSIONS: About one-fifth of firefighters had MS showing a similar prevalence compared with general workers. Therefore continuous monitoring and preventive programs for MS are needed in firefighters.

Bombeiros/estatística & dados numéricos , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Ocupações/estatística & dados numéricos , Adulto , Fatores Etários , Estudos Transversais , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Fatores Socioeconômicos