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https://www.readbyqxmd.com/read/28535026/tetanus-%C3%A2-n%C3%A3-stan-bortgl%C3%A3-md-men-allvarlig-sjukdom-%C3%A3-ldre-kvinnor-%C3%A3-r-en-riskgrupp-diagnosen-kan-vara-en-utmaning
#1
Bernhard Hozgraefe, Akad Koria, Victoria Sem, Joak Johansson
Tetanus, an almost forgotten but serious disease Tetanus is the systemic consequence of a local infection with Clostridium tetani, that produces toxin which spreads in the systemic circulation. In developed countries, it is extremely rare. Women born before 1950 are a group at risk due to lower prevalence of immunisation. This report describes a case of tetanus. The patient is a previously healthy 82-year-old woman. She presented to primary care with a complaint of stiffness in the neck and jaw. A physical exam and basic laboratory tests were normal apart from a slightly increased blood pressure...
May 22, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28534702/factors-affecting-recovery-from-anaesthesia-with-propofol-remifentanil-target-controlled-infusion-in-laparoscopic-surgery
#2
Shao-Hua Liu, Ming Tian
Objective This study was performed to analyse factors influencing the effect-site concentration (Ce) of propofol at return of consciousness (ROC) with target-controlled infusion of propofol-remifentanil after laparoscopic surgery. Methods In total, 112 patients who underwent laparoscopic surgery under general anaesthesia were given propofol at the target concentration of 3.5 µg/ml. Remifentanil (Ce: 4.0 ng/ml) and 0.9 mg/kg of rocuronium were administered when the Observer's Assessment of Alertness/Sedation score reached 1...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28534235/nasal-high-flow-in-management-of-children-with-status-asthmaticus-a-retrospective-observational-study
#3
Florent Baudin, Alexandra Buisson, Blandine Vanel, Bruno Massenavette, Robin Pouyau, Etienne Javouhey
BACKGROUND: Asthma is the most common obstructive airway disease in children and adults. Nasal high flow (NHF) is a recent device that is now used as a primary support for respiratory distress. Several studies have reported use of NHF as a respiratory support in status asthmaticus; however, there are no data to recommend such practice. We therefore conducted this preliminary study to evaluate NHF therapy for children with status asthmaticus admitted to our PICU in order to prepare a multicentre randomized controlled study...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28529003/determination-of-the-appropriate-oropharyngeal-airway-size-in-adults-assessment-using-ventilation-and-an-endoscopic-view
#4
Hyun Joo Kim, Shin Hyung Kim, Ji Young Min, Wyun Kon Park
INTRODUCTION: Size 9 and 8 airways for men and women, respectively, have been proposed as most appropriate based on endoscopy. However, a limitation of this guideline is that ventilation was not assessed. METHODS: In this retrospective review of prospectively collected data, 149 patients requiring tracheal intubation for general anesthesia were included. The adequacy for manual and pressure-controlled mechanical ventilation and views at the distal end of each airway was assessed using a fiber-optic bronchoscope with various airway sizes (7, 8, 9, 10, and 11)...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28528064/transient-aphonia-after-mediastinoscopy
#5
Frank O Velez-Cubian, Kavian Toosi, Jessica Glover, Bharat Pancholy, Edward Hong
The most common adverse event after cervical mediastinoscopy is recurrent laryngeal nerve (RLN) injury, which has an incidence of 0.6% [1]. We report the case of a 68-year-old man with non-small cell lung cancer (NSCLC) who experienced transient bilateral vocal cord paralysis after mediastinoscopy, which manifested in complete aphonia. This patient's ability to maintain his airway was carefully followed up, but neither endotracheal intubation nor tracheostomy was required. The vocal cord paralysis resolved without intervention after 5 hours...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527874/pressor-support-during-a-jarisch-herxheimer-reaction-after-initiation-of-treatment-for-weil-s-disease
#6
Randi Connor-Schuler, Anee Khan, Nikhil Goyal, Erin Zimny
We present a case of Weil's disease complicated by a Jarisch-Herxheimer reaction (JHR) after initiation of antibiotics while in the emergency department requiring invasive monitoring and vasopressor support. The case is followed by a brief review of the JHR which is rarely observed with treatment of leptospirosis. A healthy 28-year-old female who recently returned from the Caribbean presented to the emergency department with flu-like symptoms. The patient appeared jaundiced with conjunctival suffusion and was ultimately treated with the appropriate antibiotics for leptospirosis in the ED...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28527873/comparison-of-xenon-with-led-illuminant-in-difficult-and-inhalation-injury-airway-scenario-a-randomized-crossover-manikin-study
#7
Andreas Moritz, Johannes Prottengeier, Joachim Schmidt
PURPOSE: The purpose of this study was to compare the effectiveness of a Xenon halogen with a light-emitting diode (LED) laryngoscope light handle in a difficult airway scenario, as well as in an inhalation injury airway scenario that combines a difficult airway and a limited view. METHODS: We recruited forty-two anesthetists into a randomized crossover trial. Each performed tracheal intubation (TI) with a Xenon halogen and a LED light handle in the two manikin scenarios...
