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https://www.readbyqxmd.com/read/29915974/managing-a-positive-air-leak-test-during-a-gastrojejunostomy-revision
#1
Dvir Froylich, Matthew Davis, Gautam Sharma, Tammy Fouse, Philip Schauer, Stacy Brethauer
BACKGROUND: Gastrojejunostomy revision after gastric bypass surgery is a challenging procedure that requires advanced skills. The air-leak test was performed to identify gastrojejunostomy leaks. Omental patch seal technique is a well-known treatment of perforated gastrojejunostomy ulcers (Surg Obes Relat Dis 4:423-8, 2012; Surg Endosc 2:384-9, 2013; Surg Endosc 11:2110, 2007). METHODS: We present a case of a 40-year-old female, who underwent laparoscopic gastric bypass 6 years prior and subsequently developed marginal ulcer, resulting in chronic gastrojejunostomy stricture...
June 18, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29910548/clinicoetiological-pattern-and-outcome-of-neonates-requiring-mechanical-ventilation-study-in-a-tertiary-care-centre
#2
Mohini Yadav, Gauri Chauhan, A K Bhardwaj, P D Sharma
The clinical and etiological pattern of ventilated newborns, their outcome in relation to morbidity and mortality was studied with 50 ventilated newborns, including outborns. M:f ratio was 2.1:1. The most common gestational age 28-36 weeks (60%) and mostly were appropriate for gestational age (66%). Survival rate 40% (20/50) being directly proportional to the gestational age and intrauterine growth pattern ( P < 0.01). Babies by LSCS Lower Segment Cessarian Section survived more than born by normal vaginal delivery (46...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29908195/safety-of-next-day-discharge-following-lobectomy-have-we-broken-the-speed-limit
#3
Stephen Greer, Ashley D Miller, Jeremiah S Smith, Jenny M Holcombe, James R Headrick
BACKGROUND: Utilizing our standardized approach to air leak reduction (STAR) protocol has led to a continual decrease in the need for inpatient recovery following lobectomy. Although next day discharges do occur, the current literature hasn't addressed their safety. We analyzed our STAR dataset to study this group and their outcomes. METHODS: A retrospective review of prospectively collected data from the STAR dataset was performed. Characteristics were compared between patients discharged on postoperative day (POD) 1 and those with longer admissions...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29903606/ok-432-pleurodesis-for-the-treatment-of-pneumothorax-in-patients-with-interstitial-pneumonia
#4
Kazumasa Ogawa, Yui Takahashi, Kyoko Murase, Shigeo Hanada, Hironori Uruga, Hisashi Takaya, Atsushi Miyamoto, Nasa Morokawa, Atsuko Kurosaki, Kazuma Kishi
BACKGROUND: Pneumothorax occasionally develops in patients with interstitial pneumonia (IP) and is often intractable. As there exists no well-established treatment for pneumothorax with IP, we evaluated the efficacy and safety of pleurodesis with OK-432, a lyophilized preparation of Streptococcus pyogenes Su strain that has been inactivated by benzylpenicillin. METHODS: We retrospectively evaluated the efficacy and safety of pleurodesis using OK-432 in 39 patients treated for IP-related pneumothorax between January 2006 and May 2017...
June 11, 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29898763/non-invasive-high-frequency-oscillatory-ventilation-versus-nasal-continuous-positive-airway-pressure-in-preterm-infants-with-respiratory-distress-syndrome-study-protocol-for-a-multi-center-prospective-randomized-controlled-trial
#5
Xing-Wang Zhu, Yuan Shi, Li-Ping Shi, Ling Liu, Jiang Xue, Rangasamy Ramanathan
BACKGROUND: Invasive mechanical ventilation (IMV) is associated with the development of adverse pulmonary and non-pulmonary outcomes in very premature infants. Various modes of non-invasive respiratory support are increasingly being used to decrease the incidence of bronchopulmonary dysplasia. The aim of this trial is to compare the effect of non-invasive high-frequency oscillatory ventilation (NHFOV) and nasal continuous positive airway pressure (NCPAP) in preterm infants with respiratory distress syndrome (RDS) as a primary non-invasive ventilation support mode...
