Aspiration Procedures Research Articles

Changes in the ovary and the peripheral concentrations of sex hormones after the aspiration of follicular fluid from the spontaneous follicular cysts of dairy cows.

The aim of the present study was to clarify the ovarian and hormonal dynamics after the aspiration of follicular fluid in cows with follicular cysts. Follicular fluid was aspirated from the follicular cysts and follicles that were fated to become cystic follicles and other coexisting normal follicles, respectively, in lactating cows (n = 3). After the aspiration procedure, new follicles developed and reached a diameter of 25 mm without ovulation within 13–19 days. The plasma concentrations of inhibin decreased and follicle-stimulating hormone increased rapidly after the aspiration procedure, and subsequently increased and decreased, respectively, as a new follicle grew. No luteal structures developed after the aspiration procedure, and the animals’ plasma progesterone levels remained low. The present study indicates that the cystic follicles are never luteinized by the aspiration of follicular fluid, and consequently, new follicular cysts are observed to repeatedly develop.

EFFICIENCY OF DIFFERENT MODES OF USING DONORS IN OBTAINING CATTLE EMBRYOS IN VITRO IN THE SYSTEM OF TRANSVAGINAL ASPIRATION OF OOCYTES (TAO)

In the present paper the results are given of studies on the effectiveness of various TAO modes in obtaining embryos in culture in vitro. Follicle puncture was performed two and four times a month with a week break after aspiration, four and eight times a month without interruption, and also strictly regularly every three and seven days. As the analysis of the obtained results shows, performing the aspiration procedure strictly every seven days reduced the number of aspirated follicles in comparison with other donor groups by 4.2-12.8%, but at the same time increased the total oocyte yield by 7.9-16.1 pp. The yield of oocytes suitable for cultivation was 5.5-13.5 pp higher when performing aspiration once every other week (twice a month) and amounted to 84.9%. The yield of embryos from the number of fertilized eggs was higher when aspirated twice a week every other week (four times a month with a weekly break) and amounted to 32.5% versus 20.0 -25.0% in other groups of animals.

The Impact of Parental Pain-attending and Non-pain-attending Responses on Child Pain Behavior in the Context of Cancer-related Painful Procedures: The Moderating Role of Parental Self-oriented Distress.

Literature has demonstrated inconsistent findings regarding the impact of parental responses on child pain-related outcomes. Yet, research into factors that may underlie inconsistent findings regarding the variable impact of parental responses is lacking. The current study investigated the moderating role of parental distress in understanding the impact of parental pain-attending (eg, reassuring the child) and non-pain-attending (eg, distracting the child with humor) responses on child pain behavior (eg, crying). Children (18 y and younger) with leukemia, undergoing a lumbar puncture (LP) and/or bone marrow aspiration procedure, and one of their parents, were recruited from the Pediatric Ghent University Hospital. Parent-child interactions were videotaped after the procedure allowing coding of parental responses and child pain behavior. Parents self-reported on experienced personal distress. Participants consisted of 42 children (24 boys, 18 girls) with leukemia and one of their parents. Children were 0.6 to 15 (7.08±4.39) years old. Findings indicated a positive association between parental pain-attending and child pain behavior, but only when parents reported high levels of distress (β=0.56, P=0.001). No association was observed for parents reporting low levels of distress (β=-0.09, ns). Parental non-pain-attending responses contributed to lower child pain behavior (β=-0.24, P=0.045), independently of parental distress (β=-0.07, ns). The current findings point to the moderating role of parental distress in understanding the impact of parental responses on child pain behavior and highlight the importance of interventions targeting parental emotion regulation to promote optimal child pain outcomes.

