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https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#1
Matthew A Sexton, Arnoley S Abcejo, Jeffrey J Pasternak
BACKGROUND: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. METHODS: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively)...
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28225317/the-appropriate-time-for-closed-reduction-using-local-anesthesia-in-arytenoid-dislocation-caused-by-intubation-a-clinical-research
#2
Zhewei Lou, Zhihong Lin
CONCLUSION: Closed reduction is effective and safe for the treatment of arytenoid dislocation, and the selection of an appropriate time window to perform closed reduction is crucial in achieving relatively stable treatment outcomes and short treatment duration. OBJECTIVE: The aim of this study was to investigate whether there is an appropriate time window to perform closed reduction for unilateral arytenoid dislocation caused by intubation. METHODS: A retrospective chart review was carried out for the cases collected from September 2014 to May 2016 at Second Affiliated Hospital of Zhejiang University, China...
March 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28218802/non-invasive-ventilation-for-cystic-fibrosis
#3
REVIEW
Fidelma Moran, Judy M Bradley, Amanda J Piper
BACKGROUND: Non-invasive ventilation may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis by providing ventilatory support and avoiding tracheal intubation. Using non-invasive ventilation, in the appropriate situation or individuals, can improve lung mechanics through increasing airflow and gas exchange and decreasing the work of breathing. Non-invasive ventilation thus acts as an external respiratory muscle. This is an update of a previously published review...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28213800/invasive-aspergillus-laryngotracheobronchitis-in-an-adult-with-primary-cns-lymphoma
#4
Mark E Barry, William Walsh Thomas, Buer Song, Natasha Mirza
Invasive aspergillosis can be difficult to diagnose, and early recognition and initiation of therapy is imperative for improving patient outcomes. A case of invasive Aspergillus laryngotracheobronchitis is presented here with a review of the relevant literature. A 58-year-old male undergoing treatment for CNS lymphoma presented with neutropenic sepsis and acute respiratory distress requiring intubation. Following extubation, he reported persistent hoarseness for 1-month duration and he was found to have pseudomembranous plaques and ulcers of the larynx, trachea, and right mainstem bronchus consistent with Aspergillus laryngotracheobronchitis...
February 17, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28207971/emergency-department-initiated-home-oxygen-for-bronchiolitis-a-prospective-study-of-community-follow-up-caregiver-satisfaction-and-outcomes
#5
Julia Fuzak Freeman, Sara Deakyne, Lalit Bajaj
OBJECTIVE: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences. METHODS: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014)...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28203437/update-on-the-diagnosis-and-treatment-of-tracheal-and-bronchial-injury
#6
REVIEW
Zhengwei Zhao, Tianyi Zhang, Xunliang Yin, Jinbo Zhao, Xiaofei Li, Yongan Zhou
Tracheal and bronchial injury, including iatrogenic injury and traumatic injury, the former usually occurred in the operation, intubation or bronchoscopy. The latter was occurred in a variety of blunt trauma, often combined with a variety of complex injuries. The therapeutic approach can be differentiated, surgical or conservative, no criteria has been universally accepted. Successful treatment of tracheobronchial injuries requires early diagnostic evaluation. This article aims to review the indications and therapeutic options for tracheal and bronchial injuries...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203407/thoracoabdominal-aortic-replacement-for-crawford-extent-ii-aneurysm-after-thoracic-endovascular-aortic-repair
#7
Haiou Hu, Tie Zheng, Junming Zhu, Yongmin Liu, Ruidong Qi, Lizhong Sun
BACKGROUND: The surgical treatment of Crawford extent II aneurysms after thoracic endovascular aortic repair (TEVAR) remains challenging, because of the need to remove the failed endograft and the complexity of the aortic reconstruction. We retrospectively reviewed our experience with surgical management of Crawford extent II aneurysms after TEVAR using thoracoabdominal aortic replacement (TAAR). METHODS: Eleven patients (10 males, 1 female) with Crawford extent II aneurysm after TEVAR were treated with TAAR between August 2012 and May 2015...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28196506/the-success-of-pre-hospital-tracheal-intubation-by-different-pre-hospital-providers-a-systematic-literature-review-and-meta-analysis
#8
K Crewdson, D J Lockey, J Røislien, H M Lossius, M Rehn
BACKGROUND: Pre-hospital basic airway interventions can be ineffective at providing adequate oxygenation and ventilation in some severely ill or injured patients, and advanced airway interventions are then required. Controversy exists regarding the level of provider required to perform successful pre-hospital intubation. A previous meta-analysis reported pre-hospital intubation success rates of 0.849 for non-physicians versus 0.991 for physicians. The evidence base on the topic has expanded significantly in the last 10 years...