June 14, 2018: Trials
https://www.readbyqxmd.com/read/29884273/air-in-the-pleural-cavity-enhances-detection-of-pleural-abnormalities-by-ct-scan
#6
Edward T H Fysh, Rajesh Thomas, Claire Tobin, Yi Jin Kuok, Y C Gary Lee
Detection of pleural abnormalities on CT scan is critical in diagnosis of pleural disease. CT scan detects minute parenchymal lung nodules, but often fails to detect similar-sized pleural nodularity. This is likely because the density of the visceral/parietal pleura and pleural fluid is similar. We hypothesize that an air-pleural interface enhances detection of pleural abnormalities. We describe six patients with pleural abnormalities that were not (or barely) detected on initial CT scan. However, pneumothorax (either ex vacuo or from a genuine air leak) after pleural fluid drainage permitted the visualization of small pleural abnormalities on CT scan, which would be amenable to imaging-guided biopsies...
June 2018: Chest
https://www.readbyqxmd.com/read/29871643/robotic-lobectomy-has-the-greatest-benefit-in-patients-with-marginal-pulmonary-function
#7
Peter J Kneuertz, Desmond M D'Souza, Susan D Moffatt-Bruce, Robert E Merritt
BACKGROUND: Patients with limited pulmonary function have a high risk for pulmonary complications following lobectomy. Robotic approach is currently the least invasive approach. We hypothesized that robotic lobectomy may be of particular benefit in high-risk patients. METHODS: We reviewed our institutional Society of Thoracic Surgeons (STS) data on lobectomy patients from 2012 to 2017. Postoperative outcomes were compared between robotic and open lobectomy groups...
June 5, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29850993/high-resolution-fluorespirometry-and-oxphos-protocols-for-human-cells-permeabilized-fibers-from-small-biopsies-of-muscle-and-isolated-mitochondria
#8
Carolina Doerrier, Luiz F Garcia-Souza, Gerhard Krumschnabel, Yvonne Wohlfarter, András T Mészáros, Erich Gnaiger
Protocols for High-Resolution FluoRespirometry of intact cells, permeabilized cells, permeabilized muscle fibers, isolated mitochondria, and tissue homogenates offer sensitive diagnostic tests of integrated mitochondrial function using standard cell culture techniques, small needle biopsies of muscle, and mitochondrial preparation methods. Multiple substrate-uncoupler-inhibitor titration (SUIT) protocols for analysis of oxidative phosphorylation (OXPHOS) improve our understanding of mitochondrial respiratory control and the pathophysiology of mitochondrial diseases...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29850169/a-case-of-malignant-mesothelioma-detected-hydropneumothorax
#9
Toshinari Ema, Kazuhito Funai, Akikazu Kawase, Hiroaki Oiwa, Shuhei Iizuka, Norihiko Shiiya
A 61-year-old man was admitted to the emergency room because of sudden right chest pain and dyspnea. A chest X-ray and chest computed tomography (CT) revealed severe right pneumothorax with massive pleural effusion. Chest drainage was performed and approximately 1.2 L of pleural fluid was removed. Hemothorax was suspected based on the imaging findings, but the pleural effusion was serous. Active air leakage continued for 4 days after chest drainage, thus we decided to surgically control the air leakage and performed video-assisted surgery...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29845759/pressure-decay-testing-of-pleural-air-leaks-in-intact-murine-lungs-evidence-for-peripheral-airway-regulation
#10
Andrew B Servais, Cristian D Valenzuela, Alexandra B Ysasi, Willi L Wagner, Arne Kienzle, Stephen H Loring, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
The critical care management of pleural air leaks can be challenging in all patients, but particularly in patients on mechanical ventilation. To investigate the effect of central airway pressure and pleural pressure on pulmonary air leaks, we studied orotracheally intubated mice with pleural injuries. We used clinically relevant variables - namely, airway pressure and pleural pressure - to investigate flow through peripheral air leaks. The model studied the pleural injuries using a pressure-decay maneuver. The pressure-decay maneuver involved a 3 sec ramp to 30 cmH2 0 followed by a 3 sec breath hold...
