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https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#1
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29688570/diffuse-large-b-cell-lymphoma-chemotherapy-reveals-a-combined-immunodeficiency-syndrome-in-cartilage-hair-hypoplasia
#2
Alexandre Nguyen, Nicolas Martin Silva, Hubert de Boysson, Gandhi Damaj, Achille Aouba
Cartilage hair hypoplasia (CHH) is a rare autosomal recessive ribosomopathy characterised by skeletal and integumentary system manifestations. It may also present with varied forms and intensities of haematopoietic and/or immune disorders. We report a 27-year-old female who presented a picture of combined immunodeficiency after receiving an adriamycin-based chemotherapy regimen followed by autologous stem cell transplantation. Her medical history indicated neonatal dwarfism, recurrent ear, nose and throat and respiratory infections, and hypogammaglobulinaemia, which were suggestive of a primary minor B-cell immune deficiency...
April 24, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#3
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29687077/efficacy-and-outcomes-of-intrathecal-analgesia-as-part-of-an-enhanced-recovery-pathway-in-colon-and-rectal-surgical-patients
#4
Amit Merchea, Jenna K Lovely, Adam K Jacob, Dorin T Colibaseanu, Scott R Kelley, Kellie L Mathis, Grant M Spears, Marianne Huebner, David W Larson
Purpose: Multimodal analgesia is an essential component of an enhanced recovery pathway (ERP). An ERP that includes the use of single-injection intrathecal analgesia (IA) has been shown to decrease morbidity and cost and shorten length of stay (LOS). Limited data exist on safety, feasibility, and the optimal IA regimen. Our objective was to characterize the efficacy, safety, and feasibility of IA within an ERP in a cohort of colorectal surgical patients. Methods: We performed a retrospective review of all consecutive patients aged ≥ 18 years who underwent open or minimally invasive colorectal surgery from October 2012 to December 2013...
2018: Surgery Research and Practice
https://www.readbyqxmd.com/read/29686916/resolution-of-right-hemidiaphragm-paralysis-following-cervical-foraminotomies
#5
Neal Singleton, Matthew Bowman, David Bartle
Introduction: Hemidiaphragm paralysis secondary to phrenic nerve palsy is a well-recognised medical condition. There are few case reports in the literature documenting resolution of hemidiaphragm paralysis following cervical spine surgery. This case report documents our experience with one such case. Case Presentation: A 64-year-old man was referred to the orthopaedic service with right hemidiaphragm paralysis. He had a previous history of asbestos exposure and polio and was initially seen and investigated by the respiratory physicians...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29686492/transitioning-from-medical-school-to-residency-evaluation-of-an-innovative-immersion-rotation-for-pgy-1-paediatric-residents
#6
Stéphanie Vairy, Olivier Jamoulle, Arielle Levy, Ana Carceller
Transition from medical school to residency is stressful due to new responsibilities in patient care. Objective: To evaluate a new immersion curriculum on the transition from medical school to paediatric residency and its implications for future use in paediatric education. Methods: In July 2013, a month-rotation offering one-third of time for clinical rounds and two-thirds of time for formal courses was conducted for postgraduate year 1 residents beginning paediatric residency training...
April 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29684994/postoperative-infusion-of-a-low-dose-of-dexmedetomidine-reduces-intravenous-consumption-of-sufentanil-in-patient-controlled-analgesia
#7
Dae-Eun Kweon, Youngbin Koo, Seonyi Lee, Kumhee Chung, Sowoon Ahn, Chunghyun Park
Background: Combining adjunctive medications with patient-controlled analgesia (PCA) has been used to minimize opioid related side-effects. The aim of this study was to evaluate whether postoperative infusion of a sub-sedative dose of dexmedetomidine can reduce opioid consumption and opioid related side-effects. Methods: We selected 60 patients from 18 to 60 years old with an American Society of Anesthesiologists physical status of 1-2 who were scheduled for elective surgery...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29682432/an-unusually-aggressive-large-cell-carcinoma-of-the-lung-undiagnosed-until-autopsy
#8
Kartikeya Rajdev, Abdul Hasan Siddiqui, Uroosa Ibrahim, Prateek Patibandla, Tahir Khan, Dany El-Sayegh
Large cell carcinoma (LCC) of the lung has a rapid mean volume doubling time (VDT) of around 67-134 days. In some cases of LCC where the VDT is extremely rapid, clinical presentation may mimic acute lung pathologies such as pneumonia. We describe a rare presentation of an aggressive LCC of the lung with an estimated VDT of around two weeks. A 52-year-old male with a history schizophrenia presented with fever, cough, and dyspnea for three weeks duration. His medical history was significant for a recent admission six weeks before current presentation for myocardial infarction (MI) and pneumonia...
