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[PMID]:29298508
[Au] Autor:Liu K; Ge P; Sheng X; Jiang J; Qin H
[Ad] Endereço:1 Department of Laryngopharynx Head & Neck Maxillofacial Surgery, Guangdong General Hospital and Guangdong Academy of Medical Sciences, School of Medicine, South China University Technology, Guangzhou City, PR China.
[Ti] Título:Survival in Vivo Canine Phonation Model Without Stimulation.
[So] Source:Ann Otol Rhinol Laryngol;127(3):178-184, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We describe a survival nonstimulated in vivo canine phonation model using distending laryngoscope, cramp frame, and constant humidified glottal airflow to elicit phonation. METHODS: Five beagle dogs were involved in this study. One cuffed endotracheal tube was placed below the glottis through the tracheotomy and delivered humidified airflow to the glottis. Arytenoids approximation was maintained using a clamp under the distending laryngoscope. Acoustic and aerodynamic parameters were measured using synchronous signal collection system and analysis software. Vocal oscillation also was examined using stroboscope laryngeal imaging. RESULTS: For the nonstimulated in vivo phonation animal, the sound intensity and fundamental frequency were 78.3 ± 6.8 dB and 127.6 ± 29.2 Hz in the first experiment and 82.9 ± 6.6 dB and 175.2 ± 4.4 Hz 4 weeks later. The aerodynamic analysis revealed the mean subglottal phonation threshold pressure (PTP) and phonation threshold flow (PTF) were 8.5 ± 4.0 cmH 0 and 683.0 ± 356.4 mL/s in the first experiment and 16.1 ± 8.6 cmH 0 and 384.8.0 ± 230.6 mL/s in the second experiment 4 weeks later. Stroboscope image revealed sustained vocal vibration during great airflow delivery to glottis in the phonation animal model. CONCLUSIONS: We developed a survival nonstimulated in vivo phonation canine model that allows the study of long-term animal phonation study as its own control.
[Mh] Termos MeSH primário: Laringoscopia
Fonação/fisiologia
Traqueotomia/métodos
Prega Vocal
[Mh] Termos MeSH secundário: Acústica/instrumentação
Animais
Cães
Laringoscopia/instrumentação
Laringoscopia/métodos
Modelos Animais
Estroboscopia/métodos
Prega Vocal/diagnóstico por imagem
Prega Vocal/fisiologia
Prega Vocal/fisiopatologia
Qualidade da Voz
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417751473


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[PMID]:28460647
[Au] Autor:Ono Y; Kunii M; Miura T; Shinohara K
[Ad] Endereço:Emergency and Critical Care Medical Center, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan. windmill@fmu.ac.jp.
[Ti] Título:"Cannot ventilate, cannot intubate" situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report.
[So] Source:J Med Case Rep;11(1):121, 2017 May 01.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a "cannot ventilate, cannot intubate" situation following penetrating neck injury by a surfboard fin. CASE PRESENTATION: A previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin. He presented with severe hypovolemic shock because of copious bleeding from his mouth. Direct laryngoscopy failed, as did manual ventilation, because of the exacerbated upper airway bleeding and distorted upper airway anatomy. Open cricothyrotomy was immediately performed, followed by surgical exploration, which revealed extensive ablation of his tongue root and laceration of his lingual artery. After definitive hemostasis and intensive care, he returned home with no sequelae. CONCLUSIONS: The long, semi-sharp surfboard fin created both extensive crushing upper airway lesions and a sharp vascular injury, resulting in a difficult airway. This case illustrates that surfing injuries can prompt a life-threatening airway emergency and serves as a caution for both surfers and health care professionals.
