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https://www.readbyqxmd.com/read/29782482/trauma-patients-are-safe-to-fly-72-hours-after-tube-thoracostomy-removal
#1
David Zonies, Joel Elterman, Christopher Burns, Vincent Paul, John Oh, Jeremy Cannon
BACKGROUND: Current recommendations for safe air travel following traumatic pneumothorax are 2-3 weeks after radiographic resolution. These recommendations are based on several small observational studies and expert consensus which cite a theoretical risk of recurrence and hypoxia due to decreased oxygen tension at altitude. We sought to systematically study the timing of chest drain removal after traumatic pneumothorax and risk of recurrence in relation to air travel. METHODS: A retrospective cohort study of consecutively admitted patients who sustained a traumatic chest injury treated with tube thoracostomy over a 5-year period was undertaken...
May 18, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29781330/management-of-pleural-infections
#2
Lucía Ferreiro, José M Porcel, Silvia Bielsa, María Elena Toubes, José Manuel Álvarez-Dobaño, Luis Valdés
The management of infected pleural effusion is complex. Therapeutic resolution requires determining the following: appropriate antibiotic regimen, the need for pleural drainage, the optimal drainage tube size, and the need for intrapleural therapy or surgery. Areas covered: An updating of the latest advances in the management of parapneumonic pleural effusion based on the best evidence available is provided. Expert commentary: The correct management of parapneumonic pleural effusion is based on selecting an antibiotic regimen according to the origin of the pleural infection (community-acquired or nosocomial)...
May 20, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29778994/heart-rate-changes-during-positive-pressure-ventilation-after-asphyxia-induced-bradycardia-in-a-porcine-model-of-neonatal-resuscitation
#3
Maria Liza Espinoza, Po-Yin Cheung, Tze-Fun Lee, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: The Neonatal Resuscitation Program (NRP) states that if adequate positive pressure ventilation (PPV) was given for a low heart rate (HR), the infant's HR should increase within the first 15 s of PPV. OBJECTIVE: To assess changes in HR in piglets with asphyxia-induced bradycardia. METHODS: Term newborn piglets (n=30) were anaesthetised, intubated, instrumented and exposed to 50 min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the tube until severe bradycardia (defined as HR at <u><</u>25% of baseline)...
May 19, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29777243/comparison-of-formulae-for-orotracheal-intubation-depth-in-the-paediatric-population
#4
Jen Heng Pek, Elizabeth Mj Tan, Ying Hao, Gene Yk Ong
INTRODUCTION: Multiple formulae have been proposed for calculating orotracheal depth for paediatric intubation. However, literature on the validation of these formulae in the emergency department setting is limited. Three methods described in the local Advanced Paediatric Life Support curriculum include the Broselow tape, endotracheal tube (ETT) size x 3, and the age-based formula of age divided by 2, add 12. We aimed to determine their accuracy. MATERIALS AND METHODS: Patients with intubation performed in the Children's Emergency from 1 January 2009 to 31 December 2013 were included in this retrospective observational study...
April 2018: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/29773665/hypersensitivity-pneumonitis-and-acute-respiratory-distress-syndrome-from-e-cigarette-use
#5
Casey G Sommerfeld, Daniel J Weiner, Andrew Nowalk, Allyson Larkin
Electronic cigarette (e-cigarette) use, or "vaping," is gaining widespread popularity as an alternative to conventional cigarettes among adolescents. Little is known of the health risks of e-cigarette use, especially in children and adolescents. We present a Case Report of a previously healthy 18-year-old woman who presented with dyspnea, cough, and pleuritic chest pain after e-cigarette use. She developed respiratory failure with hypoxia and was intubated, and ultimately met diagnostic criteria for acute respiratory distress syndrome...
