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https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#1
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28052587/pilot-study-of-dornase-alfa-pulmozyme-therapy-for-acquired-ventilator-associated-infection-in-preterm-infants
#2
Melissa Scala, Deborah Hoy, Maria Bautista, Judith Jones Palafoutas, Kabir Abubakar
OBJECTIVE: Evaluate the feasibility, safety, and efficacy of adjunctive treatment with dornase alfa in preterm patients with ventilator-associated pulmonary infection (VAPI) compared to standard care. WORKING HYPOTHESIS: We hypothesize that therapy with dornase alfa will be safe and well tolerated in the preterm population with no worsening of symptoms, oxygen requirement, or need for respiratory support. STUDY DESIGN: Prospective, randomized, blinded, pilot study comparing adjunctive treatment with dornase alfa to sham therapy...
January 3, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28052557/adenotonsillectomy-to-treat-obstructive-sleep-apnea-is-it-enough
#3
REVIEW
A Boudewyns, F Abel, E Alexopoulos, M Evangelisti, A Kaditis, S Miano, M P Villa, S L Verhulst
Although adenotonsillectomy is the first line treatment for children with obstructive sleep apnea syndrome (0SAS),(1) improvement in objectively documented outcomes is often inadequate and a substantial number of children have residual disease. Early recognition and treatment of children with persistent OSAS is required to prevent long-term morbidity. The management of these children is frequently complex and a multidisciplinary approach is required as most of them have additional risk factors for OSAS and comorbidities...
January 3, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28050702/selective-induction-of-il-1%C3%AE-after-a-brief-isoflurane-anesthetic-in-children-undergoing-mri-examination
#4
Emmett E Whitaker, Fievos L Christofi, Kristen M Quinn, Brianne Z Wiemann, Jason C Xia, Joseph D Tobias, Bruno Bissonnette
PURPOSE: To determine if isoflurane anesthesia without surgery causes systemic inflammation in children. Inflammation is targeted as responsible for the development of many neurologic pathologies. The effect will be evaluated by measuring serum cytokine levels before and after isoflurane anesthesia. The possible neurotoxic effect of anesthetic agents is a concern in pediatric anesthesia. Questions remain as to the true effects of anesthesia alone on systemic inflammation. The current study assesses systemic inflammatory response to general anesthesia in children not exposed to surgical stress...
January 3, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28045420/a-case-of-tracheal-bronchus-associated-with-right-aortic-arch-and-partial-anomalous-pulmonary-venous-connection
#5
Vehbi Doğan, İlker Ertuğrul, Yasemin Taşcı Yıldız, Utku Arman Örün, Selmin Karademir
Tracheal bronchus includes a variety of bronchial anomalies arising in the trachea or main bronchus and directed toward the upper-lobe territory. Reported incidence varies from 1-3% in the pediatric population. It is generally associated with other congenital malformations, including costovertebral anomalies, congenital airway and lung anomalies, vascular anomalies, and congenital heart defects. Presently described was the case of a 14-year-old female with tracheal right-upper-lobe bronchus, right aortic arch with mirror image, and abnormal left upper pulmonary venous return to innominate vein...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28029756/when-and-why-to-treat-the-child-who-snores
#6
Hui-Leng Tan, Maria Luz Alonso Alvarez, Marina Tsaoussoglou, Silke Weber, Athanasios G Kaditis
Obstructive sleep-disordered breathing (SDB) can result in cardiovascular and neurocognitive morbidity as well as adversely affect behavior, growth, quality of life, and nocturnal continence. This article summarizes the latest evidence regarding the morbidity related to obstructive SDB, commenting on the impact of severity of obstruction, that is, the difference in effects seen of moderate to severe obstructive sleep apnea syndrome (OSAS) compared to those of mild OSAS or primary snoring. The impact of therapy is discussed, focusing on which children are likely to benefit from treatment interventions; namely those with moderate or severe OSAS irrespective of the presence of morbidity, children with mild OSAS with associated morbidity or predictors of SDB persistence such as obesity, and children with complex conditions accompanied by upper airway obstruction like craniosynostosis and Prader-Willi syndrome...
December 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#7
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28025644/tnf%C3%AE-affects-ciliary-beat-response-to-increased-viscosity-in-human-pediatric-airway-epithelium
#8
Claudia González, Karla Droguett, Mariana Rios, Noam A Cohen, Manuel Villalón
In airway epithelium, mucociliary clearance (MCC) velocity depends on the ciliary beat frequency (CBF), and it is affected by mucus viscoelastic properties. Local inflammation induces secretion of cytokines (TNFα) that can alter mucus viscosity; however airway ciliated cells have an autoregulatory mechanism to prevent the collapse of CBF in response to increase in mucus viscosity, mechanism that is associated with an increment in intracellular Ca(+2) level ([Ca(2+)]i). We studied the effect of TNFα on the autoregulatory mechanism that regulates CBF in response to increased viscosity using dextran solutions, in ciliated cells cultured from human pediatric epithelial adenoid tissue...