[Mh] Termos MeSH primário: Tratamento de Emergência
Intubação Intratraqueal/instrumentação
Lesões do Pescoço/terapia
Língua/lesões
Traqueotomia/métodos
Esportes Aquáticos/lesões
Ferimentos Penetrantes/terapia
[Mh] Termos MeSH secundário: Adulto
Cartilagem Cricoide
Cuidados Críticos
Tratamento de Emergência/instrumentação
Tratamento de Emergência/métodos
Seres Humanos
Intubação Intratraqueal/métodos
Masculino
Lesões do Pescoço/fisiopatologia
Glândula Tireoide
Resultado do Tratamento
Ferimentos Penetrantes/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1284-5


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[PMID]:29226664
[Au] Autor:Shimagaki T; Okamoto T; Morodomi Y; Shoji F; Akamine T; Takamori S; Katsura M; Takada K; Suzuki Y; Fujishita T; Hayamizu K; Tokuda K; Yasuda M; Maehara Y
[Ti] Título:Case of a Cardiopulmonary Arrest Due to Postoperative Subglottic Stenosis Developed on the Second Day after Lung Surgery.
[So] Source:Fukuoka Igaku Zasshi;107(7):136-40, 2016 07.
[Is] ISSN:0016-254X
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:We experienced a case of the cardiopulmonary arrest due to subglottic stenosis developed on the second day after lung cancer surgery. Case : A 73-year-old female who was diagnosed with primary lung cancer was referred to our department for surgery. The second day after left lung segmentectomy, she showed respiratory discomfort symptoms and exhibited hoarseness and stridor, which were revealed as the subglottic stenosis by bronchoscopy. During the emergency airway management, she went into cardiopulmonary arrest. We performed cardiopulmonary resuscitation and simultaneous urgent tracheotomy.
[Mh] Termos MeSH primário: Parada Cardíaca/etiologia
Laringoestenose/terapia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Pneumonectomia/efeitos adversos
Traqueotomia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29365373
[Au] Autor:Chen C; Tan LT; Xu ZM
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Fudan University, 201102 Shanghai, China.
[Ti] Título:[Evaluation and treatment of children's laryngeal clefts].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(1):9-15, 2018 Jan 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow. Of 30 cases, 18 were male and 12 were female, ranging in age from birth to 8 years. Two cases were diagnosed as type 0 LC, and they were offered thickened liquid without medication. Throughout follow-up, they remained asymptomatic and showed no respiratory complications. Nineteen children were diagnosed as type â…  LC. Six of them were significantly improved by anti-reflux therapy and feeding instructions. Four children were concomitant with swallowing dysfunction and/or neuromuscular disorders, and they were given a tracheotomy and routine management. Another 4 children were submitted surgical repair when routine treatment failed, and their symptoms were relieved. Five children were concomitant with larygomalacia, and their symptoms were totally ameliorated by supraglottoplasty. Three children were diagnosed as type â…¡ LC. Two of them received surgical repair and clinically improved, and the rest one was treated by anti-reflux therapy and still under follow-up. Three children were diagnosed as type â…¢ LC. One of them was underwent surgical repair and clinically improved. Two children were tracheotomized and treated by anti-reflux therapy. Three cases were diagnosed as type â…£ LC at birth and no one survived. Laryngeal cleft is a rare congenital anomaly manifesting with a variety of symptoms, including swallowing disorder, aspirations, dyspnea, stridor and hoarseness. Diagnosis and treatment of laryngeal clefts is a challenge. The best way to evaluate the LC is FEES by laryngeal endoscopy combined with MLB. Cases with type 0-â…  mostly were significantly improved by anti-reflux therapy and feeding instructions. When routine treatment failed, surgical repair is needed. All the cases with LC type â…¡-â…¢ need surgical repair as soon as possible. For type â…£ cases, early diagnosis, appropriate treatment and management help to reduce mortality and morbidity.
