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https://www.readbyqxmd.com/read/29792536/outcomes-in-paediatric-external-dacryocystorhinostomy-a-single-centre-experience
#1
Tarjani Vivek Dave, Edak Ezeanosike, Milind N Naik, Mohammad Javed Ali
PURPOSE: To report the outcomes of external dacryocystorhinostomy (Ext DCR) in paediatric patients. METHODS: A single-centre, retrospective, interventional, non-comparative case series was performed on all paediatric patients who underwent Ext DCR between July 2010 and July 2014. Surgery was performed as per standard Ext DCR protocols with only anterior flap suturing. Data collected include demographics, clinical presentations, primary diagnosis, associated systemic anomalies, past interventions, indications for the surgery, use of adjuvants, intraoperative and post-operative complications, aetiology of DCR failure, anatomical and functional successes...
May 24, 2018: Orbit
https://www.readbyqxmd.com/read/29792280/resource-utilization-and-indications-for-helicopter-transport-of-head-injured-children
#2
Clay M Elswick, Deidre Wyrick, Lori A Gurien, Malik Rettiganti, Marie Gowen, Ambre' Pownall, Diaa Bahgat, R Todd Maxson, Eylem Öcal, Gregory W Albert
INTRODUCTION: Helicopter emergency medical services (HEMS) have provided benefit for severely injured patients. However, HEMS are likely overused for the transportation of both adult and pediatric trauma patients. In this study, we aim to evaluate the degree of overuse of helicopter as a mode of transport for head-injured children. In addition, we propose criteria that can be used to determine if a particular patient is suitable for air versus ground transport. MATERIALS AND METHODS: We identified patients who were transported to our facility for head injuries...
May 1, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29792168/trends-in-the-incidence-and-associated-factors-of-late-onset-sepsis-associated-with-improved-survival-in-extremely-preterm-infants-born-at-23-26-weeks-gestation-a-retrospective-study
#3
Jin Kyu Kim, Yun Sil Chang, Sein Sung, So Yoon Ahn, Won Soon Park
BACKGROUND: To investigate the trends in the incidence and associated factors of late-onset sepsis (LOS) associated with improved survival in extremely preterm infants. METHODS: Medical records of 364 infants who were born at 23-26 weeks' gestation from 2000 to 2005 (period I, n = 124) and from 2006 to 2011 (period II, n = 240) were retrospectively reviewed. The infants were stratified into subgroups of 23-24 and 25-26 weeks' gestation within each period, and survival, LOS rate, and clinical characteristics were analyzed...
May 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#4
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29789053/management-of-meconium-stained-newborns-in-the-delivery-room
#5
Chintan Kiritkumar Gandhi
The approach to the management of meconium-stained newborns in the delivery room has been changing for over 40 years. The goal is to prevent meconium aspiration syndrome (MAS) and complications related to MAS. For decades, airway obstruction was believed to be a major component of MAS and, consequently, suction maneuvers to remove meconium from the airways were recommended to decrease the frequency and severity of MAS. Initial recommendations were based on observational studies. However, the incidence of MAS and mortality related to MAS has declined since the 1970s, mostly because of a decrease in the number of postterm deliveries...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29787544/a-clinical-prediction-model-for-raised-intracranial-pressure-in-patients-with-traumatic-brain-injuries
#6
J Pace, N Parry, K Vogt, R Hilsden, R Leeper, Z Markova, F Priestap, J Younan, I M Ball
BACKGROUND: Intracranial hypertension is believed to contribute to secondary brain insult in traumatically brain injured patients. Currently the diagnosis of intracranial hypertension requires intracranial monitoring or advanced imaging. Unfortunately, prehospital transport times can be prolonged, delaying time to the initial radiographic assessment. The aim of this study was to identify clinical variables associated with raised intracranial pressure (ICP) prior to the completion of neuroimaging...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787386/comparison-of-tracheal-intubation-conditions-in-operating-room-and-intensive-care-unit-a-prospective-observational-study
#7
Manuel Taboada, Patricia Doldan, Andrea Calvo, Xavier Almeida, Esteban Ferreiroa, Aurora Baluja, Agustin Cariñena, Paula Otero, Valentin Caruezo, Alberto Naveira, Pablo Otero, Julian Alvarez
BACKGROUND: Tracheal intubation is a common intervention in the operating room and in the intensive care unit. The authors hypothesized that tracheal intubation using direct laryngoscopy would be associated with worse intubation conditions and more complications in the intensive care unit compared with the operating room. METHODS: The authors prospectively evaluated during 33 months patients who were tracheally intubated with direct laryngoscopy in the operating room, and subsequently in the intensive care unit (within a 1-month time frame)...
