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https://www.readbyqxmd.com/read/28822673/the-financial-impact-of-a-hospital-based-care-coordination-program-for-children-with-special-health-care-needs
#1
Janine M Petitgout
Care coordination programs are important in caring for medically complex pediatric patients, particularly for children with special health care needs. This study is a retrospective financial analysis of a hospital-based care coordination program involving one procedural subgroup of children with special health care needs: those receiving pediatric tracheostomy. Hospital records were reviewed for patients who received a tracheostomy at a large Midwestern U.S. hospital from 1999 through 2015. The population was divided into two subgroups: patients who received a tracheostomy before the development of a care coordination program and patients who received a tracheostomy after enrollment in the care coordination program...
August 16, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#2
Shawna M Kettyle, Nikhil L Chervu, Appajosula Sarada Rao, Salaam Sadi, David Majure, Jack A Sava, Laura S Johnson
the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820843/cephalometric-predictors-of-clinical-severity-in-treacher-collins-syndrome
#3
Elcin Esenlik, Natalie M Plana, Barry H Grayson, Roberto L Flores
BACKGROUND: The aim of this study is to identify cephalometric measurements associated with clinical severity in patients with Treacher Collins Syndrome (TCS). METHODS: A retrospective single-institutional review of patients with TCS was conducted. Pre-operative cephalograms and computed tomography scans (n=30) were evaluated. 50 cephalometric measurements were compared to age-specific normative data using ANOVA. These cephalometric measurements and the patient's Pruzansky classification were correlated to clinical severity using Spearman analysis...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#4
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28815624/morbidity-and-mortality-in-children-undergoing-bronchoscopy-for-foreign-body-removal
#5
Christopher A Roberts, Michele M Carr
OBJECTIVES/HYPOTHESIS: Analyze morbidity and mortality among children undergoing bronchoscopy for foreign body removal. STUDY DESIGN: Multicenter retrospective review using the American College of Surgeons Pediatric National Surgical Quality Improvement Program from 2014 and 2015. METHODS: Patients were identified using Current Procedural Terminology code 31635. Demographics, time to surgery, operative times, hospitalization time, and complications were collected...
August 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28814580/ventrain-from-theory-to-practice-bridging-until-re-tracheostomy
#6
Bianca Maria Wahlen, Hassan Al-Thani, Ayman El-Menyar
Imminent upper airway obstruction due to life-threatening tracheal stenosis of any cause is challenging. A 77-year-old woman, with a history of temporal tracheostomy for prolonged mechanical ventilation, presented with life-threatening tracheal stenosis to the emergency department. After failed intubation with a 5.0 mm internal diameter endotracheal tube, the patient was ventilated via a tube exchanger using Ventrain. Ventrain is a manual ventilation device that, in addition to oxygen supply during inspiration, initiates expiration by actively removing gas from the lungs by suction...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28810133/floor-of-mouth-hematoma-following-dental-implant-placement-systematic-review-and-case-presentation
#7
REVIEW
Catherine Law, Peyman Alam, Farzad Borumandi
PURPOSE: The authors provide a structured review of reported cases of floor-of-mouth hematoma during or after dental implantation and frequent causes and management and present a related case. MATERIALS AND METHODS: An online search of the medical literature was conducted from 1990 through 2016. The following search terms were used: floor of mouth hematoma, sublingual hematoma, dental implant hematoma, implant in mandible, and complication of dental implant. Abstracts were screened for relevance to the aims of the review...
July 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28809368/deep-neck-infections-a-single-center-analysis-of-63-cases
#8
P Kauffmann, R Cordesmeyer, M Tröltzsch, C Sömmer, R Laskawi
BACKGROUND AND PURPOSE: With the use of antibiotic therapy, the incidence of deep neck infections has decreased in recent decades. The aim of this investigation was to review the clinical course and the management of deep neck infections in our department, compare them to the experiences of the common literature and identify predisposing factors for lethal complications. MATERIAL AND METHODS: In this single-center analysis, 63 patients with deep neck infections were treated surgically...
