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https://www.readbyqxmd.com/read/28982219/mechanical-ventilation-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#1
REVIEW
Aleksandar Radunovic, Djillali Annane, Muhammad K Rafiq, Ruth Brassington, Naveed Mustfa
BACKGROUND: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, is a fatal neurodegenerative disease. Neuromuscular respiratory failure is the most common cause of death, which usually occurs within two to five years of the disease onset. Supporting respiratory function with mechanical ventilation may improve survival and quality of life. This is the second update of a review first published in 2009. OBJECTIVES: To assess the effects of mechanical ventilation (tracheostomy-assisted ventilation and non-invasive ventilation (NIV)) on survival, functional measures of disease progression, and quality of life in ALS, and to evaluate adverse events related to the intervention...
October 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28977390/high-dose-methylprednisolone-in-video-assisted-thoracoscopic-surgery-lobectomy-a-randomized-controlled-trial
#2
Lars S Bjerregaard, Per F Jensen, Dennis R Bigler, René Horsleben Petersen, Hasse Møller-Sørensen, Kaj Gefke, Henrik J Hansen, Henrik Kehlet
OBJECTIVES: The optimal postoperative analgesic strategy after video-assisted thoracoscopic surgery lobectomy remains undetermined. We hypothesized that high-dose preoperative methylprednisolone (MP) would improve analgesia compared to placebo. METHODS: A total of 120 adult patients were randomized equally to 125 mg MP or placebo before the start of their elective video-assisted thoracoscopic surgery lobectomy. Group allocation was blinded to patients, investigators and caregivers, and all patients received standardized multimodal, opioid-sparing analgesia...
July 25, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28969747/primary-pleural-epitheliod-hemangioendothelioma-with-lung-involvement
#3
Saima Siraj, Saima Akhter, Nadeem Rizvi
The authors report a case of 50-year man who presented with 2-year history of dry cough, right sided chest pain, and shortness of breath. Chest X-ray revealed right-sided pleural effusion and left-sided opacity. Pleuroscopic pleural biopsy confirmed the diagnosis of primary pleural epitheliod hemangioendothelioma (EHE) with peripheral lung parenchymal invasion. Chest drain was inserted; and significant amount of fluid was drained, but lung failed to expand after 72 hours. Patient was planned for video assisted thoracoscopy (VATS) and also discussed with oncology department for chemotherapy; but he refused any further treatment, and left home against medical advice with chest drain in place...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28967732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-under-conscious-sedation-with-meperidine-and-midazolam
#4
Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi
Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28953671/castleman-disease-associated-diffuse-parenchymal-lung-disease-a-strobe-compliant-retrospective-observational-analysis-of-22-cases-in-a-tertiary-chinese-hospital
#5
Hui Huang, Ruie Feng, Jian Li, Xinyu Song, Shan Li, Kai Xu, Jian Cao, Lu Zhang, Yalan Bi, Zuojun Xu
Intrathoracic involvement is common in Castleman disease (CD), but CD-associated diffuse parenchymal lung disease (DPLD) is rare and not well-reported.We conducted a retrospective analysis of 262 CD patients with a definite pathological diagnosis who were hospitalized between 1999 and 2015.Twenty-two CD patients had DPLD based on chest computed tomography (CT) scans. Among them, 9 were male and 13 were female, with a mean age of 45.3 years. Coughing (72.7%), fever (68.2%), and dyspnea (59.1%) were the common clinical manifestations...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28952156/positive-expiratory-pressure-therapy-versus-other-airway-clearance-techniques-for-bronchiectasis
#6
REVIEW
Annemarie L Lee, Angela T Burge, Anne E Holland
BACKGROUND: People with bronchiectasis experience chronic cough and sputum production and require the prescription of airway clearance techniques (ACTs). A common type of ACT prescribed is positive expiratory pressure (PEP) therapy. A previous review has suggested that ACTs including PEP therapy are beneficial compared to no treatment in people with bronchiectasis. However, the efficacy of PEP therapy in a stable clinical state or during an acute exacerbation compared to other ACTs in bronchiectasis is unknown...
September 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28932352/novel-technique-of-abdominal-wall-nerve-block-for-laparoscopic-colostomy-rectus-sheath-block-with-transperitoneal-approach
#7
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
A 62-year-old man who had acute rectal obstruction due to a large rectal cancer is presented. He underwent emergency laparoscopic colostomy. We used the laparoscopic puncture needle to inject analgesia with the novel transperitoneal approach. In this procedure, both ultrasound and laparoscopic images assisted with the accurate injection of analgesic to the correct layer. The combination of laparoscopic visualization and ultrasound imaging ensured infiltration of analgesic into the correct layer without causing damage to the bowel...