May 22, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29787339/outcomes-in-pediatric-powered-endoscopic-dacryocystorhinostomy-a-single-center-experience
#8
Nandini Bothra, Milind N Naik, Mohammad Javed Ali
PURPOSE: The purpose of the article is to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR) in pediatric patients. METHODS: A single-center, single surgeon, retrospective, interventional, non-comparative case series was performed on all pediatric patients who underwent PEnDCR between July 2014 and July 2017. Patients with associated congenital anomalies like single punctum agenesis or lacrimal fistula were excluded. Surgery was performed as per standard protocols published earlier...
May 22, 2018: Orbit
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#9
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786653/role-for-cystathionine-%C3%AE-lyase-cse-in-an-ethanol-e-induced-lesion-in-fetal-brain-gsh-homeostasis
#10
Dhyanesh Patel, Marylatha Rathinam, Courtney Jarvis, Lenin Mahimainathan, George Henderson, Madhusudhanan Narasimhan
Earlier, we reported that gestational ethanol (E) can dysregulate neuron glutathione (GSH) homeostasis partially via impairing the EAAC1-mediated inward transport of Cysteine (Cys) and this can affect fetal brain development. In this study, we investigated if there is a role for the transulfuration pathway (TSP), a critical bio-synthetic point to supply Cys in E-induced dysregulation of GSH homeostasis. These studies utilized an in utero E binge model where the pregnant Sprague⁻Dawley (SD) rat dams received five doses of E at 3...
May 22, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29785406/fluid-extravasation-in-shoulder-arthroscopic-surgery-a-systematic-review
#11
REVIEW
Muzammil Memon, Jeffrey Kay, Arian Gholami, Nicole Simunovic, Olufemi R Ayeni
Background: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. Purpose: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29782242/case-254-posttraumatic-migrating-fat-embolus-causing-fat-emboli-syndrome
#12
Sébastien Molière, Stéphane Kremer, Guillaume Bierry
History An otherwise healthy 18-year-old man was admitted to the emergency department with a closed displaced fracture of the left femoral shaft ( Fig 1 ) after a high-velocity motorbike accident. At admission, other physical examination findings were unremarkable. Initial unenhanced and contrast material-enhanced (120 mL of Iomeron 400; Bracco Imaging, Milan, Italy) computed tomography (CT) was performed in the arterial and venous phases from the head to the knees. No abnormalities were noted in the brain or chest at initial CT...
June 2018: Radiology
https://www.readbyqxmd.com/read/29781361/erythromycin-combined-with-corticosteroid-reduced-inflammation-and-modified-trauma-induced-tracheal-stenosis-in-a-rabbit-model
#13
Qin Enyuan, Xu Mingpeng, Gan Luoman, Gan Jinghua, Li Yu, Li Wentao, Hou Changchun, Li Lihua, Meng Xiaoyan, Zhou Lei, Liu Guangnan
BACKGROUND: Patients with endotracheal intubation or tracheostomy are subject to benign tracheal stenosis (TS), for which current therapies are unsatisfactory. We conducted a preliminary investigation of drugs and drug combinations for the prevention and treatment of TS in a rabbit model. METHODS: Fifty-four rabbits were apportioned into nine groups according to treatment: sham-operated control; untreated TS model; amikacin; budesonide; erythromycin; penicillin; amikacin + budesonide; erythromycin + budesonide; and penicillin + budesonide...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29780070/chronic-obstructive-pulmonary-disease-and-off-pump-coronary-surgery
#14
Cengiz Ovalı, Aykut Şahin
PURPOSE: To determine to what extent chronic obstructive pulmonary disease (COPD) affects mortality and morbidity rates in patients treated with off-pump coronary artery bypass graft (CABG). METHODS: A total of 321 patients treated with off-pump CABG were included in the present study. Of the 321 patients, 46 patients had COPD and they were designated as Group 1 and the remaining 275 patients did not have COPD and they were considered as Group 2. We compared the data obtained from the patients in both groups...
