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The Bangladesh ultrasound initiative: Creating impact with education in a resource-limited setting [Meeting Abstract]
Ahmed, N; Mukherjee, V; Rahman, F; Hossain, T; Hanif, A; Nolan, A
PURPOSE: Our overall goal is to create a sustainable ultrasound(US) intervention in resource-limited settings in Dhaka, Bangladesh. Our baseline needs-assessment of the intensive care unit (ICU) of Dhaka Medical College Hospital (DMCH) found that reliable imaging is not available, including ultrasound. The lack of adequate imaging was found to be a deterrent to the proper care of patients. The growing use of point-of-care ultrasound in the ICU as a tool for rapid diagnosis and management led to the creation of the Bangladesh Ultrasound Initiative. This project is designed to bring a successful point-of-care ultrasound training program to physicians in the ICU and emergency room of DMCH. METHODS: Participants were recruited via posters and emails. Training workshops spanned the course of two days. All sessions included individuals that represented all levels of physician training. The following topics were covered: technical aspects, basic echocardiography, pleural ultrasound, DVT and IVC assessment, US-guided CVL placement, US-guided thoracentesis and FAST exam. Training sessions were divided into three parts: lecture-based learning (2 hours), image interpretation with normal and pathological images shown to participants(1.5 hours), and hands-on practical use with the aid of volunteers(2.5 hours). A pre-test and post-test with the same questions was distributed before and after each workshop respectively. Statistical analysis was completed with the use of a chi-square test and paired t-test. RESULTS: Fifty individuals were included in the final analysis. The pre-test/post-test had a total of 37 questions, 25 of which were knowledge-based. Knowledge-based questions were grouped into the topics covered as listed in the methods section. There was a statistically significant (p<0.05) difference between pre- and post-test scores; the mean pre-test score was 3 (SD=3) and the mean post-test score was 12 (SD=3). A 5-point Likert scale was used to ask questions regarding level of confidence. The mean confidence level on the pre-test was 1 (very unconfident) in every category to 5 (very confident) in the post-test(p<0.05). A subgroup analysis showed no difference in mean pre-test and post-test scores of participants who had attended an ultrasound course at any point prior to our intervention compared to those who had never attended a previous ultrasound course. CONCLUSIONS: The results of this study show that a simple workshop in point-of-care ultrasound, using lectures and hands-on practice, can improve knowledge and confidence with statistical significance. This study also shows that the pre- and post-test scores are similar despite some participants having had training in ultrasound prior to the current intervention
EMBASE:619296574
ISSN: 1931-3543
CID: 2860172
Fluid resuscitation-associated increased mortality and inflammatory cytokine expression in murine polymicrobial sepsis
Lee, Young Im; Smith, Robert L; Caraher, Erin J; Crowley, George; Haider, Syed Hissam; Kwon, Sophia; Nolan, Anna
PMCID:5890308
PMID: 29657863
ISSN: 2059-8661
CID: 3039122
Post-9/11/2001 lung function trajectories by sex and race in World Trade Center-exposed New York City emergency medical service workers
Vossbrinck, Madeline; Zeig-Owens, Rachel; Hall, Charles B; Schwartz, Theresa; Moir, William; Webber, Mayris P; Cohen, Hillel W; Nolan, Anna; Weiden, Michael D; Christodoulou, Vasilios; Kelly, Kerry J; Aldrich, Thomas K; Prezant, David J
OBJECTIVE: To determine whether lung function trajectories after 9/11/2001 (9/11) differed by sex or race/ethnicity in World Trade Center-exposed Fire Department of the City of New York emergency medical service (EMS) workers. METHOD: Serial cross-sectional study of pulmonary function tests (PFTs) taken between 9/11 and 9/10/2015. We used data from routine PFTs (forced expiratory volume in 1 s (FEV1) and FEV1% predicted), conducted at 12-18 month intervals. FEV1 and FEV1% predicted were assessed over time, stratified by sex, and race/ethnicity. We also assessed FEV1 and FEV1% predicted in current, former and never-smokers. RESULTS: Among 1817 EMS workers, 334 (18.4%) were women, 979 (53.9%) self-identified as white and 939 (51.6%) were never-smokers. The median follow-up was 13.1 years (IQR 10.5-13.6), and the median number of PFTs per person was 11 (IQR 7-13). After large declines associated with 9/11, there was no discernible recovery in lung function. In analyses limited to never-smokers, the trajectory of decline in adjusted FEV1 and FEV1% predicted was relatively parallel for men and women in the 3 racial/ethnic groups. Similarly, small differences in FEV1 annual decline between groups were not clinically meaningful. Analyses including ever-smokers were essentially the same. CONCLUSIONS: 14 years after 9/11, most EMS workers continued to demonstrate a lack of lung function recovery. The trajectories of lung function decline, however, were parallel by sex and by race/ethnicity. These findings support the use of routine, serial measures of lung function over time in first responders and demonstrate no sex or racial sensitivity to exposure-related lung function decline.
