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https://www.readbyqxmd.com/read/28820843/cephalometric-predictors-of-clinical-severity-in-treacher-collins-syndrome
#1
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
#2
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/28814580/ventrain-from-theory-to-practice-bridging-until-re-tracheostomy
#3
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/28802395/changes-in-pediatric-tracheostomy-tubes-exposed-to-home-dishwashing
#4
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/28794964/innovative-use-of-a-montgomery-cannula-in-the-bronchoscopic-management-of-tracheal-stenosis-and-failed-tracheostomy-decannulation
#5
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/28774204/apache-ii-score-cannot-predict-successful-weaning-from-prolonged-mechanical-ventilation
#6
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62-77) years), hospitalized between 1 January 2012, and 31 December 2013...
August 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28758602/eustachian-tube-dysfunction-leading-to-middle-ear-pathology-in-patients-on-chronic-mechanical-ventilation
#7
O Ilan, E-L Marcus, Y Cohen, T Farkash, R Levy, A Sasson, C Adelman
OBJECTIVE: This study aimed to investigate the prevalence of and risk factors for Eustachian tube dysfunction leading to middle-ear pathology in patients on chronic mechanical ventilation via tracheostomy tube. METHODS: A total of 40 patients on chronic ventilation were included in a prospective cohort study. Middle-ear status was determined by tympanometry. Tympanograms were categorised as types A, B or C; types B and C were defined as middle-ear pathology. RESULTS: In all, 57 ears of 40 patients were examined...
July 31, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28758080/effects-of-capping-of-the-tracheostomy-tube-in-stroke-patients-with-dysphagia
#8
Yong Kyun Kim, Sang-Heon Lee, Jang-Won Lee
OBJECTIVE: To investigate the impact of tracheostomy tube capping on swallowing physiology in stroke patients with dysphagia via videofluoroscopic swallowing study (VFSS). METHODS: This study was conducted as a prospective study that involved 30 stroke patients. Then, 4 mL semisolid swallowing was conducted with capping of the tracheostomy tube or without capping of the tracheostomy tube. The following five parameters were measured: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal sphincter width (UES), and penetration-aspiration scale (PAS) score...
June 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28756495/percutaneous-dilatational-tracheostomy-using-the-etview-tracheoscopic-ventilation-tube-%C3%A2-a-teaching-course-in-a-pig-model
#9
Alfonso Fiorelli, Fausto Ferraro, Elisabetta Frongillo, Pierluigi Fusco, Matteo Pierdiluca, Francesca Nagar, Angela Iuorio, Mario Santini
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model...
July 29, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#10
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28738121/incidence-risks-and-types-of-infections-in-pediatric-long-term-care-facilities
#11
Lisa Saiman, Philip Maykowski, Meghan Murray, Bevin Cohen, Natalie Neu, Haomioa Jia, Gordon Hutcheon, Edwin Simpser, Linda Mosiello, Luis Alba, Elaine Larson
Importance: The population of infants, children, and adolescents cared for at pediatric long-term care facilities is increasing in complexity and size and thus consumes substantial health care resources. Infections are a significant cause of morbidity and mortality in this population, but few recent data describe their incidence and effects. Objectives: To describe the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identify risk factors for respiratory tract infections (RTIs)...
July 24, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28719384/anesthetic-management-of-an-infant-with-postnatally-diagnosed-tracheal-agenesis-undergoing-tracheal-reconstruction-a-case-report
#12
Brittany L Willer, Kayla G Bryan, Daiva E Parakininkas, Michael R Uhing, Susan R Staudt, Kathleen M Dominguez, Michael E McCormick, Michael E Mitchell, John C Densmore, Keith T Oldham, Richard J Berens
A term infant born cyanotic failed multiple intubation attempts and tracheostomy placement. After esophageal intubation resulted in the ability to ventilate, he was presumed to have tracheal agenesis and distal bronchoesophageal fistula. He was transferred to our institution where he was diagnosed with Floyd Type II tracheal agenesis. He underwent staged tracheal reconstruction. He was discharged to home at 4 months of age with a tracheostomy collar, cervical spit fistula, and gastrostomy tube. He represents the sole survivor-to-discharge of tracheal agenesis in the United States...