2016: BioMed Research International
https://www.readbyqxmd.com/read/28025241/clinical-tools-to-assess-asthma-control-in-children
#9
Chitra Dinakar, Bradley E Chipps
Asthma affects an estimated 7 million children and causes significant health care and disease burden. The most recent iteration of the National Heart, Lung and Blood Institute asthma guidelines, the Expert Panel Report 3, emphasizes the assessment and monitoring of asthma control in the management of asthma. Asthma control refers to the degree to which the manifestations of asthma are minimized by therapeutic interventions and the goals of therapy are met. Although assessment of asthma severity is used to guide initiation of therapy, monitoring of asthma control helps determine whether therapy should be maintained or adjusted...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/28012533/a-review-of-acute-postoperative-sialadenitis-in-children
#10
Michael T Yim, Yi-Chun C Liu, Julina Ongkasuwan
OBJECTIVE: Acute postoperative sialadenitis is a previously described rare entity that has occurred following general anesthesia and has also been associated with prolonged neurosurgical procedures. We aim to better characterize this entity while performing a literature review regarding potential etiologies, diagnosis, airway management and treatment options. METHODS: A retrospective chart review was performed at a pediatric tertiary care center from 2000 to 2014...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28012527/improving-access-to-school-based-education-for-south-african-children-in-rural-areas-who-have-a-tracheostomy-a-case-series-and-recommendations
#11
Chengetai Mahomva, Sue Harris, Narvanie Seebran, Bridget Mudge, Brian Catlin, Louise Davies
OBJECTIVES: Currently few children with tracheostomies attend rural mainstreams schools in South Africa limiting their ability to gain an education. We sought to document the current school experience for the few children attending school who have tracheostomies and devise educational tools for teachers and administrators that will facilitate greater acceptance and safety in classrooms for this population. METHODS: The four patients that are currently attending school with a tracheostomy were identified from the patient records of a tertiary hospital with a pediatric tracheostomy home based care service...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28012513/minimally-invasive-endoscopic-treatment-for-pediatric-combined-high-grade-stenosis-as-a-laryngeal-manifestation-of-epidermolysis-bullosa
#12
Dora Palinko, Vera Matievics, Ilona Szegesdi, Balazs Sztano, Laszlo Rovo
Epidermolysis bullosa refers to a clinically and genetically heterogeneous group of inherited mucocutaneous diseases. Laryngotracheal lesions are momentous regarding the risk of sudden airway obstruction. The traditional treatment is tracheostomy. This case report highlights the advantages of minimally invasive interventions. A successful combined endoscopic management of a life-threatening respiratory crisis is presented in a 4-year-old child. Combined commissure stenosis with supraglottic spread was treated by CO2 laser dissection and bilateral endoscopic arytenoid abduction lateropexy, supplemented with mitomycin C application...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28008627/clinically-small-tonsils-are-typically-not-obstructive-in-children-during-drug-induced-sleep-endoscopy
#13
Craig Miller, Patricia L Purcell, John P Dahl, Kaalan Johnson, David L Horn, Maida L Chen, Dylan K Chan, Sanjay R Parikh
OBJECTIVE: To determine whether the degree of lateral pharyngeal wall (LPW) obstruction on pediatric drug-induced sleep endoscopy (DISE) correlates with preprocedure tonsillar hypertrophy score on physical examination, and to determine if clinically small tonsils are obstructive. METHODS: Retrospective review of 154 patients who underwent DISE at a single pediatric tertiary care center over a 4-year period. Inclusion criteria were documentation of Brodsky tonsil score on preoperative physical examination...
December 23, 2016: Laryngoscope
https://www.readbyqxmd.com/read/28004263/transoral-robotic-surgery-for-the-pediatric-head-and-neck-surgeries
#14
Evren Erkul, Umamaheswar Duvvuri, Deepak Mehta, Utku Aydil
Pediatric robotic surgery is a relatively new technology that has been shown to be safe and feasible for a number of pediatric procedures. Our literature analysis was performed using Pubmed database between January 2005 and December 2015, using key words: "robotic," "robotic surgery," "TORS," "pediatric," "children," "head and neck," and "da Vinci". We selected only publications in English. Eight published reports met the selection criteria. We totally found 41 patients, and the age range was between 2 months and 19 years...
December 21, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28004199/the-effect-of-esophagogastroduodenoscopy-probe-insertion-on-the-intracuff-pressure-of-airway-devices-in-children-during-general-anesthesia
#15
Onur Balaban, Mineto Kamata, Mumin Hakim, Dmitry Tumin, Joseph D Tobias
Given the size of the esophagogastroduodenoscopy (EGD) probe and the compressibility of the pediatric airway, the EGD probe may increase the intracuff pressure (IP) of an airway device. The current study evaluated IP changes during EGD examination under general anesthesia in pediatric patients. Following the induction of anesthesia, a laryngeal mask airway (LMA) or endotracheal tube (ETT) was placed without neuromuscular blockade. The IP was measured at baseline, during EGD probe insertion, while the EGD probe was in place, and after probe removal...