August 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28914227/a-system-analysis-of-delay-in-outpatient-respiratory-equipment-delivery
#8
Sheila Kun, Gregory Placencia, Sally Davidson Ward, Thomas Keens
OBJECTIVES: To systematically assess barriers delaying home respiratory equipment requisition and to evaluate for temporal correlation between delays and emergency room or hospitalization episodes. BACKGROUND: Initiation of home respiratory treatments is delayed because of delays in delivery of durable medical equipment (DME). This study assesses root causes of such delays from a system perspective. We also describe clinical consequences by measuring emergency room visits and hospitalization days for temporal correlations...
December 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28902845/clinical-and-epidemiologic-characteristics-of-dengue-and-other-etiologic-agents-among-patients-with-acute-febrile-illness-puerto-rico-2012-2015
#9
Kay M Tomashek, Olga D Lorenzi, Doris A Andújar-Pérez, Brenda C Torres-Velásquez, Elizabeth A Hunsperger, Jorge Luis Munoz-Jordan, Janice Perez-Padilla, Aidsa Rivera, Gladys E Gonzalez-Zeno, Tyler M Sharp, Renee L Galloway, Mindy Glass Elrod, Demetrius L Mathis, M Steven Oberste, W Allan Nix, Elizabeth Henderson, Jennifer McQuiston, Joseph Singleton, Cecilia Kato, Carlos García Gubern, William Santiago-Rivera, Jesús Cruz-Correa, Robert Muns-Sosa, Juan D Ortiz-Rivera, Gerson Jiménez, Ivonne E Galarza, Kalanthe Horiuchi, Harold S Margolis, Luisa I Alvarado
Identifying etiologies of acute febrile illnesses (AFI) is challenging due to non-specific presentation and limited availability of diagnostics. Prospective AFI studies provide a methodology to describe the syndrome by age and etiology, findings that can be used to develop case definitions and multiplexed diagnostics to optimize management. We conducted a 3-year prospective AFI study in Puerto Rico. Patients with fever ≤7 days were offered enrollment, and clinical data and specimens were collected at enrollment and upon discharge or follow-up...
September 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28894819/computational-modelling-of-cough-function-and-airway-penetrant-behavior-in-patients-with-disorders-of-laryngeal-function
#10
Bari Hoffman Ruddy, Don Nadun Kuruppumullage, Giselle Carnaby, Michael Crary, Jeffery Lehman, Olusegun J Ilegbusi
OBJECTIVE/HYPOTHESIS: Patients with laryngeal disorders often exhibit changes to cough function contributing to aspiration episodes. Two primary cough variables (peak cough flow: PCF and compression phase duration: CPD) were examined within a biomechanical model to determine their impact on characteristics that impact airway compromise. STUDY DESIGN: Computational study. METHODS: A Computational Fluid Dynamics (CFD) technique was used to simulate fluid flow within an upper airway model reconstructed from patient CT images...
February 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28893243/impact-of-pharmacy-worker-training-and-deployment-on-access-to-essential-medicines-for-children-under-five-in-malawi-a-cluster-quasi-experimental-evaluation
#11
Joseph B Babigumira, Solomon J Lubinga, Alisa M Jenny, Erin Larsen-Cooper, Jessica Crawford, Charles Matemba, Andy Stergachis
BACKGROUND: Poor access to essential medicines is common in many low- and middle-income countries, partly due to an insufficient and inadequately trained workforce to manage the medicines supply chain. We conducted a prospective impact evaluation of the training and deployment of pharmacy assistants (PAs) to rural health centers in Malawi. METHODS: A quasi-experimental design was used to compare access to medicines in two districts where newly trained PAs were deployed to health centers (intervention) and two districts with no trained PAs at health centers (comparison)...
September 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28890562/efficacy-of-atomised-local-anaesthetic-versus-transtracheal-topical-anaesthesia-for-awake-fibreoptic-intubation
#12
Bindu K Vasu, Sunil Rajan, Jerry Paul, Lakshmi Kumar
BACKGROUND AND AIMS: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. METHODS: It was a prospective, randomised controlled study of 33 patients with the American Society of Anesthesiologists' physical status 1-3 with anticipated difficult airway requiring AFOI. The primary objective was to compare the patient comfort after topical anaesthesia of the airway using atomiser with transtracheal injection of the local anaesthetic agent for AFOI in patients with anticipated difficult airway...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28889136/electro-navigational-bronchoscopy-for-bilateral-peripheral-lung-lesions-a-case-report
#13
A H Faisal, A W Sopian, H Tidi
Electromagnetic navigational bronchoscopy (ENB), one of the methods of navigational bronchoscopy is an advanced diagnostic tool allowing tissue sampling at the lung peripheries which were previously accessible only by computed tomography (CT) guidance or video-assisted thoracoscopic surgery (VATS). We report a 53-year-old man who presented with a cough and dyspnea with constitutional symptoms for one month. CT thorax revealed multiple bilateral peripheral lung nodules and there were no endobronchial lesions on flexible bronchoscopy...
