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https://www.readbyqxmd.com/read/29800096/effect-of-use-of-a-bougie-vs-endotracheal-tube-and-stylet-on-first-attempt-intubation-success-among-patients-with-difficult-airways-undergoing-emergency-intubation-a-randomized-clinical-trial
#1
Brian E Driver, Matthew E Prekker, Lauren R Klein, Robert F Reardon, James R Miner, Erik T Fagerstrom, Mitchell R Cleghorn, John W McGill, Jon B Cole
Importance: The tracheal tube introducer, known as the bougie, is typically used to aid tracheal intubation in poor laryngoscopic views or after intubation attempts fail. The effect of routine bougie use on first-attempt intubation success is unclear. Objective: To compare first attempt intubation success facilitated by the bougie vs the endotracheal tube + stylet. Design, Setting, and Patients: The Bougie Use in Emergency Airway Management (BEAM) trial was a randomized clinical trial conducted from September 2016 through August 2017 in the emergency department at Hennepin County Medical Center, an urban, academic department in Minneapolis, Minnesota, where emergency physicians perform all endotracheal intubations...
May 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29793813/umbilical-hernia-with-evisceration-two-cases-and-a-review-of-the-literature
#2
Eham Arora, Saurabh Gandhi, Ajay Bhandarwar, Abdul Haque M Quraishi, Amol Wagh, Amarjeet Tandur, Dhansagar Wakle
BACKGROUND: Evisceration of umbilical hernias is an uncommon occurrence whereby the hernial contents break through the skin overlying the sac and skin. Irrespective of cause, sudden evisceration of an umbilical hernia is associated with deterioration and a poor outcome. CASE REPORTS: Our first case was a 42-year-old woman who presented with sudden outpouring of fluid from the umbilicus with omental evisceration. Further evaluation revealed hepatic decompensation caused by hepatitis C infection belonging to Child-Turcotte-Pugh class C...
May 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29787546/selective-non-operative-management-of-pharyngo-esophageal-injuries-secondary-to-penetrating-neck-trauma-a-single-center-review-of-86-cases
#3
Andre S Madsen, George V Oosthuizen, John L Bruce, Wanda Bekker, Grant L Laing, Damian L Clarke
BACKGROUND: This paper describes our experience with penetrating pharyngo-esophageal injuries (PEI) in the light of a selective conservative approach, and has the objective to define criteria for non-operative management (NOM). METHODS: This retrospective single-center review of patients with penetrating neck injury (PNI) treated for confirmed PEI over a 6-year period aimed to test our proposed hypothesis that NOM is safe for hemodynamically stable patients with PEI, who have no competing indications for exploration, have no established sepsis and who have a water-soluble contrast swallow (WS-swallow) either showing no- or a contained extravasation...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29759498/the-extent-of-mechanical-esophageal-deviation-to-avoid-esophageal-heating-during-catheter-ablation-of-atrial-fibrillation
#4
Chandrasekar Palaniswamy, Jacob S Koruth, Alexander J Mittnacht, Marc A Miller, Subbarao Choudry, Rahul Bhardwaj, Dinesh Sharma, Jonathan M Willner, Sujata S Balulad, Elizabeth Verghese, Georgios Syros, Anurag Singh, Srinivas R Dukkipati, Vivek Y Reddy
OBJECTIVES: This study sought to determine the extent of lateral esophageal displacement required during mechanical esophageal deviation (MED) and to eliminate luminal esophageal temperature elevation (LETElev ) during pulmonary vein (PV) isolation. BACKGROUND: MED is a conceptually attractive strategy of minimizing esophageal injury while allowing uninterrupted energy delivery along the posterior left atrium during PV isolation. METHODS: MED was performed using a malleable metal stylet within a plastic tube placed within the esophagus...
October 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29747958/emergency-department-intubation-success-with-succinylcholine-versus-rocuronium-a-national-emergency-airway-registry-study
#5
Michael D April, Allyson Arana, Daniel J Pallin, Steven G Schauer, Andrea Fantegrossi, Jessie Fernandez, Joseph K Maddry, Shane M Summers, Mark A Antonacci, Calvin A Brown
STUDY OBJECTIVE: Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. METHODS: We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs...
