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https://www.readbyqxmd.com/read/28449498/trans-tracheostomy-repair-of-tracheo-esophageal-fistula-under-endoscopic-view-in-a-75-year-old-woman
#1
Francesco Paolo Caronia, Alfonso Reginelli, Mario Santini, Roberto Alfano, Sebastiano Trovato, Ettore Arrigo, Alfonso Fiorelli
Tracheo-esophageal fistula is a life-threatening condition for fatal pulmonary complications. Surgery is the treatment of choice. Unfortunately, the most of patients are unfit for surgery and in these cases there is no a standardized management. Herein, we reported a clinical case of a 75-year-old-woman with a tracheoesophageal fistula related to tracheostomy. The fistula was localized 3.5 cm below the vocal folds and extended 3 cm distally. The patient's poor clinical condition contraindicated surgery while the characteristics of fistula prevented any successfully endoscopic repair with standard methods as application of fibrin glue, clipping, or stenting...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449491/characteristics-and-provision-of-care-of-patients-with-the-acute-respiratory-distress-syndrome-descriptive-findings-from-the-dacapo-cohort-baseline-and-comparison-with-international-findings
#2
Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Sebastian Blecha, Michael Quintel, Steffen Weber-Carstens, Stefan Kluge, Patrick Meybohm, Caroline Rolfes, Björn Ellger, Friedhelm Bach, Tobias Welte, Thomas Muders, Kathrin Thomann-Hackner, Thomas Bein, Christian Apfelbacher
BACKGROUND: Little is known about the characteristics and real world life circumstances of ARDS (acute respiratory distress syndrome) patient populations. This knowledge is essential for transferring evidence-based therapy into routine healthcare. The aim of this study was to report socio-demographic and clinical characteristics in an unselected population of ARDS patients and to compare these results to findings from other large ARDS cohorts. METHODS: A German based cross-sectional observational study was carried out...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449477/continuous-administration-of-recombinant-human-b-type-natriuretic-peptide-can-improve-heart-and-renal-function-in-patients-after-cardiopulmonary-bypass-surgery
#3
Shiguan Le, Jian Xiao, Wei Li, Jing Wang, Qing Wang, Wang Xi, Jibin Xu, Zhinong Wang
BACKGROUND: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28448347/should-adults-experiencing-in-hospital-cardiac-arrest-be-intubated
#4
Dalia Sofer
A new study challenges conventional wisdom.
May 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28448320/difficult-airway-management-resulting-from-local-anesthetic-allergy-during-emergent-cesarean-delivery-a-case-report
#5
Courtney L Maxey-Jones, Alec Palmerton, Jocelyn R Farmer, Brian T Bateman
Difficult airway management in the gravid patient is a well-described phenomenon. We present a case of emergent cesarean delivery complicated by a "cannot intubate, cannot ventilate" scenario that was later determined to be secondary to an allergic, IgE-mediated reaction to epidurally administered local anesthetic.
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28448010/murine-left-anterior-descending-lad-coronary-artery-ligation-an-improved-and-simplified-model-for-myocardial-infarction
#6
Karla Reichert, Bonnie Colantuono, Isabella McCormack, Fernanda Rodrigues, Vasile Pavlov, M Ruhul Abid
Ischemic heart disease (IHD), or acute coronary syndrome (ACS), is one of the leading causes of death in the United States. IHD is characterized by reduced blood supply to the heart, resulting in the loss of oxygen to and the ensuing necrosis of the heart muscle. The MI model has gained popularity for its use as a short-term ischemia-reperfusion model and a long-term permanent ligation model. Below, we describe a reliable method for the permanent ligation of the LAD. With mouse genetic engineering technology becoming more advanced, and with an increasing availability of quality murine surgical instruments, the mouse has become a popular model for MI surgeries...