PMCID:5573813
PMID: 27810938
ISSN: 1470-7926
CID: 2297432
Predictors Of Accelerated Fev1 Decline In World Trade Center-Exposed Firefighters: a 15-Year Longitudinal Study [Meeting Abstract]
Weiden, MD; Zeig-Owens, R; Hall, CB; Singh, A; Aldrich, TK; Schwartz, T; Webber, MP; Cohen, HW; Kelly, KJ; Nolan, A; Prezant, DJ
ISI:000400372504289
ISSN: 1535-4970
CID: 2591132
Weight Loss As A Modifiable Risk: Body Mass Index And Loss Of Lung Function In World Trade Center Particulate Exposure [Meeting Abstract]
Kwon, S; Crowley, G; Haider, S; Lam, R; Zhang, L; Zeig-Owens, R; Schwartz, T; Prezant, D; Nolan, A; Nolan Lab
ISI:000400372504287
ISSN: 1535-4970
CID: 2591122
Persistence Of World Trade Center Particulate Induced Hyperresponsiveness And The Role Of Rage [Meeting Abstract]
Haider, S; Zhang, L; Crowley, G; Caraher, EJ; Lam, R; Kwon, S; Schmidt, A; Chen, L-C; Prezant, DJ; Nolan, A
ISI:000400372504286
ISSN: 1535-4970
CID: 2591112
Metabolomics Of World Trade Center Lung Injury: A Pilot Study [Meeting Abstract]
Crowley, G; Kwon, S; Haider, S; Zhang, L; Lam, R; Zeig-Owens, R; Webber, MP; Schwartz, T; Prezant, D; Liu, M; Nolan, A; Nolan Lab
ISI:000400372504284
ISSN: 1535-4970
CID: 2591092
Metabolic Fingerprints Of Protection From World Trade Center-Lung Injury: A Pilot Study [Meeting Abstract]
Crowley, G; Kwon, S; Haider, S; Zhang, L; Lam, R; Zeig-Owens, R; Webber, MP; Schwartz, T; Prezant, D; Liu, M; Nolan, A; Nolan Lab
ISI:000400372503395
ISSN: 1535-4970
CID: 2591032
World Trade Center Particulates And Lysophosphatdic Acid: Co-Exposure Induces Inflammatory Mediators [Meeting Abstract]
Zhang, L; Haider, S; Crowley, G; Lam, R; Kwon, S; Chen, L-C; Schmidt, A; Prezant, DJ; Nolan, A; Nolan Lab
ISI:000400372503402
ISSN: 1535-4970
CID: 2591052
Quantitative Lung Morphology: Semiautomated Method Of Mean Chord Length Measurements [Meeting Abstract]
Crowley, G; Kwon, S; Haider, S; Caraher, EJ; Nolan, A; Nolan Lab
ISI:000400372506469
ISSN: 1535-4970
CID: 2591292