[Mh] Termos MeSH primário: Anormalidades Congênitas/diagnóstico
Anormalidades Congênitas/terapia
Refluxo Gastroesofágico/terapia
Laringe/anormalidades
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Transtornos de Deglutição/etiologia
Feminino
Fluoroscopia
Refluxo Gastroesofágico/etiologia
Rouquidão/etiologia
Seres Humanos
Lactente
Recém-Nascido
Laringoscopia
Masculino
Sons Respiratórios/etiologia
Estudos Retrospectivos
Traqueotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.01.003


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[PMID]:29262449
[Au] Autor:Ge CX; Tai MZ; Chen T; Li KL; Qin ZP
[Ad] Endereço:Special Department of Hemangiomas, Linyi Tumor Hospital, Linyi 276001, Shandong Province, China.
[Ti] Título:[Treatment analyses of 143 patients with maxillofacial and cervical venous malformations involved in isthmus faucium area].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(12):909-914, 2017 Dec 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To analyze the clinical data and summarize therapeutic experiences of cervicofacial venous malformations involving isthmus faucium area. Clinical records from 143 patients with venous malformations involving isthmus faucium area treated at our hospital between January 2012 and January 2016 were reviewed. There were 70 males and 73 females. Age ranged from 1 to 52 years old, with a median age of 14.5 years. There were 19 cases with lesions involving in only 1 subanatomic area above and 124 cases with lesions involving in more than 1 subanatomic areas, including 63 cases with lesions involving in more than 2 areas. There were 50 patients presenting with additional maxillofacial and cervical lesions. Clinical symptoms included snoring ( =98), indistinct phonation ( =49), and tonsil hypertrophy more than degree â…¡ ( =19). Tracheotomy was performed in 3 patients prior to hospitalization, contigency tracheotomy during hospitalization in 10 patients, and oral trachea cannula in other patients. All therapeutic procedures, including single chemical ablation with ethanol injection ( =94), single lesion resection ( =9) and both of them ( =40), were performed under general anesthesia. Treatment remedies included mesh suture, macroglossia reduction and excision of maxillofacial and cervical lesions for patients presenting with extensive malformations extending to maxillofacial and cervical area. Tonsil resection were done in patients having tonsil venous malformations or tonsil hypertrophy more than degree II. Achauer's 4-grade criterion was applied to evaluate the treatment outcomes. SPSS 18.0 software was used to analyze the data. Trachea cannula were not extubated untill 24 to 48 hours after treatment. Emergency tracheotomy was done in 2 cases after extubations because of dyspnea, and successful extubations were obtained in other cases. There were no advents of pulmonary vascular spasm or pulmonary embolism. There was significant difference between before and after operation (snore: χ(2)=105.431, ambiguous pronunciation: χ(2)=59.698, tonsil hypertrophy more than degree â…¡: χ(2)=33.530, all <0.01). The patients were followed-up for 1-4 years, and there were 123 cases at grade â…£ (complete disappear of lesions in 62 cases without recurrence), 17 at grade â…¢ , 3 at grade â…¡, and no case at gradeâ… . Chemical ablation with ethanol injection for venous malformations involving isthmus faucium area is recommended, wheras combined remedies including injection, mesh suture, macroglossia reduction, and excision of cervicofacial lesions are suggested in treatment of extensive lesions extending to maxillofacial and cervical area. Tonsil resection should be done in patients having tonsil venous malformations or tonsil hypertrophy more than degree â…¡, which is safe and highly effective, with good reservation of function, in the treatment of maxillofacial and cervical venous malformations involving isthmus faucium area.
[Mh] Termos MeSH primário: Etanol/administração & dosagem
Orofaringe/irrigação sanguínea
Malformações Vasculares/terapia
Veias/anormalidades
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Terapia Combinada/métodos
Feminino
Seres Humanos
Hipertrofia/cirurgia
Lactente
Injeções
Masculino
Meia-Idade
Pescoço/irrigação sanguínea
Tonsila Palatina/irrigação sanguínea
Tonsila Palatina/patologia
Tonsila Palatina/cirurgia
Recidiva
Traqueotomia
Resultado do Tratamento
Malformações Vasculares/complicações
Malformações Vasculares/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
3K9958V90M (Ethanol)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.12.007


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[PMID]:29287880
[Au] Autor:Shay S; Shapiro NL; Bhattacharyya N
[Ad] Endereço:Department of Head and Neck Surgery, University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: sshay@luriechildrens.org.