May 7, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29707507/bioprosthetics-and-repair-of-complex-aerodigestive-defects
#6
Brooks Udelsman, Douglas J Mathisen, Harald C Ott
Aerodigestive defects involving the trachea, bronchi and esophagus are a result of prolonged intubation, operative complications, congenital defects, trauma, radiation and neoplastic disease. The vast majority of these defects may be repaired primarily. Rarely, due the size of the defect, underlying complexity, or unfavorable patient characteristics, primary repair is not possible. One alternative to primary repair is bioprosthetic repair. Materials such as acellular dermal matrix and aortic homograft have been used in a variety of applications, including closure of tracheal, bronchial and esophageal defects...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29668804/morphology-of-the-diaphragm-muscle-in-southern-tamandua-tamandua-tetradactyla-and-its-importance-in-cases-of-traumatic-hernia
#7
Érica F S Azevedo, Daniela R Costa E Silva, Tamires V S Natividade, Elane G Giese, Ana Rita DE Lima, Paola C Soares, Érika Branco
The wall of the diaphragm can be affected by changes caused by physical trauma, allowing the passage of viscera between the abdominal cavity and thoracic cavity, thus reducing the space for pulmonary expansion, leading to the formation of hernia and possible death. Thus, we aimed to characterize, size and determine the topography of the diaphragmatic muscle in the Southern Tamandua, since clinical and surgical activities in wild animals have become a reality more and more present in veterinary medicine. We used six adult animals, x-rayed and dissected, followed by collection of fragments of muscular portions for histological analysis...
April 16, 2018: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/29658863/swallow-syncope-after-whiplash-neck-injury
#8
Luka Lipar, Pia Vovk, Tereza Weiss, Jus Ksela
Swallow syncope is a rare dysautonomic syndrome characterized by temporary loss of consciousness upon swallowing solid foods or liquids, displaying primarily in individuals with an underlying structural or functional esophageal or cardiac pathology. However, the evidence also suggests that isolated vagal dysfunction or abnormal reactions of esophageal mechanoreceptors after mechanical irritation, demyelination, or trauma can potentially evoke  a cardioinhibitory response or vasodepression upon swallowing. We present a case of a 49-year-old otherwise healthy female patient who developed swallow syncope two weeks after whiplash neck injury acquired in a rear-end collision...
March 5, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29610732/thoracic-perforations-surgical-techniques
#9
REVIEW
Atilla Eroglu, Yener Aydin, Omer Yilmaz
Esophageal perforation may occur spontaneously, iatrogenically or in connection with traumas. Sepsis may develop in connection with mediastinal and pleural exposure in a very short time as a consequence of disintegration of the esophagus. Esophageal perforation is an emergency accompanied with a high level of mortality and morbidity. Rate of mortality for the perforations in the thoracic region is higher than that in the cervical and abdominal regions. Delay in diagnosis and treatment is the most important factor to affect the mortality...
February 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29609886/risk-factors-for-reinsertion-of-urinary-catheter-after-early-removal-in-thoracic-surgical-patients
#10
John Young, Travis Geraci, Steven Milman, Andrew Maslow, Richard N Jones, Thomas Ng
OBJECTIVES: To reduce the incidence of urinary tract infection, Surgical Care Improvement Project 9 mandates the removal of urinary catheters within 48 hours postoperatively. In patients with thoracic epidural anesthesia, we sought to determine the rate of catheter reinsertion, the complications of reinsertion, and the factors associated with reinsertion. METHODS: We conducted a prospective observational study of consecutive patients undergoing major pulmonary or esophageal resection with thoracic epidural analgesia over a 2-year period...
March 8, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29590143/short-term-evaluation-of-respiratory-effort-by-premature-infants-supported-with-bubble-nasal-continuous-airway-pressure-using-seattle-pap-and-a-standard-bubble-device
#11
Stephen E Welty, Craig G Rusin, Larissa I Stanberry, George T Mandy, Alfred L Gest, Jeremy M Ford, Carl H Backes, C Peter Richardson, Christopher R Howard, Thomas N Hansen, Charles V Smith
BACKGROUND: Almost one million prematurely born infants die annually from respiratory insufficiency, predominantly in countries with limited access to respiratory support for neonates. The primary hypothesis tested in the present study was that a modified device for bubble nasal continuous positive airway pressure (Bn-CPAP) would provide lower work of spontaneous breathing, estimated by esophageal pressure-rate products. METHODS: Infants born <32 weeks gestation and stable on Bn-CPAP with FiO2 <0...
2018: PloS One
https://www.readbyqxmd.com/read/29548327/mediastinoscopy-assisted-esophagectomy-for-t2-middle-and-lower-thoracic-esophageal-squamous-cell-carcinoma-patients
#12
Jun Wang, Ning Wei, Yimin Lu, Xiaoying Zhang, Nanqing Jiang
BACKGROUND: We aimed to compare mediastinoscopy-assisted esophagectomy (MAE) with the Ivor Lewis procedure in T2 middle and lower thoracic esophageal carcinoma patients in fields of perioperative complications and overall survival (OS). METHODS: The clinical data of 112 T2 esophageal cancer patients who received MAE (n = 31) or Ivor Lewis procedure (n = 81) from January 2010 to December 2015 were retrospectively analyzed in propensity score analysis. Thirty-eight T2 esophageal cancer patients who underwent MAE (n = 19) and Ivor Lewis procedure (n = 19) were included in this study...
