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At least 667 records · Page 37Linked to original sources

PubMed2003

To blow or not to blow: a randomised controlled trial of compression-only and standard telephone CPR instructions in simulated cardiac arrest.

This randomised controlled trial used a manikin model of cardiac arrest to compare skill performance in untrained lay persons randomised to receive either compression-only telephone CPR (Compression-only tel., n=29) or standard telephone CPR instructions (Standard tel., n=30). Performance was evaluated during standardised 10 min cardiac arrest simulations using a video recording and data from a laptop computer connected to the training manikin. A number of subjects in both groups did not open the airway. More than 75% in the Standard tel. group failed to deliver two effective initial rescue breaths, and only 17% provided an adequate inflation volume for subsequent breaths, delivering a median of only five inflations during the entire scenario. Most subjects in both groups gave chest compressions that were too shallow and at an inappropriately rapid rate. Hand position was also poor, but was worse in the group given simplified instructions. There was a significant delay to first compression in both groups, although this interval was shortened by over a minute when ventilations were eliminated from the telephone instruction algorithm (245 vs. 184 s, P<0.001). Over two-and-a-half times as many chest compressions were delivered during an average ambulance response time with compression-only telephone directions compared with standard CPR (461 vs. 186, P<0.001). These variables may be critical in predicting survival from out-of-hospital cardiac arrest. Further research is necessary to establish if modifications to scripted telephone instructions can remedy the identified performance deficiencies. Eliminating instructions for rescue breaths from scripted telephone directions will have little impact on the ventilation of most patients. Research is required to determine if the consequent reduction in the delay to starting chest compressions and the significant increase in the number of compressions delivered can increase survival from out-of-hospital cardiac arrest.

Adult↗

PubMed1998

The effect of rescuer fatigue on the quality of chest compressions.

OBJECTIVE: The aim of this study was to evaluate the influence of rescuer fatigue on the quality of chest compressions and the influence of the rescuer's gender, age, weight, height or professional status on the reduction of quality of chest compressions caused by fatigue. MATERIAL AND METHODS: The study was carried out with the Laerdal Skillmeter Resusci Anne manikin. The participants were doctors and nurses who work in the Intensive Care and Emergency departments, with an age ranging from 25 to 45 years and trained in cardiopulmonary resuscitation (CPR). Statistical analysis of results includes analysis variance and three models of multiple linear regression. RESULTS: Thirty-eight people took part in the experiment; 20 (52.6%) were females; 15 (39.5%) staff physicians, 15 (39.5%) nurses and eight residents. Mean age was 34.1 years (SD = 4.1). We found a significant reduction in correct compression performance over the course of time: in the first minute 79.7%, in the second 24.9%, in the third 18%, in the fourth 17.7% and in the last minute 18.5%. There were no differences related to the rescuer's gender or profession. The median interval until rescuers appreciated the effect of the fatigue on chest compressions quality was 186 s (SD = 84.1); that appreciation was not influenced by gender, age, weight, height or profession. There were no differences in the percentage of correct compressions related to gender (P = 0.07), insufficient sternal depression (P = 0.23) or total number of compressions in the first minute. DISCUSSION: A decrease of compressions quality after the first minute of CPR is produced. This effect does not depend on gender, age, weight, height or rescuer's profession and it is not adequately perceived by the person who performs the chest compressions.

Adult↗

PubMed2003

MP3 compression of Doppler ultrasound signals.

The effect of lossy, MP3 compression on spectral parameters derived from Doppler ultrasound (US) signals was investigated. Compression was tested on signals acquired from two sources: 1. phase quadrature and 2. stereo audio directional output. A total of 11, 10-s acquisitions of Doppler US signal were collected from each source at three sites in a flow phantom. Doppler signals were digitized at 44.1 kHz and compressed using four grades of MP3 compression (in kilobits per second, kbps; compression ratios in brackets): 1400 kbps (uncompressed), 128 kbps (11:1), 64 kbps (22:1) and 32 kbps (44:1). Doppler spectra were characterized by peak velocity, mean velocity, spectral width, integrated power and ratio of spectral power between negative and positive velocities. The results suggest that MP3 compression on digital Doppler US signals is feasible at 128 kbps, with a resulting 11:1 compression ratio, without compromising clinically relevant information. Higher compression ratios led to significant differences for both signal sources when compared with the uncompressed signals.

