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https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#1
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28529685/computed-tomography-guided-catheter-drainage-with-urokinase-and-ozone-in-management-of-empyema
#2
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu
AIM: To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema. METHODS: Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group II); catheter drainage, urokinase and ozone (group III). Drainage was considered successful if empyema was resolved with closure of cavity, clinical symptoms were resolved, and need for any further surgical procedure was avoided...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28526893/do-we-need-3d-tube-current-modulation-information-for-accurate-organ-dosimetry-in-chest-ct-protocols-dose-comparisons
#3
Xochitl Lopez-Rendon, Guozhi Zhang, Walter Coudyzer, Wim Develter, Hilde Bosmans, Federica Zanca
OBJECTIVES: To compare the lung and breast dose associated with three chest protocols: standard, organ-based tube current modulation (OBTCM) and fast-speed scanning; and to estimate the error associated with organ dose when modelling the longitudinal (z-) TCM versus the 3D-TCM in Monte Carlo simulations (MC) for these three protocols. METHOD: Five adult and three paediatric cadavers with different BMI were scanned. The CTDIvol of the OBTCM and the fast-speed protocols were matched to the patient-specific CTDIvol of the standard protocol...
May 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28526059/severe-polyserositis-induced-by-the-13-valent-pneumococcal-conjugate-vaccine-a-case-report
#4
Pierre Tawfik, Elie Gertner, Charlene E McEvoy
BACKGROUND: The United States Advisory Committee on Immunization Practices recommends administration of the 13-valent pneumococcal conjugate vaccine in series with the 23-valent pneumococcal polysaccharide vaccine for prevention of pneumonia in the elderly. Reports of autoimmune or auto-inflammatory diseases as a result of pneumococcal vaccination, especially pneumococcal conjugate vaccine, are extremely rare. CASE PRESENTATION: We present a case of severe serositis in a 75-year-old Caucasian woman complicated by pericardial and pleural effusions in the setting of recent 13-valent pneumococcal conjugate vaccine vaccination and no other obvious etiology...
May 20, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28523194/pneumomediastinum-and-bilateral-pneumothoraces-causing-respiratory-failure-after-thyroid-surgery
#5
Michael Koeppen, Benjamin Scott, Joseph Morabito, Matthew Fiegel, Tobias Eckle
We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. During surgery, the patient developed pneumomediastinum with bilateral pneumothoraces. Despite early treatment with bilateral chest tubes and no evidence of a tracheal perforation, the patient developed severe respiratory failure after extubation on the intensive care unit...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28523168/pleural-abrasion-should-not-routinely-preferred-in-treatment-of-primary-spontaneous-pneumothorax
#6
Zhenrong Zhang, Lanfang Du, Hongxiang Feng, Chaoyang Liang, Deruo Liu
BACKGROUND: The aim of this study was to find out whether thoracoscopic bullectomy with pleural abrasion (BLPA) could lower the recurrence ratio in primary spontaneous pneumothorax (PSP) patients compared with bullectomy alone. METHODS: All PSP patients who underwent video assisted thoracoscopy (VATS) bullectomy (120 bullectomy cases) or BLPA (225 BLPA cases) in our department between 2008.1 and 2013.12 were retrospectively reviewed. Clinical data, perioperative data, and follow-up information were collected...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523164/a-clinical-study-of-efficacy-of-polyglycolic-acid-sleeve-after-video-assisted-thoracoscopic-bullectomy-for-primary-spontaneous-pneumothorax
#7
Duo Zhang, Jinbai Miao, Xiaoxing Hu, Bin Hu, Hui Li
BACKGROUND: Primary spontaneous pneumothorax (PSP) is a common disease in thoracic surgery, and a prolonged postoperative air leakage is the most frequent and troublesome early complication after video-assisted thoracoscopic (VATS) bullectomy. This study aimed to explore the efficacy of polyglycolic acid (PGA) sleeve in preventing postoperative air leakage after a VATS bullectomy for PSP. METHODS: This study was a prospectively randomised clinical study. The patients who underwent a VATS bullectomy were continuously enrolled from January 2015 to June 2016 in the Beijing Chaoyang Hospital and were randomly assigned to the experimental and control groups...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28523161/the-safety-profile-of-preoperative-administration-of-heparin-for-thromboprophylaxis-in-chinese-patients-intended-for-thoracoscopic-major-thoracic-surgery-a-pilot-randomized-controlled-study
#8
Han-Yu Deng, Chang-Lin Shi, Gang Li, Jun Luo, Zhi-Qiang Wang, Yi-Dan Lin, Lun-Xu Liu, Qing-Hua Zhou
