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https://www.readbyqxmd.com/read/27914206/is-ultrasound-a-valid-and-reliable-imaging-modality-for-airway-evaluation-an-observational-computed-tomographic-validation-study-using-submandibular-scanning-of-the-mouth-and-oropharynx
#1
Faraj W Abdallah, Eugene Yu, Phantila Cholvisudhi, Ahtsham U Niazi, Ki J Chin, Sherif Abbas, Vincent W Chan
OBJECTIVES: Ultrasound (US) imaging of the airway may be useful in predicting difficulty of airway management (DAM); but its use is limited by lack of proof of its validity and reliability. We sought to validate US imaging of the airway by comparison to CT-scan, and to assess its inter- and intra-observer reliability. We used submandibular sonographic imaging of the mouth and oropharynx to examine how well the ratio of tongue thickness to oral cavity height correlates with the ratio of tongue volume to oral cavity volume, an established tomographic measure of DAM...
December 3, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#2
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27912898/a-clinical-prediction-model-for-prolonged-air-leak-after-pulmonary-resection
#3
Adam Attaar, Daniel G Winger, James D Luketich, Matthew J Schuchert, Inderpal S Sarkaria, Neil A Christie, Katie S Nason
OBJECTIVE: Prolonged air leak increases costs and worsens outcomes after pulmonary resection. We aimed to develop a clinical prediction tool for prolonged air leak using pretreatment and intraoperative variables. METHODS: Patients who underwent pulmonary resection for lung cancer/nodules (from January 2009 to June 2014) were stratified by prolonged parenchymal air leak (>5 days). Using backward stepwise logistic regression with bootstrap resampling for internal validation, candidate variables were identified and a nomogram risk calculator was developed...
October 14, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27911249/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-2-outcomes-after-stereotactic-radiosurgery
#4
Robert M Starke, Dale Ding, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Pediatric patients (age < 18 years) harboring brain arteriovenous malformations (AVMs) are burdened with a considerably higher cumulative lifetime risk of hemorrhage than adults. Additionally, the pediatric population was excluded from recent prospective comparisons of intervention versus conservative management for unruptured AVMs. The aims of this multicenter, retrospective cohort study are to analyze the outcomes after stereotactic radiosurgery for unruptured and ruptured pediatric AVMs. METHODS We analyzed and pooled AVM radiosurgery data from 7 participating in the International Gamma Knife Research Foundation...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27911248/international-multicenter-cohort-study-of-pediatric-brain-arteriovenous-malformations-part-1-predictors-of-hemorrhagic-presentation
#5
Dale Ding, Robert M Starke, Hideyuki Kano, David Mathieu, Paul P Huang, Caleb Feliciano, Rafael Rodriguez-Mercado, Luis Almodovar, Inga S Grills, Danilo Silva, Mahmoud Abbassy, Symeon Missios, Douglas Kondziolka, Gene H Barnett, L Dade Lunsford, Jason P Sheehan
OBJECTIVE Brain arteriovenous malformations (AVMs) are the most common cause of spontaneous intracranial hemorrhage in pediatric patients (age < 18 years). Since the cumulative lifetime risk of AVM hemorrhage is considerable in children, an improved understanding of the risk factors influencing hemorrhagic presentation may aid in the management of pediatric AVMs. The aims of this first of a 2-part multicenter, retrospective cohort study are to evaluate the incidence and determine the predictors of hemorrhagic presentation in pediatric AVM patients...
December 2, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27910253/a-computed-tomography-guided-demonstration-of-the-unilateral-distribution-of-low-volume-epidural-injectate
#6
Semih Gungor, Rohit Aiyer
The epidural space is frequently used for placement of the epidural needle, catheter, and various pharmacological agents. The presence of structures in the epidural space such as epidural fat, venous plexus, or ligaments that may lead to uneven distribution of agents within the epidural space have been described.(1-3) Whether these structures are anatomical (such as connective tissue) or functional (due to distortions of actual anatomy secondary to injection of agents epidurally) has been disputed.(2-5) We describe our management of a patient who presented with bilateral radicular symptoms and severe low back pain...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27909957/adaptive-radiation-therapy-in-head-and-neck-cancer-for-clinical-practice-state-of-the-art-and-practical-challenges
#7
REVIEW
Ovidiu Veresezan, Idriss Troussier, Alexis Lacout, Sarah Kreps, Sophie Maillard, Aude Toulemonde, Pierre-Yves Marcy, Florence Huguet, Juliette Thariat
Modern radiation therapy techniques are characterized by high conformality to tumor volumes and steep dose gradients to spare normal organs. These techniques require accurate clinical target volume definitions and rigorous assessment of set up uncertainties using image guidance, a concept called image-guided radiation therapy. Due to alteration of patient anatomy, changes in tissue density/volumes and tumor shrinkage over the course of treatment, treatment accuracy may be challenged. This may result in excessive irradiation of organs at risk/healthy tissues and undercoverage of target volumes with a significant risk of locoregional failure...