February 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28195821/idiopathic-subglottic-stenosis
#9
Deanna C Menapace, Mara C Modest, Dale C Ekbom, Eric J Moore, Eric S Edell, Jan L Kasperbauer
Objectives Idiopathic subglottic stenosis (iSGS) is rare, and its cause remains elusive. Treatment options include empiric medical therapy and endoscopic or open surgery. We present our results for open surgical technique. Study Design Case series with chart review (1978-2015). Setting Tertiary academic center. Subjects/Methods Thirty-three patients (32 female; median age, 51 years) met inclusion criteria and underwent cricotracheal resection with thyrotracheal anastomosis, tracheal resection with primary anastomosis, or laryngotracheoplasty with rib grafting...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28192893/non-invasive-ventilation-improves-respiratory-distress-in-children-with-acute-viral-bronchiolitis-a-systematic-review
#10
Yann Combret, Guillaume Prieur, Pascal LE Roux, Clément Médrinal
BACKGROUND: Non-invasive ventilation (NIV) is a common treatment for bronchiolitis. However, consensus concerning its efficacy is lacking. The aim of this systematic review was to assess NIV effectiveness to reduce respiratory distress. Secondary objectives were to summarize the effects of NIV, identify predictive factors for failure and describe settings and applications. METHODS: Searches were conducted in MEDLINE Pubmed, PEDro, COCHRANE, EMBASE, CINAHL, Web of Science, Up-todate and Sudoc from 1990 to April 2015...
February 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28188542/systemic-complications-of-spinal-cord-injury
#11
REVIEW
Rochelle Sweis, José Biller
PURPOSE OF REVIEW: To review the acute and chronic systemic complications of spinal cord injury and discuss treatment recommendations. RECENT FINDINGS: The psychological, social, economic, and permanent neurologic effects associated with spinal cord injury (SCI) have universally persisted over time. Treating acute complications and preventing secondary injury can influence outcome, highlighting the importance of proper management of this patient population. Spinal cord injury (SCI) is due to traumatic or non-traumatic causes...
February 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28188055/the-emergency-medicine-management-of-severe-alcohol-withdrawal
#12
Drew Long, Brit Long, Alex Koyfman
INTRODUCTION: Alcohol use is widespread, and withdrawal symptoms are common after decreased alcohol intake. Severe alcohol withdrawal may manifest with delirium tremens, and new therapies may assist in management of this life-threatening condition. OBJECTIVE: To provide an evidence-based review of the emergency medicine management of alcohol withdrawal and delirium tremens. DISCUSSION: The underlying pathophysiology of alcohol withdrawal syndrome (AWS) is central nervous system hyperexcitation...