[Ti] Título:Revisits after pediatric tracheotomy: Airway concerns result in returns.
[So] Source:Int J Pediatr Otorhinolaryngol;104:5-9, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo: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 < 18.0 years) and corresponding subsequent 30-day post-discharge revisits. Demographic and descriptive data were analyzed determining the revisit rate, revisit diagnoses, procedures, and discharge dispositions. RESULTS: 2,248 pediatric tracheotomy cases were extracted (60.8% male, mean age 8.3 years). There were 373 inpatient or emergency department revisits (30-day revisit rate, 16.6%), of which 34.3% occurred within 48 h after discharge. Of these, 59.2% were inpatient readmissions. There were ≤10 deaths during these revisits (30-day revisit mortality rate, ≤2.7%). The most common primary revisit diagnoses were "fitting of prosthesis and adjustment of devices" (25.7%, likely representing adjustment/replacement of the tracheotomy tube), respiratory failure (11.0%), intracranial injury (5.4%), pneumonia (4.0%), "other upper respiratory disease" (3.8%), and "complications of surgical procedures or medical care" (3.8%). The most common revisit procedures were endotracheal intubation (11.4%), mechanical ventilation (8.8%), and replacement of tracheostomy tube (≤2.7%). Children discharged to a skilled care facility (47.1%) were more likely than those discharged to home (52.9%) to have a revisit (23.3% versus 12.0%, respectively; p < 0.001). CONCLUSIONS: Children undergoing tracheotomy have a substantial 30-day revisit rate, most notably during the first 48 h after discharge, often involving tracheotomy tube or pulmonary complications. Improvements in discharge planning should target prevention of these complications.
[Mh] Termos MeSH primário: Readmissão do Paciente/estatística & dados numéricos
Traqueotomia/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Criança
Estudos Transversais
Bases de Dados Factuais
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Incidência
Lactente
Masculino
Alta do Paciente
Traqueotomia/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:29224755
[Au] Autor:Yu H; Mamey MR; Russell CJ
[Ad] Endereço:Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
[Ti] Título:Factors associated with 30-day all-cause hospital readmission after tracheotomy in pediatric patients.
[So] Source:Int J Pediatr Otorhinolaryngol;103:137-141, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine factors associated with post-tracheotomy hospital readmission within 30 days of discharge. METHODS: Children 18 years and younger who underwent tracheotomy at Children's Hospital Los Angeles (CHLA) between 1/1/2005 and 12/31/2013 with at least 30 days of follow-up at CHLA were identified through ICD-9 procedure codes. Patient characteristics and covariates were obtained by linking manual chart review and administrative data. We used multivariate logistic regression to identify the independent association between risk factors and the primary outcome of 30-day all-cause same-hospital readmission. RESULTS: Of the 273 patients included, the median age at admission was 6 months [interquartile range (IQR): 1-51 months]. Among this primarily male (60.8%) and Hispanic (66.3%) cohort with a high proportion of discharge on positive pressure ventilation (47.1%), the 30-day readmission rate was 22% (n = 60). Of the readmissions, 92% (n = 55) were unplanned and 64% (n = 35) were associated with acute respiratory illnesses. Multivariate regression analysis demonstrated that, among patients ≤12 months, discharge on positive pressure ventilation [adjusted odds ratio (aOR) = 2.88, 95% confidence interval (CI) = 1.19-6.97] was associated with increased odds of readmission, while gastrostomy tube placement during the tracheotomy hospitalization (aOR = 0.42, 95% CI = 0.19-0.96) and prematurity (aOR = 0.35, 95% CI = 0.15-0.83) were associated with decreased odds of readmission. In patients >1 year of age, increased length of hospitalization (aOR = 1.01 per hospital day, 95% CI = 1-1.02) and presence of comorbid malignancy (aOR = 6.03, 95% CI = 1.25-29.16) were associated with increased odds of readmission. CONCLUSIONS: Over one-fifth of children undergoing tracheotomy had an unplanned hospital readmission within 30 days after discharge. Because the majority of readmissions were unplanned and due to acute respiratory illnesses, future research should investigate how discharge procedures and improved care coordination may lower readmission rates in high-risk patients (e.g., patients discharged on positive pressure ventilation).
