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https://www.readbyqxmd.com/read/29454226/dysphagia-and-laryngeal-pathology-in-post-surgical-cardiothoracic-patients
#1
Anna Miles, Naomi McLellan, Rochelle Machan, David Vokes, Alexandra Hunting, Mary McFarlane, Jennifer Holmes, Kelly Lynn
PURPOSE: Cardiothoracic surgery is known to result in dysphagia and laryngeal injury. While prevalence has been explored, extent, trajectory and longevity of symptoms are poorly understood. This retrospective, observational study explored dysphagia and laryngeal injury in patients following cardiothoracic surgery referred for instrumental swallowing assessment. METHODS: Clinical notes and endoscopic recordings of 106 patients (age range 18-87yrs; mean 63yrs; SD 15yrs) (including 190 endoscopes) at one large tertiary centre were reviewed by two speech-language pathologists and a laryngologist...
February 9, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29446694/experimental-measurement-of-forces-during-percutaneous-dilatational-tracheostomy
#2
Silvia Pancani, Antonio Virga, Rosario Spina, Adriano Peris, Andrea Corvi
The measurement of mechanical effects associated with the dilatation phase of a percutaneous dilatational tracheostomy is of primary importance to identify the causes of major complications associated with this procedure, such as tracheal cartilage subluxation or fracture and bleeding. Such information can be very useful also for the design of better instruments and procedures. The aim of this study was to present a methodology to evaluate mechanical effects of the dilatation phase of a percutaneous dilatational tracheostomy on the tracheal rings and adjacent anatomical structures...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#3
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29443747/supraglottoplasty-in-neonates-and-infants-a-radiofrequency-ablation-approach
#4
Shilei Pu, Hongming Xu, Xiaoyan Li
BACKGROUND: Supraglottoplasty is the mainstay of surgical treatment for laryngomalacia. A novel supraglottoplasty surgical technique is needed to achieve better efficacy. The purpose of this study was to introduce modified microscopic radiofrequency ablation supraglottoplasty (MMRAS) for the treatment of congenital laryngomalacia and to evaluate the outcome and effectiveness of this novel approach. METHODS: Seventeen children with severe laryngomalacia who underwent MMRAS were studied retrospectively...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29435968/-a-new-phenotype-of-infantile-onset-pompe-disease
#5
A Nascimento, E Villalobos-Pinto
INTRODUCTION: Infantile-onset Pompe disease is a kind of glycogenosis resulting from a deficit of the enzyme acid alpha-glucosidase. Before specific enzyme replacement therapy (ERT) became available, the classic form was fatal during the first two years of life. ERT increases survival and improves cardiac, respiratory and motor functioning. CASE REPORTS: Case 1: 2-month-old infant with predominantly axial hypotonia who required the use of a nasogastric tube as a result of difficulties in sucking and swallowing...
February 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29433716/percutaneous-dilational-tracheostomy
#6
REVIEW
Andrew D Lerner, Lonny Yarmus
Tracheostomy tubes can be inserted surgically or percutaneously via percutaneous dilational tracheostomy (PDT). Tracheostomy is performed for upper airway obstruction, though more often to allow prolonged mechanical ventilation in place of endotracheal tubes. Preparation, performance, and postoperative management for PDT are best provided by a multidisciplinary team. Although PDT is a safe procedure in the hands of experienced operators, both early and late complications can arise. Caution must also be taken during early tracheostomy tube exchange given that immaturity of the stomal tract can risk loss of the airway...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29430408/using-bronchoscopy-to-detect-acquired-tracheoesophageal-fistula-in-mechanically-ventilated-patients
#7
Michael S Green, Johann J Mathew, Lia J Michos, Parmis Green, Mansoor M Aman
Introduction: An acquired Tracheoesophageal fistula (TEF) is commonly caused by a malignancy or trauma, with pulmonary infection or aspiration being the presenting symptom. However, in the critical care setting the presentation can be subtle and may present with difficult ventilation. High endotracheal tube cuff pressures can lead to tracheal erosions and thus increasing the chances for developing a TEF. Prolonged intubation in the presence of other risk factors like poor general state of health, episodic hypotension, nasogastric tubes, and repeated intubations can increase the likelihood of developing an acquired TEF...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29429553/intubation-in-two-patients-with-difficult-airway-management-and-tracheal-stenosis-after-tracheostomy-in-thoracic-surgery
#8
M Granell Gil, P Solís Albamonte, C Córdova Hernández, I Cobo, R Guijarro, J A de Andrés Ibañez
Lung isolation in thoracic surgery is a challenge, this is even more complex in the presence of unknown tracheal stenosis (TS). We report two cases of unknown TS and its airway management. TS appears most frequently after long term intubation close to the endotracheal tube cuff or in the stoma of tracheostomy that appears as a consequence of the granulation tissue after the surgical opening of the trachea. Clinical history, physical examination, difficult intubating predictors and imaging tests (CT scans) are crucial, however most of tracheal stenosis may be unnoticed and symptoms depend on the degree of obstruction...