Ex-Vivo Identification of Tumor From Parenchyma in Human Liver Using Electrochemical Impedance Spectroscopy on a Needle

Percutaneous ethanol injection for hepatocellular carcinoma and biopsy for pathological examination of lesions in the liver are widely performed using a fine needle under ultrasonography guidance. However, it is often difficult to distinguish a malignant tumor from a parenchyma via ultrasonography. This study proposes a method for identifying a malignant tumor in the liver using coplanar bipolar electrodes fabricated on a fine needle, called electrochemical impedance spectroscopy on a needle (EoN). The electrical impedances of the malignant tumor and parenchyma were measured in two pathological statuses, more specifically in human ex-vivo normal liver and in human ex-vivo cirrhotic liver. Statistically significant differences in the electrical impedance between the malignant tumor and parenchyma in each pathological status were observed in a frequency range of 0.46MHz to 1MHz (p < 0.05). Given a real-time measurement in clinical trials, the optimal frequency suggested was indicated by the largest value in the discrimination index between the malignant tumor and the parenchyma. The electrical properties (conductivity and permittivity) of the tissues were estimated to generalize the sensor output without regard to the dimension and shape of the electrodes. The values of the electrical properties of cancer in the cirrhotic liver and normal liver were significantly higher than those of each parenchyma. These experimental results imply that EoN can be used as a potential tool for identification of malignant tumors in the liver during percutaneous ethanol injection and fine needle aspiration procedures.

BRAF V600E as an accurate marker to complement fine needle aspiration (FNA) cytology in the guidance of thyroid surgery in the Chinese population: evidence from over 1000 consecutive FNAs with follow-up.

Currently, several commercial molecular tests have been developed for reclassifying thyroid nodules with indeterminate fine needle aspiration cytology. These tests are quite expensive and not available in China. Previous studies demonstrated a very high prevalence of the BRAF V600E mutation in Asian people. A high incidence may result in a robust sensitivity. We conducted this study to determine the prevalence of BRAF V600E mutation and its ability to reclassify cytologically indeterminate thyroid nodules in the Chinese population. Between January 2016 and October 2018, consecutive patients who underwent a fine needle aspiration procedure and agreed to provide materials for molecular analysis in our hospital were recruited in this study. All were followed up until they had a thyroidectomy and a final pathological diagnosis or until January 2019 (those did not have surgery). A total of 1960 patients were included in this study. Until January 2019, 1240 patients underwent surgery. Using histopathological diagnosis as a gold standard, the overall sensitivity and specificity of the BRAF V600E mutational analysis for the discrimination of benign nodules from cancer in thyroid fine needle aspiration samples were 83.3% (81.0-85.3%) and 96.0% (77.7-99.8%), respectively, with an area under the ROC curve of 0.90 (95% CI 0.85-0.95, P<0.001). Among cases with indeterminate cytology, BRAF-positive cases were showing malignancy in the final pathology, and BRAF-negative cases were showing safer to be followed up. The BRAF V600E mutation is highly prevalent in the Chinese population and can accurately complement cytopathology in the guidance of thyroid surgery.Mini-abstract: The BRAF V600E mutation has both high specificity and sensitivity to predict thyroid malignancy in the Chinese population. It can accurately complement cytopathology in the guidance of thyroid surgery.

Ovarian follicular dynamics in Boran and Crossbred heifers in Ethiopia: Implications for assisted reproductive techniques

