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https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#1
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28620501/efficacy-of-lenvatinib-in-a-patient-with-anaplastic-thyroid-cancer
#2
Kazuyuki Oishi, Daisuke Takabatake, Yuichi Shibuya
We experienced a case of an 82-year-old woman who presented to our hospital with a 1-month history of dysphagia and dyspnea. Cervical contrast-enhanced computed tomography revealed diffuse thyroid neoplasms causing significant tracheal stenosis with tumors, particularly of the superior mediastinum, which were associated with an embolism of the brachiocephalic vein and suspected invasion to the bilateral common carotid arteries. Anaplastic thyroid cancer (ATC) was diagnosed by fine-needle aspiration; thus, emergency tracheostomy and gastrostomy were performed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28616295/malignant-tracheal-necrosis-and-fistula-formation-following-palliative-chemoradiotherapy-a-case-report
#3
In Ae Kim, Hyeon Kang Koh, Sun Jong Kim, Kwang Ha Yoo, Kye Young Lee, Hee Joung Kim
Concurrent chemoradiotherapy is an essential treatment strategy for inoperable locally advanced non-small cell lung cancer (NSCLC). Although supportive care has improved, unexpected complications due to the disease or treatment can occur. Tracheomediastinal fistulas are very rare but can be a serious problem. Herein, we report a case of severe chondronecrosis of the distal trachea with formation of a fistula into a metastatic lymphadenopathy in a patient with stage IIIB NSCLC. The patient received external beam radiotherapy with a total dose of 35 Gy in 14 fractions, which was approximately half of the conventional therapeutic radiotherapy dose, along with concurrent cisplatin based chemotherapy...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28604085/tension-pneumothorax-after-percutaneous-tracheostomy
#4
Sarina Matsumura, Naotaka Kishimoto, Tomio Iseki, Yoshihiro Momota
A 76-year-old woman with right mandibular gingival cancer was scheduled for surgery. A percutaneous tracheostomy kit was used for tracheostomy under intravenous sedation. After puncturing the cricothyroid membrane, a dilator was inserted along a guidewire. Bucking was observed at the time of insertion of the dilator, despite intratracheal lidocaine spray applied before insertion. After that, the tracheostomy tube was inserted, but no capnographic waveforms appeared when the tube was connected to the anesthesia circuit...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28525608/surgical-resection-for-advanced-lung-cancer-using-the-hemi-clamshell-approach
#5
Yasushi Shintani, Ryu Kanzaki, Tomohiro Kawamura, Soichiro Funaki, Masato Minami, Meinoshin Okumura, Eiji Okura, Yoshihisa Kadota, Mitsunori Ohta
OBJECTIVES: The hemi-clamshell (HCS) approach consists of partial sternotomy with antero-lateral thoracotomy. This study evaluated the utilities and outcomes of the HCS approach in advanced lung cancer patients. METHODS: We retrospectively investigated 45 patients who underwent surgery for advanced lung cancer via the HCS procedure between 2000 and 2014, the indications for surgery being tumour invasion extending to the aorta arch in 5, descending aorta in 9, main pulmonary artery in 5, superior vena cava in 6, right or left atrium in 4, apical thoracic dome in 7 patients and mediastinal lymphadenopathy for left-sided lung cancer in 12...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28523194/pneumomediastinum-and-bilateral-pneumothoraces-causing-respiratory-failure-after-thyroid-surgery
#6
Michael Koeppen, Benjamin Scott, Joseph Morabito, Matthew Fiegel, Tobias Eckle
We report the first case of severe respiratory failure after thyroid surgery requiring venovenous extracorporeal membrane oxygenation (vvECMO). The patient was a 41-year-old woman with metastatic thyroid cancer. She underwent thyroidectomy, including left lateral and bilateral central neck dissection. During surgery, the patient developed pneumomediastinum with bilateral pneumothoraces. Despite early treatment with bilateral chest tubes and no evidence of a tracheal perforation, the patient developed severe respiratory failure after extubation on the intensive care unit...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28522278/a-large-french-multicenter-retrospective-series-of-t1-t2n0-vocal-cords-carcinomas-treated-with-exclusive-irradiation
#7
A Robert, Y Pointreau, G Janoray, É Bardet, M Fesneau, P Garaud, S Chapet, C Lafond, O Dupuis, G Calais
PURPOSE: The main objective of this study was to evaluate the 5-year efficacy of exclusive laryngeal radiotherapy without node prophylactic irradiation for localized cancers of the vocal cords. PATIENTS AND METHODS: We retrospectively reviewed charts from 258 patients with T1-T2N0 glottic carcinoma irradiated from April 1987 to March 2015 in four France western centers, including pretreated patients. Toxicity was analyzed according to CTCAE v4.0 classification. RESULTS: The median follow-up was 50 months...