May 18, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779887/pulmonary-capillary-hemorrhage-induced-by-diagnostic-ultrasound-in-ventilated-rats
#15
Douglas L Miller, Zhihong Dong, Chunyan Dou, Krishnan Raghavendran
Pulmonary capillary hemorrhage (PCH) can be induced by diagnostic ultrasound-a potential safety issue. Anesthetized rats were intubated for intermittent positive-pressure ventilation (IPPV) with 0 end-expiratory pressure, +4 cm H2 O end-expiratory pressure (PEEP) and -4 cm H2 O end-expiratory pressure (NEEP). Rats were imaged at 7.6 MHz with a Philips HDI 5000 ultrasound machine. The output was low (mechanical index [MI] = 0.22) for aiming and then was raised for 5 min in 20 different exposure groups with n = 8...
May 17, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29778994/heart-rate-changes-during-positive-pressure-ventilation-after-asphyxia-induced-bradycardia-in-a-porcine-model-of-neonatal-resuscitation
#16
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/29778972/hypnotic-agents-for-induction-of-general-anesthesia-in-cesarean-section-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber
STUDY OBJECTIVE: An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. DESIGN: A systematic review and meta-analysis, using PRISMA methodology, of randomized controlled trials (RCTs), comparing women undergoing CS using thiopentone with those undergoing CS with propofol, ketamine, or benzodiazepines as hypnotic agents...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29777352/forward-viewing-endoscope-for-ercp-in-patients-with-billroth-ii-gastrectomy-a-systematic-review-and-meta-analysis
#18
Tae Young Park, Chang Seok Bang, Sang Hyeon Choi, Young Joo Yang, Suk Pyo Shin, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim, Jai Hoon Yoon
BACKGROUND: The forward-viewing endoscope has been increasingly used to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients who underwent Billroth II gastrectomy. This study intended to assess efficacy and safety of the forward-viewing endoscope for ERCP in Billroth II gastrectomy patients compared with conventional side-viewing endoscope using a systematic review and meta-analysis. METHODS: A systematic review was conducted for studies that evaluated the outcomes of ERCP for patients with Billroth II gastrectomy...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29777243/comparison-of-formulae-for-orotracheal-intubation-depth-in-the-paediatric-population
#19
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/29776746/comparison-of-efficacy-of-colonoscopy-between-the-morning-and-afternoon-a-systematic-review-and-meta-analysis
#20
REVIEW
Junqi Wu, Sheng-Bing Zhao, Shu-Ling Wang, Jun Fang, Tian Xia, Xiao-Ju Su, Can Xu, Zhao-Shen Li, Yu Bai
OBJECTIVE: Colonoscopy performed in the afternoon, rather than morning, has been reported to be associated with lower rates of adenoma and polyp detection (ADR and PDR) and cecal intubation (CIR). This meta-analysis evaluated the efficacy of afternoon colonoscopy relative to morning colonoscopy. METHODS: The databases MEDLINE, Web of Science, EMBASE, and the Cochrane Library were searched to identify potential relevant studies. The primary outcome was ADR and the secondary outcomes were CIR and PDR...
April 9, 2018: Digestive and Liver Disease
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