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https://www.readbyqxmd.com/read/29313715/fluid-balance-is-associated-with-clinical-outcomes-and-extravascular-lung-water-in-children-with-acute-asthma-exacerbation
#1
David B Kantor, Eliotte L Hirshberg, Molly C McDonald, Jonathan Griffin, Tess Buccigrosso, Nicole Stenquist, Craig D Smallwood, Kyle A Nelson, David Zurakowski, Wanda Phipatanakul, Joel N Hirschhorn
RATIONALE: The effects of fluid administration during acute asthma exacerbation are likely unique in this patient population: highly negative inspiratory intrapleural pressure resulting from increased airway resistance may interact with excess fluid administration to favor the accumulation of extravascular lung water, leading to worse clinical outcomes. OBJECTIVES: Investigate how fluid balance influences clinical outcomes in children hospitalized for asthma exacerbation...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29306118/diagnostic-accuracy-of-radiology-ct-x-ray-us-for-predicting-difficult-intubation-in-adults-a-meta-analysis
#2
REVIEW
Chao Ji, Qiang Ni, Wurong Chen
OBJECTIVE: The aim of this study was to evaluate the overall accuracy of radiological measurements in prediction of difficult airway and compare the diagnostic value between the radiological measurements and the modified Mallampati score through a meta-analysis of published studies. METHODS: A comprehensive electronic search of related literature was performed in PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure. Meta-DiSc 1.4 and STATA 12...
January 3, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29284881/postoperative-chylothorax-of-unclear-etiology-in-a-patient-with-right-sided-subclavian-central-venous-catheter-placement
#3
Samie Asghar, Faisal Shamim
A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29242258/ers-statement-interventional-bronchoscopy-in-children
#4
Ernst Eber, Juan L Antón-Pacheco, Jacques de Blic, Iolo Doull, Al Faro, Raffaella Nenna, Thomas Nicolai, Petr Pohunek, Kostas N Priftis, Paola Serio, Courtney Coleman, Sarah Masefield, Thomy Tonia, Fabio Midulla
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#5
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29230133/invasive-insular-thyroid-carcinoma-presenting-as-nonparalytic-dysphonia
#6
Blake S Raggio, Blair M Barton, Maria C Grant, Judith A Fornadley, Jeffrey P Marino
Background: Patients with suspected thyroid malignancy often undergo preoperative laryngeal examination with a focus on vocal fold mobility. We present the unique case of a patient with invasive thyroid carcinoma who presented with dysphonia despite intact vocal fold motion. Case Report: A 73-year-old female with a remote thyroid lobectomy presented with dysphonia. Thyroid ultrasound and fine-needle aspiration revealed a 1.1-cm nodule consistent with a colloid cyst...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29224042/association-between-continuous-positive-airway-pressure-and-serum-aminotransferases-in-patients-with-obstructive-sleep-apnea
#7
Li-Da Chen, Liang-Ji Zhang, Xue-Jun Lin, Jia-Chao Qi, Hao Li, Zhi Wu, Qiao-Zhen Xu, Ya-Ping Huang, Li Lin
INTRODUCTION: Obstructive sleep apnea (OSA) has been suggested to be a potential contributing factor for nonalcoholic fatty liver disease (NAFLD). Studies on the association between continuous positive airway pressure (CPAP) and NAFLD in OSA patients are limited and controversial. OBJECTIVES: The aim of this study was to assess the relationship between OSA and NAFLD and the effect of CPAP therapy on serum aminotransferase levels in OSA patients. METHODS: A total of 160 consecutive patients who underwent standard polysomnography were enrolled...
December 9, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29223612/predictive-value-of-focused-assessment-with-sonography-for-trauma-fast-for-laparotomy-in-unstable-polytrauma-egyptians-patients
#8
Adel Hamed Elbaih, Sameh T Abu-Elela
PURPOSE: The emergency physicians face significant clinical uncertainty when multiple trauma patients arrive in the emergency department (ED). The priorities for assessment and treatment of polytrauma patients are established in the primary survey. Focused assessment with sonography for trauma (FAST) is very essential clinical skill during trauma resuscitation. Use of point of care ultrasound among the trauma team working in the primary survey in emergency care settings is lacking in Suez Canal University Hospitals even ultrasound machine not available in ED...
November 23, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#9
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29214060/interstitial-lung-disease-the-diagnostic-role-of-bronchoscopy
#10
REVIEW
Jad Kebbe, Tony Abdo
Interstitial lung diseases (ILDs) form one of the most fascinating fields in pulmonary medicine. They also pose one of the greatest challenges for accurate diagnosis and proper treatment. Even within the recommended and warranted multidisciplinary approach, differentiating between one disease and another may lead to frustration, especially when proper lung tissue is not available for adequate pathological review. A surgical lung biopsy (SLB) might render enough tissue for histopathology, but this could come at the expense of high morbidity and even mortality, as in the case of usual interstitial pneumonia (UIP)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29209509/realtime-ultrasound-guided-percutaneous-tracheostomy-in-emergency-setting-the-glass-ceiling-has-been-broken
#11
Parli Raghavan Ravi, M N Vijai, Sachin Shouche
Background: In recent years ultrasound guided percutaneous tracheostomy (USPCT) has become a routine practice in critical care units. Its safety and superiority over conventional percutaneous tracheostomy and bronchoscopic guided PCT is proven to be non-inferior in elective cases. However its role in emergency percutaneous tracheostomy has never been studied, since percutaneous tracheostomy itself remains an enigma in accessing emergency airway. There is no report of use of ultrasound guided percutaneous tracheostomy in emergency setting so far in the literature...