BACKGROUND: Patients undergoing major thoracic surgery especially for cancers are at a high risk of perioperative thromboembolism. Current guidelines recommended either heparin sodium (unfractionated heparin) or low-molecular-weight heparin (LMWH) for those patients at high risk of deep vein thrombosis (DVT). However, the rational timing of starting heparin has not yet been well established, because DVT can be caused by not only surgery but also comorbidities as well as prolonged hospital stay, and thoracic surgeons always concerned about heparin-related increased risk of intra- or post-operative bleeding...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28520545/hemodynamic-profile-of-acute-kidney-injury-following-the-fontan-procedure-impact-of-renal-perfusion-pressure
#9
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/28515948/cerebral-air-embolism-associated-with-penetrating-lung-injury-a-case-report-and-review-of-the-literature
#10
Ayumu Yamaoka, Kei Miyata, Eichi Narimatsu, Eiji Sakawaki, Sonoko Sakawaki, Suguru Hirayama, Shuji Uemura, Naoya Yama
CASE: A 44-year-old man intentionally stabbed himself in the anterior neck and left thorax with a fruit knife. Physical examination revealed two open wounds entering the thoracic cavity in the front chest, and a stab wound entering the trachea at the neck. Two chest tubes were initially inserted for the left lung injury with open hemopneumothorax. Nevertheless, the worsening oxygenation required positive pressure ventilation (PPV) with endotracheal intubation. OUTCOME: Right hemiparesis was found during weaning from PPV...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/28505359/thoracoscopic-anatomical-lung-segmentectomy-using-3d-computed-tomography-simulation-without-tumour-markings-for-non-palpable-and-non-visualized-small-lung-nodules%C3%A2
#11
Hirohisa Kato, Hiroyuki Oizumi, Jun Suzuki, Akira Hamada, Hikaru Watarai, Mitsuaki Sadahiro
OBJECTIVES: Although wedge resection can be curative for small lung tumours, tumour marking is sometimes required for resection of non-palpable or visually undetectable lung nodules as a method for identification of tumours. Tumour marking sometimes fails and occasionally causes serious complications. We have performed many thoracoscopic segmentectomies using 3D computed tomography simulation for undetectable small lung tumours without any tumour markings. The aim of this study was to investigate whether thoracoscopic segmentectomy planned with 3D computed tomography simulation could precisely remove non-palpable and visually undetectable tumours...
May 12, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28502236/family-presence-in-the-adult-icu-during-bedside-procedures
#12
Marnie Jakab, Alex Z Day, Alan Kraguljac, Maedean Brown, Sangeeta Mehta
PURPOSE: To understand perspectives of family members of adult patients admitted to the medical-surgical intensive care unit (ICU) regarding their presence during procedures. METHODS: Respondents completed a questionnaire about procedures the patient had undergone, their desire to be present, and their experience. Procedures of interest were endotracheal intubation; chest compressions; vascular catheter insertion; and gastric, chest, and rectal tubes. Impact of Events Scale-Revised (IES-R) was completed at the time of questionnaire completion and again 1 month later to evaluate the psychological impact of witnessing a procedure...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28500579/robotic-repair-of-a-right-sided-bochdalek-hernia-a-case-report-and-literature-review
#13
Amani Jambhekar, Shawn Robinson, Brian Housman, James Nguyen, Kevin Gu, Vadim Nakhamiyayev
BACKGROUND: Bochdalek hernias (BHs) are usually diagnosed in the neonatal period, occurring in 1/2200-1/12,500 live births. There are few reported cases of BHs in adults. Robotic repair has not been described in current literature as opposed to the laparoscopic approach. Here we present a case of an adult with clinical signs of bowel obstruction secondary to a BH which was repaired using a robotic approach. CASE REPORT: A 74-year-old gentleman with past medical history of benign prostatic hyperplasia presented to the emergency department with a 1-week history of nausea, vomiting, diarrhea, and decline in appetite...
May 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28499641/outcomes-of-research-biopsies-in-clinical-trials-of-egfr-mutation-positive-non-small-cell-lung-cancer-patients-pretreated-with-egfr-tyrosine-kinase-inhibitors
#14
Bin-Chi Liao, Ya-Ying Bai, Jih-Hsiang Lee, Chia-Chi Lin, Shu-Yung Lin, Yee-Fan Lee, Chao-Chi Ho, Jin-Yuan Shih, Yeun-Chung Chang, Chong-Jen Yu, James Chih-Hsin Yang, Pan-Chyr Yang
BACKGROUND/PURPOSE: Research biopsies (RBs) are crucial for developing novel molecular targeted agents. However, the safety and diagnostic yields of RBs have not been investigated in EGFR mutation-positive non-small cell lung cancer (NSCLC) patients pretreated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). METHODS: We searched the medical records of NSCLC patients who participated in lung cancer clinical trials and underwent mandatory RBs between 2012 and 2014 at our institution...
