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https://www.readbyqxmd.com/read/29928641/evaluating-the-cost-effectiveness-of-proportional-assist-ventilation-plus-vs-pressure-support-ventilation-in-the-intensive-care-unit-in-two-countries
#1
Rhodri Saunders, Dimitris Geogopoulos
Background: Mechanical ventilation is an integral, but expensive, part of the intensive care unit (ICU). Optimal use of mechanical ventilation could save costs and improve patient outcomes. Here, the cost effectiveness of proportional assist ventilation (PAV™ ventilation by Medtronic) is estimated relative to pressure support ventilation (PSV). Methods: A cohort-level, clinical model was built using data from clinical trials. The model estimates patient-ventilator asynchrony >10%, tracheostomy, ventilator-associated pneumonia, other nosocomial infections, spontaneous breathing trial success, hypoxemia, and death...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29927429/-modern-diagnostics-and-treatment-of-posttraumatic-hydrocephalus
#2
Ya A Latyshev, A D Kravchuk, L B Likhterman, N E Zakharova, O S Zaytsev, A G Gavrilov, V A Okhlopkov, A A Potapov
One of the frequent consequences of severe traumatic brain injury is posttraumatic hydrocephalus that not only hampers the processes of consciousness recovery, rehabilitation, and social adaptation of patients but also is the cause of disability. Pathological processes underlying the clinical picture of posttraumatic hydrocephalus and the relationship between CSF circulation disorders and structural changes in the brain substance have not been adequately studied. Of particular importance are patients in the chronic vegetative or minimally conscious state, recovery from which is blocked by posttraumatic hydrocephalus...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/29926338/outcomes-of-transoral-laser-microsurgery-for-oropharyngeal-squamous-cell-carcinoma-in-ireland-and-review-of-the-literature-on-transoral-approaches
#3
Robbie S R Woods, Lina Geyer, Ana Ionescu, Deirdre Callanan, Patrick Sheahan
BACKGROUND: The optimal treatment for oropharyngeal squamous cell carcinoma (OPSCC) is controversial. There is increasing evidence that, in selected cases, minimally invasive transoral surgery can offer improved functional outcomes, with equivalent oncologic outcomes, compared to chemoradiotherapy. AIMS: We report the outcomes of transoral laser microsurgery (TLM) for treatment of OPSCC at our institution. METHODS: Patients with OPSCC undergoing TLM at the South Infirmary Victoria University Hospital, Cork, between 2010 and 2016, were identified from an institutional database...
June 21, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29923418/laryngomalacia-in-patients-with-craniosynostosis
#4
Fasil Mathews, Amber D Shaffer, Matthew W Georg, Matthew D Ford, Noel Jabbour, Jeffrey P Simons
OBJECTIVE: To characterize differences in the clinical presentation and treatment outcomes of laryngomalacia in patients with and without craniosynostosis. METHODS: A retrospective cohort study was performed comparing all patients with concomitant laryngomalacia and craniosynostosis seen at a tertiary care children's hospital between 2000 and 2016 with a control group of patients with isolated laryngomalacia. Thirty-two patients with craniosynostosis (59% male) and 68 control patients (56% male) were included...
June 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29922540/management-of-airway-obstruction-in-infants-with-pierre-robin-sequence
#5
Christopher M Runyan, Armando Uribe-Rivera, Shahryar Tork, Tasneem A Shikary, Zarmina Ehsan, K Nicole Weaver, Md Monir Hossain, Christopher B Gordon, Brian S Pan
Background: Pierre Robin sequence (PRS)-related airway obstruction is often treated surgically; however, objective measures predicting the need for surgery are poorly defined. Methods: A retrospective chart review was performed on 171 neonates with PRS. Infants were grouped based upon intervention modality: nonsurgical (conservative) or surgical [mandibular distraction osteogenesis (MDO) or tracheostomy]. Demographic data, physical examination findings, and study results were compared between groups to determine risk factors for surgical intervention, and to predict long-term success or failure of those interventions...
May 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29921058/-management-strategies-of-granulation-in-tracheal-post-tracheostomy-caused-by-prolonged-mechanical-ventilation
#6
Y Yang, L Y Wang, L Zhang, X Y Wang, H T Song, W N Huang
Objective: To analyze the effect and safety of treatment in patients with airway stenosis caused by tracheotomy for mechanical ventilation. Method: We treated the patients with airway stenosis caused by granulation tissue. The patients with grade Ⅰ,Ⅱ airway stenosis were treated with adjustable flange tracheostomy tube, and the holmium laser under a fibro-laryngoscope were applied for the patients with grade Ⅲ airway stenosis.Two hundred and sixteen patients were enrolled in this study. Forty-four patients had been found tracheal stenosis caused by granulomatous hyperplasia, accounting for 20...