December 21, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/28000669/a-live-rsv-vaccine-with-engineered-thermostability-is-immunogenic-in-cotton-rats-despite-high-attenuation
#16
Christopher C Stobart, Christina A Rostad, Zunlong Ke, Rebecca S Dillard, Cheri M Hampton, Joshua D Strauss, Hong Yi, Anne L Hotard, Jia Meng, Raymond J Pickles, Kaori Sakamoto, Sujin Lee, Michael G Currier, Syed M Moin, Barney S Graham, Marina S Boukhvalova, Brian E Gilbert, Jorge C G Blanco, Pedro A Piedra, Elizabeth R Wright, Martin L Moore
Respiratory syncytial virus (RSV) is a leading cause of infant hospitalization and there remains no pediatric vaccine. RSV live-attenuated vaccines (LAVs) have a history of safe testing in infants; however, achieving an effective balance of attenuation and immunogenicity has proven challenging. Here we seek to engineer an RSV LAV with enhanced immunogenicity. Genetic mapping identifies strain line 19 fusion (F) protein residues that correlate with pre-fusion antigen maintenance by ELISA and thermal stability of infectivity in live RSV...
December 21, 2016: Nature Communications
https://www.readbyqxmd.com/read/27999601/reservoir-cannulas-for-pediatric-oxygen-therapy-a-proof-of-concept-study
#17
Grace Wu, Alec Wollen, Robert M DiBlasi, Stephen Himley, Eugene Saxon, Glenn Austin, Jaclyn Delarosa, Rasa Izadnegahdar, Amy Sarah Ginsburg, Darin Zehrung
Hypoxemia is a complication of pneumonia-the leading infectious cause of death in children worldwide. Treatment generally requires oxygen-enriched air, but access in low-resource settings is expensive and unreliable. We explored use of reservoir cannulas (RCs), which yield oxygen savings in adults but have not been examined in children. Toddler, small child, and adolescent breathing profiles were simulated with artificial lung and airway models. An oxygen concentrator provided flow rates of 0 to 5 L/min via a standard nasal cannula (NC) or RC, and delivered oxygen fraction (FdO2) was measured...
2016: International Journal of Pediatrics
https://www.readbyqxmd.com/read/27983955/reconstruction-of-anterior-tracheal-defects%C3%A2-using-a-bioengineered-graft-in-a%C3%A2-porcine-model
#18
Adnan M Al-Ayoubi, Sadiq S Rehmani, Catherine F Sinclair, Robert S Lebovics, Faiz Y Bhora
BACKGROUND: Reconstruction of long-segment tracheal defects can be challenging and a suitable tracheal substitute remains lacking. We sought to create a bioengineered tracheal graft to repair such lesions using acellullar bovine dermis extracellular matrix (ECM) and male human mesenchymal stem cells (hMSCs) and implant it in a porcine model. METHODS: hMSCs were seeded on the ECM and incubated for 1 week with chondrogenic factors. An anterior 4 cm × 3 cm defect was surgically created in the trachea of 4-week-old female Yorkshire pigs...
October 27, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27976564/nasal-chondromesenchymal-hamartoma-a-rare-pediatric-tumor-case-report
#19
Adnan Ünal, Rauf Oğuzhan Kum, Yonca Avcı, Devrim Tuba Ünal
Nasal chondromesenchymal hamartoma has characteristic clinicopathological features and it is accepted as the upper airway analogue of mesenchymal hamartoma of the chest wall. It is a rare lesion and only 31 cases have been reported in the English literature until 2014. In this article, a 13-year-old nasal chondromesenchymal hamartoma case is presented, which is the first nasal chondromesenchymal hamartoma case from Turkey. Although, nasal chondromesenchymal hamartoma has been accepted as a benign lesion, the possibility of malignant transformation should be kept in mind, and detailed histologic examination should be performed particularly in adult nasal chondromesenchymal hamartoma cases...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27976361/early-nasal-intermittent-positive-pressure-ventilation-nippv-versus-early-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-infants
#20
REVIEW
Brigitte Lemyre, Matthew Laughon, Carl Bose, Peter G Davis
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) is a strategy for maintaining positive airway pressure throughout the respiratory cycle through the application of bias flow of respiratory gas to an apparatus attached to the nose. Treatment with NCPAP is associated with decreased risk of mechanical ventilation and might be effective in reducing chronic lung disease. Nasal intermittent positive pressure ventilation (NIPPV) is a form of noninvasive ventilation during which patients are exposed intermittently to higher levels of airway pressure, along with NCPAP through the same nasal device...
December 15, 2016: Cochrane Database of Systematic Reviews
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