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https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#1
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#2
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28338517/improving-nutritional-support-of-burn-service-patients-by-increasing-the-number-of-days-when-100-of-prescribed-formula-is-given
#3
Peggie F Conrad, Julie Liberio, Razia Aleem, Marcia M Halerz, Michael J Mosier, Arthur P Sanford, Richard L Gamelli
The authors sought to increase the number of days when burn service patients receive 100% of prescribed enteral nutrition. The authors first performed a retrospective review of 37 patients (group 1) receiving enteral nutrition. The authors then created and implemented a nurse-directed feeding algorithm, placing patients into three age groups addressing maximum hourly infusion rates, high residual limits, initiating feeding, refeeding residuals, and replacing formula. The authors then performed a prospective review of 37 patients (group 2) fed utilizing the new algorithm...
March 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28337978/microrna-filters-hox-temporal-transcription-noise-to-confer-boundary-formation-in-the-spinal-cord
#4
Chung-Jung Li, Tian Hong, Ying-Tsen Tung, Ya-Ping Yen, Ho-Chiang Hsu, Ya-Lin Lu, Mien Chang, Qing Nie, Jun-An Chen
The initial rostrocaudal patterning of the neural tube leads to differential expression of Hox genes that contribute to the specification of motor neuron (MN) subtype identity. Although several 3' Hox mRNAs are expressed in progenitors in a noisy manner, these Hox proteins are not expressed in the progenitors and only become detectable in postmitotic MNs. MicroRNA biogenesis impairment leads to precocious expression and propagates the noise of Hoxa5 at the protein level, resulting in an imprecise Hoxa5-Hoxc8 boundary...
March 24, 2017: Nature Communications
https://www.readbyqxmd.com/read/28335674/an-unexpected-cause-of-transient-diarrhea
#5
Yoen-Young Chuah, Yeong-Yeh Lee, Tzung Jiun Tsai
Migration of percutaneous endoscopic gastrostomy (PEG) tube to colon with gastro-colonic-cutaneous fistula formation is a rare complication of the procedure. Transient episodic diarrhea following each PEG tube feeding is typical of this complication. We present a 72-year-old man with cerebrovascular disease and scoliosis who encountered episodes of transient diarrhea after each PEG tube feeding. His diarrhea was refractory to medications. Colonoscopy demonstrated a mal-positioned PEG in the transverse colon...
March 24, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28331537/combined-totally-mini-invasive-approach-in-necrotizing-pancreatitis-a-case-report-and-systematic-literature-review
#6
REVIEW
Luca Sorrentino, Osvaldo Chiara, Massimiliano Mutignani, Fabrizio Sammartano, Paolo Brioschi, Stefania Cimbanassi
BACKGROUND: Currently, both the step-up approach, combining percutaneous drainage (PD) and video-assisted retroperitoneal debridement (VARD), and endoscopic transgastric necrosectomy (ETN) are mini-invasive techniques for infected necrosis in severe acute pancreatitis. A combination of these approaches could maximize the management of necrotizing pancreatitis, conjugating the benefits from both the experiences. However, reporting of this combined strategy is anecdotal. This is the first reported case of severe necrotizing pancreatitis complicated by biliary fistula treated by a combination of ETN, PD, VARD, and endoscopic biliary stenting...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28331447/novel-biliary-reconstruction-techniques-during-liver-transplantation
#7
Ian C Carmody, John Romano, Humberto Bohorquez, Emily Bugeaud, David S Bruce, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Biliary complications remain a significant problem following liver transplantation. Several surgical options can be used to deal with a significant size mismatch between the donor and recipient bile ducts during the biliary anastomosis. We compared biliary transposition to recipient biliary ductoplasty in cadaveric liver transplant. METHODS: A total of 33 reconstructions were performed from January 1, 2005 to December 31, 2013. In the biliary transposition group (n=23), 5 reconstructions were performed using an internal stent (5 or 8 French pediatric feeding tube), and 18 were performed without...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28325648/role-of-bromocriptine-in-multi-spectral-manifestations-of-traumatic-brain-injury
#8
Sunil Munakomi, Binod Bhattarai, Bijoy Mohan Kumar
PURPOSE: Despite the prevalence and cost of traumatic brain injury related disabilities, there is paucity in the literature on modern approaches to pharmacotherapy. Medications may promote recovery by enhancing some neurological functions without impacting others. Herein we discussed the role of bromocriptine in neurorehabilitation for patients with traumatic brain injury. METHODS: A cohort comprising of 36 selective nonsurgical cases of traumatic brain injury in minimally conscious state were enrolled in the study...
