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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/29435968/-a-new-phenotype-of-infantile-onset-pompe-disease
#2
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
#3
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
#4
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
#5
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/29416476/fractured-tracheostomy-tube-posted-for-bronchoscopic-removal-an-anesthetic-challenge
#6
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/29398476/frequent-isolation-of-extended-spectrum-beta-lactamase-producing-bacteria-from-fecal-samples-of-individuals-with-severe-motor-and-intellectual-disabilities
#7
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/29395561/-tracheostomy-performed-in-icu-professional-practice-assessment-and-patient-outcome
#8
L Martinez, J Demanet, V Mignaux, F Dewavrin
INTRODUCTION: Tracheostomy is a commonly performed procedure. The aim of this study was to assess professional practice, describe patient characteristics and examine short and long-term outcomes. METHODS: All patients with CCAM GEPA004 code were retrospectively included. RESULTS: Two hundred and fourteen (7%) patients who were mecanically ventilated had a tracheostomy performed in intensive care unit (ICU). Median time to tracheostomy was 22 (14-28) days...
January 29, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29386758/challenges-in-management-of-pediatric-life-threatening-neck-and-chest-trauma
#9
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29362217/outcomes-of-tracheostomized-subjects-undergoing-prolonged-mechanical-ventilation-in-an-intermediate-care-facility
#10
Bertrand Herer
BACKGROUND: The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a tracheostomy tube in an intermediate-care facility. METHODS: Sixty-six subjects with chronic respiratory failure who experienced 109 hospitalizations between December 2010 and December 2012 in a 34-bed post-care unit were retrospectively included and followed for at least 1 y...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29359618/surgical-fires-in-otolaryngology-a-systematic-and-narrative-review
#11
Andrew T Day, Erika Rivera, Janice L Farlow, Christine G Gourin, Brian Nussenbaum
Objective To bring attention to the epidemiology, prevention, management, and consequences of surgical fires in otolaryngology by reviewing the literature. Data Sources PubMed, EMBASE, Web of Science, and Scopus. Review Methods Comprehensive search terms were developed, and searches were performed from data source inception through August 2016. A total of 4506 articles were identified; 2351 duplicates were removed; and 2155 titles and abstracts were independently reviewed. Reference review was also performed...
January 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29349733/point-of-care-ultrasound-pocus-of-the-upper-airway
#12
REVIEW
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
January 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29347960/long-term-outcome-of-definitive-radiotherapy-for-cervical-esophageal-squamous-cell-carcinoma
#13
Katsuyuki Sakanaka, Yuichi Ishida, Kota Fujii, Satoshi Itasaka, Shin'ichi Miyamoto, Takahiro Horimatsu, Manabu Muto, Takashi Mizowaki
BACKGROUND: The aim of this study was to identify the long-term clinical outcome of definitive radiotherapy using three-dimensional conformal radiotherapy (3DCRT) for cervical esophageal squamous cell carcinoma (CESCC). METHODS: We retrospectively reviewed the medical records of 30 patients with CESCC [clinical stage I/II/III/IV(M1LYM); 3/2/12/13] (TNM 7th edition) who underwent definitive radiotherapy using 3DCRT between 2000 and 2014 in our institution. The median prescribed dose for the gross tumor and metastatic lymph nodes was 60 Gy...
January 18, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29327864/limits-of-endoscopic-endonasal-approach-for-cranio-vertebral-junction-tumors
#14
Matteo Zoli, Nicolò Rossi, Filippo Friso, Carmelo Sturiale, Giorgio Frank, Ernesto Pasquini, Diego Mazzatenta
INTRODUCTION: The endoscopic endonasal approach has been recently proposed for cranio-vertebral junction lesions. The more common indication for this sagittal extension of the endonasal route is represented by odontoidectomy for irreducible ventral brainstem compression due to congenital or degenerative conditions. However, in an increasing number of studies its adoption for tumors involving the cranio-cervical junction has been reported. The aim of this study is to consider retrospectively our surgical series, focusing on the advantages and limits of this approach...