May 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526060/comparison-of-the-effect-of-oral-care-with-four-different-antiseptics-to-prevent-ventilator-associated-pneumonia-in-adults-protocol-for-a-network-meta-analysis
#8
Zhigang Zhang, Yuying Hou, Jun Zhang, Bo Wang, Juxia Zhang, Ailing Yang, Ge Li, Jinhui Tian
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as the occurrence of pneumonia in patients receiving mechanical ventilation for more than 48 h after endotracheal intubation. The implementation of effective oral care with antiseptics may reduce the incidence of ventilator-associated pneumonia. However, previous studies have been unclear about the best antiseptic for this purpose. Therefore, present protocol proposed to perform a network meta-analysis to evaluate the efficacy of different antiseptics to prevent ventilator-associated pneumonia...
May 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28525401/glidescope-versus-airtraq-dl-for-double-lumen-tracheal-tube-insertion-in-patients-with-a-predicted-or-known-difficult-airway-a-randomised-study
#9
Olivier Belze, Evan Lepage, Yvan Bazin, Pierre Kerourin, Jacques Fusciardi, Francis Remérand, Fabien Espitalier
BACKGROUND: Double-lumen tracheal tube (DLT) insertion can be managed with videolaryngoscopes such as the Glidescope or indirect laryngoscopes like the Airtraq DL. No study has compared both devices when a difficult intubation is predicted. OBJECTIVE: Our hypothesis was that the Glidescope is superior to the Airtraq for double-lumen tube insertion in patients with a predicted or known difficult airway. DESIGN: Adult patients scheduled for elective thoracic surgery with a predicted risk (evaluated preoperatively using the Arné score) or history of difficult intubation were allocated randomly to one of two groups: a Glidescope group and an Airtraq group...
May 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28524026/-high-flow-nasal-cannulae-oxygen-in-patients-with-respiratory-failure-a-meta-analysis
#10
Weigang Yue, Zhigang Zhang, Caiyun Zhang, Liping Yang, Jufang He, Yuying Hou, Ying Tang, Jinhui Tian
OBJECTIVE: To systematically evaluate the efficacy of high-flow nasal cannulae oxygen (HFNC) in patients with respiratory failure. METHODS: Computerized PubMed, Embase, Web of Science, the Cochrane Library, CNKI, CBM, VIP, Wanfang Database up to March 31st, 2017, all published available randomized controlled trials (RCTs) or cohort studies about HFNC therapy for patients with respiratory failure were searched. The control group was treated with face mask oxygen therapy (FM) or non-invasive positive pressure ventilation (NIPPV), while the experimental group was treated with HFNC...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523336/multum-in-parvo
#11
Dan Cristian Voinescu, Aurel George Mohan, Andrei Alexandru Marinescu, Alexandru Vlad Ciurea
The authors begin from the Latin expression Multum in parvo, which is used to summarize the essential aspects of something. This phrase is used in this case to define the Glasgow Coma Scale (GCS) - the posttraumatic conscious state evaluation scale. The authors gather the entire information regarding the creation of a uniform evaluation scale for the patients that have the state of consciousness altered or are even in a posttraumatic coma. This subject has been thoroughly debated for over 40 years. Teasdale & Jennett represented a huge step in the evaluation of patient's state of consciousness...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28523156/predictors-of-length-of-stay-and-duration-of-tracheal-intubation-after-transcatheter-aortic-valve-implantation
#12
Vasileios Patris, Konstantinos Giakoumidakis, Mihalis Argiriou, Katerina K Naka, Efstratios Apostolakis, Mark Field, Manoj Kuduvalli, Aung Oo, Stavros Siminelakis
BACKGROUND: While short-term outcomes for patients undergoing transcatheter aortic valve implantation (TAVI) have long been studied, there is very little data on their predictors. We aimed to identify the predictors of outcomes, such as intensive care unit (ICU) and in-hospital length of stay (LOS), duration of postoperative intubation and in-hospital mortality, after TAVI procedures. METHODS: We conducted a retrospective cohort study of 162 consecutive patients with aortic valve disease, who were admitted to a tertiary hospital of Liverpool for TAVI, during a five-year period...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522955/colonic-dysmotility-and-morphological-abnormality-frequently-detected-in-japanese-patients-with-irritable-bowel-syndrome
#13
Takeshi Mizukami, Shinya Sugimoto, Tatsuhiro Masaoka, Hidekazu Suzuki, Takanori Kanai
BACKGROUND/AIMS: Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS. METHODS: One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#14
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522168/is-pre-hospital-cpr-a-risk-factor-for-early-death-in-patients-transferred-to-an-adult-burn-center
#15
Kanika Trehan, Stacey Rotta, Shea C Gregg, Kristen Glasgow, Roselle E Crombie, Walter M Cholewczynski, Nabil Atweh, Alisa Savetamal
BACKGROUND: Burn patients who require cardiopulmonary resuscitation (CPR) prior to admission to a Burn Center are anecdotally known to suffer higher mortality than those who do not require pre-hospital CPR. STUDY DESIGN: A retrospective chart review identified adult patients admitted to our burn center between 2013 and 2015. Included patients met one or both of the following criteria: (1) 20 percent or more total body surface area (%TBSA) burned and (2) need for intubation prior to admission to our facility...