February 21, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28324899/infant-guided-co-regulated-feeding-in-the-neonatal-intensive-care-unit-part-i-theoretical-underpinnings-for-neuroprotection-and-safety
#9
Catherine S Shaker
The rapid progress in medical and technical innovations in the neonatal intensive care unit (NICU) has been accompanied by concern for outcomes of NICU graduates. Although advances in neonatal care have led to significant changes in survival rates of very small and extremely preterm neonates, early feeding difficulties with the transition from tube feeding to oral feeding are prominent and often persist beyond discharge to home. Progress in learning to feed in the NICU and continued growth in feeding skills after the NICU may be closely tied to fostering neuroprotection and safety...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28322006/aspiration-and-dysphagia-screening-in-acute-stroke-the-gugging-swallowing-screen-revisited
#10
T Warnecke, S Im, C Kaiser, C Hamacher, S Oelenberg, R Dziewas
BACKGROUND AND PURPOSE: The Gugging Swallowing Screen (GUSS) is a tool to screen aspiration risk in acute stroke. We aimed to replicate its validity in a larger second cohort of patients with acute stroke, including the more severe with a National Institutes of Health Stroke Scale (NIHSS) ≥ 15. METHODS: In a prospective, double-blind design, the GUSS was validated with the Fiberoptic Endoscopic Evaluation of Swallowing scale. Patients were categorized into different stroke severities as assessed by the NIHSS, and the diagnostic properties were calculated separately for each subgroup...
April 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28320382/laparoscopic-t-tube-feeding-jejunostomy-as-an-adjunct-to-staging-laparoscopy-for-upper-gastrointestinal-malignancies-the-technique-and-review-of-outcomes
#11
Sze Li Siow, Hans Alexander Mahendran, Chee Ming Wong, Nirumal Kumar Milaksh, Myo Nyunt
BACKGROUND: In recent years, staging laparoscopy has gained acceptance as part of the assessment of resectability of upper gastrointestinal (UGI) malignancies. Not infrequently, we encounter tumours that are either locally advanced; requiring neoadjuvant therapy or occult peritoneal disease that requires palliation. In all these cases, the establishment of enteral feeding during staging laparoscopy is important for patients' nutrition. This review describes our technique of performing laparoscopic feeding jejunostomy and the clinical outcomes...
March 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28317083/numerical-simulation-of-reactive-extraction-of-benzoic-acid-from-wastewater-via-membrane-contactors
#12
Mehdi Ghadiri, Saeed Shirazian
Membrane-based non-dispersive solvent extraction is used in many chemical processes due to its significant benefits such as straightforward scale-up and low energy consumption. A mechanistic model was developed to predict recovery of benzoic acid (BA) from wastewater using membrane contactors. Model equations were derived for benzoic acid transport in the membrane module, and solved using FEM. The model findings were compared with experimental results, and an average deviation of 4% was observed between experimental and simulation results...
March 20, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28301856/the-role-of-dietary-experience-in-the-development-of-eating-behavior-during-the-first-years-of-life
#13
Sophie Nicklaus
Infants are born equipped to ingest nutrients, but because of the transitions in the mode of feeding in the first years (from "tube" feeding in utero to eating table foods with the family), they have to learn how, what and how much to eat. Eating behavior established during early years may follow throughout childhood; therefore, it is fundamental to understand the most important drivers of the early development of eating behavior. Beyond the first flavor discoveries during the gestational and lactation periods (through the infant's exposure to flavors from foods of the mother's diet), the most important phases for learning food preferences and appetite control may be the beginning of complementary feeding (CF)...
