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https://www.readbyqxmd.com/read/28340493/conservative-treatment-with-octreotide-to-provide-early-recovery-of-children-with-esophageal-perforation
#1
Ramazan Karabulut, Zafer Turkyilmaz, Kaan Sonmez, Abdullah Can Basaklar
Background The effectiveness of nonoperative treatment of esophageal perforation (EP) in children with octreotide is highlighted. Methods Records of nine patients (seven boys and two girls with an average age of 5.83 ± 5.35 years) with EP were reviewed. Results EP developed in six patients during dilation of esophageal stenosis (five of six caused by caustic burns). In the other three patients, EP developed after nasogastric placement, after endotracheal intubation, and during endoscopy for foreign body...
March 24, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28337407/fentanyl-induced-chest-wall-rigidity-syndrome-in-a-routine-bronchoscopy
#2
Chee Kiang Phua, Audrey Wee, Albert Lim, John Abisheganaden, Akash Verma
Combination of sedatives such as fentanyl and midazolam during bronchoscopy is recommended by American College of Chest Physician due to its favourable drug profile. It improves patient comfort and tolerance, and is commonly given unless contraindicated. We describe a rare case of fentanyl-induced chest wall rigidity syndrome during a routine bronchoscopy with endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) in a 55 year old male presenting with a lung mass and mediastinal lymphadenopathy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28333694/high-flow-nasal-cannula-therapy-beyond-the-perinatal-period
#3
Michael Lee, Joshua Nagler
PURPOSE OF REVIEW: High-flow nasal cannula (HFNC) is emerging as a means of oxygen delivery and respiratory support for a range of conditions outside the perinatal period. We aim to review the mechanisms of action and advantages of HFNC and to summarize current findings regarding clinical benefit in specific pediatric disease processes and in patients with significant respiratory distress. RECENT FINDINGS: Currently published studies outside the neonatal population demonstrate both safety and efficacy of this mode of respiratory support...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28331796/an-unexpected-finding-in-a-man-with-multiple-pulmonary-nodules-a-pleural-effusion-and-respiratory-failure
#4
Yik Lam Pang, Quentin Jones
We report the case of a 47-year old Caucasian man with a history of depression and high alcohol intake who presented with a one-month history of weight loss, dry cough and abdominal pain. He had no smoking history of note. The patient was treated for a suspected chest infection, however developed respiratory failure and was intubated. A CT showed multiple pulmonary nodules, left pleural thickening extending to the mediastinum and bilateral pleural effusions-larger on the left, suggestive of disseminated malignancy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28330573/implication-of-general-anaesthetic-and-sedation-techniques-in-temporomandibular-joint-disorders%C3%A2-%C3%A2-a-systematic-review
#5
J Talaván-Serna, J M Montiel-Company, C Bellot-Arcís, J M Almerich-Silla
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest...
February 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28328859/single-stage-nonintubated-uniportal-thoracoscopic-resection-of-synchronous-bilateral-pulmonary-nodules-after-coil-labeling-a-case-report-and-literature-review
#6
Miao Zhang, Tao Wang, You-Wei Zhang, Wen-Bin Wu, Heng Wang, Rong-Hua Xu
RATIONALE: Preoperative localization of small pulmonary nodules is essential for precise resection, besides, the optimal treatment for pulmonary nodules is controversial and the prognosis without surgery is uncertain. PATIENT CONCERNS: Herein we present a patient with compromised pulmonary function harboring synchronous triple ground-glass nodules located separately in different pulmonary lobes. DIAGNOSES: The pathological diagnosis of the nodules were chronic inflammation, inflammatory pseudotumor and atypical adenomatous hyperplasia, respectively...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28327922/factors-influencing-the-reliability-of-the-glasgow-coma-scale-a-systematic-review
#7
Florence Cm Reith, Anneliese Synnot, Ruben van den Brande, Russell L Gruen, Andrew Ir Maas
