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https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#1
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28640084/effect-of-dexmedetomidine-and-midazolam-for-flexible-fiberoptic-bronchoscopy-in-intensive-care-unit-patients-a-retrospective-study
#2
Yang Gao, Kai Kang, Haitao Liu, Liu Jia, Rong Tang, Xing Zhang, Hongliang Wang, Kaijiang Yu
This study aimed to investigate the clinical effectiveness of dexmedetomidine and midazolam for sedation of intensive care unit (ICU) patients requiring flexible fiberoptic bronchoscopy (FFB).This retrospective cohort study included 148 patients from the third ICU ward of the Second Affiliated Hospital of Harbin Medical University (Harbin, China) who received simultaneous invasive mechanical ventilation and FFB between March 2012 and December 2014. Patients were divided into dexmedetomidine (n  =  72) and midazolam (n  =  76) groups according to sedative mode...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28620597/feeding-problems-and-their-underlying-mechanisms-in-the-esophageal-atresia-tracheoesophageal-fistula-patient
#3
REVIEW
Lisa Mahoney, Rachel Rosen
Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28619016/clinical-application-of-a-novel-endoscopic-mask-a-randomized-controlled-multi-center-trial-in-patients-undergoing-awake-fiberoptic-bronchoscopic-intubation
#4
Tianxiao Zou, Zhenling Huang, Xiaoxue Hu, Guangyu Cai, Miao He, Shanjuan Wang, Ping Huang, Bin Yu
BACKGROUND: Awake fiberoptic bronchoscopic tracheal intubation is usually regarded as an effective method in the management of predicted difficult airway. Hypoxia during awake nasal fiberoptic bronchoscopic intubation leads to discontinuation of the procedure, prolonged manipulation time and increased risk of severe complications. The main aim of the study was to test whether the novel endoscopic mask is helpful for hypoxia during the intubation. METHODS: This was a randomized, controlled, multi-center study...
June 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28616901/-the-methods-and-clinical-significance-of-early-diagnosis-of-lung-cancer
#5
REVIEW
Wei-Min Li, Shuang Zhao, Lun-Xu Liu
Lung cancer is the leading contributor to morbidity and mortality from cancer worldwide, with its 5-year overall survival being only about 15.6%. Due to the lack of specific early screening methods for lung cancer, about 75% patients are diagnosed late. Therefore, it remains the big challenge for the early diagnosis of lung cancer. We need to pay more attention to the screening of lung cancer, and more precise assessment and management to the pulmonary nodules screened out. Further study on liquid biopsy, optimization of new fiberoptic bronchoscopy and the sampling methods to harvest small volume of lung tissue, could be helpful to improve the early diagnosis of lung cancer...
May 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28616236/effect-of-applied-energy-in-renal-sympathetic-denervation-with-magnetic-resonance-guided-focused-ultrasound-in-a-porcine-model
#6
Jill Shea, Joshua de Bever, Eugene Kholmovski, Hannah Beal, J Rock Hadley, Emilee Minalga, Mohamed E Salama, Nassir F Marrouche, Allison Payne
BACKGROUND: Past catheter-based and focused ultrasound renal denervation studies have indicated that procedure efficacy is related to the number of ablations performed or the amount of energy used for the ablation. This study extends those prior results and investigates energy level effects on the efficacy of MR guided focused ultrasound renal denervation performed in a porcine model. METHODS: Twenty-four normotensive pigs underwent unilateral denervation at three intensity levels...
2017: Journal of Therapeutic Ultrasound
https://www.readbyqxmd.com/read/28606617/management-of-patients-with-predicted-difficult-airways-in-an-academic-emergency-department
#7
John C Sakles, Matthew J K Douglas, Cameron D Hypes, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: Patients with difficult airways are sometimes encountered in the emergency department (ED), however, there is a little data available regarding their management. OBJECTIVES: To determine the incidence, management, and outcomes of patients with predicted difficult airways in the ED. METHODS: Over the 1-year period from July 1, 2015 to June 30, 2016, data were prospectively collected on all patients intubated in an academic ED. After each intubation, the operator completed an airway management data form...
