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pneumothorax management

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https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#1
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28810113/an-unusual-presentation-of-an-unusual-disease-spontaneous-pneumomediastinum
#2
Kalyan Chakravarthy Potu, Maheedhar Gedela, Kashif Abbas Shaikh, Sujithasree Ketineni, Eric Larson
We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. A 30-year-old previously healthy man presented with complaints of neck swelling and hoarseness of voice beginning after an intense coughing spell. He had no other complaints. He denied any trauma to the chest, nausea, vomiting, recent air travel, scuba diving or recreational drug use...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28795034/chemical-pleurodesis-using-doxycycline-and-viscum-album-extract
#3
Kyung Sub Song, DongYoon Keum, Jae Bum Kim
BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28761804/partial-ambulatory-management-of-severe-secondary-spontaneous-pneumothorax
#4
Izhaq Masih, Yusuf Vali, Muhammed Naeem, R V Reddy
Secondary spontaneous pneumothorax can be difficult to manage especially in patients with advanced lung disease and respiratory failure. Such patients are unfit for surgery and may endure prolonged hospital stays with chest drains in situ. We describe two such cases where the air leak was persistent despite conventional management. Ambulatory devices which we ordinarily use to manage pneumothoraces in patients with a good lung reserve, were employed as a palliative measure. The strategy not only allowed the patients to return home, but also resulted in healing of the air leak which had persisted with conventional management...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#5
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
July 27, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#6
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28741012/management-of-computed-tomography-detected-pneumothorax-in-patients-with-blunt-trauma-experience-from-a-community-based-hospital
#7
Ashraf F Hefny, Fathima T Kunhivalappil, Nikolay Matev, Norman A Avila, Masoud O Bashir, Fikri M Abu-Zidan
INTRODUCTION: With near-routine use of computed tomography (CT) for imaging trauma patients, the diagnosis of pneumothorax, especially occult pneumothorax, has increased. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. METHODS: Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, from October 2010 to October 2014 were retrospectively studied...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28735736/postoperative-pulmonary-complications-following-laparoscopy
#8
REVIEW
P G Paul, Thampi Mathew, Hemant Shintre, Saumya Bulusu, George Paul, Sumina Mannur
Postoperative pulmonary complications unrelated to anesthesia, especially hydropneumothorax, after gynecological laparoscopy is rare. Hydropneumothorax can cause respiratory failure and be life-threatening. Awareness, prompt diagnosis, and timely intervention are important for clinical management. We review the literature for postoperative pulmonary complications including pneumothorax, hydrothorax, hydropneumothorax, and pleural effusion following laparoscopy along with a recent case of hydropneumothorax at our institution...
July 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28728546/successful-rescue-combination-of-extracorporeal-membrane-oxygenation-high-frequency-oscillatory-ventilation-and-prone-positioning-for-the-management-of-severe-methicillin-resistant-staphylococcus-aureus-pneumonia-complicated-by-pneumothorax-a-case-report-and
#9
Hangyong He, Hao Wang, Xuyan Li, Xiao Tang, Rui Wang, Bing Sun, Zhaohui Tong
BACKGROUND: To describe the experience of combination therapy with extracorporeal membrane oxygenation(ECMO), high-frequency oscillatory ventilation(HFOV) and prone positioning in treating severe respiratory failure caused by community acquired methicillin resistant Staphylococcus aureus(CA-MRSA). CASE PRESENTATION: A 30-year-old female presented with fever and dyspnea for 3 days. She was diagnosed CA-MRSA pneumonia complicated by severe respiratory failure, pneumothorax and neutropenia...
July 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28724308/eus-guided-recanalization-of-complete-gastrointestinal-strictures
#10
Miguel Martínez-Guillén, Joan B Gornals, Claudia F Consiglieri, Josep M Castellvi, Carme Loras
BACKGROUND AND AIM: Complete gastrointestinal strictures are a technically demanding problem. In this setting, an anterograde technique is associated with a high risk of complications and a combined anterograde-retrograde technique requires a prior ostomy. Our aim was to assess the outcome of a first case series for the management of complete gastrointestinal strictures using endoscopic ultrasound (EUS)-guided puncture as a novel endoscopic approach. PATIENTS AND METHODS: This retrospective case-series describes four cases that were referred for treatment of complete benign gastrointestinal strictures, three upper and one lower...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28718239/permanent-pace-maker-implantation-through-axillary-vein-approach
#11
Bakhtawar Shah, Cheragh Hussain, Zahid Aslam Awan
BACKGROUND: Device implantation is an integral part of interventional cardiology particularly electrophysiology. In this study, we are going to shear our experience of device implantation technique at electrophysiology department Hayatabad Medical Complex, Peshawar. METHODS: The study was conducted from June 2011 to December 2015. Axillary vein was used to implant the devices but in some cases when this rout was not convenient due to any reason then subclavian vein was entered through the Seldinger technique...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712199/multimodality-imaging-approach-for-the-early-diagnosis-boerhaave-syndrome
#12
Javed Anwar, Rasikh Maqsood, Sanaullah Soomro
Boerhaave's syndrome is a spontaneous transmural rupture or perforation of the oesophagus or post-emesis oesophageal rupture. Boerhaave's syndrome has a high risk of morbidity and mortality, and early, definitive diagnosis leading to prompt management improves outcomes. Definitive diagnosis of this syndrome is made with imaging, including x-ray, USG and computed tomography Scan. This is a case of a 50-year male with history of sudden onset of epigastric pain after an episode of forceful emesis was referred for Ultrasound (USG) abdomen...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#13
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28678570/head-and-neck-subcutaneous-emphysema-a-rare-complication-of-iatrogenic-perforation-during-colonoscopy-management-review-of-reported-cases-from-2000-2016
#14
Mathew John Lee, Tara M Connelly
INTRODUCTION: Subcutaneous face and neck emphysema secondary to colonic perforation is a rare complication of colonoscopy. Presentation may be complicated by pneumothorax and/or respiratory distress. Evidence limited to case studies. Therefore, no management consensus of these rarely reported cases exists. METHODS: All cases published on PubMed between 1 January 2000-1 November 2016 reporting subcutaneous face and/or neck emphysema after colonoscopy are included...
