Background: Video laryngoscopy is beneficial in difficult airway intubation; however, various factors complicate the process. These devices come in different designs, and their usefulness may vary by type. In this study, we compared the effectiveness of several video laryngoscopic .instruments across three simulated difficult intubation scenarios using manikin models. Methods: Training simulators for tracheal intubation were set to four conditions: (i) Normal (mouth opening:50 mm, normal neck); (ii) Head tilt disorder (mouth opening: 50 mm, rigid neck); (iii) Trismus (mouth opening:20 mm, normal neck); and (iv) Head tilt disorder + trismus (mouth opening: 20 mm, rigid neck). Seventeen dental anesthesiologists attempted oral tracheal intubation using the following video laryngoscopes: Airway Scope;McGRATH (Normal blade [size 3]); McGRATH (X-blade); and i-view. Evaluated parameters included total intubation time, glottic visualization time, tube induction time, success rate, and difficulty grading of tracheal intubation (Cormack-Lehane classification and the Numerical Rating Scale [NRS]). Statistical analysis was conducted using mixed models, incorporating two-way ANOVA, Tukey’s test, two-way ANOVA without repeated measures, and Kruskal-Wallis test, with P < 0.05 deemed statistically significant. Results: Intubation time using i-view was significantly longer for head tilt disorder and trismus compared to other video laryngoscopes (head tilt disorder: P < 0.001 for all, trismus: P = 0.021 vs. Airway Scope, P = 0.028 vs. X-blade). The Cormack-Lehane grade was notably high (P = 0.001) for tracheal intubation with i-view in the head tilt disorder scenario, with intubation failing in three cases. In the combined situation of head tilt disorder and trismus, intubation time with Airway Scope was shorter (P < 0.001 vs. X-blade), achieving a success rate of 100%. However, all attempts with i-view were unsuccessful. The NRS score was significantly higher for i-view compared to the other video laryngoscopes (P < 0.001). Conclusion Video laryngoscopy effectiveness varies by type in difficult tracheal intubation cases. The Airway Scope or McGRATH instrument appears more suitable for such cases, as indicated by the metrics of intubation time, success rate, and difficulty level.

Background: Video laryngoscopy is beneficial in difficult airway intubation; however, various factors complicate the process. These devices come in different designs, and their usefulness may vary by type. In this study, we compared the effectiveness of several video laryngoscopic .instruments across three simulated difficult intubation scenarios using manikin models. Methods: Training simulators for tracheal intubation were set to four conditions: (i) Normal (mouth opening:50 mm, normal neck); (ii) Head tilt disorder (mouth opening: 50 mm, rigid neck); (iii) Trismus (mouth opening:20 mm, normal neck); and (iv) Head tilt disorder + trismus (mouth opening: 20 mm, rigid neck). Seventeen dental anesthesiologists attempted oral tracheal intubation using the following video laryngoscopes: Airway Scope;McGRATH (Normal blade [size 3]); McGRATH (X-blade); and i-view. Evaluated parameters included total intubation time, glottic visualization time, tube induction time, success rate, and difficulty grading of tracheal intubation (Cormack-Lehane classification and the Numerical Rating Scale [NRS]). Statistical analysis was conducted using mixed models, incorporating two-way ANOVA, Tukey’s test, two-way ANOVA without repeated measures, and Kruskal-Wallis test, with P < 0.05 deemed statistically significant. Results: Intubation time using i-view was significantly longer for head tilt disorder and trismus compared to other video laryngoscopes (head tilt disorder: P < 0.001 for all, trismus: P = 0.021 vs. Airway Scope, P = 0.028 vs. X-blade). The Cormack-Lehane grade was notably high (P = 0.001) for tracheal intubation with i-view in the head tilt disorder scenario, with intubation failing in three cases. In the combined situation of head tilt disorder and trismus, intubation time with Airway Scope was shorter (P < 0.001 vs. X-blade), achieving a success rate of 100%. However, all attempts with i-view were unsuccessful. The NRS score was significantly higher for i-view compared to the other video laryngoscopes (P < 0.001). Conclusion Video laryngoscopy effectiveness varies by type in difficult tracheal intubation cases. The Airway Scope or McGRATH instrument appears more suitable for such cases, as indicated by the metrics of intubation time, success rate, and difficulty level.

