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https://www.readbyqxmd.com/read/28715529/changes-in-peak-airflow-measurement-during-maximal-cough-after-vocal-fold-augmentation-in-patients-with-glottic-insufficiency
#1
Gregory R Dion, Efstratios Achlatis, Stephanie Teng, Yixin Fang, Michael Persky, Ryan C Branski, Milan R Amin
Importance: Compromised cough effectiveness is correlated with dysphagia and aspiration. Glottic insufficiency likely yields decreased cough strength and effectiveness. Although vocal fold augmentation favorably affects voice and likely improves cough strength, few data exist to support this hypothesis. Objective: To assess whether vocal fold augmentation improves peak airflow measurements during maximal-effort cough following augmentation. Setting, Design, Participants: This case series study was conducted in a tertiary, academic laryngology clinic...
July 13, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28707827/cat-scratch-disease-u-s-clinicians-experience-and-knowledge
#2
C A Nelson, A R Moore, A E Perea, P S Mead
Cat scratch disease (CSD) is a zoonotic infection caused primarily by the bacterium Bartonella henselae. An estimated 12,000 outpatients and 500 inpatients are diagnosed with CSD annually, yet little is known regarding clinician experience with and treatment of CSD in the United States. Questions assessing clinical burden, treatment and prevention of CSD were posed to 3,011 primary care providers (family practitioners, internists, paediatricians and nurse practitioners) during 2014-2015 as part of the annual nationwide DocStyles survey...
July 14, 2017: Zoonoses and Public Health
https://www.readbyqxmd.com/read/28681751/assessment-of-surgical-risk-factors-in-the-development-of-ventilator-associated-pneumonia-in-neurosurgical-intensive-care-unit-patients-alarming-observations
#3
Deepashu Sachdeva, Daljit Singh, Poonam Loomba, Amandeep Kaur, Monica Tandon, Ishu Bishnoi
BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in patients receiving mechanical ventilation (MV) and contributes to a longer intensive care unit (ICU) stay, duration of MV, and a high morbidity and mortality. OBJECTIVE: The purpose of study was to determine the incidence of VAP in neurosurgery ICU patients and to assess the probable contributing neurosurgical risk factors like the site and nature of the lesion in the brain, the duration of surgery, blood loss during surgery, and infection elsewhere in the body, in the development of VAP...
July 2017: Neurology India
https://www.readbyqxmd.com/read/28677255/anaerobic-antibiotic-usage-for-pneumonia-in-the-medical-intensive-care-unit
#4
Mutsumi J Kioka, Bruno DiGiovine, Mohamed Rezik, Jeffrey H Jennings
BACKGROUND AND OBJECTIVE: Pneumonia is a common admitting diagnosis in the intensive care unit (ICU). When aspiration is suspected, antibiotics to cover anaerobes are frequently used, but in the absence of clear risk factors, current guidelines have questioned their role. It is unknown how frequently these guidelines are followed. METHODS: We conducted a single-centre observational study on practice patterns of anaerobic antibiotic use in consecutive patients admitted to the ICU with aspiration pneumonia (Asp), community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP)...
July 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28675504/ultrasound-assessment-of-gastric-emptying-after-breakfast-in-healthy-preschool-children
#5
Anne E Sümpelmann, Robert Sümpelmann, Michael Lorenz, Ilona Eberwien, Nils Dennhardt, Dietmar Boethig, Sebastian G Russo
BACKGROUND: In current guidelines, 6 hours of fasting is recommended for solids to limit the risk of pulmonary aspiration during anesthesia in children. Ultrasonography has recently been introduced to evaluate gastric volumes in children in the context of preanesthetic fasting. Therefore, in this study, we firstly evaluated the precision of ultrasound assessment of gastric volume in an experimental setting and secondly studied gastric emptying times after a normal breakfast in healthy preschool children using ultrasound...
July 4, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28666656/reasons-for-and-experiences-with-surgical-interventions-for-female-genital-mutilation-cutting-fgm-c-a-systematic-review
#6
REVIEW
Rigmor C Berg, Sølvi Taraldsen, Maryan A Said, Ingvil Krarup Sørbye, Siri Vangen
BACKGROUND: Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. AIM: To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. METHODS: We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines...
June 27, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/28660142/clinical-application-of-concentrated-bone-marrow-aspirate-in-orthopaedics-a-systematic-review
#7
Arianna L Gianakos, Li Sun, Jay N Patel, Donald M Adams, Frank A Liporace
AIM: To examine the evidence behind the use of concentrated bone marrow aspirate (cBMA) in cartilage, bone, and tendon repair; establish proof of concept for the use of cBMA in these biologic environments; and provide the level and quality of evidence substantiating the use of cBMA in the clinical setting. METHODS: We conducted a systematic review according to PRISMA guidelines. EMBASE, MEDLINE, and Web of Knowledge databases were screened for the use of cBMA in the repair of cartilage, bone, and tendon repair...