May 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29773409/correlation-of-objective-assessment-data-with-general-surgery-resident-in-training-evaluation-reports-and-operative-volumes
#6
Jad M Abdelsattar, Yazan N AlJamal, Raaj K Ruparel, Phillip G Rowse, Stephanie F Heller, David R Farley
OBJECTIVE: Faculty evaluations, ABSITE scores, and operative case volumes often tell little about true resident performance. We developed an objective structured clinical examination called the Surgical X-Games (5 rooms, 15 minutes each, 12-15 tests total, different for each postgraduate [PGY] level). We hypothesized that performance in X-Games will prove more useful in identifying areas of strength or weakness among general surgery (GS) residents than faculty evaluations, ABSITE scores, or operative cases volumes...
May 14, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29771328/association-of-preoperative-plasma-fibrinogen-level-with-postoperative-bleeding-after-on-pump-coronary-bypass-surgery-does-plasma-fibrinogen-level-affect-the-amount-of-postoperative-bleeding
#7
Sameh Alagha, Murat Songur, Tugba Avci, Kerem Vural, Sadi Kaplan
OBJECTIVES: Our primary aim was to investigate the association between the preoperative concentration of plasma fibrinogen and the volume of postoperative bleeding. Our secondary aim was to identify whether there is a possible correlation between the patients' different characteristics and haemostatic laboratory variables and the postoperative amount of bleeding after on-pump coronary artery bypass grafting procedures. METHODS: A total of 550 adult patients undergoing isolated coronary artery bypass grafting on cardiopulmonary bypass in our hospital were enrolled and investigated retrospectively...
May 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29769481/a-case-of-thoracic-endometriosis-syndrome-presenting-with-recurrent-catamenial-pneumothorax
#8
Shoaib Z Junejo, Sandeep Singh Lubana, Sukhdip Singh Shina, Sandeep Singh Tuli
BACKGROUND Catamenial pneumothorax (CP) is a spontaneous pneumothorax commonly associated with menstrual periods. Endometrial tissues most commonly involve the pelvic region. However, after the pelvis, the lungs are most frequently involved. Thoracic endometriosis should always be suspected in young women presenting with CP. CASE REPORT A 30-year-old woman with history of endometriosis presented with chief complaint of umbilical pain. A computerized tomography (CT) scan of the abdomen and pelvis was performed, which showed an incidental finding of a large right-sided pneumothorax...
May 17, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29755848/ct-dose-modulation-using-automatic-exposure-control-in-whole-body-pet-ct-effects-of-scout-imaging-direction-and-arm-positioning
#9
Yusuke Inoue, Kazunori Nagahara, Hiroko Kudo, Hiroyasu Itoh
Automatic exposure control (AEC) modulates tube current and consequently X-ray exposure in CT. We investigated the behavior of AEC systems in whole-body PET/CT. CT images of a whole-body phantom were acquired using AEC on two scanners from different manufactures. The effects of scout imaging direction and arm positioning on dose modulation were evaluated. Image noise was assessed in the chest and upper abdomen. On one scanner, AEC using two scout images in the posteroanterior (PA) and lateral (Lat) directions provided relatively constant image noise along the z-axis with the arms at the sides...
2018: American Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29755798/bradycardia-after-tube-thoracostomy-for-spontaneous-pneumothorax
#10
Yomi Fashola, Sanjeev Kaul, Douglas Finefrock
We present the case of an elderly patient who became bradycardic after chest tube insertion for spontaneous pneumothorax. Arrhythmia is a rare complication of tube thoracostomy. Unlike other reported cases of chest tube induced arrhythmias, the bradycardia in our patient responded to resuscitative measures without removal or repositioning of the tube. Our patient, who had COPD, presented with shortness of breath due to spontaneous pneumothorax. Moments after tube insertion, patient developed severe bradycardia that responded to Atropine...
