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https://www.readbyqxmd.com/read/28334427/capnography-versus-standard-monitoring-for-emergency-department-procedural-sedation-and-analgesia
#1
REVIEW
Brian F Wall, Kirk Magee, Samuel G Campbell, Peter J Zed
BACKGROUND: Procedural sedation and analgesia (PSA) is used frequently in the emergency department (ED) to facilitate painful procedures and interventions. Capnography, a monitoring modality widely used in operating room and endoscopy suite settings, is being used more frequently in the ED setting with the goal of reducing cardiopulmonary adverse events. As opposed to settings outside the ED, there is currently no consensus on whether the addition of capnography to standard monitoring modalities reduces adverse events in the ED setting...
March 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28331271/adenoid-cystic-carcinoma-of-trachea
#2
Ashish Varghese, Swati Suneha, John C Watkinson
Adenoid cystic carcinoma (ACC) is the second most common primary malignant tumor of the trachea, after squamous cell carcinoma. Patients present with upper airway obstructive symptoms and signs including dyspnoea, cough, haemoptysis, and stridor which are often insidious, delaying diagnosis and optimal management. Described here is an unusual case of primary ACC cervical trachea with concomitant micropapillary thyroid carcinoma (microPTC) in a middle-aged lady presenting with cough and breathing difficulty since 3 months...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#3
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28330573/implication-of-general-anaesthetic-and-sedation-techniques-in-temporomandibular-joint-disorders%C3%A2-%C3%A2-a-systematic-review
#4
J Talaván-Serna, J M Montiel-Company, C Bellot-Arcís, J M Almerich-Silla
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest...
February 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28329273/is-surgical-resection-superior-to-bronchoscopic-resection-in-patients-with-symptomatic-endobronchial-hamartoma
#5
Sarah M Abdel Hady, Salma E Elbastawisy, Aly S Hassaballa, Hany H Elsayed
A best evidence topic was written according to a structured protocol. The question addressed was: in surgically fit patients with biopsy proven symptomatic endobronchial hamartoma (EH), is surgical resection superior to bronchoscopic resection in terms of outcome. A total of 756 articles were identified using the reported search, of which 8 represented the best evidence to answer the clinical question. The authors, date, journal, country, study type, population, outcomes and key results are tabulated. Three studies included patients who had either bronchoscopic or surgical treatment of EH in the same study...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#6
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#7
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28326906/a-practical-guide-to-the-sublingual-immunotherapy-tablet-adverse-event-profile-implications-for-clinical-practice
#8
David I Bernstein, Jose A Bardelas, Bodil Svanholm Fogh, Amarjot Kaur, Ziliang Li, Hendrik Nolte
OBJECTIVES: Treatment with allergy immunotherapy improves allergic rhinoconjunctivitis, but can also improve comorbidities associated with allergic rhinitis such as asthma. Sublingual immunotherapy (SLIT)-tablets are a convenient and efficacious method of allergy immunotherapy. They are self-administered after the first tablet has been provided under medical supervision. Therapy may elicit local reactions or, rarely, systemic allergic reactions. The objective of this report is to inform healthcare practitioners about the safety and tolerability profile of SLIT-tablets and use this information to provide practical guidance that may inform patients regarding potential adverse reactions and how to manage them...
March 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28325523/total-management-of-chronic-obstructive-pulmonary-disease-copd-as-an-independent-risk-factor-for-cardiovascular-disease
#9
REVIEW
Katsuya Onishi
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#10
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323237/comparison-of-the-mcgrath-%C3%A2-mac-video-laryngoscope-with-direct-macintosh-laryngoscopy-for-novice-laryngoscopists-in-children-without-difficult-intubation-a-randomized-controlled-trial
#11
Antoine Giraudon, Maryline Bordes-Demolis, Barbara Blondeau, Nadia Sibai de Panthou, Nathan Ferrand, Maeva Bello, Victoria Dahlet, François Semjen, Matthieu Biais, Karine Nouette-Gaulain
INTRODUCTION: Airway management and tracheal intubation are routinely performed in paediatric anaesthesia and yet are associated with preventable adverse events. The McGrath(®) MAC is a video laryngoscope with a curved blade similar to the Macintosh blade, which has not been previously described in first intention paediatric tracheal intubation. We aimed to compare direct laryngoscopy to the McGrath(®) MAC video laryngoscope among novice laryngoscopists. METHODS: Six paediatric anaesthesia residents with novice skills in paediatric laryngoscopy were randomly assigned to perform tracheal intubation using either direct Macintosh laryngoscopy (DL) or the McGrath(®) MAC video laryngoscope (MM) as the first attempted device in children weighing between 10 and 20kg without difficult intubation...