December 1, 2016: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27909490/effects-of-atrial-fibrillation-cardioversion-after-percutaneous-mitral-balloon-valvuloplasty-on-echocardiographic-left-and-right-atrial-functions
#8
Ayman Morttada Md, Aly Ramzy Md, Said Khaled Md, Amal Ayoub Md, Sameh Samir Md, Hossam Zaki Md
Amongst patients with mitral stenosis (MS), the most common complication is AF.Our study aimed at evaluating the effect of AF cardioversion after Percutaneous Mitral Balloon Valvuloplasty (PMBV) on echocardiographic atrial functions. The study included 34 patients with MS and AF, presenting to Ain-shams University hospitals, who underwent successful PMBV then randomized into 2 different groups according to AF management strategy. Group-I patients (n=16) received DC cardioversion after amiodarone infusion (within 24 hours post-PMBV) in addition to anticoagulation...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908586/standard-wide-local-excision-or-bilateral-reduction-mammoplasty-in-large-breasted-women-with-small-tumours-surgical-and-patient-reported-outcomes
#9
R Di Micco, R L O'Connell, P A Barry, N Roche, F A MacNeill, J E Rusby
INTRODUCTION: Oncoplastic breast surgery is used to extend the role of breast-conserving surgery (BCS) to women with an unfavourable tumour to breast volume ratio. However, large-breasted women with a relatively small breast cancer may be offered bilateral reduction mammoplasty (BRM) despite being suitable for standard BCS as the more complex surgery may have advantages in terms of patient satisfaction and reduced adverse effects of radiotherapy. PATIENT AND METHODS: This retrospective study evaluated surgical and patient-reported outcome measures (PROMs) in large-breasted women with early (<3 cm) breast cancer, who have undergone unilateral standard BCS or BRM...
November 17, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27908178/a-probability-based-multi-cycle-sorting-method-for-4d-mri-a-simulation-study
#10
Xiao Liang, Fang-Fang Yin, Yilin Liu, Jing Cai
PURPOSE: To develop a novel probability-based sorting method capable of generating multiple breathing cycles of 4D-MRI images and to evaluate performance of this new method by comparing with conventional phase-based methods in terms of image quality and tumor motion measurement. METHODS: Based on previous findings that breathing motion probability density function (PDF) of a single breathing cycle is dramatically different from true stabilized PDF that resulted from many breathing cycles, it is expected that a probability-based sorting method capable of generating multiple breathing cycles of 4D images may capture breathing variation information missing from conventional single-cycle sorting methods...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27907957/surgical-strategies-for-spontaneous-intracerebral-hemorrhage
#11
Wendy Ziai, J Ricardo Carhuapoma, Paul Nyquist, Daniel F Hanley
In recent decades, the medical and surgical treatment of intracerebral hemorrhage (ICH) have become the focus of a number of scientific investigations. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new medical and surgical treatments to facilitate improved clinical outcomes. Currently, two of the most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#12
Raúl J Gazmuri, Kasen Whitehouse, Kruti Shah, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32 to 40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#13
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27906696/medical-therapy-refractory-chronic-rhinosinusitis-and-productivity-costs
#14
Kristine A Smith, Luke Rudmik
PURPOSE OF REVIEW: The purpose of this review is to address the most recent advances in the medical therapy for chronic rhinosinusitis (CRS), define recalcitrant and refractory CRS, and discuss the productivity costs associated with CRS. RECENT FINDINGS: Recent studies evaluating anti-IL-4 receptor α antibodies and calcium channel blockers have demonstrated promising early results during management of CRS. Recent appropriateness criteria have been developed to assist clinicians with defining which patients have 'refractory' CRS and may be considered candidates for endoscopic sinus surgery...
November 30, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#15
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27906525/the-clinical-utility-of-qsm-disease-diagnosis-medical-management-and-surgical-planning
#16
REVIEW
Sarah Eskreis-Winkler, Yan Zhang, Jingwei Zhang, Zhe Liu, Alexey Dimov, Ajay Gupta, Yi Wang
Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients...
December 1, 2016: NMR in Biomedicine
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#17
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905503/advancing-ovarian-folliculometry-with-selective-plane-illumination-microscopy
#18
Hsiao-Chun Amy Lin, Rahul Dutta, Subhamoy Mandal, Alexander Kind, Angelika Schnieke, Daniel Razansky
Determination of ovarian status and follicle monitoring are common methods of diagnosing female infertility. We evaluated the suitability of selective plane illumination microscopy (SPIM) for the study of ovarian follicles. The large field of view and fast acquisition speed of our SPIM system enables rendering of volumetric image stacks from intact whole porcine ovarian follicles, clearly visualizing follicular features including follicle volume and average diameter (70 μm-2.5 mm), their spherical asymmetry parameters, size of developing cumulus oophorus complexes (40 μm-110 μm), and follicular wall thickness (90 μm-120 μm)...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27905155/optimising-qualitative-longitudinal-analysis-insights-from-a-study-of-traumatic-brain-injury-recovery-and-adaptation
#19
Joanna K Fadyl, Alexis Channon, Alice Theadom, Kathryn M McPherson
Knowledge about aspects that influence recovery and adaptation in the postacute phase of disabling health events is key to understanding how best to provide appropriate rehabilitation and health services. Qualitative longitudinal research makes it possible to look for patterns, key time points and critical moments that could be vital for interventions and supports. However, strategies that support robust data management and analysis for longitudinal qualitative research in health-care are not well documented in the literature...
November 30, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/27904836/pulmonary-complications-of-transcatheter-arterial-chemoembolization-for-hepatocellular-carcinoma
#20
Quan M Nhu, Harry Knowles, Paul J Pockros, Catherine T Frenette
Transarterial chemoembolization (TACE) is an effective palliative intervention that is widely accepted for the management of hepatocellular carcinoma (HCC). Post-TACE pulmonary complications resulting in acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) are rare events. Pulmonary complications after TACE are thought to be related to chemical injury subsequent to the migration of the infused ethiodized oil or chemotherapeutic agent to the lung vasculature, facilitated by arteriovenous (AV) shunts within the hyper-vascular HCC...
2016: World Journal of Respirology
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