[Mh] Termos MeSH primário: Readmissão do Paciente/estatística & dados numéricos
Traqueotomia/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Estudos de Coortes
Comorbidade
Feminino
Seres Humanos
Lactente
Modelos Logísticos
Los Angeles
Masculino
Alta do Paciente/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29216451
[Au] Autor:Iwata R; Kiyonari H; Imai T
[Ad] Endereço:Laboratory for Sensory Circuit Formation, RIKEN Center for Developmental Biology, Kobe 650-0047, Japan.
[Ti] Título:Mechanosensory-Based Phase Coding of Odor Identity in the Olfactory Bulb.
[So] Source:Neuron;96(5):1139-1152.e7, 2017 Dec 06.
[Is] ISSN:1097-4199
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mitral and tufted (M/T) cells in the olfactory bulb produce rich temporal patterns of activity in response to different odors. However, it remains unknown how these temporal patterns are generated and how they are utilized in olfaction. Here we show that temporal patterning effectively discriminates between the two sensory modalities detected by olfactory sensory neurons (OSNs): odor and airflow-driven mechanical signals. Sniff-induced mechanosensation generates glomerulus-specific oscillatory activity in M/T cells, whose phase was invariant across airflow speed. In contrast, odor stimulation caused phase shifts (phase coding). We also found that odor-evoked phase shifts are concentration invariant and stable across multiple sniff cycles, contrary to the labile nature of rate coding. The loss of oscillatory mechanosensation impaired the precision and stability of phase coding, demonstrating its role in olfaction. We propose that phase, not rate, coding is a robust encoding strategy of odor identity and is ensured by airflow-induced mechanosensation in OSNs.
[Mh] Termos MeSH primário: Mecanotransdução Celular/fisiologia
Bulbo Olfatório/fisiologia
Olfato/fisiologia
[Mh] Termos MeSH secundário: Absorciometria de Fóton
Animais
Comportamento Animal/fisiologia
Imuno-Histoquímica
Camundongos
Neuroimagem
Odorantes
Condutos Olfatórios/fisiologia
Neurônios Receptores Olfatórios/fisiologia
Traqueotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


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[PMID]:28964315
[Au] Autor:Lin CY; Ting TT; Hsiao TY; Hsu WC
[Ad] Endereço:Department of Otolaryngology, National Taiwan University, College of Medicine and National Taiwan University Hospital, Taipei, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Yunlin Branch, Yunlin, Taiwan.
[Ti] Título:Pediatric tracheotomy: A comparison of outcomes and lengths of hospitalization between different indications.