April 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28447930/a-novel-and-simple-method-for-tracheal-intubation-in-a-swine-model-preparing-for-the-era-of-xenotransplantation
#7
Hyub Huh, Hyong Hwan Lim, Ji Yeong Kim, Hye Won Shin, Hae Ja Lim, Suk Min Yoon, Seung Zhoo Yoon, Hye Won Lee
OBJECTIVES: Organ transplant in humans is an established therapy for a variety of end-stage organ diseases. However, due to organ shortages and lack of donors, the need for xenotransplant has gradually increased. Xenotransplantation has great potential to solve many of the problems facing organ transplantation. Pigs are being developed as xenogeneic organ donors for use in humans. In this study, we propose a novel and simple method for tracheal intubation in a swine model using neuromuscular blocking agents and laryngeal mask airway...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28447274/classification-and-regression-tree-model-for-predicting-tracheostomy-in-patients-with-traumatic-cervical-spinal-cord-injury
#8
Dae-Sang Lee, Chi-Min Park, Keumhee Chough Carriere, Joonghyun Ahn
PURPOSE: In patients with cervical spinal cord injury (CSCI), respiratory compromise and the need for tracheostomy are common. The purpose of this study was to identify common risk factors for tracheostomy following traumatic CSCI and develop a decision tree for tracheostomy in traumatic CSCI patients without pulmonary function test. METHODS: Data of 105 trauma patients with CSCI admitted in our institution from April, 2008 to February, 2014 were retrospectively analyzed...
April 26, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28446800/oxidative-stress-evoked-damages-on-rat-sperm-and-attenuated-antioxidant-status-on-consumption-of-aspartame
#9
I Ashok, P S Poornima, D Wankhar, R Ravindran, R Sheeladevi
Although several studies on toxic effect of aspartame metabolite have been studied, controversial reports over the use of aspartame owing to the fact that it releases methanol as one of its metabolite during metabolism exist. This present study is proposed to investigate whether aspartame (40 mg kg(-1) b.wt) administration for 90 days could induce oxidative stress and alter antioxidant status of epididymal sperm in Wistar strain male albino rats. To mimic the human methanol metabolism, methotrexate (MTX)-treated rats were included to study the effects of aspartame...
April 27, 2017: International Journal of Impotence Research
https://www.readbyqxmd.com/read/28446075/comparison-of-bronchoscopy-guided-and-real-time-ultrasound-guided-percutaneous-dilatational-tracheostomy-safety-complications-and-effectiveness-in-critically-ill-patients
#10
Aykut Sarıtaş, Muhammed M Kurnaz
OBJECTIVE: To compare the efficacy, safety, and incidence of complications between fiber-optic bronchoscopy-guided percutaneous dilatational tracheostomy (FOB-PDT) and ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) and to determine whether US-PDT is a viable alternative to FOB-PDT. METHODS: This randomized prospective study was carried out in 80 patients who were randomly divided into US-PDT and FOB-PDT groups. Demographic data and Acute Physiology and Chronic Health Evaluation II (APACHE II), procedure duration, hemorrhage status, complications, procedure difficulty, displacement of entry location after US, and hemodynamic data were evaluated in both groups...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28445944/angiotensin-converting-enzyme-2-overexpression-protects-against-doxorubicin-induced-cardiomyopathy-by-multiple-mechanisms-in-rats
#11
Hui Ma, Jing Kong, Yu-Lin Wang, Jun-Long Li, Nai-Hao Hei, Xin-Ran Cao, Jing-Jing Yang, Wen-Jiang Yan, Wen-Jing Liang, Hong-Yan Dai, Bo Dong
Angiotensin-converting enzyme 2 (ACE2) is considered a potential therapeutic target of the renin-angiotensin system (RAS) for the treatment of cardiovascular diseases. We aimed to explore the effects of ACE2 overexpression on doxorubicin-induced cardiomyopathy in rats. Rats were randomly divided into treatment and control groups. The rats of treatment group were injected intraperitoneally with 6 doses of doxorubicin (2.5 mg/kg) within a period of two weeks. Two weeks after the initial injection of doxorubicin, these rats were randomly divided into Mock, Ad-EGFP, Ad-ACE2, and Cilazapril groups...