February 8, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29428620/postoperative-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair
#9
Darrell Wu, Arina E Chesnokova, Shahab Akvan, Matt D Price, David J Sugarbaker, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Chylothorax is a potentially deadly complication that can occur after thoracoabdominal aortic aneurysm (TAAA) repair. We describe our contemporary experience (2005-2014) with this complication, our efforts to identify perioperative variables associated with it, and our attempts to assess treatment outcomes. METHODS: We reviewed the records of 1092 consecutive patients who underwent TAAA repair between 2005 and 2014. Standard bivariate analysis was used to test for between-group differences...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29416476/fractured-tracheostomy-tube-posted-for-bronchoscopic-removal-an-anesthetic-challenge
#10
Suruchi Ambasta, Suman Lata Gupta, G Rajiv, Srinivasan Swaminathan
No abstract text is available yet for this article.
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29415198/extended-surgery-using-anterior-mediastinal-tracheostomy-for-recurrent-mediastinal-liposarcoma
#11
Masaru Takenaka, Yoshinobu Ichiki, Akihiro Taira, Fumihiro Tanaka
Mediastinal liposarcoma is an extremely rare malignancy with a poor prognosis. We report the case of a 73-year-old man who presented with severe respiratory distress. He had previously been diagnosed with mediastinal liposarcoma, which had been treated with extirpation 6 years ago. The histological type was a well-differentiated liposarcoma. Three years ago, he experienced respiratory distress due to postoperative recurrence of mediastinal liposarcoma. To establish an airway, tracheotomy was urgently performed...
February 3, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29410034/repeated-endovascular-treatments-in-patients-with-recurrent-cerebral-vasospasms-after-subarachnoid-hemorrhage-a-worthwhile-strategy
#12
Claudia Ditz, Alexander Neumann, Jann Wojak, Emma Smith, Jan Gliemroth, Volker Tronnier, Jan Küchler
OBJECTIVE: Endovascular interventions in patients with subarachnoid hemorrhage (SAH) and symptomatic cerebral vasospasm (sCVS) are commonly performed. But potential benefits of repeated interventions have not been proven. The aim of this study was to show the potential burden and opportunities of repeated endovascular interventions in case of recurrent sCVS. METHODS: We reviewed 15 patients with SAH who underwent more than 2 endovascular treatments of recurrent sCVS (CVS group) regarding the radiation doses, their clinical course and their functional outcome...
January 31, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29409380/ultrasound-guided-percutaneous-dilational-tracheostomy-a-systematic-review-of-randomized-controlled-trials-and-meta-analysis
#13
André L N Gobatto, Bruno A M P Besen, Mino Cestari, Paolo Pelosi, Luiz M S Malbouisson
INTRODUCTION: Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. OBJECTIVE: To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29405845/areas-for-quality-improvement-for-airway-dilation-in-children-nsqip-pediatric-30-day-outcomes
#14
Jeffrey Cheng, Beiyu Liu, Alfredo E Farjat
Objective To identify predictors of adverse events and highlight areas for quality improvement for children who underwent laryngeal or tracheal dilation, without prior tracheostomy placement. Study Design Cross-sectional analysis using a US national database. Setting American College of Surgeons (ACS) National Surgical Quality Improvement Program (ACS NSQIP-pediatric), years 2012 to 2015. Subjects and Methods Patients 18 years and younger were included. Patients without prior tracheostomy placement were identified using 2017 Current Procedural Terminology ( CPT) codes: 31528, 31529, and 31630...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29404735/riluzole-and-other-prognostic-factors-in-als-a-population-based-registry-study-in-italy
#15
Jessica Mandrioli, Sara Angela Malerba, Ettore Beghi, Nicola Fini, Antonio Fasano, Elisabetta Zucchi, Silvia De Pasqua, Carlo Guidi, Emilio Terlizzi, Elisabetta Sette, Alessandro Ravasio, Mario Casmiro, Fabrizio Salvi, Rocco Liguori, Lucia Zinno, Yasmin Handouk, Romana Rizzi, Annamaria Borghi, Rita Rinaldi, Doriana Medici, Mario Santangelo, Enrico Granieri, Vittoria Mussuto, Marina Aiello, Salvatore Ferro, Marco Vinceti
OBJECTIVE: In this prospective population-based registry study on ALS survival, we investigated the role of riluzole treatment, together with other clinical factors, on the prognosis in incident ALS cases in Emilia Romagna Region (ERR), Italy. METHODS: A registry for ALS has been collecting all incident cases in ERR since 2009. Detailed clinical data from all patients diagnosed with ALS between 1.1.2009 and 31.12.2014 have been analyzed for this study, with last follow up date set at 31...