August 15, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28807655/first-clinical-consensus-and-national-recommendations-on-tracheostomized-children-of-the-brazilian-academy-of-pediatric-otorhinolaryngology-abope-and-brazilian-society-of-pediatrics-sbp
#9
Melissa A G Avelino, Rebecca Maunsell, Fabiana Cardoso Pereira Valera, José Faibes Lubianca Neto, Cláudia Schweiger, Carolina Sponchiado Miura, Vitor Guo Chein, Dayse Manrique, Raquel Oliveira, Fabiano Gavazzoni, Isabela Furtado de Mendonça Picinin, Paulo Bittencourt, Paulo Camargos, Fernanda Peixoto, Marcelo Braciela Brandão, Tania Maria Sih, Wilma Terezinha Anselmo-Lima
INTRODUCTION: Tracheostomy is a procedure that can be performed in any age group, including children under 1year of age. Unfortunately health professionals in Brazil have great difficulty dealing with this condition due to the lack of standard care orientation. OBJECTIVE: This clinical consensus by Academia Brasileira de Otorrinolaringologia Pediátrica (ABOPe) and Sociedade Brasileira de Pediatria (SBP) aims to generate national recommendations on the care concerning tracheostomized children...
June 27, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28807072/clavicle-fracture-with-osteomyelitis-after-neck-dissection-and-post-operative-radiotherapy-case-report
#10
R Shodo, Y Sato, H Ota, A Horii
BACKGROUND: Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. CASE REPORT: A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer...
August 15, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28804685/percutaneous-dilatational-tracheostomy-through-paramedian-technique-and-lateral-approach-in-a-patient-with-cervical-esophagostomy-a-case-report
#11
Kapil D Soni, Neha Garg, Richa Aggarwal, Ambuj Ambuj
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) is a common surgical procedure and established as first choice for securing the airway in critically ill patients needing prolonged mechanical ventilation. There are case reports of open tracheostomy through paramedian approach without complications. This case report presents a case of PDT through paramedian approach. CASE REPORT: An 18 year old female, case of firearm injury underwent cervical esophagostomy on the left side of neck approaching midline...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28802395/changes-in-pediatric-tracheostomy-tubes-exposed-to-home-dishwashing
#12
David E Smolar, Brian Ho, Steven M Kent, C Anthony Hughes, Donald Mettenburg, Fredrick A Rueggeberg, Michael W Groves
OBJECTIVE: Determine the effects of household dishwashing on Tracheostomy Tube safety. INTRODUCTION: Tracheostomy tubes accumulate biofilms, which may limit their lifespan. Frequent cleaning of the tubes is a method for biofilm prevention. Cleaning practices vary widely. Some families prefer dishwashing of tubes, but its effects are currently unknown. We hypothesize that dishwashing has no significant effect on the physical properties of tracheostomy tubes and can be recommended as a safe way to clean tracheostomy tubes...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802009/duration-of-tracheostomy-dependence-and-development-of-tracheocutaneous-fistula-in-children
#13
Tu-Anh Ha, Meha Goyal, Julina Ongkasuwan
OBJECTIVE: To determine whether the risk of developing a tracheocutaneous fistula (TCF) increases with longer tracheostomy dependence times in children. STUDY DESIGN: Retrospective review of medical records. METHOD: A retrospective chart review was conducted for all children who both underwent tracheotomy and were decannulated between 2002 and 2011 at a tertiary children's hospital. Charts were analyzed for duration of tracheostomy and evidence of TCF up to 12 months...
August 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#14
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28796800/the-temporal-dynamics-of-the-tracheal-microbiome-in-tracheostomised-patients-with-and-without-lower-respiratory-infections
#15
Marcos Pérez-Losada, Robert J Graham, Madeline Coquillette, Amenah Jafarey, Eduardo Castro-Nallar, Manuel Aira, Robert J Freishtat, Jonathan M Mansbach
BACKGROUND: Airway microbiota dynamics during lower respiratory infection (LRI) are still poorly understood due, in part, to insufficient longitudinal studies and lack of uncontaminated lower airways samples. Furthermore, the similarity between upper and lower airway microbiomes is still under debate. Here we compare the diversity and temporal dynamics of microbiotas directly sampled from the trachea via tracheostomy in patients with (YLRI) and without (NLRI) lower respiratory infections...