The study was conducted to characterize the follicular dynamics of purebred Boran (Bos indicus) and Boran * Holstein Friesian crossbred heifers during estrous cycles; for use in ovum pick up and in-vitro embryo production. Insight of reproductive physiology of cattle would help to understand and exploit the reproductive potential of elite animals for breed improvement. Follicular development, growth and atresia during estrous cycles were evaluated using a trans-rectal real-time B-mode ultrasound system for three consecutive estrus cycles. Luteal activity was evaluated by serum progesterone level. Follicular aspirations were done to investigate the potential of Boran cattle and their crosses for transvaginal oocyte production; using a vacuum pressure pump and Aloka SSD Prosound-2 ultrasound device. Boran heifers (n=15) manifested two (n = 6, 40%), three (n = 5, 33%), four (n= 3, 20%) and five (n=1, 6.7%) follicular waves. Crossbred heifers (n=14) showed one (n= 2, 14%), two (n= 6, 43%) and three (n= 6, 43%) follicular waves. Interovulatory interval was 21.1 ± 3.4 and 21.4 ± 2.7 days for Boran (n=45) and crossbred (n=42) heifers, respectively. The progesterone level in Boran and Crossbred heifers during diestrus was 9.5 ± 11.0 and 4.6 ± 8.8 ng/ml, respectively. The maximum diameter of the ovulatory follicle for crossbred heifers was higher (15.4 ± 1.6 mm) than the diameter of the Boran (14.0 ± 1.9 mm) heifers (p&lt;0.005). Differences (p&lt;0.005) were observed in the size of both right (26.6 ± 5.14 and 28.6 ± 5.1 mm) and left (21.7 ± 4.85 and 24.1 ± 5.07 mm) ovaries of Boran and Crossbred heifers, respectively. Difference (p&lt;0.005) was also observed in follicular count of the right ovaries of Boran (4.84 ± 1.96) and Crossbred (5.13 ± 2.05) heifers. Oocyte recovery rate in once weekly collection scheme for Boran and their crossbred heifers was (n=19, 42.08%) and (n=17, 42.55%), respectively. The recovery rate for twice weekly collection scheme was (n=24, 34.53%) and (n=23, 40.44%) for Boran and crossbred heifers, respectively. Follicular dynamics in Boran heifers is characterized by a higher incidence of cycles with two, three and four waves, associated with a low persistence of the dominant follicles; and smaller size of ovulatory follicles and less intense heat signs from their crossbred counterpart. Boran heifers proved to have potential for comparable number of follicular population and ease of aspiration procedures that can be tapped for advancedreproductive techniques.&#x0D; Keywords: Estrus cycle; follicular wave; ovarian follicle; ovum pickup; ultrasound.

A STUDY ON LEVELS OF CHOLINESTERASE IN PLEURAL FLUIDS OF DIVERSE ETIOLOGIES

Introduction: Acetylcholinesterase , also known as true, specific, type I cholinesterase or RBC cholinesterase: It is found in nervous tissue, erythrocytes, lungs, spleen and grey matter. It is decreased in pernicious anaemia and after antimalarial therapy. Methodology: Patients participating in the study were explained about the procedure, technique and complications of pleural fluid aspiration. Pleural fluid aspiration was performed under strict aseptic precautions after analysing the fluid levels by percussion and chest x-rays. In few of the cases, ultrasonography-guided pleural fluid aspiration was performed. Results: The mean values of pleural fluid cholinesterase levels were 806.26 + 516.28 U/L in the transudates group and 3476.11 + 1250.17 U/L in the exudates group. The normal levels of cholinesterase varies between laboratories. The cut-off value is 1/10th of the upper limit of normal level of cholinesterase in the respective laboratory. Conclusion: In this study Light’s criteria had a sensitivity of 91.9% and specificity of 87.3% in comparison to pleural fluid to serum cholinesterase ratio that had a sensitivity of 96.8% and specificity of 95.2%.

Effects of nasal aspiration by the Proetz® method in pediatric patients with sinusitis.

To characterize the effects of nasal aspiration with Proetz® in peak nasal inspiratory flow (PNIF) in pediatric sinusitis (PS) patients with nasal obstruction. This is a non-randomized descriptive-analytical clinical trial with a quantitative approach. The sample comprised 30 children. Initially, the PNIF was measured and the Visual Analogical Scale (VAS) was used for nasal obstruction, followed by the nasal aspiration procedure. The SNOT-22 questionnaire was applied to the legal guardian of each child, and one week later, it was reapplied for the sake of follow-up. 16 (53.3%) patients were females and 14 (46.7%) were males, with an average age of 6.4±1.8 years (between 4 and 10 years of age). Analyses of the VAS for obstruction before the intervention revealed that 10 of the participants (33.3%) presented moderate levels, and 20 of them (66.7%) severe levels. However, after the Proetz® method was applied, all the samples (n=30) had mild levels. The PNIF significantly increased after the technique was used, with an improvement of 23.4% in mean values. There was no significant correlation between the VAS and the PNIF. Nasal aspiration with the Proetz® method significantly improved the clinical condition of sinusitis patients with nasal obstruction according to the visual analogical scale, the PNIF, and the SNOT-22 questionnaire. No correlation between the VAS and the PNIF could be found. The study confirms the importance of non-pharmacological interventions in the treatment of sinusitis in children, thus resulting in an improvement in their quality of life.