April 11, 2017: Oncotarget
https://www.readbyqxmd.com/read/28445793/predictors-of-30-day-pulmonary-complications-after-outpatient-surgery-relative-importance-of-body-mass-index-weight-classifications-in-risk-assessment
#12
Gildasio S De Oliveira, Robert J McCarthy, Kristopher Davignon, Herb Chen, Heather Panaro, William G Cioffi
BACKGROUND: The current literature is controversial regarding the importance of obese body mass index (BMI) classifications as a risk factor for pulmonary complications following outpatient surgery. The objective of the current investigation was to evaluate predictors of pulmonary outcomes following outpatient surgery and to assess the importance of BMI weight classifications in risk assessment. STUDY DESIGN: Patients with "outpatient" recorded as their inpatient/outpatient status in the 2012-2013 NSQIP database were included...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445418/hyponatremia-is-associated-with-worse-outcomes-from-fall-injuries-in-the-elderly
#13
Spencer C H Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included...
April 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#14
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28444824/a-comparison-between-patients-with-epiphora-and-cataract-of-the-activity-limitations-they-experience-in-daily-life-due-to-their-visual-disability
#15
Elin Bohman, Maria Wyon, Mats Lundström, Eva Dafgård Kopp
PURPOSE: The objective of this study was to compare patients with epiphora and cataract in terms of the activity limitations they experience in daily life due to their visual disability and to validate the use of the Catquest-9SF questionnaire for epiphora patients. METHODS: Seventy-two consecutively encountered adult patients with confirmed lacrimal obstruction and listed for dacryocystorhinostomy (DCR) or lacrimal intubation at the St. Erik Eye Hospital, Stockholm, Sweden, completed the Catquest-9SF questionnaire, which measures activity limitations in daily life due to visual disability...
April 26, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28444559/effectiveness-of-an-interdisciplinary-medical-hospital-admission-center-the-role-of-the-dental-section-in-the-interdisciplinary-system-for-perioperative-management-of-patients-awaiting-surgery
#16
Akifumi Enomoto, Eri Morikage, Takeshi Shimoide, Kazuhide Matsunaga, Suguru Hamada
Perioperative oral functional management (POFM) involves total oral management of a patient before surgery. Considerable benefits have been reported, but POFM remains scarce in medical settings. An interdisciplinary Medical Hospital Admission Center (MHAC) opened in our hospital in December 2014, and has since provided unified perioperative management for patients. This study reports on the clinical system and contributions of the systematized, standardized POFM applied through the MHAC. Patients awaiting surgery undergo oral screening before admission, with patients classified into three groups: red, needing surgical oral management (tooth extraction or other oral surgery) before surgery; yellow, needing non-surgical oral management before surgery, due to the planned surgery or the risk of tooth injury in connection with general anesthesia; or green, patients with good oral hygiene considered capable of suitable oral self-management...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#17
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443579/determining-the-efficiency-of-different-preoperative-difficult-intubation-tests-on-patients-undergoing-caesarean-section
#18
İlker Yıldırım, Mehmet Turan İnal, Dilek Memiş, F Nesrin Turan
BACKGROUND: Pregnancy induced anatomical and physiological changes in the airway makes airway management difficult in obstetric patients, thus the preoperative evaluation of the airway is important for obstetric patients. AIMS: The first aim was determine the effectiveness of the modified mallampati test, the interincisor, sternomental, thyromental distances, the upper limb bite tests and the second aim was to access the effectiveness of the combination of the upper limb bite test with the other tests in obstetric patients...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#19
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28443558/towards-evidence-based-resuscitation-of-the-newborn-infant
#20
REVIEW
Brett J Manley, Louise S Owen, Stuart B Hooper, Susan E Jacobs, Jeanie L Y Cheong, Lex W Doyle, Peter G Davis
Effective resuscitation of the newborn infant has the potential to save many lives around the world and reduce disabilities in children who survive peripartum asphyxia. In this Series paper, we highlight some of the important advances in the understanding of how best to resuscitate newborn infants, which includes monitoring techniques to guide resuscitative efforts, increasing awareness of the adverse effects of hyperoxia, delayed umbilical cord clamping, the avoidance of routine endotracheal intubation for extremely preterm infants, and therapeutic hypothermia for hypoxic-ischaemic encephalopathy...
April 22, 2017: Lancet
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