May 2018: Physiological Reports
https://www.readbyqxmd.com/read/29791936/is-right-sleeve-lower-lobectomy-necessary-is-it-safe
#11
Celalettin Ibrahim Kocaturk, Ozkan Saydam, Celal Bugra Sezen, Cem Emrah Kalafat, Levent Cansever, Ali Cevat Kutluk, Hasan Akin, Muzaffer Metin
OBJECTIVES:  The right sleeve lower lobectomy is the least used of the bronchial sleeve operations. There are only case-based studies in the literature. In this study, we compared this technique to those used in patients who underwent a right lower bilobectomy. METHODS:  We retrospectively reviewed the data of patients who had been operated on due to non-small cell lung cancer (NSCLC) from January 2005 to December 2015 from a dataset that was formed prospectively...
May 23, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29784426/financial-validation-of-the-european-society-of-thoracic-surgeons-risk-score-predicting-prolonged-air-leak-after-video-assisted-thoracic-surgery-lobectomy
#12
Alessandro Brunelli, Cecilia Pompili, Padma Dinesh, Vinod Bassi, Andrea Imperatori
OBJECTIVES: The objective of this study was to verify whether the European Society of Thoracic Surgeons prolonged air leak risk score for video-assisted thoracoscopic lobectomy was associated with incremental postoperative costs. METHODS: We retrospectively analyzed 353 patients subjected to video-assisted thoracoscopic lobectomy or segmentectomy (April 2014 to March 2016). Postoperative costs were obtained from the hospital Finance Department. Patients were grouped in different classes of risk according to their prolonged air leak risk score...
April 27, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29783709/sensitivity-analysis-of-weather-variables-on-offsite-consequence-analysis-tools-in-south-korea-and-the-united-states
#13
Min-Uk Kim, Kyong Whan Moon, Jong-Ryeul Sohn, Sang-Hoon Byeon
We studied sensitive weather variables for consequence analysis, in the case of chemical leaks on the user side of offsite consequence analysis (OCA) tools. We used OCA tools Korea Offsite Risk Assessment (KORA) and Areal Location of Hazardous Atmospheres (ALOHA) in South Korea and the United States, respectively. The chemicals used for this analysis were 28% ammonia (NH₃), 35% hydrogen chloride (HCl), 50% hydrofluoric acid (HF), and 69% nitric acid (HNO₃). The accident scenarios were based on leakage accidents in storage tanks...
May 18, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29779908/fixation-of-lung-apex-in-spontaneous-pneumothorax-is-safe-and-efficient-in-decrease-recurrences
#14
Wendy Yang, Pei-Yeh Chang, Ai-Hua Yeh, Yung-Ching Ming, Jeng Chang Chen, Jin-Yao Lai
BACKGROUND: Video-assisted thoracoscopic bullectomy with pleurodesis is widely used to treat spontaneous pneumothorax. However, 1%-3% of patients experience postoperative complications that may require reoperation, such as bleeding or prolonged air leaks, and 3%-7% of patients require a repeat thoracoscopic bullectomy due to recurrence. Therefore, a modified procedure with improved outcomes is required. METHODS: Between January 1, 2011 and December 31, 2015, 196 patients with spontaneous pneumothorax underwent thoracoscopic bullectomy and pleurodesis with or without fixation of the lung apex to the chest wall...