BACKGROUND: The Glasgow Coma Scale (GCS) characterizes patients with diminished consciousness. In a recent systematic review, we found overall adequate reliability across different clinical settings, but reliability estimates varied considerably between studies, and methodological quality of studies was overall poor. Identifying and understanding factors that can affect its reliability is important, in order to promote high standards for clinical use of the GCS. OBJECTIVE: The aim of this systematic review was to identify factors that influence reliability and to provide an evidence base for promoting consistent and reliable application of the GCS...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28323727/experience-with-the-use-of-single-use-disposable-bronchoscope-in-the-icu-in-a-tertiary-referral-center-of-singapore
#8
Dominic C Marshall, Rucha S Dagaonkar, Chan Yeow, Anura T Peters, Siew Kin Tan, Dessmon Y H Tai, Soon Keng Gohs, Albert Y H Lim, Benjamin Ho, Sennen J W Lew, John Abisheganaden, Akash Verma
BACKGROUND: Flexible bronchoscopy is performed frequently in intensive care units (ICUs) for various indications using the reusable conventional bronchoscope (CB). Recently, "single-use disposable bronchoscope" (SB) was introduced into the health care industry. The purpose of this study was to compare the utility of SB with CB in ICU. METHODS: A retrospective review of medical records of patients undergoing flexible bronchoscopy in the ICUs in the year 2015. RESULTS: Ninety-three patients undergoing flexible bronchoscopy in the ICU were studied...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28321993/metatropic-dysplasia-a-skeletal-dysplasia-with-challenging-airway-and-other-anesthetic-concerns
#9
Mary C Theroux, Martha Lopez, Patricia J Olszewsky, Sabina DiCindio, Lynda Arai, Colleen Ditro, Michael B Bober, Olubukola Opeyemi Olla, Tetsu Uejima, David W West, William G Mackenzie
BACKGROUND: Metatropic dysplasia is a rare form of skeletal dysplasia requiring multiple anesthetics for surgical and imaging procedures, most of which are orthopedic procedures. We provide centralized care to patients with skeletal dysplasia at our tertiary care pediatric hospital, and we were able to collect the largest number of metatropic dysplasia patients reported to date. AIM: The aim of this retrospective study was to describe and characterize the anesthetic difficulties in this high-risk population...
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28320439/mechanical-ventilation-in-obese-icu-patients-from-intubation-to-extubation
#10
REVIEW
Audrey De Jong, Gerald Chanques, Samir Jaber
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#11
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28319524/combined-therapy-of-ventricular-assist-device-and-extracorporeal-membrane-oxygenation-for-profound-acute-cardiopulmonary-failure
#12
Kevin Fujita, Koji Takeda, Boyganzi Li, Christine Mauro, Paul Kurlansky, Sowmyashree Sreekanth, Jiho Han, Lauren K Truby, Reshad Garan, Veli Topkara, Melana Yuzefpolskaya, Paolo Colombo, Yoshifumi Naka, Hiroo Takayama
Short-term ventricular assist devices (ST-VAD) have been effective in treating patients with refractory cardiogenic shock. Membrane oxygenators (MO) can be added to the circuit for concomitant profound refractory hypoxia. This study reports outcomes of combined therapy in this portion of patients. This is a retrospective review of 166 patients who received an ST-biventricular assist device (BiVAD) or right ventricular assist device (RVAD) for cardiogenic shock between November 2007 and November 2014. An MO was added to the RVAD for profound hypoxia refractory to maximized ventilation...
March 17, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28301956/the-effect-of-tracheostomy-performed-within-72%C3%A2-h-after-traumatic-brain-injury
#13
Keita Shibahashi, Kazuhiro Sugiyama, Hidenori Houda, Yuichi Takasu, Yuichi Hamabe, Akio Morita
The optimal timing of tracheostomy in patients with traumatic brain injury (TBI) remains unclear. The purpose of this study was to examine the effects of tracheostomy performed within 72 h after admission. In this retrospective cohort study, the authors reviewed the data for a series of 120 consecutive patients who underwent tracheostomy after suffering TBI with an Abbreviated Injury Scale (AIS) score of ≥4. The exclusion criteria were as follows: age <18 years, severe chest injury with an AIS score of ≥4, and a requirement for intubation because of upper airway obstruction...