February 4, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28187797/airway-management-and-mechanical-ventilation-in-acute-brain-injury
#13
D B Seder, J Bösel
Patients with acute neurologic disease often develop respiratory failure, the management of which profoundly affects brain physiology and long-term functional outcomes. This chapter reviews airway management and mechanical ventilation of patients with acute brain injury, offering practical strategies to optimize treatment of respiratory failure and minimize secondary brain injury. Specific concerns that are addressed include physiologic changes during intubation and ventilation such as the effects on intracranial pressure and brain perfusion; cervical spine management during endotracheal intubation; the role of tracheostomy; and how ventilation and oxygenation are utilized to minimize ischemia-reperfusion injury and cerebral metabolic distress...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#14
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28183554/comparison-of-laryngeal-mask-airway-vs-tracheal-intubation-a-systematic-review-on-airway-complications
#15
REVIEW
Babette F van Esch, Inge Stegeman, Adriana L Smit
To determine whether the laryngeal mask airway (LMA) has advantages over the tracheal tube (TT) in terms of incidence of cough, sore throat, laryngospasm, dysphagia, dysphonia, and blood staining. This is a systematic literature review performed at the Universtity Medical Center of Utrecht. The online databases PubMed, Embase, and the Cochrane Library were searched for relevant randomized controlled trials. Two independent reviewers selected relevant articles after title, abstract, and full text screening. Articles were assessed on risk of bias in accordance with the Cochrane risk of bias tool...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#16
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28161028/update-on-traumatic-acute-spinal-cord-injury-part-1
#17
R Galeiras Vázquez, M E Ferreiro Velasco, M Mourelo Fariña, A Montoto Marqués, S Salvador de la Barrera
Traumatic spinal cord injury requires a multidisciplinary approach both for specialized treatment of the acute phase and for dealing with the secondary complications. A suspicion or diagnosis of spinal cord injury is the first step for a correct management. A review is made of the prehospital management and characteristics of the acute phase of spinal cord injury. Respiratory monitoring for early selective intubation, proper identification and treatment of neurogenic shock are essential for the prevention of secondary spinal cord injury...
February 1, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28156478/using-touch-based-technology-to-screen-patients-in-the-icu
#18
Matthew J Loscalzo, Rupinder Sidhu, David Horak, Sorin Buga
: 76 Background: The intensive care unit (ICU) is associated with high mortality rates, significant costs, along with occasionally futile and non-indicated care. Surveys of patients indicate the majority wish to focus on comfort and being at home at the end of life as opposed to the aggressive interventions received in the hospital. Although a small percentage of patients may be awake, medical teams look to the families to provide the direction of care for a patient in the ICU. City of Hope National Medical Center has utilized tablet-based screening of caregivers for years, and now in conjunction with delirium screening has started to roll out tablet-based screening for patients who are awake and do not have delirium...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153614/internal-maxillary-artery-preoperative-embolization-using-nbca-and-pushable-coils-for-temporomandibular-joint-ankylosis-surgery-technical-note
#19
Yazan J Alderazi, Darshan Shastri, John Wessel, Melvin Mathew, Tareq Kass-Hout, Shahid R Aziz, Charles J Prestigiacomo, Chirag D Gandhi
INTRODUCTION: Temporomandibular joint (TMJ) ankylosis causes disability through impaired digestion, mastication, speech and appearance. Surgical treatment increases range of motion with resultant functional improvement. However, substantial perioperative blood loss can occur, up to three liters, if the internal maxillary artery (IMAX) is injured as it traverses the ankylotic mass. Achieving hemostasis is difficult due to limited proximal IMAX access and poor visualization. Our aim is to investigate the technical feasibility and preliminary safety of preoperative IMAX embolization in patients undergoing TMJ ankylosis surgery...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28152751/identifying-avoidable-terminal-oncology-icu-hospitalizations
#20
Andrew Hantel, Blase N Polite
: 56 Background: Eight percent of cancer patients expire in the ICU. There is no association between spending on aggressive end of life (EOL) care and survival outcomes. This aggressive care is also associated with reduced quality of life for patients and families. The National Quality Forum endorses the number of patients admitted to the ICU in the last 30 days of life as a quality of care measure. Our hypothesis is that a significant number of oncology patients suffer avoidable terminal ICU hospitalizations...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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