June 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28652955/perioperative-fasting-and-the-patient-experience
#8
Telliane Chon, Alfred Ma, Connie Mun-Price
Standard preparation for a surgical procedure requires patients to fast (nulla per os [NPO]) after midnight before their operation. Unfortunately, given the unpredictable nature of operating room scheduling and unavoidable delays, patients may find themselves anxiously waiting and fasting much longer than expected. In recent years, the usefulness of prolonged fasting to prevent pulmonary aspiration has been questioned. According to the American Society of Anesthesiologists (ASA) guidelines, unnecessarily prolonged fasting can be avoided by allowing patients to have clear liquids with the minimal fasting time of only two hours...
May 24, 2017: Curēus
https://www.readbyqxmd.com/read/28625166/impact-of-gram-stain-results-on-initial-treatment-selection-in-patients-with-ventilator-associated-pneumonia-a-retrospective-analysis-of-two-treatment-algorithms
#9
Jumpei Yoshimura, Takahiro Kinoshita, Kazuma Yamakawa, Asako Matsushima, Naoki Nakamoto, Toshimitsu Hamasaki, Satoshi Fujimi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common and serious problem in intensive care units (ICUs). Several studies have suggested that the Gram stain of endotracheal aspirates is a useful method for accurately diagnosing VAP. However, the usefulness of the Gram stain in predicting which microorganisms cause VAP has not been established. The purpose of this study was to evaluate whether a Gram stain of endotracheal aspirates could be used to determine appropriate initial antimicrobial therapy for VAP...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28619290/sparing-dysphagia-aspiration-related-structures-using-novel-hybrid-volumetric-modulated-arc-therapy
#10
Sitaraman BalajiSubramanian, Karunakaran Balaji, Moorthi Thirunavukarasu, Sumana Premkumar
PURPOSE: Studies using split field IMRT to spare dysphagia/aspiration related structures (DARS) have raised concern regarding dose uncertainty at matchline. This study explores the utility of hybrid VMAT in sparing the DARS and assesses matchline dose uncertainty in postoperative oral cavity cancer patients and compares it with VMAT. METHODS & MATERIALS: Ten postoperative oral cavity cancer patients were planned with h-VMAT and VMAT using the same planning CT dataset...
July 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28609825/the-use-of-the-bethesda-system-for-reporting-thyroid-cytopathology-in-korea-a-nationwide-multicenter-survey-by-the-korean-society-of-endocrine-pathologists
#11
Mi Mi Kim, Hyo Jin Park, Hye Sook Min, Hyeong Ju Kwon, Chan Kwon Jung, Seoung Wan Chae, Hyun Ju Yoo, Yoo Duk Choi, Mi Ja Lee, Jeong Ja Kwak, Dong Eun Song, Dong Hoon Kim, Hye Kyung Lee, Ji Yeon Kim, Sook Hee Hong, Jang Sihn Sohn, Hyun Seung Lee, So Yeon Park, Soon Won Hong, Mi Kyung Shin
Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea. Materials and Methods: Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed...
June 14, 2017: Journal of Pathology and Translational Medicine
https://www.readbyqxmd.com/read/28609359/pancreatic-cysts-controversies-advances-diagnoses-and-therapies
#12
Jodie A Barkin, Jamie S Barkin
Pancreatic cysts are commonly found on cross-sectional imaging. The question arises in determining which lesions are premalignant or malignant and may require further testing, intervention, or follow-up. In pancreatic cysts without obvious malignancy on imaging, we approach them using the Four "S" Criteria. These are (1) symptoms that may be originating from the pancreatic cyst; (2) size of the cyst 2 cm or larger and/or main pancreatic duct greater than 5 mm; (3) survival of the patient, based on comorbidity index to determine surgical fitness; and then endoscopic ultrasound with fine needle aspiration (FNA) recommended to determine (4) solid component presence in the cyst, namely, nodule or thick walls, as well as to perform FNA to obtain cyst content...
July 2017: Pancreas
https://www.readbyqxmd.com/read/28609009/triage-of-the-indeterminate-thyroid-aspirate-what-are-the-options-for-the-practicing-cytopathologist
#13
Ayse M Onenerk, Marc P Pusztaszeri, Sule Canberk, William C Faquin
Fine-needle aspiration (FNA) plays a key role in the early evaluation of patients with thyroid nodules; however, from 15% to 30% of FNA specimens are cytologically indeterminate. Molecular testing has proven useful when applied to indeterminate thyroid FNAs, and its use has been endorsed in the American Thyroid Association guidelines. In addition to the noncommercial ("in-house") application of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF), rat sarcoma (RAS), rearranged in transformation/papillary thyroid carcinoma (RET/PTC), and peroxisome proliferator-activated receptor γ/paired box gene 8 (PPARγ/PAX8) testing, there are currently 3 commercially available molecular panels that vary in their relative reported performances, strengths, and limitations...