May 9, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28498236/feasibility-of-transabdominal-cardiophrenic-lymphnode-dissection-in-advanced-ovarian-cancer-initial-experience-at-a-tertiary-center
#15
Annalisa Garbi, Vanna Zanagnolo, Nicoletta Colombo, Giovanni Aletti, Maria Teresa Achilarre, Luca Bocciolone, Fabio Landoni, Stefania Rizzo, Roberto Biffi, Angelo Maggioni
OBJECTIVES: The purpose of this retrospective report is to define the safety and feasibility, based on our preliminary experience, of surgical transdiaphragmatic resection of enlarged cardiophrenic lymph nodes (CPLNs), as a part of upfront debulking surgery. Supradiaphragmatic nodes located between the diaphragm and the heart are frequently a location for lymph node metastasis in advanced ovarian cancer, and their removal is aimed to obtain no gross residual disease at the primary cytoreductive surgery often requiring aggressive surgical procedures...
May 12, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28495203/treatment-of-air-leak-in-polytrauma-patients-with-blunt-chest-injury
#16
Gabriel Halat, Lukas L Negrin, Konstantina Chrysou, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
INTRODUCTION: Precise diagnostics and an adequate therapeutic approach are mandatory in the treatment of air leak in polytrauma patients with blunt chest trauma. The aim of this study was to evaluate the incidence, characteristics, and management of air leak following this injury pattern. PATIENTS AND METHODS: Data from 110 polytrauma patients was collected retrospectively. Fifty-four patients received initial treatment by chest tube placement for pneumothorax. These patients were classified into two groups, one with severe air leak and one with minor air leak...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28494978/post-operative-chylothorax-in-patients-with-congenital-heart-disease
#17
Jill J Savla, Maxim Itkin, Joseph W Rossano, Yoav Dori
BACKGROUND: Post-operative chylothorax in patients with congenital heart disease is a challenging problem with substantial morbidity and mortality. Currently, the etiology of chylothorax is poorly understood and treatment options are limited. OBJECTIVES: This study aimed to report lymphatic imaging findings, determine the mechanism of chylothorax after cardiac surgery, and analyze the outcomes of lymphatic embolization. METHODS: We conducted a retrospective review of 25 patients with congenital heart disease and post-operative chylothorax who presented for lymphatic imaging and intervention between July 2012 and August 2016...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28489809/cannabis-induced-bullous-lung-disease-leading-to-pneumothorax-case-report-and-literature-review
#18
Rashmi Mishra, Ravi Patel, Misbahuddin Khaja
RATIONALE: Marijuana use has been increasing in the United States among college students and young adults. Marijuana use has been associated with bullous lung disease which can lead to pneumothorax. There are other recreational drugs like methylphenidate, cocaine and heroin which have been associated with pneumothorax. PATIENT CONCERNS: We present a case of a 30-year-old man with spontaneous pneumothorax associated with marijuana use. The patient had no medical conditions and presented to the emergency room with chest pain...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28487142/risk-factors-for-recurrent-pneumonia-in-post-irradiated-patients-with-nasopharyngeal-carcinoma
#19
Jing-Jie Wang, Rong-San Jiang, Ting-Ting Yen, Kai-Li Liang
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a common cancer in eastern Asia. Chemoradiotherapy is the main treatment modality for NPC. Dysphagia and aspiration is not uncommon in post-irradiated NPC patients. The purpose of this study was to investigate the risk factors for recurrent pneumonia and the prognosis. METHODS: A retrospective chart review was conducted from January 2004 to December 2014. NPC patients who had been hospitalized for pneumonia in the study hospital were enrolled...
May 6, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28478929/low-voltage-chest-ct-another-way-to-reduce-the-radiation-dose-in-asbestos-exposed-patients
#20
D Macía-Suárez, E Sánchez-Rodríguez, B Lopez-Calviño, C Diego, M Pombar
AIM: To assess whether low voltage chest computed tomography (CT) can be used to successfully diagnose disease in patients with asbestos exposure. MATERIALS AND METHODS: Fifty-six former employees of the shipbuilding industry, who were candidates to receive a standard-dose chest CT due to their occupational exposure to asbestos, underwent a routine CT. Immediately after this initial CT, they underwent a second acquisition using low-dose chest CT parameters, based on a low potential (80 kV) and limited tube current...
May 4, 2017: Clinical Radiology
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