July 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28699390/randomized-controlled-trial-of-chest-tube-removal-aided-by-a-party-balloon
#13
Puwadon Thitivaraporn, Natawat Narueponjirakul, Pasurachate Samorn, Supparerk Prichayudh, Sukanya Sriussadaporn, Rattaplee Pak-Art, Suvit Sriussadaporn, Kritaya Kritayakirana
Background Recurrent pneumothorax is one of the most common complications after thoracostomy tube removal. The purpose of this study was to assess the optimal method of thoracostomy tube removal by comparing party balloon-assisted Valsalva and classic Valsalva techniques. Methods Trauma patients with indications for tube thoracostomy from 2014 to 2015 were recruited. Exclusion criteria were age < 15- or > 64-years-old, history of chronic lung disease, Glasgow Coma Scale < 13, latex allergy, or tracheostomy...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#14
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28688550/a-quality-study-of-family-centered-care-coordination-to-improve-care-for-children-undergoing-tracheostomy-and-the-quality-of-life-for-their-caregivers
#15
Christopher Hartnick, Gillian Diercks, Vanessa De Guzman, Elizabeth Hartnick, Jeanne Van Cleave, Kevin Callans
IMPORTANCE: Approximately 4000 U.S. children undergo tracheostomy yearly [1], and these surgeries often result in hospital re-admissions that have definite cost and caregiver burdens due to complications that are avoidable with proper training and support. OBJECTIVE: To assess the impact of a Family-Centered Care Coordination (FCCC) program on the quality of care received by children undergoing tracheostomy and their caregivers. DESIGN: Caregivers of children undergoing tracheostomies from January 2012 to January 2013 and then a different set of caregivers of children undergoing tracheostomies from January 2015 to January 2016 completed both the Pediatric Tracheostomy Health Status Instrument (PTHSI) 1 month after discharge and the Medical Complications Associated with Pediatric Tracheostomy (MCAT) questionnaire 6 months after initial tracheostomy...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28662378/application-of-a-flexible-lightwand-in-percutaneous-dilatational-tracheotomy
#16
Zhuang Zhao, Shu Pan, Dunwei Wang, Chengyu Wang, Zhiwen Li
PURPOSE: By comparing flexible lightwand-assisted and conventional endotracheal tube (ETT) withdrawal in percutaneous dilatational tracheotomy (PDT), this paper aims to provide guidance for precise ETT withdrawal by anesthesiologists and accurate determination of the incision site by surgeons. METHODS: Sixty patients who underwent PDT in our hospital were randomly divided into the lightwand group (Group L, n=30) and the withdrawal group (Group W, n=30) using the envelope method...
June 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28651556/clinical-outcomes-of-transoral-videolaryngoscopic-surgery-for-hypopharyngeal-and-supraglottic-cancer
#17
Yorihisa Imanishi, Hiroyuki Ozawa, Koji Sakamoto, Ryoichi Fujii, Seiji Shigetomi, Noboru Habu, Kuninori Otsuka, Yoichiro Sato, Yoshihiro Watanabe, Mariko Sekimizu, Fumihiro Ito, Toshiki Tomita, Kaoru Ogawa
BACKGROUND: Transoral videolaryngoscopic surgery (TOVS) was developed as a new distinct surgical procedure for hypopharyngeal cancer (HPC) and supraglottic cancer (SGC) staged at up to T3. However, long-term treatment outcomes of TOVS remain to be validated. METHODS: Under a straight broad intraluminal view provided by combined use of a distending laryngoscope and a videolaryngoscope, we performed en bloc tumor resection via direct bimanual handling of the ready-made straight-form surgical instruments and devices...
June 26, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28648664/high-dose-ivig-successfully-reduces-high-rhgaa-igg-antibody-titers-in-a-crim-negative-infantile-pompe-disease-patient
#18
Mugdha Rairikar, Zoheb B Kazi, Ankit Desai, Crista Walters, Amy Rosenberg, Priya S Kishnani
Alglucosidase alfa (rhGAA) has altered the course of an otherwise fatal outcome in classic infantile Pompe disease (IPD), which presents with cardiomyopathy and severe musculoskeletal involvement. However, the response to therapy is determined by several factors including the development of high and sustained antibody titers (HSAT) to rhGAA. Cross-reactive immunologic material (CRIM) negative patients are at the highest risk for development of HSAT. Immune tolerance induction (ITI) with methotrexate, rituximab, and intravenous immunoglobulin (IVIG) has been largely successful in preventing the immune response and in achieving tolerance when done in conjunction with enzyme replacement therapy (ERT) initiation...
May 18, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28638427/colopharyngoplasty-in-patients-with-severe-pharyngoesophageal-corrosive-injury-a-complicated-but-worthwhile-procedure-to-restore-gi-tract-continuity-a-case-series
#19
Mahdi Zangi, Seyed Reza Saghebi, Ali Biharas Monfared, Seyedamirmohammad Lajevardi, Mohammad Behgam Shadmehr
BACKGROUND: Pharyngoesophageal strictures (PES) after corrosive injury impose a problematic condition for both physicians and patients in terms of their management and patients' quality of life. Colopharyngoplasty is a complex procedure, which is used to restore swallowing in these severely disabled patients. We describe our experience in treating nine patients with severe PES after corrosive injuries in a referral center. MATERIALS AND METHODS: A retrospective analysis of our database from 2009 to 2014 showed nine patients (seven men; age range: 18 to 47 years) with severe PES who underwent colopharyngoplasty ∼6 months (range: 4-10) after caustic material ingestion...
2017: Tanaffos
https://www.readbyqxmd.com/read/28635221/-treatment-of-intractable-aspiration-after-partial-laryngectomy-by-cuffed-tracheostomy-tube-with-inner-cannula
#20
P Wang, Y H Liu, Q S Xu, Z S Zheng
Objective: To evaluate the efficacy of cuffed tracheostomy tube with inner cannula for the treatment of intractable aspiration after partial laryngectomy. Methods: From May 2010 to June 2015, 15 patients with intractable aspiration after partial laryngectomy of laryngeal and hypopharyngeal carcinoma were enrolled. Cuffed tracheostomy tube with inner cannula was used in the 15 patients for treatment of intractable aspiration. The patients and their family were trained to manage the cuffed tracheostomy tube with inner cannula and to eat since the 14th day after surgery...
June 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
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