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https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#1
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#2
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28322006/aspiration-and-dysphagia-screening-in-acute-stroke-the-gugging-swallowing-screen-revisited
#3
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/28321165/fibrin-sealant-for-closure-of-mucosal-penetration-at-the-cardia-during-peroral-endoscopic-myotomy-a-retrospective-study-at-a-single-center
#4
Wen-Gang Zhang, En-Qiang Linghu, Hui-Kai Li
AIM: To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy (POEM). METHODS: Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration...
March 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28316761/polyethylene-glycol-and-lactulose-versus-lactulose-alone-in-the-treatment-of-hepatic-encephalopathy-in-patients-with-cirrhosis-a-non-inferiority-randomized-controlled-trial
#5
Mohammadreza Naderian, Heshmatollah Akbari, Morteza Saeedi, Amir Ali Sohrabpour
BACKGROUND In this clinical trial, polyethylene glycol (PEG) solution was compared with lactulose in the treatment of hepatic encephalopathy in patients with cirrhosis. METHODS This randomized controlled trial was performed on 40 patients in two groups. The patients in the lactulose group received either 20-30 grams of lactulose orally or by a nasogastric tube, or 200 grams of lactulose enema by a rectal tube. The patients in the PEG-lactulose group received the same amount of oral or rectal lactulose, plus 280 grams of PEG in 4 liters of water orally as a single dose in 30-120 minutes...
January 2017: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28298944/4-point-ultrasonography-to-confirm-the-correct-position-of-the-nasogastric-tube-in-114-critically-ill-patients
#6
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
#7
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/28292527/enteral-nutrition-volume-is-not-correlated-with-lower-respiratory-tract-infection-in-patients-on-mechanical-ventilation
#8
A Colomar, B Guardiola, J A Llompart-Pou, I Ayestarán, J Rodríguez-Pilar, M Ferreruela, J M Raurich
OBJECTIVE: To evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). DESIGN: A retrospective secondary analysis was carried out. SETTING: The Intensive Care Unit of a University Hospital. PATIENTS OR PARTICIPANTS: Patients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV...
March 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28289630/recommendation-of-nasogastric-tube-removal-in-acute-stroke-patients-based-on-videofluoroscopic-swallow-study
#9
Jong-Moon Hwang, Youn-Soo Cheong, Min-Gu Kang, Seong Min Chun, Yu-Sun Min, Yang-Soo Lee, Tae-Du Jung
OBJECTIVE: To evaluate the safety of nasogastric tube (NGT) removal and change to oral feeding with a food thickener for acute stroke patients in whom a videofluoroscopic swallow study (VFSS) confirmed thin liquid aspiration. METHODS: We retrospectively examined data of 199 patients with first stroke who were diagnosed with dysphagia from 2011 to 2015. Swallowing function was evaluated using VFSS. Patients included in this study were monitored for 4 weeks to identify the occurrence of aspiration pneumonia...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28285365/postoperative-ileus-in-an-enhanced-recovery-pathway-a-retrospective-cohort-study
#10
Fabian Grass, Juliette Slieker, Jonas Jurt, Anne Kummer, Josep Solà, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
PURPOSE: Enhanced recovery after surgery (ERAS) protocols advocate no nasogastric tubes after colorectal surgery, but postoperative ileus (POI) remains a challenging clinical reality. The aim of this study was to assess incidence and risk factors of POI. METHODS: This retrospective analysis included all consecutive colorectal surgical procedures since May 2011 until November 2014. Uni- and multivariate risk factors for POI were identified by multiple logistic regression and functional and surgical outcomes assessed...
March 11, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28272849/enhanced-recovery-after-surgery-eras-in-penetrating-abdominal-trauma-a-prospective-single-center-pilot-study
#11
M R Moydien, R Oodit, S Chowdhury, S Edu, A J Nicol, P H Navsaria
BACKGROUND: Enhanced recovery after surgery (ERAS) programmes employed in elective surgery have provided strong evidence for decreased lengths of hospital stay without increase in postoperative complications. The aim of this study was to explore the role and benefits of ERAS implemented in patients undergoing emergency laparotomy for penetrating abdominal trauma. METHOD: Institutional University of Cape Town Human Research Ethics Committee (UCT-HREC) approved study...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28265731/primary-surgery-for-malignant-large-bowel-obstruction-postoperative-nasogastric-tube-reinsertion-is-not-mandatory
#12
A Venara, J Barbieux, P A Colas, A Le Fouler, E Lermite, A Hamy
BACKGROUND: Malignant large bowel obstructions frequently require emergency surgery. Compliance with enhanced recovery after surgery programmes is significantly reduced due to non-removal of the nasogastric tube in the postoperative period. The first aim of the present study was to research factors associated with the failure of immediate nasogastric tube removal in patients who had undergone emergency surgery for malignant large bowel obstruction. The second aim was to assess the morbidity linked to nasogastric tube reinsertion...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28255251/bioavailability-of-a-dexlansoprazole-delayed-release-orally-disintegrating-tablet-effects-of-food-and-mode-of-administration
#13
Michael Kukulka, Sai Nudurupati, Maria Claudia Perez
BACKGROUND: Dexlansoprazole is a proton pump inhibitor (PPI) approved for use in dual delayed-release capsule and orally disintegrating tablet (ODT) formulations. AIM: To assess effects of food, water, and route of administration on the bioavailability of dexlansoprazole 30-mg ODT. METHODS: Two separate open-label, phase 1, single-dose crossover studies were conducted in healthy adults. In study 1, pharmacokinetic parameters were analyzed in participants receiving dexlansoprazole ODT in a fed or fasted state with and without water...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28249875/administering-polyethylene-glycol-electrolyte-solution-via-a-nasogastric-tube-pulmonary-complications
#14
Norma A Metheny, Kathleen L Meert
BACKGROUND: Patients sometimes require insertion of a nasogastric tube for the administration of a large volume of a polyethylene glycol electrolyte solution. If the tube is malpositioned, the risk for direct instillation of the solution into the lung increases. The risk for aspiration also increases if the infusion rate exceeds gastrointestinal tolerance. PURPOSE: To review published cases of patients' experiencing adverse pulmonary events after administration of polyethylene glycol electrolyte solution via a nasogastric tube and to offer suggestions to prevent these outcomes...