Algorithms↗

PubMed1999

Characterization of particle deformation during compression measured by confocal laser scanning microscopy.

Direct compression of riboflavin sodium phosphate tablets was studied by confocal laser scanning microscopy (CLSM). The technique is non-invasive and generates three-dimensional (3D) images. Tablets of 1% riboflavin sodium phosphate with two grades of microcrystalline cellulose (MCC) were individually compressed at compression forces of 1.0 and 26.8 kN. The behaviour and deformation of drug particles on the upper and lower surfaces of the tablets were studied under compression forces. Even at the lower compression force, distinct recrystallized areas in the riboflavin sodium phosphate particles were observed in both Avicel PH-101 and Avicel PH-102 tablets. At the higher compression force, the recrystallization of riboflavin sodium phosphate was more extensive on the upper surface of the Avicel PH-102 tablet than the Avicel PH-101 tablet. The plastic deformation properties of both MCC grades reduced the fragmentation of riboflavin sodium phosphate particles. When compressed with MCC, riboflavin sodium phosphate behaved as a plastic material. The riboflavin sodium phosphate particles were more tightly bound on the upper surface of the tablet than on the lower surface, and this could also be clearly distinguished by CLSM. Drug deformation could not be visualized by other techniques. Confocal laser scanning microscopy provides valuable information on the internal mechanisms of direct compression of tablets.

Drug Compounding↗

PubMed1994

The effects of matrix compression on proteoglycan metabolism in articular cartilage explants.

The effects of compressive stress on the rate of proteoglycan synthesis and release were determined in bovine articular cartilage from 4-5-month-old animals. Full depth cartilage explants were compressed in an unconfined configuration at various stresses ranging up to 1.0 MPa. At mechanical equilibrium (after 24 h), no significant changes were detected in the rate of [35S]-sulfate (35SO4) incorporation at the low level of compressive stresses used (less than 0.057 MPa). At an intermediate level of compressive stress (0.057, 0.1, 0.5 MPa), 35SO4 incorporation rates were reduced to approximately 60% of control values. At the highest level compressive stress (1.0 MPa) studied, 35SO4 incorporation rates were further reduced to approximately 20% that of controls. Recovery experiments at intermediate stress levels showed increased rates of 35SO4 incorporation at 24 h after compression. In explants loaded for 24 h at stresses of 0.1 MPa or higher, there was a stress-dose dependent inhibition of proteoglycan release into the media (up to 61% at 1.0 MPa), and proteoglycan release rates did not return to control values following a 24 h recovery period. While cartilage composition and biosynthetic activity were found to vary significantly with depth in control cartilage, the observed suppression (% change) in biosynthetic activity was relatively uniform with depth in both loading and recovery experiments. The study indicates that compression of the tissue to physiological strain magnitudes serves as a signal to modulate chondrocyte biosynthetic and catabolic responses through the depth of cartilage, while prolonged compression at higher strains may be responsible for tissue and cell damage.

Animals↗

PubMed1997

Diagnostic efficacy of compressed digitized real-time sonography of uterine fibroids.

RATIONALE AND OBJECTIVES: The authors investigated the diagnostic efficacy of compression of real-time ultrasound (US) examinations. METHODS: Low- and high-compression recordings (9:1 and 15:1, respectively) of examinations were generated by using Joint Photographic Experts Group algorithms. Seven radiologists used a five-level response scale to answer questions about the presence, number, and location of focal fibroid tumors in 67 randomly sorted uterine examinations. The images were viewed after no, low, and high compression. Results were evaluated by using multipatient, multireader receiver operating characteristic jack-knife analysis. RESULTS: Given the reduction in the US digital video rates from 74 Mbit/sec for uncompressed images to 8 Mbit/sec for low compression and 4.7 Mbit/sec for high compression, there were no statistically significant differences in accuracy between the compression schemes. Confidence intervals suggested that the sample size was adequate. CONCLUSION: Compressed images with compression ratios of 9:1 and 15:1 were diagnostically equivalent to uncompressed images of uterine fibroid tumors.

Female↗

PubMed1999

Laboratory analysis of superelastic NiTi compression springs.