A study on the Aspiration Procedures in Syringes among Health Care Professionals

A study on the Aspiration Procedures in Syringes among Health Care Professionals

Endobronchial Ultrasound Elastography for Differentiating Benign and Malignant Lymph Nodes

Background: Endobronchial ultrasound elastography that provides information on tissue stiffness may help distinguish malignant from benign mediastinal and hilar lymph nodes. Objectives: In this prospective trial, we assessed the diagnostic value of elastographic images and the interobserver agreement in its evaluation. Method: Elastographic images from 77 lymph nodes in 65 patients were reviewed by 3 pneumologists. The elastographic image was classified based on the predominant colour: predominantly green, intermediary, and predominantly blue. With 2 or 3 interobserver matches, the corresponding elastographic image was correlated with the pathological result obtained from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and/or other invasive procedures. Results: All 3 reviewers had agreement in classifying elastographic images in 45% (35/77). Overall, the interobserver agreement among the 3 readers for classifying elastographic pattern was found to be moderate (Fleiss Kappa index = 0.519; 95% CI = [0.427; 0.611]). On cytological/histological evaluation, 55 lymph nodes were malignant and 22 were benign. In classifying “green” as benign and “blue” as malignant, the sensitivity and specificity were 71% (95% CI = [54%; 85%]) and 67% (95%-CI = [35%; 90%]), respectively. Conclusions: Elastography will not replace invasive EBUS-TBNA due to a moderate interobserver agreement and insufficient sensitivity and specificity. However, elastography will, maybe, present an additional feature to identify malignant lymph nodes in the context of clinical, radiological, and cytological results.

Yenidoğanın Doğum Odasında Aspirasyon İlkelerinde Güncel Yaklaşımlar; Ebelerin Rol ve Sorumlulukları

Neonatatal mortalite istatistikleri incelendiğinde, önemli bir bölümünün yaşamın ilk günü meydana geldiği görülmektedir. Bu durum yenidoğanın doğum odasındaki bakım ve izleminin ne kadar önemli olduğunu ortaya koymaktadır. Doğum odasında yenidoğanlara yapılan uygulamalar arasında yer alan aspirasyon işlemi yaygın olarak kullanılmaktadır. Aspirasyon işlemine bağlı solunum ve dolaşım sisteminin çalışmasını olumsuz etkileyen birçok komplikasyon gelişebilmektedir. Bu açıdan yenidoğanda dikkatli uygulanması gereken bir girişimdir. Yıllar içerisinde yenidoğanlara doğum odasında yaklaşım uygulamaları değişiklik göstermiştir. Yenidoğan bakımına yön veren Dünya Sağlık Örgütü, Türk Neonatoloji Derneği, Amerikan Kalp Derneği ve Uluslararası Resüsitasyon Komitesi’nin güncel önerileri incelendiğinde, yenidoğanlara rutin aspirasyon işlemi önerilmemektedir. Ebelerin görev ve sorumlulukları arasında yenidoğanın ilk bakım ve muayenesi ve gerektiğinde acil resüsitasyon gerçekleştirmesi de yer almaktadır. Bu durum ebelerin yenidoğanın aspirasyon işleminde anahtar role sahip olduğunu göstermektedir. Bu açıdan ebelerin yenidoğanda aspirasyon ilkeleri hakkında ayrıntılı bilgi sahibi olması ve konuyla ilgili güncel yaklaşımları bilmesi önemli bir konudur. Aspirasyon yenidoğanlara doğum odasında oro-nazofarenks, endotrakeal ve mide içeriği aspirasyonu yöntemlerinde uygulanmakta ve ebelik bakımında önemli yer tutmaktadır. Bu makalede, yenidoğanın doğum odasında aspirasyon ilkelerinde güncel yaklaşımlar ve ebelerin rol ve sorumlulukları literatür bilgisi kapsamında derlenmiştir.