Background: Video laryngoscopy is beneficial in difficult airway intubation; however, various factors complicate the process. These devices come in different designs, and their usefulness may vary by type. In this study, we compared the effectiveness of several video laryngoscopic .instruments across three simulated difficult intubation scenarios using manikin models. Methods: Training simulators for tracheal intubation were set to four conditions: (i) Normal (mouth opening:50 mm, normal neck); (ii) Head tilt disorder (mouth opening: 50 mm, rigid neck); (iii) Trismus (mouth opening:20 mm, normal neck); and (iv) Head tilt disorder + trismus (mouth opening: 20 mm, rigid neck). Seventeen dental anesthesiologists attempted oral tracheal intubation using the following video laryngoscopes: Airway Scope;McGRATH (Normal blade [size 3]); McGRATH (X-blade); and i-view. Evaluated parameters included total intubation time, glottic visualization time, tube induction time, success rate, and difficulty grading of tracheal intubation (Cormack-Lehane classification and the Numerical Rating Scale [NRS]). Statistical analysis was conducted using mixed models, incorporating two-way ANOVA, Tukey’s test, two-way ANOVA without repeated measures, and Kruskal-Wallis test, with P < 0.05 deemed statistically significant. Results: Intubation time using i-view was significantly longer for head tilt disorder and trismus compared to other video laryngoscopes (head tilt disorder: P < 0.001 for all, trismus: P = 0.021 vs. Airway Scope, P = 0.028 vs. X-blade). The Cormack-Lehane grade was notably high (P = 0.001) for tracheal intubation with i-view in the head tilt disorder scenario, with intubation failing in three cases. In the combined situation of head tilt disorder and trismus, intubation time with Airway Scope was shorter (P < 0.001 vs. X-blade), achieving a success rate of 100%. However, all attempts with i-view were unsuccessful. The NRS score was significantly higher for i-view compared to the other video laryngoscopes (P < 0.001). Conclusion Video laryngoscopy effectiveness varies by type in difficult tracheal intubation cases. The Airway Scope or McGRATH instrument appears more suitable for such cases, as indicated by the metrics of intubation time, success rate, and difficulty level.

Well water could be a stable source of drinking water. Recently, the use of well water as drinking water has been encouraged in developing countries. However, many kinds of disorders caused by toxic elements in well drinking water have been reported. It is our urgent task to resolve the global issue of element-originating diseases. In this review article, our multidisciplinary approaches focusing on oncogenic toxicities and disturbances of sensory organs (skin and ear) induced by arsenic and barium are introduced. First, our environmental monitoring in developing countries in Asia showed elevated concentrations of arsenic and barium in well drinking water. Then our experimental studies in mice and our epidemiological studies in humans showed arsenic-mediated increased risks of hyperpigmented skin and hearing loss with partial elucidation of their mechanisms. Our experimental studies using cultured cells with focus on the expression and activity levels of intracellular signal transduction molecules such as c-SRC, c-RET, and oncogenic RET showed risks for malignant transformation and/or progression arose from arsenic and barium. Finally, our original hydrotalcite-like compound was proposed as a novel remediation system to effectively remove arsenic and barium from well drinking water. Hopefully, comprehensive studies consisting of (1) environmental monitoring, (2) health risk assessments, and (3) remediation will be expanded in the field of environmental health to prevent various disorders caused by environmental factors including toxic elements in drinking water.
Animals ; Arsenic ; toxicity ; Barium ; toxicity ; Drinking Water ; analysis ; Environmental Exposure ; Environmental Health ; Environmental Monitoring ; Humans ; Mice ; Water Pollutants, Chemical ; toxicity ; Water Wells