May 3, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29778333/radiotracer-localization-of-nonpalpable-pulmonary-nodules-a-single-center-experience
#15
Sandra L Starnes, Michael Wolujewicz, Julian Guitron, Valerie Williams, Jennifer Scheler, Ross Ristagno
OBJECTIVE: Multiple localization techniques to facilitate intraoperative identification of small or nonsolid pulmonary nodules have been developed. Radiotracer localization using technetium-labeled macroaggregated albumin has been our preferred localization method since 2009. We report our experience, including technical pitfalls and modifications, of our initial 77 patients who underwent this technique. METHODS: All patients undergoing preoperative radiotracer localization were identified from a prospective database...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29776705/-pneumothorax-in-young-cannabis-smokers-a-propos-of-three-cases
#16
M-L Chardon, J-C Dalphin, B Degano
INTRODUCTION: Cannabis consumption is common among adolescents and young adults in France. In addition to its neurological effect, cannabis smoking can induce severe pulmonary emphysema, even in young patients. When a spontaneous pneumothorax occurs in a cannabis smoker, the possibility of a secondary spontaneous pneumothorax should be considered. This may be of importance as management of secondary spontaneous pneumothorax may differ from the well-codified handling of primary spontaneous pneumothorax...
May 15, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29775604/the-use-of-stitching-and-bioabsorbable-mesh-and-glue-to-combat-prolonged-air-leaks
#17
Toshiki Tanaka, Kazuhiro Ueda, Junichi Murakami, Kimikazu Hamano
Prolonged postoperative air leaks are associated with extended periods of postoperative hospitalization, increased hospital costs, and an increased incidence of major cardiopulmonary complications. To prevent prolonged air leaks, we used small pieces of polyglycolic acid mesh as a pledget during the stitching of air leak sites. The stitched sites were then covered with mesh and fibrin glue. This novel technique showed the highest airway pressure tolerance in an ex vivo experimental study. There were no incidents of prolonged air leak among the five clinical cases in which this technique was initially applied...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29765003/passive-versus-active-circuit-during-invasive-mechanical-ventilation-in-subjects-with-amyotrophic-lateral-sclerosis
#18
Elisa De Mattia, Elisa Falcier, Andrea Lizio, Christian Lunetta, Valeria A Sansone, Nicola Barbarito, Barbara Garabelli, Marino Iatomasi, Elisabetta Roma, Fabrizio Rao, Annalisa Carlucci
BACKGROUND: Until recently, it has been considered essential to maintain the use of a double-limb circuit in patients with amyotrophic lateral sclerosis (ALS) to avoid rebreathing expired air during invasive mechanical ventilation. Currently, life-sustaining home ventilators can work with a single, lighter circuit that is easier to manage. Our aim was to evaluate the effectiveness and safety of a single-limb circuit with intentional leaks (passive circuit) in comparison with a circuit with an expiratory valve (active circuit), in subjects with ALS who use invasive home ventilation...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29764819/penetrating-trauma-causing-cerebrospinal-fluid-leak-without-nerve-root-damage
#19
Holly Carpenter, Katherine-Helen Hurndall, Ajay K Asokan, Roland Fernandes
A 19-year-old man with a stab injury to the lower back presented with no focal neurology or haemodynamic instability. He complained of a headache that was improved by lying flat and underwent imaging to look for damage to local structures. He was found to have air in his intraspinal space. Initially this case was managed conservatively; however, 2 weeks after discharge, he presented with cerebrospinal fluid leak from his wound. This was managed with neurosurgical intervention and watertight closure of fascia...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29756107/analysis-of-89-patients-who-underwent-tube-thoracostomy-performed-by-general-surgeons
#20
Cihad Tatar, Ahmet Kocakuşak, Bahri Özer, Mehmet Celal Kızılkaya, Tamer Karşıdağ, Aziz Arı, Kenan Büyükaşık
Objective: Death due to thoracic trauma accounts for 20% of all trauma deaths. The aim of this study was to discuss the approach applied by general surgeons to thoracic trauma in our center. Material and Methods: A total of 89 patients (82 male, 7 female; mean age: 26.8 years; range: 7 to 77 years) with thoracic trauma who were admitted to the emergency department and underwent thoracostomy performed by general surgeons between January 2008 and December 2013 were retrospectively analyzed...
2018: Turkish Journal of Surgery
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