May 15, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28505322/exosomes-in-toxicology-relevance-to-chemical-exposure-and-pathogenesis-of-environmentally-linked-diseases
#8
Dilshan S Harischandra, Shivani Ghaisas, Dharmin Rokad, Anumantha G Kanthasamy
Chronic exposure to environmental toxins has been known to initiate or aggravate various neurological disorders, carcinomas and other adverse health effects. Uptake by naïve cells of pathogenic factors such as danger-associated molecules, mRNAs, miRNAs or aggregated proteins leads to disruption in cellular homeostasis further resulting in inflammation and disease propagation. While early research tended to focus solely on exosomal removal of unwanted cellular contents, more recent reports indicate that these nano-vesicles play an active role in intercellular signaling...
May 15, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28462437/clinical-assessment-of-reconstruction-involving-gastric-pull-up-combined-with-free-jejunal-graft-after-total-pharyngolaryngoesophagectomy
#9
Hiroshi Miyata, Keijiro Sugimura, Masaaki Motoori, Yoshiyuki Fujiwara, Takeshi Omori, Masahiro Mun, Masayuki Ohue, Masayoshi Yasui, Norikatsu Miyoshi, Takashi Fujii, Hiroki Tajima, Tomoyuki Kurita, Masahiko Yano
BACKGROUND: Total pharyngolaryngoesophagectomy (PLE) is used as a curative treatment for synchronous laryngopharyngeal and thoracic esophageal cancer or for multiple cancers in the cervical and thoracic esophagus. Gastric pull-up is commonly used after PLE, but postoperative complications are common. The present study evaluated these procedures in patients with esophageal cancer. METHODS: Fourteen patients (7 with synchronous pharyngeal and thoracic esophageal cancer, 4 with synchronous cervical and thoracic esophageal cancer, and 3 with cervicothoracic esophageal cancer) underwent reconstructive surgery after PLE involving gastric pull-up combined with free jejunal graft between 2004 and 2015...
May 1, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28431562/effects-of-the-common-polymorphism-in-the-human-aldehyde-dehydrogenase-2-aldh2-gene-on-the-lung
#10
Aoi Kuroda, Ahmed E Hegab, Gao Jingtao, Shuji Yamashita, Nobuyuki Hizawa, Tohru Sakamoto, Hideyasu Yamada, Satoshi Suzuki, Makoto Ishii, Ho Namkoong, Takanori Asakura, Mari Ozaki, Hiroyuki Yasuda, Junko Hamamoto, Shizuko Kagawa, Kenzo Soejima, Tomoko Betsuyaku
BACKGROUND: Aldehyde dehydrogenases (ALDHs) play a major role in detoxification of aldehydes. High expression of ALDHs is a marker for stem cells of many organs including the lungs. A common polymorphism in ALDH2 gene (ALDH2*2) results in inactivation of the enzyme and is associated with alcohol flushing syndrome and increased risk for cardiovascular and Alzheimer's diseases and some cancers. The effect of this ALDH2 polymorphism on the lung and its stem cells has not been thoroughly examined...
April 21, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28401532/gram-positive-pneumonia-augments-nonsmall-cell-lung-cancer-metastasis-via-host-toll-like-receptor-2-activation
#11
Stephen D Gowing, Simon C Chow, Jonathan J Cools-Lartigue, Crystal B Chen, Sara Najmeh, Henry Y Jiang, France Bourdeau, Annie Beauchamp, Ugo Mancini, Isabelle Angers, Betty Giannias, Jonathan D Spicer, Simon Rousseau, Salman T Qureshi, Lorenzo E Ferri
Surgical resection of early stage nonsmall cell lung cancer (NSCLC) is necessary for cure. However, rates of postoperative bacterial pneumonias remain high and may confer an increased risk for metastasis. Toll-like receptors (TLRs) mediate the inflammatory cascade by recognizing microbial products at the surface of numerous cell types in the lung; however, little is known about how host TLRs influence NSCLC metastasis. TLR2 recognizes gram-positive bacterial cell wall components activating innate immunity. We demonstrate that lower respiratory tract infection with Streptococcus pneumonia augments the formation of murine H59 NSCLC liver metastases in C57BL/6 mice through host TLR2 activation...
April 12, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28387356/pectoralis-major-myocutaneous-flap-for-head-and-neck-defects-in-the-era-of-free-flaps-harvesting-technique-and-indications
#12
Muyuan Liu, Weiwei Liu, Xihong Yang, Haipeng Guo, Hanwei Peng
The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28360477/bronchoscopic-management-of-critical-central-airway-obstruction-by-thyroid-cancer-combination-airway-stenting-using-tracheal-and-inverted-y-carinal-self-expanding-metallic-stents
#13
Karan Madan, Prajowl Shrestha, Rakesh Garg, Vijay Hadda, Anant Mohan, Randeep Guleria
Central airway obstruction (CAO) can result from various benign and malignant etiologies. Anaplastic thyroid cancer (ATC) is the most aggressive form of thyroid cancer. Rapid airway compromise is the main cause of death in ATC. We report a patient with ATC who presented with a large neck mass leading to CAO with long segment tracheal and right main bronchial compression and respiratory failure. Urgent Rigid Bronchoscopy was performed for airway stabilization and patient was managed with a combination airway stenting approach...