The force/compression characteristics of 32 commercially available nickel titanium (NiTi) compression springs from seven distributors were investigated in vitro in order to support the orthodontist in deciding to select an appropriate spring for a given treatment. The geometrical properties of the coil springs, i.e., inner spring diameter, winding diameter and winding configuration, differed significantly, as well as the alloy composition and the thermo-mechanical treatment of the springs. All springs were mounted on a guiding rod made of an orthodontic steel wire (dimension: 0.016" x 0.022"), were compressed to a maximum extent and then relieved. Force/compression characteristics were measured at ambient temperatures of 27 degrees C, 37 degrees C and 47 degrees C. Three specimens were taken from each individual compression spring of a certain manufacturer and batch to check for constant material behaviour. A possible influence of sterilization on the mechanical properties of the compression springs was studied by autoclaving one spring of each manufacturer five times (6 minutes at 134 degrees C) and subsequently performing a force/deflection measurement. The NiTi compression springs were classified into three groups and covered a broad range of orthodontic forces between 0.5 N and 3.5 N. The width of the superelastic plateaus of the different NiTi coil springs reached from 0% to 66% of relative compression. An increase in the application temperature from 27 degrees C to 47 degrees C caused a rise in the height and a shortening of the width of the superelastic plateau. The resultant change in plateau force was as high as 0.4 N to 0.9 N, depending on the spring type investigated, the width of the plateaus was shortened by 4.0% to 15% of relative compression. All compression springs investigated displayed constant material behaviour within a certain batch. However, differences from one batch to another had a high level of significance. Forces on the plateau varied from one batch to the other by about +/-18%. An influence of sterilization on the force/compression behaviour could not be proved. Consequently, springs made of superelastic NiTi alloys cover a broad field of application with predefined and nearly constant force levels.

Analysis of Variance↗

PubMed2003

Ventilatory load compensation response to long-term chest compression in rat model.

Short-term chest compression has been shown to decrease tidal volume and increase respiratory frequency. The present study was designed to assess and characterize the effect of long-term chest compression on breathing pattern and blood gases in awake rats. Chest compression was carried out by inflating a pneumatic cuff placed around the chest to a pressure of 25 mmHg and the pressure was maintained for 28 days. Respiratory frequency increased progressively until 14 days after chest compression whereas a decrease in tidal volume was stabilized within 3 days after chest compression. Although the changes in minute ventilation were small and no substantial change in Pa(CO2) was observed, an impairment of weight gain and a decrease in body temperature with a concomitant hypoxemia were evident during sustained chest compression. These observations suggest that the ventilatory response to chest compression may involve not only neural reflex mechanisms but also other non-reflex mechanisms. Sustained chest compression possibly impairs growth and metabolism.

Animals↗

PubMed2006

Does the slow compression technique of hyperbaric oxygen therapy decrease the incidence of middle-ear barotrauma?

OBJECTIVE: To note the incidence of middle-ear barotrauma following standard and slow compression during hyperbaric oxygen therapy (HBOT). The standards used were: (1) less than 40 per cent of the cohort should develop barotraumas, and (2) the incidence of barotrauma following the slow technique should be less than that caused by the standard technique. DESIGN: Prospective clinical audit. MATERIAL AND METHODS: Forty-two consecutive patients who received either standard compression or slow compression HBOT were included. Pre- and post-treatment otoscopy (graded according to a modified Teed's scale), tympanometry, audiometry and subjective ear complaints were compared between the groups and also compared with the set standard. RESULTS: Significantly less middle-ear barotrauma was noted when using the slow compression technique compared with the standard compression technique (p < 0.05). The incidence of barotrauma when using standard compression failed to meet the set standard of less than 40 per cent. CONCLUSION: The slow compression method of HBOT proved to be both safe and superior to the standard compression technique.

Adult↗

PubMedDate not supplied

Can correct closed-chest compressions be performed during prehospital transport?