June 9, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28604336/characteristics-of-dysphagia-in-infants-with-microcephaly-caused-by-congenital-zika-virus-infection-brazil-2015
#8
Mariana C Leal, Vanessa van der Linden, Thiago P Bezerra, Luciana de Valois, Adriana C G Borges, Margarida M C Antunes, Kátia G Brandt, Catharina X Moura, Laura C Rodrigues, Coeli R Ximenes
We summarize the characteristics of dysphagia in 9 infants in Brazil with microcephaly caused by congenital Zika virus infection. The Schedule for Oral Motor Assessment, fiberoptic endoscopic evaluation of swallowing, and the videofluoroscopic swallowing study were used as noninstrumental and instrumental assessments. All infants had a degree of neurologic damage and showed abnormalities in the oral phase. Of the 9 infants, 8 lacked oral and upper respiratory tract sensitivity, leading to delays in initiation of the pharyngeal phase of swallowing...
August 15, 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#9
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28577127/utility-of-intraoperative-nerve-monitoring-in-thyroid-surgery-20-year-experience-with-1418-cases
#10
Sameep Kadakia, Moustafa Mourad, Shirley Hu, Ryan Brown, Thomas Lee, Yadranko Ducic
PURPOSE: The efficacy of intraoperative nerve monitoring is controversial in the literature. This study of a single surgeon's experience seeks to determine if the use of intraoperative nerve monitoring influences recurrent laryngeal nerve injury during thyroid surgery. METHODS: Six hundred fifty-seven patients with normal pre-operative vocal fold function underwent thyroid surgery without the use of intraoperative nerve monitoring from September 1997 to January 2007, while 761 patients underwent thyroid surgery from February 2007 to February 2016 with routine use of nerve monitoring...
June 2, 2017: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28562735/dieulafoy-s-disease-of-the-bronchial-tree-a-case-report
#11
Massoud Baghai Wadji, Athena Farahzadi
CONTEXT: Dieulafoy's disease of the bronchial tree is a very rare condition. Few cases have been reported in the literature. It can be asymptomatic or manifest with massive hemoptysis. This disease should be considered among heavy smokers when recurrent massive hemoptysis is present amid otherwise normal findings. The treatment can be arterial embolization or surgical intervention. CASE REPORT: A 16-year-old girl was admitted to the emergency department due to hemoptysis with an unknown lesion in the bronchi...
May 29, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28542045/massive-hemoptysis-through-endotracheal-tube-during-emergency-cesarean-delivery-a-case-report-and-literature-review
#12
Von Vee Ng, Mukesh Kumar Shah, Ting Ting Oh, Abirami Ramanathan, Thangavelautham Suhitharan
Severe pulmonary hemorrhage occurred through the endotracheal tube during an emergency cesarean delivery. Intubation trauma was excluded with fiberoptic bronchoscopy. Episodes of hemoptysis continued for 48 hours. The patient was subsequently diagnosed with diffuse alveolar hemorrhage because of systemic lupus erythematosus. The diagnostic workup, successful management, and literature review are presented.
May 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28534319/case-report-human-papilloma-virus-type-120-related-papillomatosis-mimicking-laryngeal-carcinoma
#13
Valeria Belvisi, Salvatore Martellucci, Anna Rosa Garbuglia, Cosmo Del Borgo, Stanislao Martellucci, Andrea Baiocchini, Anna Maria Manicone, Oreste Bagni, Claudio Maria Mastroianni, Andrea Gallo
INTRODUCTION: The relationship between human papilloma virus (HPV) and upper respiratory tract pathology was better understood in recent years and represents now an issue of particular interest in carcinogenesis and in immunocompromised host. We describe a case in which a rare genotype HPV-related papillomatosis mimics laryngeal carcinoma in an immunocompromised host. METHODS: A 54-year-old woman with a history of HIV-HCV coinfection and anal and laryngeal cancer successfully treated some years before was hospitalized for severe dyspnea, cough and dysphagia...
May 22, 2017: Infection
https://www.readbyqxmd.com/read/28515525/management-of-an-intraoperatively-damaged-endotracheal-tube-in-a-case-of-difficult-airway-using-fibre-optic-bronchoscope-with-minimal-apnoea-period
#14
Jayachandran Himarani, S Mary Nancy, V B Krishna Kumar Raja, S Shanmuga Sundaram
Damage to the endotracheal tube (ETT) is common in head and neck surgeries, especially in maxillary osteotomy. Airway management in such a crisis is crucial as there is risk of aspiration of blood into lungs, hypoxia and apnoea. This case illustrates a patient with an anticipated difficult airway who had an intraoperative damage to the ETT and was successfully managed by re-intubation with fiberoptic bronchoscope in a minimal apnoea period of <15 s using a new technique.