2017: PloS One
https://www.readbyqxmd.com/read/28794964/innovative-use-of-a-montgomery-cannula-in-the-bronchoscopic-management-of-tracheal-stenosis-and-failed-tracheostomy-decannulation
#16
Haidong Huang, Changming Chen, Harmeet Bedi, Chong Bai, Qiang Li, Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis
BACKGROUND: Endoprosthesis are being used in the everyday clinical practice either as a permanent solution or transient. They can be used in both benign and malignant situations. CASE PRESENTATION: We report a case in which a temporary Montgomery cannula is used in conjunction with therapeutic bronchoscopy to manage a patient with failed tracheostomy decannulation secondary to a distal complex tracheal stenosis. CONCLUSIONS: This innovative use of the Montgomery cannula allowed for successful management of the patient's tracheal stenosis and subsequent tracheostomy tube decannulation...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28794882/interruption-of-enteral-nutrition-in-the-intensive-care-unit-a-single-center-survey
#17
Midori Uozumi, Masamitsu Sanui, Tetsuya Komuro, Yusuke Iizuka, Tadashi Kamio, Hiroshi Koyama, Hideyuki Mouri, Tomoyuki Masuyama, Kazuyuki Ono, Alan Kawarai Lefor
BACKGROUND: Interruption of enteral nutrition (EN) in the intensive care unit (ICU) occurs frequently for various reasons including feeding intolerance and the conduct of diagnostic and therapeutic procedures. However, few studies have investigated the details of EN interruption practices including reasons for and duration of interruptions. There is no standard protocol to minimize EN interruptions. METHODS: This is a retrospective review of 100 patients in the ICU staying more than 72 h and receiving EN in a 12-bed, medical/surgical ICU in a tertiary care center in 2013...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28793102/deaths-among-the-elderly-with-icu-infections
#18
Álvaro Francisco Lopes de Sousa, Artur Acelino Francisco Luz Nunes Queiroz, Layze Braz de Oliveira, Luana Kelle Batista Moura, Denise de Andrade, Evandro Watanabe, Maria Eliete Batista Moura
Objective: to evaluate the clinical outcome of elderly patients admitted to intensive care units who had nosocomial infection, correlating the findings with sociodemographic and clinical variables. Method: descriptive research, performed with 308 elderly patients. The collection was made from medical records and covers the years 2012 to 2015. Uni-/bivariate analyses were performed. Results: a statistical association was found between the clinical outcome types and the variables age, length of stay, presence of previous comorbidities, main diagnosis, respiratory and urinary tract infections, use of central venous and indwelling urinary catheters, mechanical ventilation, and tracheostomy...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28782106/sirolimus-as-treatment-for-19-patients-with-refractory-cervicofacial-lymphatic-malformation
#19
Julie E Strychowsky, Reza Rahbar, Meghan J O'Hare, Alexandria L Irace, Horacio Padua, Cameron C Trenor
OBJECTIVE: Lymphatic malformations (LMs) are challenging to manage, particularly those involving the cervicofacial region and airway. Traditional therapy is sclerotherapy and/or resection. We aim to establish the emerging therapeutic role of sirolimus. STUDY DESIGN: Institutional review board-approved retrospective review. METHODS: All patients treated for cervicofacial LM with sirolimus at Boston Children's Hospital, Massachusetts, from November 2012 to October 2016 were included...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28780390/a-12-year-experience-with-tracheostomy-for-neonates-and-infants-in-northern-taiwan-indications-hospital-courses-and-long-term-outcomes
#20
Chia-Huei Chen, Jui-Hsing Chang, Chyong-Hsin Hsu, Nan-Chang Chiu, Chun-Chin Peng, Wai-Tim Jim, Hung-Yang Chang, Kuo-Sheng Lee
BACKGROUND: Tracheostomy is a valuable procedure in infants and neonates with chronic respiratory failure or severe airway obstruction. The aim of this study is to identify the indication, hospital course, and long-term outcome in a cohort of infants who required tracheostomy in a neonatal and pediatric tertiary care center in northern Taiwan. METHODS: Medical records of infants, who underwent tracheostomy between January 2002 and December 2013, were retrospectively reviewed...
July 24, 2017: Pediatrics and Neonatology
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