INTRODUCTION: The resuscitation rate from out-of-hospital cardiac arrest is low. There are many factors to be considered as contributing to this phenomenon. One factor not previously considered is the impact of a moving ambulance environment on the ability to perform closed-chest compressions. HYPOTHESIS: Proper closed-chest compressions can be performed in a moving ambulance. METHODS: A cardiopulmonary resuscitation (CPR) training mannequin with an attached skill meter (Skillmeter ResusciAnnie, Laerdal, Armonk, N.Y., USA) that measures each chest compression for proper depth and hand placement was used. Ten emergency medical technician-basic (EMT-B) certified prehospital providers were assigned into one of five teams. Each team performed a total of four sessions of five minutes of continuous closed-chest compressions on the mannequin. Two sessions were done by each team: one in the control environment with the mannequin placed on the floor, and the other in the experimental environment with the mannequin placed in the back of a moving ambulance. The ambulance was operated without warning lights and siren, and all traffic rules were obeyed. The percentage of correct closed-chest compressions was recorded for each session, and the mean values were compared using Student's t-test with alpha set at 0.01 for statistical significance. RESULTS: Ten sessions of compressions were done in both environments. The mean percentage of correct compressions was 77.6 +/- 15.6 for the control group and 45.6 +/- 18.3 for the ambulance group (p = 0.0005). CONCLUSION: A moving ambulance environment appears to impair the ability to perform closed-chest compressions.

Ambulances↗

PubMed1995

Improved static compression behaviors and tablettabilities of spherically agglomerated crystals produced by the spherical crystallization technique with a two-solvent system.

PURPOSE: Poorly compressible crystals of acebutolol hydrochloride were agglomerated by the spherical crystallization technique with a two-solvent system to improve the compressibility for direct tabletting. The mechanism of improvements in static compression behaviors and tablettabilities of the spherically agglomerated crystals were investigated. METHODS: The improvement of static compression behaviors of the agglomerated crystals was determined by measuring the stress relaxations and elastic recoveries of compressed powder of original and agglomerated crystals. The improved tablettability of agglomerated crystals was evaluated by the pressure transmission ratio upon compression, the ejection pressure for releasing the tablet from the die and the tablet strength, i.e., tensile strength required for breaking. RESULTS: The higher relaxation pressure and the lower elastic recovery of the agglomerated crystals than of the original crystals were found. The pressure transmission ratio data showed that the friction pressures of the two crystals were similar during the compression period. The ejection pressure of the agglomerated crystals was lower than that of the original crystals. The tensile strength of the tablet of agglomerated crystals was greater than that of the original crystals. CONCLUSIONS: The compressibility and tablettability of the spherically agglomerated crystals prepared by the spherical crystallization technique were much improved due to their increased plastic property and reduced adhesive property compared to the original crystals.

Acebutolol↗

PubMed1999

Effect of different compression therapies on the reflux in deep veins with a post-thrombotic syndrome.

BACKGROUND: Reflux in deep veins is an important pathophysiological factor of post-thrombotic syndrome which can be demonstrated by colour-coded duplexsonography. This study investigates the effect of different compression therapies on the reflux velocity in deep veins in patients with a post-thrombotic syndrome. PATIENTS AND METHODS: Sixty patients with a post-thrombotic syndrome-confirmed by phlebography, in the deep veins of the calf and the thigh were investigated in two groups: In group A, 30 patients (mean age 58 +/- 10 years) received compression stockings (calf compression class II and III, thigh compression class II) and in group B 30 patients (mean age 58 +/- 14 years) received a Sigg short traction bandage of the calf. The velocity at the time of the greatest reflux in the popliteal vein was determined as reflux parameter with the colour-coded duplex sonography using a cuff applied at the calf. All patients stood upright and were measured with and without different kinds of compression therapies. The reflux velocities were graded as low, moderate and high. RESULTS: A significant decrease of the reflux velocity by about more than 45% with compression therapy was found in both groups. The decrease of the refluxes in group A (mean 47.9%) did not differ significantly from the decrease of refluxes in group B (mean 55.8%). The greatest decrease of the reflux velocity under compression therapy was found in high-grade refluxes in both groups. CONCLUSION: A significant decrease of the reflux velocity in post-thrombotic syndrome can be readily demonstrated with different kinds of compression stockings as well as with bandages by means of colour-coded duplex sonography.

Adult↗

PubMed2001

Do cool water or physiologic saline compresses enhance resolution of experimentally-induced irritant contact dermatitis?