Spontaneous infarction of pleomorphic adenoma of the parotid gland: A case report.

Infarction after the fine-needle aspiration (FNA) procedure is a well-recognized phenomenon of salivary gland lesions. Though extremely rare, spontaneous infarction without previous FNA can occur in pleomorphic adenoma (PA). The present report describes a fourth cytological case of spontaneous infarction of PA of the parotid gland using immunocytochemical analysis, to the best of our knowledge, for the first time. A 57-year-old Japanese female presented with persistent swelling of the right neck region. Physical examination revealed a tumour in the right parotid gland, and FNA examination of the tumour was performed following surgical resection. The Papanicolaou smear demonstrated the presence of fully necrotic cell clusters of varying sizes in a necrotic background. Only a few viable cell clusters were observed. These cells were polygonal to spindle-shaped, and exhibited large round to oval nuclei with a conspicuous nucleoli. Although nuclear pleomorphism was noted, the nuclear chromatin was fine. No neoplastic myoepithelial cells were observed. Therefore, it was suspected that these cells were malignant. Immunocytochemical analysis indicated that these atypical cells were positive for p40. Histopathological examination of the resected parotid gland tumour revealed infarcted PA. Our study revealed that the presence of atypical squamous metaplastic cells in a necrotic background was a characteristic cytological feature of infarcted PA, and that these atypical squamous cells can have large nuclei with conspicuous nucleoli and exhibit pleomorphism. Although cytological diagnosis of infarcted PA is difficult, pathologists and cytopathologists must consider the presence of atypical metaplastic squamous cells in benign salivary gland tumours, including infarcted PA.

Family planning practices of women working in the Cambodian garment industry: a qualitative study

BackgroundWomen working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.MethodsWe conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 min and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.ResultsWe interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children.ConclusionThis research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.

Bevel angle study of flexible hollow needle insertion into biological mimetic soft-gel: Simulation and experimental validation

BackgroundA thorough understanding of cutting-edge geometry and cutting forces of hollow biopsy needles are required to optimise needle tip design to improve fine needle aspiration procedures. ObjectivesTo incorporate the dynamics of needle motion in a model for flexible hollow bevel tipped needle insertion into a biological mimetic soft-gel using parameters obtained from experimental work. Additionally, the models will be verified against corresponding needle insertion experiments. MethodsTo verify simulation results, needle deflection and insertion forces were compared with corresponding experimental results acquired with an in-house developed needle insertion mechanical system. Additionally, contact stress distribution on needles from agar gel for various time scales were also studied. ResultsFor the 15°, 30°, 45°, 60° bevel angle needles, and 90° blunt needle, the percentage error in needle deflection of each needle compared to experiments, were 7.3%, 9.9%, 8.6%, 7.8%, and 9.7% respectively. Varying the bevel angle at the needle tip demonstrates that the needle with a lower bevel angle produces the largest deflection, although the insertion force does not vary too much among the tested bevel angles. ConclusionThis experimentally verified computer-based simulation model could be used as an alternative tool for better understanding the needle-tissue interaction to optimise needle tip design towards improved biopsy efficiency.

Bone marrow-derived from the human femoral shaft as a new source of mesenchymal stem/stromal cells: an alternative cell material for banking and clinical transplantation