February 19, 2018: Curēus
https://www.readbyqxmd.com/read/29681933/retrospective-assessment-of-antibiotics-prescribing-at-public-primary-healthcare-facilities-in-addis-ababa-ethiopia
#9
Fikru Worku, Dagmawit Tewahido
Background. Antibiotic overprescribing is the major driving force for the emergence of antibiotics resistance. The aim of this study was to assess antibiotics prescribing at primary healthcare facilities in Addis Ababa, Ethiopia. Methods. The study was conducted in six public health centers found in Addis Ababa City. Data was collected retrospectively from a total of 900 prescriptions and selected medical charts of patients in the health centers in 2016. Data was entered and analyzed using EPI Info 7 and SPSS 20, respectively...
2018: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/29681729/risk-factors-for-respiratory-hospitalizations-in-a-population-of-patients-with-a-clinical-diagnosis-of-copd
#10
Jovica Veljanovski, Daniel R Ouellette
Purpose: The purpose of this study was to examine differences between patients clinically diagnosed with COPD with and without obstruction by spirometry and to identify risk factors for respiratory hospitalizations. Materials and methods: This is a retrospective analysis of all patients diagnosed with COPD at a large academic Internal Medicine Clinic in 2014, who had spirometry performed during the period 2013-2014. Two groups existed: one with obstruction termed classical COPD and another without obstruction...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29681109/safety-and-efficacy-of-noncardiac-surgical-procedures-in-the-management-of-patients-with-trisomy-13-a-single-institution-based-detailed-clinical-observation
#11
Soichi Shibuya, Yuichiro Miyake, Shigeru Takamizawa, Eriko Nishi, Katsumi Yoshizawa, Tomoko Hatata, Kazuki Yoshizawa, Kenya Fujita, Masahiko Noguchi, Jun Ohata, Takehiko Hiroma, Tomohiko Nakamura, Tomoki Kosho
Intensive treatment including surgery for patients with trisomy 13 (T13) remains controversial. This study aimed to evaluate the safety and efficacy of noncardiac surgical intervention for T13 patients. Medical records of patients with karyotypically confirmed T13 treated in the neonatal intensive care unit in Nagano Children's Hospital from January 2000 to October 2016 were retrospectively reviewed, and data from patients who underwent noncardiac surgery were analyzed. Of the 20 patients with T13, 15 (75%) underwent a total of 31 surgical procedures comprising 15 types, including tracheostomy in 10 patients and gastrostomy in 4...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29680828/viral-pneumonia-etiologies-and-treatment
#12
Dima Dandachi, Maria C Rodriguez-Barradas
Viral pathogens are increasingly recognized as a cause of pneumonia, in immunocompetent patients and more commonly among immunocompromised. Viral pneumonia in adults could present as community-acquired pneumonia (CAP), ranging from mild disease to severe disease requiring hospital admission and mechanical ventilation. Moreover, the role of viruses in hospital-acquired pneumonia and ventilator-associated pneumonia as causative agents or as co-pathogens and the effect of virus detection on clinical outcome are being investigated...
April 20, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29679606/regulatory-pitfalls-and-opportunities-when-repurposing-for-inhalation-therapy
#13
Svetlana Lyapustina
This article reviews regulatory considerations for companies wishing to develop drugs for delivery via the respiratory tract (e.g., by oral inhalation or intranasally) using molecules previously approved for a different therapeutic indication and/or a different delivery route. Conceptually, such repurposing has many medical and business advantages, but turning promising ideas into real products requires overcoming a number of practical challenges. Obtaining regulatory approval to market a candidate product comes at the end of a product development, but being aware of the regulatory requirements is necessary before the development even starts...