February 5, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29404575/factors-associated-with-variation-in-long-term-acute-care-hospital-vs-skilled-nursing-facility-use-among-hospitalized-older-adults
#16
Anil N Makam, Oanh Kieu Nguyen, Lei Xuan, Michael E Miller, James S Goodwin, Ethan A Halm
Importance: Despite providing an overlapping level of care, it is unknown why hospitalized older adults are transferred to long-term acute care hospitals (LTACs) vs less costly skilled nursing facilities (SNFs) for postacute care. Objective: To examine factors associated with variation in LTAC vs SNF transfer among hospitalized older adults. Design, Setting, and Participants: We conducted this retrospective observational cohort study of hospitalized older adults (≥65 years) transferred to an LTAC vs SNF during fiscal year 2012 using national 5% Medicare data...
February 5, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29401237/pre-emptive-glottic-enlargement-before-laryngotracheal-surgery-in-patients-at-high-risk-for-postoperative-bilateral-vocal-fold-paralysis
#17
Thomas Schweiger, Konrad Hoetzenecker, Imme Roesner, Berit Schneider-Stickler, Doris-Maria Denk-Linnert, Walter Klepetko
OBJECTIVES: Bilateral vocal fold paralysis (VFP) is a severe complication after laryngotracheal (LT) surgery. The reduced glottic opening leads to significant respiratory distress immediately after the operation and requires the placement of a tracheostomy in most cases. Patients with a pre-existing unilateral VFP or expected recurrent nerve resection are at the highest risk for glottic failure. These patients might benefit from a pre-emptive glottic enlargement before LT surgery. METHODS: We performed a retrospective review of patients who received a pre-emptive glottis enlargement before LT surgery at the Medical University of Vienna from October 2011 to December 2016...
February 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29398476/frequent-isolation-of-extended-spectrum-beta-lactamase-producing-bacteria-from-fecal-samples-of-individuals-with-severe-motor-and-intellectual-disabilities
#18
Chika Takano, Mitsuko Seki, Hiroaki Shiihara, Shihoko Komine-Aizawa, Kazumichi Kuroda, Shori Takahashi, Hiroshi Ushijima, Satoshi Hayakawa
Extended-spectrum beta-lactamase (ESBL) producing bacteria spread worldwide and became major concern for antibiotic treatment. Although surveillance reports in general hospitals and long-term care facilities are increasing, their frequencies in individuals with severe motor and intellectual disabilities (SMID) are so far unknown. In this study, we examined the frequency of ESBL in stool samples collected from 146 asymptomatic SMID subjects hospitalized in a single institution. With their clinical information, we evaluated possible risk factors for ESBL colonization...
February 2, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29397926/bronchial-mismatch-as-a-predictor-of-respiratory-failure-after-congenital-tracheal-stenosis-repair
#19
Enrico Cetrano, Matteo Trezzi, Aurelio Secinaro, Luca Di Chiara, Marilena Trozzi, Sergio Bottero, Angelo Polito, Adriano Carotti
BACKGROUND: The purpose of this study was to identify predictors of postoperative respiratory failure after surgical tracheoplasty for congenital tracheal stenosis. METHODS: Between February 2011 and April 2017, 16 infants underwent congenital tracheal stenosis repair. Preoperative computed tomography evaluation of the trachea and mainstem bronchi was performed. The primary outcome was midterm freedom from postoperative respiratory failure defined as persistent need for mechanical ventilation or surgical tracheobronchial reoperation...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29397301/-vocal-cord-dyskinesia-and-or-asthma
#20
J J Braun, C Delmas, A Charloux, P Schultz, F de Blay
INTRODUCTION: Vocal cord dyskinesia or vocal cord dysfunction (VCD) is characterized by intermittent abnormal adduction of the vocal cords leading to airflow limitation at the level of the larynx, in the absence of local organic disease. It may occur in isolation or in association with asthma. The pathophysiology is complex and poorly understood. Wheeze, stridor or apparent upper airway obstruction are the most common symptoms. It occurs in a wide age range, more commonly in women, and diagnosis is often delayed and leads to unnecessary treatments (intubation, tracheostomy and high dose steroids)...
January 31, 2018: Revue des Maladies Respiratoires
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