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https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#1
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28210456/severe-odontogenic-infection-an-emergency-case-report
#2
Marcelo Guzmán-Letelier, Claudia Crisosto-Jara, Camilo Diaz-Ricouz, Miguel Peñarrocha-Diago, David Peñarrocha-Oltra
Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. However, some OI can spread to vital and deep structures, overcome the host immune system - especially in diabetic, immunocompromised or weakened patients - and even prove fatal. Ludwig's angina is a severe form of diffuse cellulitis that can have an acute onset and spread very rapidly, bilaterally affecting areas of the head and neck, and may prove life threatening...
February 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#3
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28208178/lingual-tonsillectomy-for-treatment-of-pediatric-obstructive-sleep-apnea-a-meta-analysis
#4
Kun-Tai Kang, Peter J Koltai, Chia-Hsuan Lee, Ming-Tzer Lin, Wei-Chung Hsu
Importance: Evidence indicates correlations between lingual tonsil hypertrophy and pediatric obstructive sleep apnea (OSA). However, to our knowledge, a meta-analysis of surgical outcomes for lingual tonsillectomy in children with OSA has not been conducted. Objective: To evaluate the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric OSA. Data Sources: The study protocol was registered on PROSPERO (CRD42015027053). PubMed, MEDLINE, EMBASE, and the Cochrane Reviews databases were searched independently by 2 authors for relevant articles published by September 2016...
February 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28206886/guideline-for-monitoring-and-management-of-pediatric-patients-before-during-and-after-sedation-for-diagnostic-and-therapeutic-procedures-update-2016
#5
(no author information available yet)
The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase thepotential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age- and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, sufficient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28204920/a-review-of-congenital-lung-malformations-with-a-simplified-classification-system-for-clinical-and-research-use
#6
REVIEW
Michael Seear, Jennifer Townsend, Amy Hoepker, Douglas Jamieson, Deborah McFadden, Patrick Daigneault, William Glomb
PURPOSE: Congenital lung abnormalities are rare malformations increasingly detected early by prenatal ultrasound. Whether management of these frequently asymptomatic lesions should be surgical or conservative is an unresolved issue. The necessary prospective studies are limited by the absence of a widely accepted practical classification system. Our aim was to develop a simple, clinically relevant system for classifying and studying congenital lung abnormalities. MATERIALS AND METHODS: We based our proposed grouping on a detailed analysis of clinical, radiological, and histological data from well-documented cases, plus an extensive review of the literature...
February 15, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28203440/tracheobronchial-tuberculosis-a-clinical-review
#7
REVIEW
Wen Ting Siow, Pyng Lee
Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree. The exact pathogenesis is unclear, and it has a heterogenous clinical course. Its diagnosis requires the clinician to have a high index of suspicion based on clinical symptoms and radiological features. Computed tomography and bronchoscopy are useful tools in its evaluation. The goal of treatment is in the eradication of tuberculous bacilli with appropriate anti-tuberculous therapy. Use of corticosteroids is controversial for the prevention of tracheobronchial stenosis...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#8
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203438/current-concepts-in-severe-adult-tracheobronchomalacia-evaluation-and-treatment
#9
REVIEW
Daniel H Buitrago, Jennifer L Wilson, Mihir Parikh, Adnan Majid, Sidhu P Gangadharan
There is increasing recognition of tracheobronchomalacia (TBM) in patients with respiratory complaints, though its true incidence in the adult population remains unknown. Most of these patients have an acquired form of severe diffuse TBM of unclear etiology. The mainstays of diagnosis are dynamic (inspiratory and expiratory) airway computed tomography (CT) scan and dynamic flexible bronchoscopy with forced expiratory maneuvers. While the prevailing definition of TBM is 50% reduction in cross-sectional area, a high proportion of healthy volunteers meet this threshold, thus this threshold fails to identify patients that might benefit from intervention...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203423/clinical-analysis-of-eight-patients-with-blunt-main-stem-bronchial-injuries
#10
Jie Lei, Jinbo Zhao, Feng Tian, Xiaoping Wang, Yongan Zhou, Xiaofei Li, Jian Wang
BACKGROUND: Blunt main stem bronchial injuries are rare but potentially life-threatening injuries in clinical. The aim of this study was to sum up the experience on diagnosis and treatment of blunt main stem bronchial injuries. METHODS: This report retrospective1y analyzed eight cases of main stem bronchial injuries induced by blunt chest trauma between 2013 and 2016 in Tangdu Hospital, Fourth Military Medical University. RESULTS: There were eight patients, including four men and four women...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28198643/the-role-of-curvilinear-distraction-system-in-pediatric-obstructive-sleep-apnea-a-case-report
#11
David Serrano Faustino Ângelo, Bruno Rosa, Rogério Santos, Carlos Diogo Matos
OBJECTIVE: The authors present a case of obstructive sleep apnea associated with severe mandibular micrognathia treated by mandibular bone distraction with curvilinear system planned under computer assistance. CLINICAL PRESENTATION: A 15-year-old child with limited compliance to continuous positive airway therapy was referred to the authors' department. Observation revealed severe mandibular micrognathia as the major cause for obstructive sleep apnea syndrome. The first polysomnography study revealed 14 obstructive apneas, 16 obstructive hypopneas, and 4...