April 18, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29679597/management-of-dyspnea-in-the-terminally-ill
#14
REVIEW
Lara Pisani, Nicholas S Hill, Angela Maria Grazia Pacilli, Massimiliano Polastri, Stefano Nava
The genesis of dyspnea involves the activation of several mechanisms that are mediated and perceived depending on previous experiences, values, emotions and beliefs. Breathlessness may become unbearable, especially in terminally ill patients, whether afflicted by respiratory, cardiac or cancer-related disorders, due to a final stage of a chronic process, an acute event or both. Compared to pain, palliation of dyspnea has received relatively little attention in clinical practice and the medical literature. This is particularly true when the breathlessness is associated with acute respiratory failure since most of the studies on pharmacological and non-pharmacological treatments of respiratory distress have excluded such patients...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29679596/observational-studies-of-inhaled-corticosteroid-effectiveness-in-copd-lessons-learned
#15
Samy Suissa, Pierre Ernst
BACKGROUND: Randomized controlled trials at times investigate findings suggested by observational studies. For example, the TORCH trial, which did not show a mortality reduction with inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), was motivated by some observational studies that suggested considerable reductions in mortality with these drugs. Reasons for these discrepancies are unclear. METHODS: We searched the literature to identify all observational studies, including cohort and case-control studies, investigating the effectiveness of ICS on major outcomes in COPD patients, including death and hospitalization for COPD...
April 18, 2018: Chest
https://www.readbyqxmd.com/read/29679518/new-insights-in-the-use-of-pleural-ultrasonography-for-diagnosis-and-treatment-of-pleural-disease
#16
Giampietro Marchetti, Sabrina Arondi, Francesca Baglivo, Sara Lonni, Federico Quadri, Alberto Valsecchi, Nicola Venturoli, Paolo Ceruti
The use of transthoracic ultrasound has acquired a wide consensus among respiratory physicians during the last few years. The developing of portable and easily available devices favorites patient's bedside evaluation. Transthoracic ultrasound provides rapid, real-time and low-cost diagnostic information, allowing image-guided chest interventions and reducing procedural risks. The different acoustic impedance between aerated and not aerated organs produces artifacts known as A lines, B lines, sliding sign, lung point, etc...
April 21, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29679366/blood-group-and-incidence-of-asthma-and-chronic-obstructive-pulmonary-disease
#17
Bożena Mroczek, Zygmunt Sitko, Agnieszka Sujewicz, Weronika Wolińska, Iwona Karpeta-Pawlak, Donata Kurpas
Chronic respiratory diseases are determined by genetic predisposition, and environmental and socioeconomic variables. One genetic factor underlying susceptibility to such diseases can be the ABO blood group system. The purpose of this study was to investigate the hypothesis that there would be a relationship between the blood group and risk of developing asthma and chronic obstructive pulmonary disease (COPD). We reviewed medical history files of patients with the diagnosis of COPD or asthma, including those suffering from a cancerous disease accompanied by asthma or COPD, hospitalized from January 2016 to July 2017...
April 21, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29678484/chronic-respiratory-rhinitis
#18
R Jankowski, P Gallet, D T Nguyen, C Rumeau
The clinical distinction of chronic respiratory rhinitis appears to confirm the evo-devo theory of the three noses. The authors report two cases of advanced allergic rhinitis, in which chronic inflammation had induced a violaceous colour of the mucosa of the respiratory nose and a whitish polypoid appearance of the free edge of the middle turbinate. Nose and paranasal sinus CT scan revealed, beyond the virtual nasal cavities observed on nasal endoscopy and CT imaging, normal radiolucency or only minor opacities of the ethmoid (i...
April 17, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29677087/military-supplement-perfluorocarbon-gas-transport-an-overview-of-medical-history-with-yet-unrealized-potentials
#19
Bruce D Spiess
Perfluorocarbon (PFCs) compounds have been a hereto fore under realized pharmaceutical class of intravenous emulsions and respiratory adjuvants researched extensively since the late 1970. This review represents an introduction for a series of more detailed lectures/manuscripts that were part of a combined United States collaborative Federal agency meeting in early February, 2017 at Ft Detrick, MD, focused upon potential technologies in development to fulfill a perceived need: "When blood transfusion is not available...
April 19, 2018: Shock
https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#20
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
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