March 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28248796/how-to-predict-oral-rehydration-failure-in-children-with-gastroenteritis
#15
Dorien Geurts, Ewout W Steyerberg, Henriëtte Moll, Rianne Oostenbrink
OBJECTIVES: Oral rehydration is the standard in most current guidelines for young children with acute gastroenteritis (AGE). Failure of oral rehydration can complicate the disease course, leading to morbidity due to severe dehydration. We aimed to identify prognostic factors of oral rehydration failure in children with AGE. METHODS: Design A prospective, observational study.Setting Emergency department (ED), Erasmus Medical Centre, Rotterdam, The Netherlands, 2010- 2012...
February 28, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28247267/options-for-treating-pain-in-cancer-patients-with-dysphagia
#16
REVIEW
Sebastiano Mercadante
Patients with chronic pain often develop dysphagia during the course of an advanced disease such as cancer. Opioids are the cornerstone of the management of cancer pain and are commonly administered orally. However, the oral route does not suit patients with dysphagia, who require alternative methods to administer analgesic drugs. Opioids given by parenteral or transdermal routes provide adequate pain control, being at least as efficacious as the oral route, but knowledge and experience in conversion ratios are mandatory when using these routes of administration...
March 1, 2017: Drugs
https://www.readbyqxmd.com/read/28246469/restoration-of-energy-level-in-the-early-phase-of-acute-pediatric-pancreatitis
#17
REVIEW
Dóra Mosztbacher, Nelli Farkas, Margit Solymár, Gabriella Pár, Judit Bajor, Ákos Szűcs, József Czimmer, Katalin Márta, Alexandra Mikó, Zoltán Rumbus, Péter Varjú, Péter Hegyi, Andrea Párniczky
Acute pancreatitis (AP) is a serious inflammatory disease with rising incidence both in the adult and pediatric populations. It has been shown that mitochondrial injury and energy depletion are the earliest intracellular events in the early phase of AP. Moreover, it has been revealed that restoration of intracellular ATP level restores cellular functions and defends the cells from death. We have recently shown in a systematic review and meta-analysis that early enteral feeding is beneficial in adults; however, no reviews are available concerning the effect of early enteral feeding in pediatric AP...
February 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28243007/analysis-of-patients-%C3%A2-65-with-predominant-cervical-spine-fractures-issues-of-disposition-and-dysphagia
#18
Lisa M Poole, Phong Le, Rachel M Drake, Stephen D Helmer, James M Haan
BACKGROUND: Cervical spine fractures occur in 2.6% to 4.7% of trauma patients aged 65 years or older. Mortality rates in this population ranges from 19% to 24%. A few studies have specifically looked at dysphagia in elderly patients with cervical spine injury. AIMS: The aim of this study is to evaluate dysphagia, disposition, and mortality in elderly patients with cervical spine injury. SETTINGS AND DESIGN: Retrospective review at an the American College of Surgeons-verified level 1 trauma center...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28237300/radiographer-workforce-role-expansion-to-improve-patient-safety-related-to-nasogastric-tube-placement-for-feeding-in-adults
#19
G Roe, K M Harris, H Lambie, D J M Tolan
AIM: To determine whether the active involvement of radiographers in nasogastric tube (NGT) management at a large multisite healthcare institution can contribute to risk reduction regarding feeding through misplaced NGTs. MATERIALS AND METHODS: Despite national guidance in the National Health Service advising on safe practice to confirm NGT position, a number of "never events" (feeding through misplaced NGT) continue to occur due to misinterpretation of the check radiograph...
February 22, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28224234/one-day-nasogastric-tube-decompression-after-distal-gastrectomy-a-prospective-randomized-study
#20
Yutaka Kimura, Hiroshi Yano, Takashi Iwazawa, Junya Fujita, Shoichiro Fujita, Kazuyoshi Yamamoto, Takushi Yasuda
PURPOSE: Many surgeons in Japan use 1-day nasogastric tube (NGT) decompression after gastrectomy as a standard procedure. This prospective randomized study aimed to define whether 1-day NGT decompression is necessary after distal gastrectomy. METHODS: The subjects were 233 patients with gastric cancer, randomized into two groups immediately after distal gastrectomy: one group received 1-day NGT decompression (NGT group, n = 119) and the other did not (no-NGT group, n = 114)...
February 21, 2017: Surgery Today
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