March 17, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28298944/4-point-ultrasonography-to-confirm-the-correct-position-of-the-nasogastric-tube-in-114-critically-ill-patients
#14
Marianna Zatelli, Norberto Vezzali
PURPOSE: Nasogastric feeding tube is routinely positioned in intensive care units. The complications of misplacement are rare but very dangerous for the patients. The aim of this study is to estimate the diagnostic accuracy of this new technique, 4-point ultrasonography to confirm nasogastric tube placement in intensive care. METHODS: One hundred fourteen critical ill patients monitored in ICU were included. The intensivist provided in real time to perform the exam in four steps: sonography from either the right or left side of the patient's neck to visualize the esophagus, sonography of epigastrium to confirm the passage through the esophagogastric junction and the positioning in antrum, sonography of the fundus...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28298795/a-novel-and-innovative-way-of-nasogastric-tube-insertion-in-anesthetized-intubated-patient
#15
Sandeep Sahu, Kamal Kishore, Vertika Sachan, Arnidam Chatterjee
Nasogastric tube (NGT) placement in anesthetized and intubated is sometimes very challenging with more than 50% failure rate in the first attempt. We describe a newer innovative Sahu's three in one, technique with use of GlideScope and forward placement of intubated trachea by external laryngeal maneuver, these both techniques lead to separation of trachea from esophagus so that endoscopic jejunal feeding tube guide wire strengthen NGT can be guided and manipulated to esophagus under direct vision. After informed consent, we used Sahu's three in one combo technique to insert NGT in adult anesthetized and intubated patients of both the sexes with high success in the first attempt...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#16
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28295569/simultaneous-vascularized-bony-reconstruction-of-the-maxilla-and-mandible-using-a-single-fibula-a-case-report
#17
Alexander F Mericli, Jonathan S Friedstat, Edward I Chang, Matthew M Hanasono
Simultaneous maxillary and mandibular reconstruction is exceedingly rare. These are complicated cases, requiring consideration of multiple variables: defect components, donor site morbidity, recipient vessels, and so forth. We describe a unique case of secondary maxillary/mandibular reconstruction in a 59-year-old male. The original defect was created after removal of a buccal squamous cell carcinoma, involving the external cheek skin, buccal mucosa, right mandibular body, and right inferior maxilla; a free vertical rectus abdominis musculocutaneous flap was used for the initial reconstruction...
March 2017: Microsurgery
https://www.readbyqxmd.com/read/28294445/the-challenge-of-nutritional-profiling-of-a-protein-free-feed-module-for-children-on-low-protein-tube-feeds-with-organic-acidaemias
#18
A Daly, S Evans, C Ashmore, S Chahal, S Santra, A MacDonald
BACKGROUND: Enteral tube feeding for children with organic acidaemias (OA) is recommended. Protein restriction, providing minimum safe levels of protein intake, is advocated. Standard paediatric tube feeding formulae provide more than the minimum safe protein requirements and are unsuitable in OA without modification. Modified paediatric enteral feeds consist of several modular ingredients. The aim of this prospective longitudinal interventional study was to assess the efficacy of a premeasured novel protein-free module developed for children aged over 12 months compared to conventional practice...
March 10, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28291716/the-relevance-of-readmissions-after-common-ir-procedures-readmission-rates-and-association-with-early-mortality
#19
Ammar Sarwar, Lujia Zhou, Nihara Chakrala, Olga R Brook, Jeffrey L Weinstein, Max P Rosen, Muneeb Ahmed
PURPOSE: To determine all-cause readmission rates for 12 IR procedures and association of time to readmission with risk-adjusted 90-day mortality. MATERIALS AND METHODS: Patients discharged after 12 inpatient IR procedures at a tertiary-care hospital between June 2008 and May 2013 (N = 4,163) were categorized as no readmission (n = 1,479; 40.5%) or readmission between 0 and 7 (n = 379; 10.4%), 8 and 30 (n = 650; 17.8%), 31 and 60 (n = 378; 10.3%), 61 and 90 (n = 169; 4...
March 10, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28289851/withdrawal-of-artificial-nutrition-and-hydration-in-neonatal-intensive-care-parents-and-healthcare-practitioners-views
#20
Véronique Fournier, Elisabeth Belghiti, Laurence Brunet, Marta Spranzi
Withdrawing Artificial Nutrition and Hydration (WANH) in the neonatal intensive care units (NICUs) has long been controversial. In France, the practice has become a legal option since 2005. But even though, the question remains as to what the stakeholders' experience is, and whether they consider it ethically appropriate. In order to contribute to the debate, we initiated a study in 2009 to evaluate parental and health care professionals (HCP) perspectives, after they experienced WAHN for a newborn. The study included 25 cases from 5 different clinical neonatology departments...
March 13, 2017: Medicine, Health Care, and Philosophy
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