July 19, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28675094/effect-of-increased-body-mass-index-on-complication-rates-during-laryngotracheal-surgery-utilizing-jet-ventilation
#15
Rachel A Barry, Daniel S Fink, Dusty Cole Pourciau, Kasey Hayley, Rachael Lanius, Schuylor Hayley, Eddy Sims, Andrew J McWhorter
Objective Jet ventilation has been used for >30 years as an anesthetic modality for laryngotracheal surgery. Concerns exist over increased risk with elevated body mass index (BMI). We reviewed our experience using jet ventilation for laryngotracheal stenosis to assess for complication rates with substratification by BMI. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods A total of 126 procedures with jet ventilation were identified from October 2006 to December 2014...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28674772/detection-of-unexpected-emergency-diseases-using-fdg-pet-ct-in-oncology-patients
#16
Akira Toriihara, Emi Yamaga, Masashi Nakadate, Jun Oyama, Ukihide Tateishi
PURPOSE: To evaluate the frequency of emergency diseases that were detected unexpectedly using FDG-PET/CT. MATERIALS AND METHODS: Interpretation reports for 11,663 FDG-PET/CT studies in our hospital were retrospectively reviewed. Patients with major emergency diseases were extracted according to the following exclusion criteria: (1) relevant findings had been recognized prior to the PET/CT; (2) an intervention or operation that may have been relevant to the present findings was performed within 1 month prior to the PET/CT; and (3) the clinical course could not be investigated sufficiently (e...
July 3, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28673640/small-tube-thoracostomy-20-22-fr-in-emergent-management-of-chest-trauma
#17
Shinsuke Tanizaki, Shigenobu Maeda, Makoto Sera, Hideya Nagai, Minoru Hayashi, Hiroyuki Azuma, Ken-Ichi Kano, Hiroki Watanabe, Hiroshi Ishida
BACKGROUND: The optimal tube size for an emergent thoracostomy for traumatic pneumothorax or hemothorax is unknown. Both small catheter tube thoracostomy and large-bore chest tube thoracostomy have been shown to work for the nonemergent management of patients with traumatic pneumothorax or hemothorax. This study was conducted to compare the efficacy of a small chest tube with that of a large tube in emergent thoracostomy due to chest trauma. Our hypothesis was that there would be no difference in clinical outcomes including tube-related complications, the need for additional tube placement, and thoracotomy, with the replacement of large tubes with small tubes...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28671165/diagnostic-evaluation-of-mediastinal-lesions-analysis-of-144-cases
#18
Ramakant Dixit, Narender Singh Shah, Mukesh Goyal, Chetan B Patil, Mukesh Panjabi, Rakesh C Gupta, Neeraj Gupta, Sabarigiri Vasan Harish
BACKGROUND: Mediastinum is a "Pandora's box" with many neoplastic and nonneoplastic lesions. The purpose of this study was to analyze our institutional experience of mediastinal lesions on fine-needle aspiration cytology (FNAC) and/or biopsy. MATERIALS AND METHODS: This study was an analysis of 144 patients who had undergone ultrasound-guided FNAC and/or core biopsy for mediastinal lesions. RESULTS: A total of 144 cases of suspected mediastinal masses were seen, and in 139 cases, tissue diagnosis was attempted...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28660205/pneumothoraces-in-collagen-vi-related-dystrophy-a-case-series-and-recommendations-for-management
#19
Kristin L Fraser, Scott Wong, A Reghan Foley, Sameer Chhibber, Carsten G Bönnemann, Daniel J Lesser, Carla Grosmann, Anne Rutkowski
Collagen VI-related dystrophy (collagen VI-RD) is a rare neuromuscular condition caused by mutations in the COL6A1, COL6A2 or COL6A3 genes. The phenotypic spectrum includes early-onset Ullrich congenital muscular dystrophy, adult-onset Bethlem myopathy and an intermediate phenotype. The disorder is characterised by distal hyperlaxity and progressive muscle weakness, joint contractures and respiratory insufficiency. Respiratory insufficiency is attributed to chest wall contractures, scoliosis, impaired diaphragmatic function and intercostal muscle weakness...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28640890/systematic-review-and-meta-analysis-of-initial-management-of-pneumothorax-in-adults-intercostal-tube-drainage-versus-other-invasive-methods
#20
Min Joung Kim, Incheol Park, Joon Min Park, Kyung Hwan Kim, Junseok Park, Dong Wun Shin
OBJECTIVES: The ideal invasive management as initial approach for pneumothorax (PTX) is still under debate. The purpose of this systematic review and meta-analysis was to examine the evidence for the effectiveness of intercostal tube drainage and other various invasive methods as the initial approach to all subtypes of PTX in adults. METHODS: Three databases were searched from inception to May 29, 2016: MEDLINE, EMBASE, and the Cochrane CENTRAL. Randomised controlled trials that evaluated intercostal tube drainage as the control and various invasive methods as the intervention for the initial approach to PTX in adults were included...
2017: PloS One
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