March 16, 2018: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29508361/surgical-chylothorax-in-neonates-management-and-outcomes
#13
Karina Miura Costa, Amulya Kumar Saxena
BACKGROUND: Postoperative chylothorax occurs due to trauma to lymphatic vessels and can occur after any thoracic procedure. This study reviewed recent literature to evaluate the management and outcomes of surgical chylothorax in neonates. METHODS: PubMed database was searched for articles in English, Portuguese and Spanish from 2000 to 2016. Data were collected for surgery, chylothorax management, complications, mortality and length of hospital stay (LOS). RESULTS: Twenty studies offered 107 neonates: congenital diaphragmatic hernia (CDH) (n = 76, 71%), cardiac malformations (n = 25, 23...
April 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29439775/right-ventricular-fractional-area-of-change-is-predictive-of-ventilator-support-days-in-trauma-and-burn-patients
#14
Duraid Younan, David C Pigott, C Blayke Gibson, John P Gullett, Ahmed Zaky
Echocardiography has contributed to the care of critically ill patients but there remains a need for more publications about its association with outcomes to confirm its role. We conducted a retrospective review of trauma and burn patients that were admitted to our intensive care unit between 2015 and 2017 that underwent hemodynamic transesophageal echocardiography. Data collected included demographics, clinical and laboratory data. Right ventricle fractional area of change (RVFAC) measurements were performed on still mages obtained from mid-esophageal four-chamber-view clips...
February 5, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29399461/figure-of-8-reconstruction-technique-for-chronic-posterior-sternoclavicular-joint-dislocation
#15
Dean Wang, Christopher L Camp, Brian C Werner, Joshua S Dines, David W Altchek
Dislocation of the sternoclavicular joint is a rare injury and typically requires high-energy forces applied through the joint. Initial treatment is dependent on the direction of dislocation, with acute reduction indicated for posterior dislocations presenting with signs of tracheal, esophageal, or neurovascular compression. Although most patients do well with conservative treatment after the initial trauma, some can have persistent pain and scapular dyskinesia due to instability or locked dislocation of the sternoclavicular joint...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29392975/respiratory-digestive-tract-fistula-two-center-retrospective-observational-study
#16
Sameh I Sersar, Lamees A Maghrabi
Background Aerodigestive fistulae can be defined as abnormal communications between the gastrointestinal tract and the respiratory tract. Choking after meals, coughing, feeding difficulties, tachycardia, and persistent pneumonia are the main presentations. The aim of our study was to review our experience in the management of 27 cases of acquired aerodigestive fistulae of different types, levels, and management. Methods We conducted a retrospective observational study on 27 cases of fistulae between the respiratory and digestive tracts, which were managed in 2 hospitals in Saudi Arabia in the last 5 years...
March 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29355959/optimized-thoracoport-design-for-the-thoracoscopic-procedure-during-minimally-invasive-esophagectomy
#17
Yunke Zhu, Xiaolong Zhang, Yang Hu, Lunxu Liu
Minimally invasive esophagectomy has several benefits as an effective alternative treatment for esophageal cancer. The three-phase esophageal resection may be the most popular approach to esophagectomy. Numerous thoracoport designs are available for the thoracoscopic procedure. The present study aims to contribute a distinctive three-port technique that is designed to minimize surgical trauma and facilitate operation during the thoracoscopic procedure. In this paper, we describe and demonstrate the details of the port design and each operation step...
January 22, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29316591/minimally-invasive-myotomy-percutaneous-laparoscopic-surgical-approach-for-achalasia
#18
Lavinia Alessandra Barbieri, Davide Bona, Alberto Aiolfi, Giancarlo Micheletto, Marta Cavalli, Francesca Lombardo, Piero Giovanni Bruni, Giampiero Campanelli
The laparoscopic approach of the upper gastrointestinal tract is considered the gold standard for the treatment of functional benign esophageal disorders since 1990. In recent years, many efforts have been made to minimize the abdominal wall's trauma to reduce postoperative pain and to obtain a prompt return to daily activities, as well as improve cosmetic results of surgery. The progressive development of novel surgical devices has allowed for the introduction of new minimally-invasive surgical techniques...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29283964/the-american-association-for-the-surgery-of-trauma-uniform-grading-of-hemorrhagic-emergency-general-surgery-diseases
#19
Gail T Tominaga, Carlos V R Brown, John T Schulz, Ronald R Barbosa, Suresh Agarwal, Nathaniel McQuay, Garth Utter, Marie Crandall
No abstract text is available yet for this article.
April 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29026937/-minimally-invasive-and-robotic-assisted-surgical-management-of-upper-gastrointestinal-cancer
#20
REVIEW
P P Grimminger, H F Fuchs
Total minimally invasive upper gastrointestinal resections are currently mainly performed in centers. The advantages include reduction of operative trauma, magnified enlargement of the operation field and the resulting improvement in operative precision. Robotic-assisted minimally invasive esophagectomy (RAMIE) and laparoscopic/thoracoscopic minimally invasive esophagectomy (MIE) are currently the most commonly performed strategies for esophageal cancer. Laparoscopic (MIG) and robotic-assisted gastrectomy (RAG) are the equivalent procedures for gastric cancer...
December 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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