January 10, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29287880/revisits-after-pediatric-tracheotomy-airway-concerns-result-in-returns
#15
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES: Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy. METHODS: Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29287857/a-novel-technique-for-unilateral-supraglottoplasty
#16
Harry H Ching, Alycia G Spinner, Nathaniel H Reeve, T J O-Lee
OBJECTIVES: Traditional supraglottoplasty for pediatric laryngomalacia is most commonly conducted with either CO2 laser or cold steel instruments. While the procedure enjoys high success rates, serious complications such as excessive bleeding, supraglottic stenosis and aspiration can occur. Unilateral coblation supraglottoplasty may reduce this risk, but data on respiratory and swallowing outcomes are lacking. This study reports our experiences with unilateral coblation supraglottoplasty...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29284882/guidewire-migrating-into-murphy-s-eye-of-endotracheal-tube-an-unusual-complication-of-percutaneous-dilational-tracheostomy
#17
Rohini Arora, Sandeep Kumar, Sumit Sachan
Percutaneous dilational tracheostomy (PDT) is a frequently carried out bedside procedure in a critical care setting. It is usually performed under fiberoptic endoscopic guidance. Studies with PDT performed with endoscopic guidance have reported lower complication rates than studies performed with "blind" PDT. We report a case where PDT was performed without endoscopic assistance and the j-shaped guidewire got stuck in the Murphy's eye of endotracheal tube causing difficulty in railroading of tracheostomy tube (TT)...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284857/to-compare-the-effect-of-two-different-doses-of-dexmedetomidine-on-the-attenuation-of-airway-and-pressor-response-during-tracheostomy-tube-change-in-traumatic-brain-injury-patients
#18
Abdul Alim Khan, Neeraj Kumar, Yashpal Singh, Atul Kumar Singh, Sharad Kumar Mathur
Background: Tracheostomy tube (TT) change is the common procedure in trauma Intensive Care Unit (ICU) and almost always associated with cough reflex, increase in blood pressure, and heart rate. Dexmedetomidine (DEX) is a selective α2-adrenergic receptor agonist well studied for the prevention of pressor response during laryngoscopy and extubation, but literature on prevention of pressor response during TT change is lacking. Aims: The aim of this study is to compare two doses (0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284503/bronchoscopy-versus-an-endotracheal-tube-mounted-camera-for-the-peri-interventional-visualization-of-percutaneous-dilatational-tracheostomy-a-prospective-randomized-trial-vivapdt
#19
Jörn Grensemann, Lars Eichler, Sophie Kähler, Dominik Jarczak, Marcel Simon, Hans O Pinnschmidt, Stefan Kluge
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) in critically ill patients often involves bronchoscopic optical guidance. However, this procedure is not without disadvantages. Therefore, we aimed to study a recently introduced endotracheal tube-mounted camera (VivaSightTM-SL tube [VST]; ETView, Misgav, Israel) for guiding PDT. METHODS: This was a randomized controlled trial involving 46 critically ill patients who received PDT using optical guidance with a VST or with bronchoscopy...
December 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29279248/primary-surgical-management-with-radial-forearm-free-flap-reconstruction-in-t4-oropharyngeal-cancer-complications-and-functional-outcomes
#20
John R Sims, Eric J Moore
PURPOSE: Functional outcomes and complication rates after open surgery for advanced-stage oropharyngeal cancers are rarely reported. These measures are critical for choice of treatment modality and patient counseling. We describe the long term functional outcomes and associated complications of primary surgical management of T4 oropharyngeal cancers reconstructed with radial forearm free flaps. MATERIALS AND METHODS: A retrospective review was performed of 40 patients with T4 oropharyngeal cancers treated between 2005 and 2015 at a tertiary care center...
December 18, 2017: American Journal of Otolaryngology
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