June 2017: Cancer
https://www.readbyqxmd.com/read/28608456/is-axillary-surgery-beneficial-for-patients-with-adenoid-cystic-carcinoma-of-the-breast
#14
Jessemae L Welsh, Michael G Keeney, Tanya L Hoskin, Katrina N Glazebrook, Judy C Boughey, Sejal S Shah, Tina J Hieken
BACKGROUND AND OBJECTIVES: Adenoid cystic carcinoma (ACC) is a rare, typically triple-negative, breast cancer reported to have a favorable prognosis and low rate of nodal metastasis. No consensus guidelines exist for axillary staging and treatment. METHODS: We identified all patients with ACC evaluated at our institution from January 1994 to August 2016. Patient, tumor, and treatment variables were abstracted and analyzed. RESULTS: We identified 20 pure ACCs (0...
June 12, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28607765/paediatric-bone-and-joint-infection
#15
REVIEW
Alexios D Iliadis, Manoj Ramachandran
Despite advances in understanding and management, paediatric osteoarticular infections continue to pose diagnostic difficulties for clinicians. Delays in diagnosis can lead to potentially devastating morbidity.No single investigation, including joint aspiration, is sufficiently reliable to diagnose conclusively paediatric bone and joint infection. Diagnosis should be based on a combination of clinical signs, imaging and laboratory investigations. Algorithms should supplement, and not replace, clinical decision making in all cases...
January 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28603647/multicentric-study-of-endobronchial-ultrasound-transbronchial-needle-aspiration-for-lung-cancer-staging-in-italy
#16
Nicola Rotolo, Andrea Imperatori, Mario Nosotti, Luigi Santambrogio, Alessandro Palleschi, Lorenzo Dominioni, Giorgio Crosta, Pierfranco Foccoli, Gianluca Pariscenti, Eliseo Passera, Luigi Bortolotti, Giovanni Falezza, Maurizio Infante, Elisa Daffrè, Maria Cattoni, Lorenzo Rosso
BACKGROUND: Multi-institutional studies of endobronchial-ultrasound transbronchial needle aspiration (EBUS-TBNA) for mediastinal staging in lung cancer are scarce. It is unclear if the high diagnostic performance of EBUS-TBNA reported by experts' guidelines can be generally achieved. METHODS: This is a retrospective study performed in five tertiary referral centers of thoracic surgery in Italy, to assess the EBUS-TBNA diagnostic performance in patients with non-small cell lung cancer (NSCLC)...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28603646/ten-year-experience-with-endobronchial-ultrasound-guided-transbronchial-needle-aspiration-single-center-results-in-mediastinal-diagnostic-and-staging
#17
Lorenzo Rosso, Stefano Ferrero, Paolo Mendogni, Eleonora Bonaparte, Rosaria Carrinola, Alessandro Palleschi, Ilaria Righi, Matteo Montoli, Francesco Damarco, Davide Tosi
BACKGROUND: Endobronchial ultrasonography with transbronchial needle aspiration (EBUS-TBNA) is recognized as an accurate and minimal invasive procedure for diagnosis and staging of lung cancer and lymph nodal malignancies. EBUS is recommended as the first choice procedure for mediastinal staging in lung cancer in international guidelines. METHODS: A retrospective evaluation was performed on single center experience with EBUS-TBNA in our thoracic surgery department in a 10-year time frame...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28590353/proposed-clinical-pathway-for-non-operative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#18
Bindi J Naik-Mathuria, Eric H Rosenfeld, Adam Vogel, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Alex Ler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for non-operative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers in order to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (AAST grade III-V) pancreatic injuries treated with NOM between 2010-15...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28589088/a-2016-italian-survey-about-guidelines-and-clinical-management-of-thyroid-nodules
#19
Roberto Negro, Roberto Attanasio, Franco Grimaldi, Andrea Frasoldati, Rinaldo Guglielmi, Enrico Papini
BACKGROUND: While thyroid nodules are frequent in endocrine clinical practice, patients are often asymptomatic and euthyroid, and death is rare in cases of malignancy. OBJECTIVES: To evaluate the perception of current international guidelines regarding thyroid nodule management among Italian endocrinologists, and to compare daily clinical practice with suggested recommendations. METHODS: Italian Association of Clinical Endocrinologists (AME) members were invited to participate in a Web-based survey...
April 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28588423/dysphagia-screening-after-acute-stroke-a-quality-improvement-project-using-criteria-based-clinical-audit
#20
Jorun Sivertsen, Birgitte Graverholt, Birgitte Espehaug
BACKGROUND: Dysphagia is common after stroke and represents a major risk factor for developing aspiration pneumonia. Early detection can reduce the risk of pulmonary complications and death. Despite the fact that evidence-based guidelines recommend screening for swallowing deficit using a standardized screening tool, national audits has identified a gap between practice and this recommendation. The aim was to determine the level of adherence to an evidence-based recommendation on swallow assessment and to take actions to improve practice if necessary...
2017: BMC Nursing
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