August 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28878603/abdominal-mass-after-robotic-assisted-laparoscopic-prostatectomy-spigelian-type-trocar-hernia
#14
Seyed Behzad Jazayeri, Johnson F Tsui, David B Samadi
Prostate cancer is the most common cancer in men. Men are diagnosed at early stages of prostate cancer with the use of prostate specific antigen. Surgical removal of the prostate is the standard treatment in localized prostate cancer. Complications after surgical procedures are inevitable. Although robotic prostatectomy has resulted in decreased complications compared to open surgery, complications occur. After an uneventful robotic assisted laparoscopic prostatectomy in a 71-year-old gentleman, with history of chronic cough and continued low dose glucocorticoid use, the patient returned to hospital with complain of a tender abdominal mass in right lower quadrant...
August 2017: Current Urology
https://www.readbyqxmd.com/read/28874962/usefulness-of-the-hook-knife-in-flexible-endoscopic-myotomy-for-zenker-s-diverticulum
#15
Olivier Rouquette, Armando Abergel, Aurélien Mulliez, Laurent Poincloux
AIM: To investigate the outcome of flexible endoscopic myotomy performed with the Hook knife in patients with symptomatic Zenker's diverticulum (ZD). METHODS: All consecutive patients treated for ZD at our institution between 7/2012 and 12/2016 were included. The flexible endoscopic soft diverticuloscope-assisted technique with endoclips placement and Hook knife myotomy were performed in all patients. Here we report a retrospective review of prospectively collected data...
August 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28864688/effect-of-propofol-combined-with-opioids-on-cough-reflex-suppression-in-gastroscopy-study-protocol-for-a-double-blind-randomized-controlled-trial
#16
Ning Yin, Jiangyan Xia, Yi-Zhi Cao, Xinjian Lu, Jing Yuan, Jue Xie
INTRODUCTION: The best methods for inducing analgesia and sedation for gastroscopy are still debated but finding an adequate regimen of sedation/analgesia is important. Stimulation of the larynx under sedation can cause reflex responses. Propofol with opioids has been recommended for gastroscopy sedation but the effects on cough reflex suppression remain unclear. This trial will evaluate the effects of propofol combined with small doses of dezocine, oxycodone, sufentanil or fentanyl for gastroscopy...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28861115/a-pediatric-case-of-relapsed-pulmonary-alveolar-proteinosis-despite-successful-whole-lung-lavage
#17
Seung Young Jin, Hye Ri Yun, Yun Jung Choi, Jun Dong Park, Jin Tae Kim, Chang Hyun Kang, Young Sik Park, Young Hun Choi, Woo Sun Kim, Dong In Suh
Pulmonary alveolar proteinosis (PAP) is a rare disease in children characterized by intra-alveolar accumulation of surfactant proteins, which severely reduces gaseous exchange. Whole lung lavage (WLL) is the preferred technique for the treatment of severe PAP. Herein, we present a pediatric case of PAP treated with WLL. An 11-year-old boy was admitted with the chief complaint of a dry cough lasting 6 months. He developed symptoms of dyspnea on exertion and had difficulty in climbing stairs. He was ultimately diagnosed with PAP through video-assisted thoracoscopic lung biopsy...
July 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28852836/indications-for-surgical-stabilization-of-rib-fractures-in-patients-without-flail-chest-surveyed-opinions-of-members-of-the-chest-wall-injury-society
#18
Fredric M Pieracci, Suresh Agarwal, Andrew Doben, Adam Shiroff, Larwence Lottenberg, Sarah Ann Whitbeck, Thomas W White
PURPOSE: There are currently no evidence-based indications for surgical stabilization of rib fractures (SSRF) in patients without flail chest. The purpose of this survey was to identify patients for whom there is relative equipoise (operative vs. non-operative) in order to assist in designing a randomized clinical trial. METHODS: Members of the Chest Wall Injury Society were sent an online survey, in which 18 patient scenarios were presented. The baseline patient had ≥ three displaced, contiguous fractures and had no other contraindications for surgery...
August 29, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28846527/kinking-of-the-outflow-graft-consequent-ventricular-tachycardia-and-the-need-for-reoperation-in-a-patient-with-left-ventricular-assist-device
#19
Dusko Terzic, Emilija Nestorovic, Svetozar Putnik, Dejan Markovic, Miljko Ristic
BACKGROUND: Left ventricular assist devices (LVAD) have become a lifesaving solution for patients awaiting heart transplantation as well as an option to support the failing hearts of non-transplant candidates as a lifelong, or destination therapy (DT). Improvements in LVAD design have enabled greater durability and broader patient applicability, but not without complications. Ventricular arrhythmias in LVAD patients were considered benign in the early days of LVADs, but today are increasingly recognized for their harmful impact on morbidity and quality of life...
August 24, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#20
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
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