March 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#12
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28321336/guideline-based-early-detection-of-chronic-obstructive-pulmonary-disease-in-eight-danish-municipalities-the-top-kom-study
#13
Ulla Borup Hemmingsen, Margit Stycke, Jens Dollerup, Peter Bo Poulsen
Background. Early detection of chronic obstructive pulmonary disease (COPD) and prevention of disease progression are important. Only 40% of COPD cases are diagnosed in Denmark. Recommendations for early case finding have been established. This study investigates early detection of pulmonary obstruction in a Danish municipality setting. Methods. Eight municipalities participated. Citizens fulfilling national case finding recommendations, age ≥35 years, smokers/ex-smokers/relevant occupational exposure, and at least one respiratory symptom, were invited to spirometry...
2017: Pulmonary Medicine
https://www.readbyqxmd.com/read/28321190/skeletal-dysplasias-growing-therapy-for-growing-bones
#14
REVIEW
Angie C Jelin, Elizabeth O'Hare, Karin Blakemore, Eric B Jelin, David Valle, Julie Hoover-Fong
Skeletal dysplasias represent a large and diverse group of rare conditions affecting collagen and bone. They can be clinically classified based on radiographic and physical features, and many can be further defined at a molecular level (Bonafe et al., 2015). Early diagnosis is critical to proper medical management including pharmacologic treatment when available. Patients with severe skeletal dysplasias often have small chests with respiratory insufficiency or airway obstruction and require immediate intubation after birth...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#15
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28319489/autogenic-drainage-in-children-with-cystic-fibrosis
#16
Lieselotte Corten, Brenda M Morrow
PURPOSE: Airway clearance is an essential part of the management of cystic fibrosis (CF) as it facilitates clearance of viscous pulmonary secretions. This review aimed to determine the effect of autogenic drainage (AD) and assisted autogenic drainage (AAD) compared with no, sham, or other types of airway clearance in children with CF. SUMMARY OF KEY POINTS: Two pediatric randomized cross-over trials were identified on the use of AD in children with CF; no studies were available on the use of AAD...
March 17, 2017: Pediatric Physical Therapy
https://www.readbyqxmd.com/read/28319487/videolaryngoscopy-in-neonates-infants-and-children
#17
Onur Balaban, Joseph D Tobias
Airway management is vital during anesthetic care and during resuscitative efforts in the PICU, the emergency department, and the delivery room. Given specific anatomic and physiologic differences, neonates and infants may be more prone to complications during airway management. Videolaryngoscopy may offer an alternative to or advantages over direct laryngoscopy in specific clinical scenarios. The following article reviews some of the basic types of videolaryngoscopy and discusses their potential applications in the pediatric population...
March 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28318455/airway-management-in-disaster-response-a-manikin-study-comparing-direct-and-video-laryngoscopy-for-endotracheal-intubation-by-prehospital-providers-in-level-c-personal-protective-equipment
#18
Sami Yousif, Jason T Machan, Yasser Alaska, Selim Suner
Introduction Airway management is one of many challenges that medical providers face in disaster response operations. The use of personal protective equipment (PPE), in particular, was found to be associated with higher failure rates and a prolonged time to achieve airway control. Hypothesis/Problem The objective of this study was to determine whether video laryngoscopy could facilitate the performance of endotracheal intubation by disaster responders wearing Level C PPE. METHODS: In this prospective, randomized, crossover study, a convenience sample of practicing prehospital providers were recruited...
March 20, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28314465/data-capture-and-communication-during-transfers-to-definitive-care-in-an-inclusive-trauma-system
#19
Nori L Bradley, Naisan Garraway, Nathaniel Bell, Nasira Lakha, S Morad Hameed
INTRODUCTION: Background trauma survivors in rural areas transferred to urban centers have higher mortality than trauma patients admitted directly to urban centers. Transfer data in trauma registries is important for injury control. Prehospital and early physiologic data may reflect processes of pre-hospital care. British Columbia currently has no standardized process for trauma patient data transfer. PATIENTS AND METHODS: We performed a retrospective data analysis for major trauma patients (ISS>15) transferred to a Level I trauma center over a 1year period (n=243)...
November 5, 2016: Injury
https://www.readbyqxmd.com/read/28306353/management-of-chronic-airway-diseases-what-can-we-learn-from-real-life-data
#20
James D Chalmers
No abstract text is available yet for this article.
March 15, 2017: COPD
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