February 15, 2017: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/28197929/epithelial-mesenchymal-transition-emt-and-non-small-cell-lung-cancer-nsclc-a-mutual-association-with-airway-disease
#12
Malik Quasir Mahmood, Chris Ward, Hans Konrad Muller, Sukhwinder Singh Sohal, Eugene Haydn Walters
NSCLC is a leading cause of morbidity and mortality worldwide. It includes adeno- and squamous cell carcinoma. In the background, COPD and smoking play a vital role in development of NSCLC. Local progression and metastasis of NSCLC has been associated with various mechanisms, but in particular by a process called epithelial mesenchymal transition (EMT), which is implicated in COPD pathogenesis. In this study, we have investigated whether expression of EGFR (activation marker) and S100A4, vimentin and N-cadherin (as EMT) is different both in central and leading edge of NSCLC and to what extent related to EMT activity of both small and large airways, stage and differentiation of NSCLC...
March 2017: Medical Oncology
https://www.readbyqxmd.com/read/28195009/the-combination-of-anatomy-and-genioglossus-activity-in-predicting-the-outcomes-of-velopharyngeal-surgery
#13
Di Zhao, YanRu Li, JunFang Xian, Yue Qu, Xin Cao, JingYing Ye
Objective This study aims to evaluate the combination of genioglossus (GG) activity and anatomical characteristics in predicting outcomes of velopharyngeal surgery in patients with obstructive sleep apnea (OSA). Study Design Case series with planned data collection. Setting Sleep medical center. Subjects and Methods Forty patients with OSA underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway anatomy was evaluated by 3-dimensional computed tomography in patients with OSA...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28194490/ranula-current-concept-of-pathophysiologic-basis-and-surgical-management-options
#14
Daniel Kokong, Augustine Iduh, Ikechukwu Chukwu, Joyce Mugu, Samuel Nuhu, Sule Augustine
BACKGROUND: There is no consensus opinion on a definitive surgical management option for ranulas to curtail recurrence, largely from the existing gap in knowledge on the pathophysiologic basis. AIM: To highlight the current scientific basis of ranula development that informed the preferred surgical approach. DESIGN: Retrospective cohort study. SETTING: Public Tertiary Academic Health Institution. METHOD: A 7-year 7-month study of ranulas surgically managed at our tertiary health institution was undertaken-June 1, 2008-December 31, 2015-from case files retrieved utilising the ICD-10 version 10 standard codes...
February 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28194479/-airway-management-in-intensive-care-units-in-rhineland-palatinate-evolution-over-five-years
#15
T Piepho, T Härer, L Ellermann, R R Noppens
BACKGROUND: Securing the airway in severely ill patients is associated with a high rate of complications. So far, no information exists about the equipment readily available for airway management in German intensive care units (ICUs). It is also unknown if the range of material has improved over time. OBJECTIVES: In the present trial the availability of equipment for airway management in ICUs in Rhineland-Palatinate was evaluated at two different times. MATERIALS AND METHODS: Using a structured questionnaire, all ICUs in the state were contacted in the years 2010 and 2015...