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28511547/smell-and-taste-impairment-after-total-laryngectomy
#15
Giuseppe Riva, Matteo Sensini, Andrea Corvino, Giancarlo Pecorari, Massimiliano Garzaro
OBJECTIVE: Aim of this observational study is the evaluation of olfactory and gustatory impairments in laryngectomized long-term survivors compared to control subjects. Correlation between smell and taste alterations, age, and previous adjuvant treatments in laryngectomees was investigated. METHODS: Fifty control subjects and 50 patients who underwent total laryngectomy for advanced laryngeal carcinoma were evaluated. All subjects underwent symptoms evaluation, oropharyngeal exam, endoscopic fiberoptic nasal examination, and Taste Strips and Sniffin' Sticks tests...
July 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28508288/repetitive-postoperative-extubation-failure-and-cardiac-arrest-due-to-laryngomalacia-after-general-anesthesia-in-an-elderly-patient-a-case-report
#16
Jun Takeshita, Kei Nishiyama, Masashi Fujii, Hiroyuki Tanaka, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Four hours later, a second extubation was performed without any neurological complications. However, 2 h later, he experienced cardiopulmonary arrest again. Immediately after the third extubation, 12 h after the second cardiopulmonary arrest, fiberoptic laryngoscopy revealed laryngomalacia...
May 15, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28502417/analysis-of-bronchial-biopsies-in-chronic-cough
#17
Patricia Macedo, Qingling Zhang, Junpei Saito, Zhike Liang, Lorrette Ffolkes, Andrew G Nicholson, Kian Fan Chung
BACKGROUND: Chronic cough is commonly associated with asthma, gastro-oesophageal reflux disease and postnasal drip, but in a significant proportion, no associated cause can be found. We determined whether examination of bronchial biopsies would be useful in determining the cause associated with chronic cough. METHODS: 100 consecutive patients referred to a specialist cough clinic underwent a systematic assessment including a fiberoptic bronchoscopy for bronchial biopsies...
June 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28494884/less-postoperative-sore-throat-after-nasotracheal-intubation-using-a-fiberoptic-bronchoscope-than-using-a-macintosh-laryngoscope-a-double-blind-randomized-controlled-study
#18
Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage
STUDY OBJECTIVE: To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat. DESIGN: Prospective, double-blinded, randomized, and controlled study. SETTING: Postoperative areas and surgical ward of a university hospital. PATIENTS: Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28483151/postoperative-swallowing-assessment-after-lung-transplantation
#19
Brooke Baumann, Sara Byers, Tamara Wasserman-Wincko, Libby Smith, Bridget Hathaway, Jay Bhama, Norihisa Shigemura, J W Awori Hayanga, Jonathan D'Cunha, Jonas T Johnson
BACKGROUND: Dysphagia, aspiration, and potential pneumonia represent a major source of morbidity in patients undergoing lung transplantation. Conditions that potentiate dysphagia and aspiration include frailty and prolonged intubation. Our group of speech-language pathologists has been actively involved in performance of a bedside evaluation of swallowing, and instrumental evaluation of swallowing with modified barium swallow, and postoperative management in patients undergoing lung transplantation...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28480154/congenital-tracheobronchomegaly-mounier-kuhn-syndrome-in-a-woman-with-human-immunodeficiency-virus-a-case-report
#20
Amanda Fletcher, Justin Stowell, Socrates Jamoulis
Congenital tracheobronchomegaly (Mounier-Kuhn Syndrome, MKS) is a rare idiopathic disorder characterized by dilation of the central airways, including the trachea and first through fourth order bronchi. MKS disproportionately affects men and results in chronic respiratory tract infections. The diagnosis is made through the synthesis of clinical and radiological data. Here we report a unique case of MKS in a patient with human immunodeficiency virus (HIV) infection. A 45-year-old African American woman with a past medical history of HIV, tobacco and recreational drug abuse, chronic obstructive pulmonary disease, sleep apnea, and a 15-year history of recurrent respiratory infections presented with dyspnea, wheezing, a productive cough, increased yellow-green sputum production, and subjective fevers...
April 4, 2017: Curēus
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