2017: Disaster and Military Medicine
https://www.readbyqxmd.com/read/29187760/the-exit-ex-utero-intrapartum-treatment-procedure-from-the-paediatric-ent-perspective
#12
B Pucher, J Szydlowski, K Jonczyk-Potoczna, J Sroczynski
The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29163661/ultrasound-guided-removal-of-hypopharyngeal-foreign-body-in-the-emergency-department
#13
Nadia Maria Shaukat, Alexis Lenz, Poonam Desai
Foreign body impaction at the cricopharyngeal level can be a life-threatening emergency. While traditionally, removal of these is performed in the operating room setting, patients with relatively unstable airways or significant discomfort may require immediate extraction to prevent further injury. This is the case of an 85-year-old man who presented to the emergency department in significant discomfort following aspiration of a large partial denture. We report here the first known use of ultrasound in an emergent airway situation to rapidly localize and retrieve an aspirated foreign body...
November 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/29142842/prevention-and-management-of-bleeding-in-thyroid-surgery
#14
REVIEW
Gabriele Materazzi, Carlo Enrico Ambrosini, Lorenzo Fregoli, Luigi De Napoli, Gianluca Frustaci, Valeria Matteucci, Piermarco Papini, Sohail Bakkar, Paolo Miccoli
Post-thyroidectomy neck hematoma represents a major concern for surgeons because it can result in severe and even life-threatening complications. In fact, postoperative hemorrhage may result in airway compression and respiratory distress, and therefore, effective hemostasis is an important goal in thyroid surgery. Postoperative hematoma occurs at a rate of approximately 0.1% to 1.1%. Almost all cases occur in the first 6 h after surgery and can be the result of several surgeon or patient factors. For many years the clamp-and-tie technique has been the most common way to divide the main vascular pedicles of the thyroid gland...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29114418/stop-being-so-sensitive-an-exceptionally-rare-report-of-ustekinumab-induced-sub-acute-hypersensitivity-pneumonitis
#15
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29101956/anesthesia-for-routine-and-advanced-upper-gastrointestinal-endoscopic-procedures
#16
REVIEW
Christopher D Sharp, Ezekiel Tayler, Gregory G Ginsberg
This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29095310/sonography-used-in-the-infantile-desmoid-fibromatosis-of-postcricoid-area-a-case-report
#17
Chunxia Xia, Qiang Zhu, Changli Yue, Minxia Hu, Pingdong Li, Zheng Li
RATIONALE: Infantile desmoid fibromatosis of the postcricoid area is a rare disease and is characterized by a proliferation of fibrous tissue with non-metastasis, local infiltration, and a high rate of recurrence after surgical resection. Currently, ultrasound is scarcely used in the hypopharynx and larynx area. PATIENT CONCERNS: A 4-year-old boy presented with hoarseness, deep voice and snoring for 2∼4 years without any surgical history. On sonography, the lesion was found in the postcricoid area, and the left larynx showed impaired mobility in real time observation...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29067636/a-novel-finding-of-rapunzel-syndrome
#18
Itaru Iwama, Ryusuke Nambu, Tomoko Hara
Rapunzel syndrome is a rare form of gastric trichobezoar (hair ball) involving extension of a tail of the hair into the small bowel. A 13-year-old girl was admitted with a 4-day history of epigastric pain and nausea which worsened after meals. Abdominal ultrasound showed duodenal wall thickening and lymphadenopathy. Esophagogastroduodenoscopy identified a gastric trichobezoar with a tail extending into the duodenum. In addition, multiple longitudinal duodenal and jejunal ulcers were noted. The ulcers appeared to be a result of direct pressure by the tail itself against the intestinal mucosa...
October 24, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29063711/role-of-ultrasound-measuring-position-and-ventilation-pressure-in-determining-correct-tube-size-in-children
#19
Christoph Schramm, Luzie S Eisleben, Jens Kessler, Katrin Jensen, Konstanze Plaschke
BACKGROUND: Ultrasound measurements of the airway are useful for determining correctly sized, uncuffed endotracheal tubes in children. AIMS: The primary objective of this study was to evaluate the influence of ventilation pressure on the sonographically measured tracheal diameter at different levels. METHODS: A total of 100 patients (under 7 years) were enrolled in this study. Six sonographic measurements of minimal transverse diameters at 3 locations (vocal chords, cricoid cartilage, and proximal trachea) and at 2 different ventilation pressures (0 and 15 mbar) were performed before the intubation procedure...
October 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29058628/effect-of-strength-training-on-sleep-apnea-severity-in-the-elderly-study-protocol-for-a-randomized-controlled-trial
#20
Roberto Pacheco da Silva, Denis Martinez, Pedro Lopez, Eduardo Lusa Cadore
BACKGROUND: Obstructive sleep apnea (OSA) occurs due to sleep-induced upper airway muscle relaxation resulting in increased pharyngeal collapsibility. Clinical trials have shown a favorable effect of exercise training on OSA severity in middle-aged adults. Aging is characterized by motor-unit loss. Force training may affect the whole body muscle tone. We hypothesize that interventions increasing muscle strength might propagate to motor units at the abductor pharyngeal muscles, reducing collapsibility and, hence, sleep apnea severity in elderly patients with obstructive sleep apnea...
October 23, 2017: Trials
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