2018: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/29755625/minimal-invasive-technique-in-atrial-septal-defect-surgery
#11
Feridoun Sabzi, Reza Faraji, Mahmood Kazeminasab
Background: Median sternotomy with minimal skin incision (MSWMSI) and modified anterior mini-thoracotomy (MAMT) approach that both are innovative techniques modified from previous documented techniques are important alternative to conventional median sternotomy in atrial septal defect (ASD) repair. Our aim is to explain the details of two performed techniques in our center and explain the results. Methods: Totally 54 children with ASD (20 female and 34 male) were operated with two different techniques i...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29750136/dysfunctional-closed-chest-drainage-common-causative-factors-and-recommendations-for-prevention
#12
Usman Hashmi, Muhammad Nadeem, Abdul Aleem, Fuad Ul Hasan H Khan, Rabeea Gull, Kaleen Ullah, Iftikhar H Khan
Introduction Dysfunctional closed chest drainage unit (CDU) dysfunction is a common but serious clinical problem associated with tube thoracostomy and results in a significant rise in morbidity, prolonged hospital stays, and increased economic burden. This observational study examines the proximate factors of closed CDU dysfunction in addition to their relative frequency. Based on our findings, we suggest logical recommendations for preventing the factors that contribute to closed chest drainage unit dysfunction...
March 9, 2018: Curēus
https://www.readbyqxmd.com/read/29741691/the-volume-threshold-of-300-versus-100-ml-day-for-chest-tube-removal-after-pulmonary-lobectomy-a-meta-analysis
#13
Tian-Xiang Zhang, Ye Zhang, Zhi-Dong Liu, Shi-Jie Zhou, Shao-Fa Xu
OBJECTIVES: In this meta-analysis, we conducted a pooled analysis of clinical studies comparing the efficacy of a volume threshold of 300 ml/day before removing a chest tube (CT) versus 100 ml/day after a lobectomy. METHODS: According to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of PubMed, Embase, Cochrane Library, Web of Science databases, CNKI, the Wanfang database, CBMdisc and Google Scholar to identify articles to include in our meta-analysis...
May 7, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29735355/association-of-focal-radiation-dose-adjusted-on-cross-sections-with-subsolid-nodule-visibility-and-quantification-on-computed-tomography-images-using-aidr-3d-comparison-among-scanning-at-84-42-and-7-mas
#14
Yukihiro Nagatani, Hiroshi Moriya, Satoshi Noma, Shigetaka Sato, Shinsuke Tsukagoshi, Tsuneo Yamashiro, Mitsuhiro Koyama, Noriyuki Tomiyama, Yoshiharu Ono, Sadayuki Murayama, Kiyoshi Murata
RATIONALE AND OBJECTIVES: The objectives of this study were to compare the visibility and quantification of subsolid nodules (SSNs) on computed tomography (CT) using adaptive iterative dose reduction using three-dimensional processing between 7 and 42 mAs and to assess the association of size-specific dose estimate (SSDE) with relative measured value change between 7 and 84 mAs (RMVC7-84 ) and relative measured value change between 42 and 84 mAs (RMVC42-84 ). MATERIALS AND METHODS: As a Japanese multicenter research project (Area-detector Computed Tomography for the Investigation of Thoracic Diseases [ACTIve] study), 50 subjects underwent chest CT with 120 kV, 0...
May 4, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29726546/the-role-of-standard-non-ecg-gated-chest-ct-in-cardiac-assessment-design-and-rationale-of-the-cardiac-pathologies-in-standard-chest-ct-capact-study
#15
Nienke G Eijsvoogel, Babs M F Hendriks, Hugo B Park, Sibel Altintas, Casper Mihl, Barbora Horehledova, Bastiaan L J H Kietselaer, Harry J G M Crijns, Joachim E Wildberger, Marco Das
Modern high-performance computed tomography (CT) scanners with improved scan acquisition times now allow for routine assessment of cardiac pathologies on chest CTs, which can result in numerous incidental cardiac findings. The CaPaCT study, an observer blinded, single-centre study, aims to assess the visibility, management and possible clinical impact of incidental cardiac pathologies that are now becoming visible on standard chest CTs. A total of 217 consecutive patients referred for a chest CT on a high-performance third-generation dual-source CT scanner will be included...