May 15, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28520886/use-of-an-anaesthesia-workstation-barrier-device-to-decrease-contamination-in-a-simulated-operating-room
#16
S Hunter, D Katz, A Goldberg, H-M Lin, R Pasricha, G Benesh, B Le Grand, S DeMaria
Background.: Strategies to achieve reductions in perioperative infections have focused on hand hygiene among anaesthestists but have been of limited efficacy. We performed a study in a simulated operating room to determine whether a barrier covering the anaesthesia workstation during induction and intubation might reduce the risk of contamination of the area and possibly, by extension, the patient. Methods.: Forty-two attending and resident anaesthetists unaware of the study design were enrolled in individual simulation sessions in which they were asked to induce and intubate a human simulator that had been prepared with fluorescent marker in its oropharynx as a marker of potentially pathogenic bacteria...
May 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28520832/evaluation-of-monitored-anesthesia-care-in-sialendoscopy
#17
Oscar Trujillo, Madeleine A Drusin, Parwane P Pagano, Gulce Askin, Rahmatullah Rahmati
Importance: In the United States, sialendoscopy is most often performed under general anesthesia with endotracheal intubation (GETA); however, monitored anesthesia care (MAC) may be a viable alternative. Objective: To investigate patient characteristics and outcomes following sialendoscopy performed under MAC or GETA to assess the potential of MAC as an alternative anesthetic option. Design, Setting, and Participants: A retrospective review of medical records on patients who underwent sialendoscopy between October 1, 2011, and August 31, 2014, was performed...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28520718/retrospective-observational-evaluation-of-postoperative-oxygen-saturation-levels-and-associated-postoperative-respiratory-complications-and-hospital-resource-utilization
#18
Satya Krishna Ramachandran, Aleda Thompson, Jaideep J Pandit, Scott Devine, Amy M Shanks
INTRODUCTION: The clinical importance of postoperative episodic hypoxemia is still unclear, and therefore largely under-studied. As a result, there is limited understanding of its relationship with early postoperative respiratory complications (PRC, defined as intubation within three days of surgery) and hospital resource utilization. MATERIALS AND METHODS: This single center study was performed using a retrospective observational design. We described population based definitions of desaturation from continuous SpO2 monitoring data captured in the post anesthesia care unit (PACU), namely median SpO2 in PACU, duration of desaturation below median, nadir desaturation, and length of oxygen therapy relative to PACU duration...
2017: PloS One
https://www.readbyqxmd.com/read/28520545/hemodynamic-profile-of-acute-kidney-injury-following-the-fontan-procedure-impact-of-renal-perfusion-pressure
#19
Taylor Patterson, David A Hehir, Matthew Buelow, Pippa M Simpson, Michael E Mitchell, Liyun Zhang, Mehdi Eslami, Kathleen Murkowski, John P Scott
BACKGROUND: Acute kidney injury (AKI) is common following cardiopulmonary bypass. Fontan completion may result in systemic venous hypertension and low cardiac output, reducing renal perfusion pressure (RPP) and further increasing the risk of AKI. We investigated the incidence and risk factors for post-Fontan AKI. METHODS: Single-center retrospective study of children undergoing Fontan completion from 2005 to 2012. Demographic and hemodynamic variables were assessed for association with AKI...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28515954/a-prospective-cohort-study-of-thoracic-ultrasound-in-acute-respiratory-failure-the-c3po-protocol
#20
Peter D Wallbridge, Simon A Joosten, Liam M Hannan, Daniel P Steinfort, L Irving, J Goldin, Mark Hew
OBJECTIVES: This study was performed to assess the clinical utility of a standardised thoracic ultrasound examination when added to standard care in patients with acute respiratory failure admitted to an intermediate care unit. This study aimed to assess the impact on clinical diagnosis, clinician confidence and management. Ultrasound has been shown to have utility in patients admitted to intensive care and emergency; however, utility in a ward setting is unknown. DESIGN: Prospective cohort study...
May 2017: JRSM Open
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