BackgroundMesenchymal stem/stromal cells (MSC) are commonly used in regenerative medicine. Among different tissues, iliac crest bone marrow (BM) represents the most exploited source, but its disadvantages are a painful aspiration procedure and low cell number. An alternative, readily available source of MSC for research would be beneficial for regenerative medicine development. This work aimed to propose a new source of bone marrow isolation in which the femoral shaft is taken during total hip arthroplasty (THA).MethodsIn preliminary experiments, three different gradient methods for cell separation (Ficoll-Paque 1.078 g/mL, 17% sucrose gradient, BM seeding fraction) were tested with regard to the time of primary culture, initial cell number, the phenotype, and morphology of MSC. Then human bone marrow MSC derived from two different sources, iliac crest aspirate (BM-MSCi) or femoral shaft (BM-MSCt), were analyzed in terms of cell number and colony-forming ability followed by differentiation potential of MSC into osteo-, chondro-, and adipogenic lineages as well as mRNA expression of a variety of cytokines and growth factors.ResultsOur studies showed that MSC isolated from the bone marrow of two different sources and cultured under appropriate conditions had similar characteristics and comparable propensity to differentiate into mesodermal cells. MSC derived from BM-MSCi or BM-MSCt expressed various growth factors. Interestingly, the expression of EGF, FGF, IGF, and PDGF-A was much higher in BM-MSCt than BM-MSCi.ConclusionsThe results of our study demonstrate that human MSC isolated from the BM of the femoral shaft have similar biological characteristics as MSC derived from the iliac crest, suggesting the femoral shaft as a possible alternative source for mesenchymal stem/stromal cells.

Surface Texturing Design to Enhance Echogenicity of Biopsy Needles During Endoscopic Ultrasound Imaging

The ultrasonic visibility of a biopsy needle tip is of critical importance for the success and safety of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) procedures. The aim of this study was to design a surface topology, in silico, which enhances the ultrasound visibility of a needle by controlling and optimising the direction of the reflections. Topographic enhancements to needle surface redirect scattered waves back to the transducer to enhance needle visibility, or “echogenicity.” Echogenicity enhancement is demonstrated across insonification angles of 30°–90° on full-length scale of biopsy needles used in practice. By applying a textured surface across the full length of the needle surface, the signal being returned to the transducer can be tripled from that of a constant periodic dimple echogenic surface and seven times that of an untextured flat surface. Our first principles model provides a quantitative insight to echogenicity and its enhancement. The model allows in silico design of needles for USG-FNA and biopsy with enhanced echogenicity and consequent improvement in visibility, including but not limited to needle tip area.

Bypassing physiological puberty, a novel procedure of oocyte cryopreservation at age 7: a case report and review of the literature

To report the first successful oocyte cryopreservation in a prepubertal girl. Case report and review of the literature. Tertiary medical center. A 7-year-old prepubertal girl with Turner syndrome mosaicism (45,X[37]/47,XXX[15]) who underwent a novel fertility preservation procedure after fertility preservation counseling and informed decision of the parents. Controlled ovarian hyperstimulation with daily administration of 100 IU recombinant human follicle-stimulating and 50 IU recombinant human luteinizing hormone per milliliter, injection of 250 μg human chorionic gonadotropin was given 36 hours before the follicular aspiration procedure, and oocytes retrieved by a transabdominal ultrasound guided approach. Mature oocyte cryopreservation. The first cryopreservation cycle with use of a gonadotropin-releasing hormone agonist trigger failed to yield oocytes. The second cycle with human chorionic gonadotropin trigger was successful. Six oocytes were retrieved, and all were mature metaphase 2. The patient was discharged in good condition with no complications. This novel procedure bypasses the timely physiologic progression of pubertal maturation of the hypothalamic-pituitary-ovarian axis to directly target the ovaries and achieve mature ovarian follicles. This innovative approach offers a new treatment modality for prepubertal girls who need fertility preservation such as in Turner syndrome or in cases that ovarian tissue cryopreservation is contraindicated.