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28329055/chylous-pericardial-effusion-after-pulmonary-lobectomy
#14
Weixiong Yang, Canqiao Luo, Zhenguo Liu, Chao Cheng
Chylous pericardial effusion is a rarely reported complication of lung cancer surgery. Here, we report a case of an elderly man who suffered chylous pericardial effusion after radical right upper lung resection for cancer. The massive chylous effusion first occurred in the pericardium, drained to the right chest after the drainage of the hydropericardium and subsequently moved back to the pericardium again. Lymphoscintigraphy examination indicated that a chylous fistula was present in the plane of the tracheal carina...
March 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28293493/technique-to-improve-tracheostomy-speaking-valve-tolerance-after-head-and-neck-free-flap-reconstruction
#15
John T Stranix, Keri M Danziger, Veturia L Dumbrava, Ginger Mars, David L Hirsch, Jamie P Levine
Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28255381/can-endobronchial-or-endotracheal-metastases-appear-from-rectal-adenocarcinoma
#16
G L Serbanescu, R M Anghel
Background: Endobronchial and endotracheal metastases from extra-pulmonary solid tumors are rare. Patients and methods: We reported the case of a patient diagnosed with endobronchial and endotracheal metastases from rectal adenocarcinoma. Case report: Patient P.G., 62 years old, was diagnosed with a rectal tumor in 2011, for which, a surgical intervention was performed (pT3 pN2a M0, stage IIIB). Afterwards, she underwent adjuvant chemotherapy and concomitant radiochemotherapy. In September 2013, the chest CT showed 2 nodules for which, an incomplete surgical resection was done and which were histopathologically diagnosed as metastases from rectal cancer...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28249616/tumor-to-tumor-metastases-papillary-thyroid-carcinoma-into-a-clear-cell-renal-cell-carcinoma
#17
Jin Soo Andy Song, S Mark Taylor, Jonathan Trites, Matthew H Rigby, Martin Joseph Bullock, Jennifer Merrimen, Ricardo Rendon, Robert D Hart
BACKGROUND: Thyroid metastases to distant sites are uncommon incidents, most often metastasizing to the lungs and bones. Rates of metastasis to the kidney are particularly low, ranging from 2.8-3.8% for papillary and 6-20% for follicular variants of well-differentiated thyroid cancers (WDTCs). In rare instances, tumor-to-tumor metastasis between two true primary neoplasms can occurs. This medical phenomenon has previously occurred as a clear cell renal cell carcinoma (CCRCC) spreading to a WDTC...
March 1, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28230036/single-lumen-tracheal-ventilation-for-minimally-invasive-esophagectomy-in-patients-with-esophageal-cancer
#18
Yu Bai, Yi Zhou, Xi Hua Lu
OBJECTIVE: The aim of this study was to observe the efficacy and safety of single-lumen tracheal ventilation for esophageal cancer surgery. METHODS: Thirty-eight patients with esophageal carcinoma who prepared for minimally invasive esophagectomy were included in this study. All of the included 38 patients were received single-lumen tracheal ventilation. The arterial blood gas index was monitored through the operation procedure and recorded at four-time points: before induction (T0), at the end of chest operation (T1), at the end of the abdominal operation (T2), and 30 min after extubation (T3)...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28225857/malignant-melanoma-with-synchronous-thyroid-metastases-case-report-and-literature-review
#19
Maria Manuel Costa, Sandra Belo, João Capela-Costa, Jennifer Costa, Davide Carvalho
Thyroid metastases are rare in clinical practice. We describe the case of an 85-year-old woman who was referred to our department due to a multinodular goiter with compressive symptoms and subclinical hyperthyroidism. The patient was also undergoing evaluation for a polyp in her left nasal cavity, which was then diagnosed as a malignant melanoma of the nasal mucosa. A thoracoabdominal magnetic resonance imaging obtained for cancer staging revealed a > 50% tracheal obstruction caused by the goiter. The patient underwent simultaneous total thyroidectomy and melanoma excision...
February 16, 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28196122/detrimental-elavl-1-hur-dependent-gsk3%C3%AE-mrna-stabilization-impairs-resolution-in-acute-respiratory-distress-syndrome
#20
Olivia Hoffman, Nana Burns, István Vadász, Holger K Eltzschig, Michael G Edwards, Christine U Vohwinkel
A hallmark of acute respiratory distress syndrome (ARDS) is accumulation of protein-rich edema in the distal airspaces and its removal is critical for patient survival. Previous studies have shown a detrimental role of Glycogen Synthase Kinase (GSK) 3β during ARDS via inhibition of alveolar epithelial protein transport. We hypothesized that post-transcriptional regulation of GSK3β could play a functional role in ARDS resolution. To address this hypothesis, we performed an in silico analysis to identify regulatory genes whose expression correlation to GSK3β messenger RNA utilizing two lung cancer cell line array datasets...
2017: PloS One
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