March 16, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28299353/safety-and-efficacy-of-single-balloon-enteroscopy-in-management-of-gastrointestinal-bleeding-in-patients-with-a-left-ventricular-assist-device
#14
Abhinav Koul, Donald M Pham, Arjun Nanda, Kevin E Woods, Steven D Keilin
Background and study aims Left ventricular assist devices (LVADs) are currently the standard of care in treatment of patients with end-stage heart failure waiting for heart transplant as well as destination therapy for non-transplant candidates. However, patients with LVADs are at increased risk of gastrointestinal bleeding due to the device's unique effects on hemodynamics. A major source of gastrointestinal bleeding in these patients are gastrointestinal angioectasias located within the small bowel that can only be reached with deep enteroscopy...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28299194/recent-trends-in-airway-management
#15
REVIEW
Joelle Karlik, Michael Aziz
Tracheal intubation remains a life-saving procedure that is typically not difficult for experienced providers in routine conditions. Unfortunately, difficult intubation remains challenging to predict and intubation conditions may make the event life threatening. Recent technological advances aim to further improve the ease, speed, safety, and success of intubation but have not been fully investigated. Video laryngoscopy, though proven effective in the difficult airway, may result in different intubation success rates in various settings and in different providers' hands...
2017: F1000Research
https://www.readbyqxmd.com/read/28298767/airway-management-in-patients-with-tracheal-compression-undergoing-thyroidectomy-a-retrospective-analysis
#16
Binu Sajid, K Rekha
BACKGROUND: Airway management in large and retrosternal goiters with tracheal compression is often fraught with challenges and is a source of apprehension among anesthesiologists globally. AIMS: In this study we attempt to delineate the preferred techniques of airway management of such cases in our institution and also to assess whether airway management was unnecessarily complicated. SETTING AND DESIGN: Retrospective analysis. MATERIALS AND METHODS: A retrospective review was conducted of thyroidectomies performed in our institution over a three year period from January 2013...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#17
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286563/antispasmodic-drugs-in-colonoscopy-a-review-of-their-pharmacology-safety-and-efficacy-in-improving-polyp-detection-and-related-outcomes
#18
REVIEW
Santosh Sanagapalli, Kriti Agnihotri, Rupert Leong, Crispin John Corte
Antispasmodic drugs are cheap, effective and generally safe. They may improve outcomes in colonoscopy, however their use has not been consistent or widespread. This manuscript reviews the three most commonly used antispasmodics in colonoscopy, namely, hyoscine butylbromide (and related ammonium compounds), glucagon and peppermint oil. The pharmacology, action and safety of the agents, as well as the evidence for them improving colonoscopic outcomes will be discussed. In addition to polyp detection, other colonoscopic outcome endpoints of interest include cecal and ileal intubation, and patient comfort...
January 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28284468/the-influence-of-tracheostomy-timing-on-outcomes-in-trauma-patients-a-meta-analysis
#19
Shi-Qi Cai, Jun-Wu Hu, Dong Liu, Xiang-Jun Bai, Jie Xie, Jia-Jun Chen, Fan Yang, Tao Liu
OBJECTIVE: This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia. METHOD: A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI). RESULT: 20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group...
February 24, 2017: Injury
https://www.readbyqxmd.com/read/28279620/asystole-during-direct-laryngoscopy-for-vocal-fold-injection-in-a-healthy-patient
#20
Zahrah Taufique, Gregory R Dion, Milan R Amin
OBJECTIVES: This study aims (1) to present a case of asystole during direct laryngoscopy in an otherwise healthy patient at an outpatient surgery center and (2) to review literature on cardiac complications, specifically asystole and bradycardia, during direct laryngoscopy. METHODS: A 67-year-old woman with no prior cardiac history underwent induction with succinylcholine and remifentanil for direct laryngoscopy and vocal fold augmentation. During suspension laryngoscopy, the patient became asystolic, and advanced care life support measures were started...
March 6, 2017: Journal of Voice: Official Journal of the Voice Foundation
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