February 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28193800/cardiovascular-and-ventilatory-consequences-of-laparoscopic-surgery
#16
Tamara M Atkinson, George D Giraud, Brandon M Togioka, Daniel B Jones, Joaquin E Cigarroa
Although laparoscopic surgery accounts for >2 million surgical procedures every year, the current preoperative risk scores and guidelines do not adequately assess the risks of laparoscopy. In general, laparoscopic procedures have a lower risk of morbidity and mortality compared with operations requiring a midline laparotomy. During laparoscopic surgery, carbon dioxide insufflation may produce significant hemodynamic and ventilatory consequences such as increased intraabdominal pressure and hypercarbia. Hemodynamic insults secondary to increased intraabdominal pressure include increased afterload and preload and decreased cardiac output, whereas ventilatory consequences include increased airway pressures, hypercarbia, and decreased pulmonary compliance...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/28185772/impact-of-weight-loss-management-in-osa
#17
REVIEW
Simon A Joosten, Garun S Hamilton, Matthew T Naughton
The interaction between obesity and obstructive sleep apnea (OSA) is complex. Whilst it is often assumed that obesity is the major cause of OSA, and that treatment of the OSA might mitigate further weight gain, new evidence is emerging that suggest these statements may not be the case. Obesity explains about 60% of the variance of the apnea hypopnea index definition of OSA, mainly in those < 50 years and less so in the elderly. Moreover, long term treatment of OSA with continuous positive airway pressure is associated with small but significant weight gain...
February 6, 2017: Chest
https://www.readbyqxmd.com/read/28185010/evaluation-of-effects-of-anterior-palatoplasty-operation-on-upper-airway-parameters-in-computed-tomography-in-patients-with-pure-snoring-and-obstructive-sleep-apnea-syndrome
#18
Adin Selcuk, Tulay Ozer, Erkan Esen, Fatih Ozdogan, Halil Erdem Ozel, Turgut Yuce, Sebla Caliskan, Sinem Dasli, Nagihan Bilal, Gulden Genc, Selahattin Genc
AIM: To investigate changes in upper airway volume parameters measured by computerized tomography scans in patients with surgically treated by anterior palatoplasty of whom having pure snoring and mild-moderate obstructive sleep apnea. METHOD: A prospective study on consecutively anterior palatoplasty performed pure snoring and obstructive sleep apnea patients. Computerized tomography scans were obtained preoperatively and following anterior palatoplasty procedure to measure changes in upper airway volume...
February 9, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28183579/determination-of-insertion-depth-of-flexible-laryngeal-mask-airway-in-pediatric-population-a-prospective-observational-study
#19
Ji-Hyun Lee, Hye-Won Oh, In-Kyung Song, Jin-Tae Kim, Chong-Sung Kim, Hee-Soo Kim
STUDY OBJECTIVE: The purpose of this study was to determine the ideal insertion depth of the flexible laryngeal mask airway (FLMA) by elucidating the relationships between insertion depth and patient's age, body weight, height, and other parameters. We also evaluated an insertion technique that uses the change in intracuff pressure for proper positioning of the FLMA in cases where it is difficult to sense resistance during FLMA insertion. DESIGN: This study was a prospective observational study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183569/gastric-regurgitation-in-patients-undergoing-gynecological-laparoscopy-with-a-laryngeal-mask-airway-a-prospective-observational-study
#20
Jeconias Lemos, Gildasio S De Oliveira, Hugo Eckner Dantas de Pereira Cardoso, Lavínia Dantas Cardoso Neiva Lemos, Lígia Raquel de Carvalho, Norma Suely Pinheiro Módolo
OBJECTIVE: The use of pneumoperitonium and the placement of patients in Trendelenburg position are commonly cited reasons for the potential development of intraoperative regurgitation of gastric contents and the need for an endotracheal tube in laparoscopic surgery. The main objective of the current investigation was to evaluate the presence of regurgitation of gastric contents in the oropharynx of patients having laparoscopic gynecological surgery with a laryngeal mask airway (LMA). DESIGN: Prospective, observational clinical investigation...
February 2017: Journal of Clinical Anesthesia
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