Acute irritant contact dermatitis (ICD) is frequently treated with cool water or saline compresses. While presumed effective, little quantitative evaluation documents the treatment's benefit. This study sought to determine the efficacy of both distilled water and physiologic saline compresses on experimentally-induced ICD. 24-h application of both the lipophilic nonanoic acid (NAA) and the hydrophilic sodium lauryl sulfate (SLS) were used to induce irritant contact dermatitis in 9 healthy volunteers. Following irritation, compresses were applied 0.5 h 2x daily for 4 consecutive days. Transepidermal water loss (TEWL), laser Doppler flowmetry (LDF), chromametry and visual scoring were used to quantify results. Cool compresses of both water and saline significantly reduced TEWL and LDF, with no statistically significant difference between the efficacy of the saline or water compresses. Chromametry and visual scoring did not detect a significant effect with either the water or saline compresses. The results suggest an improvement with 2x-daily application of either water or physiologic saline compresses in the treatment of acute ICD, though true clinical benefit will be elucidated through further experimentation. Certainly, the current recommendation regarding the use of cool compresses for treating ICD should not be discarded.

Adult↗

PubMed1996

Effect of single-channel compression on temporal speech information.

Although syllabic compression systems are available in many currently marketed hearing aids, the benefit of such systems continues to be debated. The goal of this study was to determine the effect of single-channel amplitude compression on use of speech information were considered, with particular focus on temporal cues. Speech recognition scores were assessed under four conditions, using two types of speech materials. Both temporal and spectral information were provided in the FullSpeech or natural speech stimuli. Unlike previous studies in which use of temporal information may have been confounded by spectral changes, in this study the listener's ability to use temporal information was tested directly using signal-correlated noise (SCN) stimuli, which consisted of a time-varying speech envelope modulating a broad-band noise carrier. Two conditions (FullSpeech and SCN) retained their natural amplitude characteristics. In two corresponding conditions the same stimuli were compressed digitally, using compression parameters appropriate for syllabic compression. This compression reduced the range of time-intensity variations. Recognition scores were obtained from listeners with mild-to-severe sensorineural loss and from a control group of listeners with normal hearing. All stimuli were presented at high levels to reduce potential effects of reduced audibility. Additionally, short-term speech level measurements were compared to individual listener's hearing thresholds to determine the range of speech levels in each frequency region that was audible for each stimulus condition. Results demonstrated no effect of compression on recognition scores for either the FullSpeech or SCN signals for listeners with normal hearing or listeners with hearing loss. This suggests that single-channel syllabic compression processing, of the type used in this study, does not alter the temporal (or spectral) signal sufficiently to cause decreased recognition for VCV syllables when speech audibility is maintained.

Adult↗

PubMed1998

Multichannel compression, temporal cues, and audibility.

Although multichannel compression systems are quickly becoming integral components of programmable hearing aids, research results have not consistently demonstrated their benefit over conventional amplification. The present study examined two confounding factors that may have contributed to this inconsistency in results: alteration of temporal information and audibility of speech cues. Recognition of linearly amplified and multichannel-compressed speech was measured for listeners with mild-to-severe sensorineural hearing loss and for a control group of listeners with normal hearing. In addition to the standard speech signal, which provided both temporal and spectral information, the listener's ability to use temporal information in a multichannel compressed signal was directly tested using a signal-correlated noise (SCN) stimulus. This stimulus consisted of a time-varying speech envelope modulating a two-channel noise carrier. It preserved temporal cues but provided minimal spectral information. For each stimulus condition, short-term level measurements were used to determine the range of audible speech. Multichannel compression improved speech recognition under conditions where superior audibility was provided by the two-channel compression system over linear amplification. When audibility of both linearly amplified and multichannel-compressed speech was maximized, the multichannel compression had no significant effect on speech recognition score for speech containing both temporal and spectral cues. However, results for the SCN stimuli show that more extreme amounts of multichannel compression can reduce use of temporal information.

Adult↗

PubMed2003

Breast compression in mammography: how much is enough?