June 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29920872/perioperative-outcomes-and-management-in-midface-advancement-surgery-a-multicenter-observational-descriptive-study-from-the-pediatric-craniofacial-collaborative-group
#7
Chris D Glover, Allison M Fernandez, Henry Huang, Christopher Derderian, Wendy Binstock, Russell Reid, Nicholas M Dalesio, John Zhong, Paul A Stricker
BACKGROUND/AIMS: The evolution of Le Fort III and Monobloc procedures with utilization of distraction devices has resulted in shortened surgical times, greater facial advancements, and decreased transfusion requirements. The aim of this observational study was to utilize data from the multicenter Pediatric Craniofacial Surgery Perioperative Registry to present and compare patient characteristics and outcomes in children undergoing midface advancement with distraction osteogenesis. METHODS: We queried the Pediatric Craniofacial Surgery Perioperative Registry for children undergoing midface advancement involving distractor application from June 2012 to September 2016...
June 19, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29916889/a-new-technique-in-management-of-depressed-posttracheostomy-scars
#8
Sevgi Kurt Yazar, Erkan Yüce, Merdan Serin, Memet Yazar, Zeliha Gül, Fatih Irmak, Serhat Selami Şirvan
BACKGROUND: The goals of tracheostomy scar revision are filling of the depressed area, providing easy sliding of skin over the trachea. There are various techniques described to correct this situation. In this article, a modification of split sternocleidomastoid (SCM) muscle flap used in the correction of posttracheostomy defects is described. METHODS: Thirteen patients who had depressed scars after tracheostomy are included in this study. The mean patient age was 44 years (range, 27-56 years)...
June 19, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29915928/changes-in-swallowing-and-cough-functions-among-stroke-patients-before-and-after-tracheostomy-decannulation
#9
Min Kyu Park, Sook Joung Lee
We investigated the functional changes in swallowing and voluntary coughing before and after tracheostomy decannulation among stroke patients who had undergone a tracheostomy. We also compared these functions between stroke patients who underwent tracheostomy tube removal and those who did not within 6 months of their stroke. Seventy-seven stroke patients who had undergone a tracheostomy were enrolled. All patients were evaluated by videofluoroscopic swallowing studies and a peak flow meter through the oral cavity serially until 6 months after their stroke...
June 18, 2018: Dysphagia
https://www.readbyqxmd.com/read/29915536/use-of-submicron-vaterite-particles-serves-as-an-effective-delivery-vehicle-to-the-respiratory-portion-of-the-lung
#10
Olga Gusliakova, Elena N Atochina-Vasserman, Olga Sindeeva, Sergey Sindeev, Sergey Pinyaev, Nikolay Pyataev, Viktor Revin, Gleb B Sukhorukov, Dmitry Gorin, Andrew J Gow
Nano- and microencapsulation has proven to be a useful technique for the construction of drug delivery vehicles for use in vascular medicine. However, the possibility of using these techniques within the lung as an inhalation delivery mechanism has not been previously considered. A critical element of particle delivery to the lung is the degree of penetrance that can be achieved with respect to the airway tree. In this study we examined the effectiveness of near infrared (NIR) dye (Cy7) labeled calcium carbonate (vaterite) particles of 3...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29914900/tracheal-agenesis-in-a-new-born-lessons-learnt
#11
P Naina, Mary John, Mohamed Abdul Kathar, Manish Kumar
Tracheal agenesis is a rare but fatal congenital tracheal malformation. Lack of prenatal symptom and a typical clinical presentation lead to failure to arrive at a correct diagnosis and confusion during resuscitation. We report a case of a newborn male child with type 2 tracheal agenesis. Despite a typical presentation, diagnosis was delayed after unsuccessful intubation, examination under anaesthesia and emergency tracheostomy. The embryology, diagnostic criteria and potential treatment options are discussed...
June 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29907656/temporal-trends-in-the-outcomes-of-dialysis-patients-admitted-with-acute-ischemic-stroke
#12
Fahad Alqahtani, Chalak O Berzingi, Sami Aljohani, Mohamed Al Hajji, Anas Diab, Muhammad Alvi, Khaled Boobes, Mohamad Alkhouli
BACKGROUND: There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (AIS) in patients on maintenance dialysis. METHODS AND RESULTS: We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of AIS in dialysis patients. A total of 930 010 patients were admitted with AIS between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of AIS among dialysis patients decreased significantly ( P trend <0...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907469/management-of-the-airway-in-maxillofacial-surgery-part-1
#13
REVIEW
S W Evans, R A McCahon
In part 1 of this review of management of the airway in maxillofacial surgery we discuss preoperative assessment of the airway, and the practical means to deal with difficulties. We review the evidence for videolaryngoscopy and flexible indirect laryngoscopy, together with surgical access to the airway including tracheostomy, cricothyroidotomy, and submental intubation.