2018: European radiology experimental
https://www.readbyqxmd.com/read/29724675/the-use-of-model-based-iterative-reconstruction-to-optimize-chest-ct-examinations-for-diagnosing-lung-metastases-in-patients-with-sarcoma-a-phantom-study
#16
Touko Kaasalainen, Teemu Mäkelä, Anna Kelaranta, Mika Kortesniemi
RATIONALE AND OBJECTIVES: This phantom study aimed to evaluate low-dose (LD) chest computed tomography (CT) protocols using model-based iterative reconstruction (MBIR) for diagnosing lung metastases in patients with sarcoma. MATERIALS AND METHODS: An adult female anthropomorphic phantom was scanned with a 64-slice CT using four LD protocols and a standard-dose protocol. Absorbed organ doses were measured with 10 metal-oxide-semiconductor field-effect transistor dosimeters...
April 30, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29717340/successful-balloon-assisted-hepatic-tract-embolization-using-the-pull-through-technique-to-remove-a-malpositioned-chest-tube-penetrating-the-liver-and-into-the-right-ventricle
#17
Kunio Hamanaka, Yuusuke Hirokawa, Tsuyoshi Itoh, Michio Yamasaki, Kazuki Hayashi, Satoru Sawai, Kei Nishiyama
Intra-abdominal injury is an uncommon complication of chest tube insertion. A 66-year-old man had empyema and underwent chest tube insertion for drainage. Massive hemorrhage occurred; the postprocedural radiograph showed the malpositioned chest tube in the mediastinum. Computed tomography scan showed that the tube's tip penetrated through the liver capsule and passed through the hepatic vein to the right ventricle. Hepatic tract embolization with coiling was performed during chest tube removal under a controlled condition with the hepatic tract occluded by a balloon catheter...
May 1, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29715709/dissection-of-incomplete-fissure-using-electrocautery-is-a-safe-and-acceptable-method-for-thoracoscopic-right-upper-lobectomy
#18
Hao Xu, Linyou Zhang
OBJECTIVE:  The incidence of prolonged air leak may be highest after right upper lobectomy due to incomplete minor fissure. The objective of this study was to compare the efficacy of direct electrocautery division and suture with that of a fissureless technique during thoracoscopic right upper lobectomy with incomplete fissure. METHODS:  One hundred and two patients underwent right upper lobectomy between January 2016 and December 2016. Of these, 60 patients underwent a right upper lobectomy conducted using the fissureless technique (group A), and 42 consecutive patients underwent a right upper lobectomy via electrocautery division of the fissure and suture (group B)...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29715708/the-feasibility-of-thoracoscopic-left-pneumonectomy
#19
Hao Xu, Linyou Zhang
OBJECTIVE:  In this study, we describe our experience with video-assisted thoracoscopic surgery (VATS) left pneumonectomy as a treatment for advanced malignant and benign diseases. METHODS:  Patients who underwent VATS left pneumonectomy in our clinic between October 2013 and August 2017 were retrospectively evaluated. VATS pneumonectomy was successfully completed in 46 patients. We reviewed and analyzed the characteristics of the patients in addition to intraoperative parameters, chest tube duration, length of hospital stay, morbidity, and mortality...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29708918/adjusting-pediatric-endotracheal-tube-depths-relative-to-the-cricoid-by-using-longitudinal-ultrasound-images-of-the-saline-inflated-cuff-in-the-trachea-two-case-reports
#20
Kenji Kayashima, Hayato Mizuyama, Miyuki Takesue, Taku Doi, Keiko Imai, Koji Murashima
Cuff positions of endotracheal tubes should be confirmed to ensure safe anesthesia. However, determining the cuff positions relative to the cricoid by using chest radiography or fiberoptic bronchoscopy is difficult. We identified the cephalad edges of saline-inflated pediatric endotracheal tube cuffs relative to the cricoid on longitudinal ultrasound images over the larynx and trachea in 2 children. Thereafter, we adjusted the endotracheal tube depths and confirmed the cuff positions relative to the cricoid...
May 1, 2018: A&A practice
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