The amount of breast compression that is applied during mammography potentially influences image quality and the discomfort experienced. The aim of this study was to determine the relationship between applied compression force, breast thickness, reported discomfort and image quality. Participants were women attending routine breast screening by mammography at BreastScreen New South Wales Central and Eastern Sydney. During the mammographic procedure, an 'extra' craniocaudal (CC) film was taken at a reduced level of compression ranging from 10 to 30 Newtons. Breast thickness measurements were recorded for both the normal and the extra CC film. Details of discomfort experienced, cup size, menstrual status, existing breast pain and breast problems were also recorded. Radiologists were asked to compare the image quality of the normal and manipulated film. The results indicated that 24% of women did not experience a difference in thickness when the compression was reduced. This is an important new finding because the aim of breast compression is to reduce breast thickness. If breast thickness is not reduced when compression force is applied then discomfort is increased with no benefit in image quality. This has implications for mammographic practice when determining how much breast compression is sufficient. Radiologists found a decrease in contrast resolution within the fatty area of the breast between the normal and the extra CC film, confirming a decrease in image quality due to insufficient applied compression force.

Adult↗

PubMed2003

Ambulatory phlebectomy versus compression sclerotherapy: results of a randomized controlled trial.

BACKGROUND: Although no randomized controlled trial has assessed the effects of either compression sclerotherapy or ambulatory phlebectomy, both techniques are used to treat varicose veins worldwide. We performed a randomized controlled trial to compare recurrence rates of varicose veins and complications after compression sclerotherapy and ambulatory phlebectomy. METHODS: From September 1996 to October 1998, we randomly allocated 49 legs to compression sclerotherapy and 49 legs to ambulatory phlebectomy. Our primary outcome parameters were as follows: recurrence rates at 1 and 2 years and complications related to therapy. Eighty-two patients were included, of whom 16 were included with both of their legs. The number of treated legs was therefore 98, but two patients were lost to follow-up. RESULTS: One year recurrence amounted to 1 out of 48 for phlebectomy and 12 out of 48 for compression sclerotherapy (P<0.001); at 2 years, six additional recurrences were found, but then solely for compression sclerotherapy (P<0.001). Significant differences in complications occurring more in phlebectomy than in compression sclerotherapy therapy were blisters, teleangiectatic matting, scar formation, and bruising from bandaging. CONCLUSION: Our results show that ambulatory phlebectomy is an effective therapy for varicose veins of the leg. Recurrence rates are significantly lower than for compression sclerotherapy therapy. If varicose veins persist 4 weeks after compression sclerotherapy, it can be argued that to reduce the risk of future recurrence ambulatory phlebectomy should be considered as the better treatment option.

Ambulatory Surgical Procedures↗

PubMed2003

Documentation of brachial plexus compression (in the thoracic inlet) utilizing provocative neurosensory and muscular testing.

Diagnosis and documentation of brachial plexus compression in the thoracic inlet, "thoracic outlet syndrome", remains difficult because the syndrome complex overlaps that of patients with cervical disc disease, intrinsic shoulder pathology, and peripheral nerve compression. While traditional electrodiagnostic testing can identify cervical radiculopathy and the rare isolated lower trunk compression, it cannot identify brachial plexus compression in the thoracic inlet. In 2000, neurosensory testing with the Pressure-Specified Sensory Device (PSSD) was applied to this diagnostic dilemma, demonstrating a significant increase in the one-point static touch cutaneous pressure threshold between controls and patients, when the index finger (upper trunk) and little finger (lower trunk) were tested with the hands at rest and after provoking the plexus by elevating the hands above the head. In the present study, this approach has been extended to include two-point static touch thresholds with the PSSD, and pinch and grip strength (Digit-Grip). Sixteen controls (mean: 34.2, range: 11 to 48 years) were tested and the 99 percent upper confidence limit calculated for percent change after elevation of the hands for 3 min. Forty-one patients symptomatic for brachial plexus compression (mean: 41.0, range: 21 to 62 years) were tested. The clinical severity of the plexus compression was dichotomized as either "severe" or "not severe" judged by the Roos and Tinel sign. Results demonstrated that when five or more of the eight possible neurosensory and motor test results were > 99 percent normal confidence limit for change, this testing has a sensitivity of 82 percent, a specificity of 100 percent, and a positive predictive value of 100 percent for the diagnosis of clinically severe brachial plexus compression. Seventeen patients who were in the "severe" category prior to surgery, were tested before and after plexus neurolysis and anterior scalenectomy. All 17 patients were clinically improved and in 16 of these patients, postoperative neurosensory and motor testing returned to a normal pattern (no significant increase in thresholds with hand elevation). It is concluded that neurosensory (PSSD) and motor testing (Digit-Grip) can help in the diagnosis and documentation of brachial plexus compression.

Adolescent↗