June 12, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29907209/using-artificial-intelligence-to-predict-prolonged-mechanical-ventilation-and-tracheostomy-placement
#14
Joshua Parreco, Antonio Hidalgo, Jonathan J Parks, Robert Kozol, Rishi Rattan
BACKGROUND: Early identification of critically ill patients who will require prolonged mechanical ventilation (PMV) has proven to be difficult. The purpose of this study was to use machine learning to identify patients at risk for PMV and tracheostomy placement. MATERIALS AND METHODS: The Multiparameter Intelligent Monitoring in Intensive Care III database was queried for all intensive care unit (ICU) stays with mechanical ventilation. PMV was defined as ventilation >7 d...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29905603/treacher-collins-syndrome-and-tracheostomy-decannulation-using-mandibular-distraction-osteogenesis
#15
Safi Ali-Khan, Christopher Runyan, Gil Nardini, Pradip Shetye, David Staffenberg, Joseph G McCarthy, Roberto L Flores
INTRODUCTION: Treacher Collins syndrome (TC) and Pierre Robin sequence (RS) are associated with hypoplastic mandible, glossoptosis, and consequent airway obstruction. Although TC and RS are often grouped together, airway outcomes of bilateral mandibular distraction osteogenesis (MDO) have not been specifically studied in TC. The purpose of this study is to report on the clinical outcomes of MDO in the TC patient population. MATERIALS AND METHODS: A twenty-year single-institution retrospective review of all patients with TC who underwent bilateral MDO was performed...
June 13, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29903602/toxic-epidermal-necrolysis-data-from-the-celeste-multinational-registry-part-ii-specific-systemic-and-local-risk-factors-for-the-development-of-infectious-complications
#16
B Lipový, J Holoubek, M Hanslianová, M Cvanová, L Klein, I Grossová, R Zajíček, P Bukovčan, J Koller, M Baran, P Lengyel, L Eimer, M Jandová, M Košťál, P Brychta
The aim of the study was to identify the most important systemic and local risk factors for the development of infectious complications in patients with toxic epidermal necrolysis (TEN). MATERIAL AND METHODOLOGY: This is a multicentric study that included all patients with TEN who were hospitalized between 2000-2015 in specialized centres in the Czech Republic and Slovakia. The total catchment area included a population of over 12.5 million inhabitants. The actual implementation of the project was carried out using data obtained from the CELESTE (Central European LyEll Syndrome: Therapeutic Evaluation) registry, wherein specific parameters related to epidemiological indicators and infectious complications in patients with TEN were evaluated as a retrospective analysis...
June 11, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29898859/widening-of-posterior-glottis-through-rotation-of-the-arytenoid-on-its-axis-report-of-nine-cases
#17
Luis F Tintinago, William Victoria, Estephania Candelo, Juan Camilo Diaz, Juan Carlos Arce, Luis Miguel Aristizabal, Claudia Sanz, Maria Claudia Montes, Maria A Velez-Esquivia
INTRODUCTION: Bilateral vocal folds' immobility is a challenge in laryngology. Multiple procedures have been proposed to improve breathing by statically enlarging the glottal airway, what also results in loss of voice and aspiration. We proposed a technique to enlarge the posterior glottis by rotating the arytenoids on its axis, imitating the function of the posterior cricoarytenoid muscle, with the objective of evaluating the results regarding decannulation, voice quality, and bronchoaspiration...
June 5, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29898830/is-there-need-for-technical-investigations-in-order-to-predict-potential-length-of-hospital-stay-of-oral-infections
#18
Maximiliaan Smeets, Bert Gemels, Lisanne Groeneveldt, Constantinus Politis
OBJECTIVE: Oral and maxillofacial infections are generally treated by primary dental or medical caregivers. Nevertheless, because these infections are known to have life-threatening complications, there is a need of clear indicators for emergency services medical staff, particularly in determining when morbidity can be expected and when in-hospital treatment is required. This retrospective study aimed to identify variables that were observable at admission, which could indicate high complication rates, long hospital stays, and/or a need for tracheostomy...
June 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29898662/decannulation-of-tracheotomized-patients-after-long-term-mechanical-ventilation-results-of-a-prospective-multicentric-study-in-german-neurological-early-rehabilitation-hospitals
#19
Maria-Dorothea Heidler, Annett Salzwedel, Michael Jöbges, Olaf Lück, Christian Dohle, Michael Seifert, Andrea von Helden, Wibke Hollweg, Heinz Völler
BACKGROUND: In the course of neurological early rehabilitation, decannulation is attempted in tracheotomized patients after weaning due to its considerable prognostic significance. We aimed to identify predictors of a successful tracheostomy decannulation. METHODS: From 09/2014 to 03/2016, 831 tracheotomized and weaned patients (65.4 ± 12.9 years, 68% male) were included consecutively in a prospective multicentric observation study. At admission, sociodemographic and clinical data (e...
June 13, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29893060/long-term-outcome-of-permanent-tracheostomy-in-15-dogs-with-severe-laryngeal-collapse-secondary-to-brachycephalic-airway-obstructive-syndrome
#20
Matteo Gobbetti, Stefano Romussi, Paolo Buracco, Valerio Bronzo, Samuele Gatti, Matteo Cantatore
OBJECTIVE: To report the long-term outcome of permanent tracheostomy for the management of severe laryngeal collapse secondary to brachycephalic airway obstructive syndrome. STUDY DESIGN: Retrospective case series. ANIMALS: Fifteen brachycephalic dogs with severe laryngeal collapse treated with permanent tracheostomy. METHODS: Follow-up data were obtained from medical records or via telephone conversation with the owners...
June 12, 2018: Veterinary Surgery: VS
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