Evaluation of knowledge and behavior of nurses working in intensive care units for endotracheal aspiration application

Aim: Endotracheal aspiration is one of the most common invasive procedures administered by intensive care nurses in patients receiving mechanical ventilation to provide and maintain adequate oxygenation, alveolar ventilation, and gas exchange, prevent pulmonary consolidation and atelectasis, and reduce the risk of ventilator-associated pneumonia. When the endotracheal aspiration procedure is not administered correctly, the patient may have serious complications such as arterial and venous desaturation, cardiac arrhythmia, cardiac arrest, atelectasis, bronchospasm, lower respiratory tract contamination, ventilator-induced pneumonia, anxiety, and dyspnea. The study aims to evaluate the knowledge and behaviors of nurses working in intensive care units for endotracheal aspiration applications.Methods: This study used a cross-sectional and descriptive design including a questionnaire-based nurse survey. It was conducted between 17 March 2015-30 June 2015 with 54 nurses working in intensive care units in a public hospital. In the study, the data were collected with a questionnaire, endotracheal aspiration information form, and nurse observation form for endotracheal aspiration. The evaluation of the data was conducted using numbers and percentages. The ethics committee approval, institutional permission, and participant consent were obtained before starting the research.Results: It was determined that the nurses participating in the study were incompetent before, during, and after the endotracheal aspiration procedure and that they did not have sufficient information about endotracheal aspiration.Conclusion: In line with the results of the study, it was suggested that the nurses should be trained on endotracheal aspiration, the effect of education on practice should be evaluated, and that standardization studies should be carried out to minimize deficient and erroneous practices in endotracheal aspiration.

Benefits of Routine, Opt-Out Abortion and Family Planning Training: 20 Years of the Ryan Program [02J

INTRODUCTION: To describe the effects of routine, opt-out abortion and family planning training on clinical exposure to uterine evacuation skills and intentions to provide abortion post-residency. METHODS: Data from the first 20 years of the Ryan Residency Training Program in Abortion and Family Planning (RP) were analyzed. Post-rotation surveys assessed residents’ experiences with abortion and intentions to provide abortions post-residency. The 2019 residency program director survey assessed benefits of training from the educators’ perspective. This study is considered exempt by the University of California San Francisco IRB. RESULTS: A total of 3,197 residents completed post-rotation surveys, for an overall response rate of 80.1%. During the rotation, residents, including those who partially participated, gained significant exposure to all methods of first- and second-trimester termination, with an average of 7.4 medication abortions, 11.8 manual uterine aspirations, 15.6 electric uterine aspirations and 5.8 second-trimester dilation and evacuations (D&amp;E). Residents reported feeling competent to do aspiration procedures independently up to an average of 12.8 weeks. Eighty-one percent of residents intend to do abortions for medical reasons after residency and sixty-one percent for all reasons. Ninety-six percent of directors reported increased clinical competence in abortion and contraception among all residents after the rotation, and 68% reported the RP training helped improve continuity of care for patients. CONCLUSION: Routine, opt-out training in abortion and family planning gives OB-GYN residents an opportunity to gain the clinical skills necessary to integrate abortion into their patient care after residency.

Tracheoesophageal diversion improves oral uptake of food: a retrospective study.

Tracheoesophageal diversion (TED) is an effective therapeutic procedure for intractable aspiration. In this study, we performed TED in cases of intractable aspiration and/or repetitive pneumonia, investigated the main route of nutritional uptake after the procedure, and evaluated the swallowing method using videofluoroscopy. We also evaluated the validity of TED for treating intractable aspiration. We retrospectively reviewed 44 patients (30 male and 14 female patients; median age, 55years; range 15-85years) who underwent TED for the treatment of intractable aspiration between January 2008 and December 2017. We examined the route of nutritional uptake before and after the operation and performed videofluoroscopy to detect the swallowing method after the operation. The percentage of patients with oral intake increased from 21% (9/44) before TED to 56% (25/44) within 1month after TED (p < 0.01); this percentage included patients with poor preoperative swallowing function. Overall, 60% patients who were able to communicate and mobilize using a wheelchair as well as 92% patients who were able to communicate and mobilize in the supine position were able to consume food orally. We subsequently performed videofluoroscopy in 24 of the 25 patients with oral intake and assessed the passage route of the contrast agent, which was found to move through the laryngeal route in 54% of these patients. TED may be suitable for the treatment of intractable aspiration and can improve oral intake, particularly in patients with good mobility and communication ability.