[So] Source:Int J Pediatr Otorhinolaryngol;101:75-80, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To assess outcomes of pediatric tracheotomy and duration of associated hospital stay according to indications. SUBJECTS AND METHODS: In this retrospective study, subjects were 142 consecutive pediatric patients (<18 years old) who underwent tracheotomy at a tertiary referral medical center, National Taiwan University Hospital, in 1997-2012. Age, sex, indications, pre-operative status (oxygen demand, number of repeated intubations), and post-operative status (duration of weaning, length of hospital stay, mortality) were analyzed. RESULTS: The indications included craniofacial anomalies (n = 19, 13.4%), upper airway obstruction (n = 41, 28.9%), neurological deficit (n = 58, 40.8%), prolonged ventilation (n = 15, 10.6%), and trauma (n = 9, 6.3%). Ninety-one patients (64.1%) were successfully weaned off ventilation after tracheotomy (40% in the prolonged ventilation group). Total hospital stay and duration of ventilation before tracheotomy were longest in patients with craniofacial anomalies (150.9 ± 98.8 days, p = 0.004; 108.8 ± 88.2, p < 0.001). The early tracheotomy group had a shorter duration of post-tracheotomy mechanical ventilation support than the late tracheotomy group (14.4 ± 19.0, n = 49 vs. 34.9 ± 58.6, n = 80, p = 0.004). Decannulation was successful in 20 patients (14.1%), with the highest rate in the upper airway obstruction group (n = 14, 34.1%) and lowest in the prolonged ventilation group (none). Thirteen patients (9.2%) died during admission from causes unrelated to tracheotomy. CONCLUSION: Outcomes of pediatric tracheotomy and duration of hospitalization depend on indications. Children with craniofacial anomalies had earlier tracheotomy age and longer mechanical ventilation before tracheotomy resulted in longer hospitalization. Earlier tracheotomy can shorten the duration of post-tracheotomy mechanical ventilation in several conditions.
[Mh] Termos MeSH primário: Remoção de Dispositivo/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
Traqueotomia/métodos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Hospitais Universitários
Seres Humanos
Lactente
Masculino
Respiração Artificial
Estudos Retrospectivos
Taiwan
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


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[PMID]:28766955
[Au] Autor:Mei J; Huang Z; Wu K; Zhao Y; Yang J; Liu Y
[Ad] Endereço:1 Department of Otorhinolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
[Ti] Título:Risk Factors of Stomal Recurrence After Laryngectomy: A Systematic Review and Meta-analysis.
[So] Source:Ann Otol Rhinol Laryngol;126(9):654-668, 2017 Sep.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We wished to investigate the risk factors for stoma recurrence following laryngectomy. METHODS: PubMed, Cochrane Library, and Embase were searched to identify primary research studies published between January 1, 1967, and October 31, 2016. We only included observational epidemiological studies and used risk ratios (RRs) and 95% confidence intervals (CI) to summarize the primary risk factors associated with recurrence following laryngectomy. RESULTS: A total of 44 articles, including 11 928 patients, were included in the current meta-analysis. The pooled estimates of the stomal recurrence rate and the local recurrence rate following laryngectomy were 6.60% (95% CI, 5.40-7.90) and 19.40% (95% CI, 14.00%-24.80%), respectively. For stomal recurrence, we confirmed a series of earlier identified factors, including tumor site, prior tracheotomy, tracheotomy timing, T-classification, lymph node metastases, postoperative pharyngoperistomal fistula, and a positive surgical margin. For local recurrence, postoperative radiotherapy, overexpression of p53, and overexpression of p21 were significant, while preoperative tracheostomy and postoperative pharyngoperistomal fistula had an unexpectedly low impact on risk. CONCLUSION: This study has confirmed a series of earlier identified factors for stomal recurrence and local recurrence following laryngectomy. Our results will provide important insights for clinical practice.
[Mh] Termos MeSH primário: Neoplasias Laríngeas/cirurgia
Laringectomia
Recidiva Local de Neoplasia/epidemiologia
Estomas Cirúrgicos/patologia
Traqueostomia
[Mh] Termos MeSH secundário: Inibidor de Quinase Dependente de Ciclina p21/metabolismo
Seres Humanos
Neoplasias Laríngeas/metabolismo
Neoplasias Laríngeas/patologia
Linfonodos/patologia
Margens de Excisão
Recidiva Local de Neoplasia/patologia
Estadiamento de Neoplasias
Doenças Faríngeas/epidemiologia
Radioterapia Adjuvante
Fístula do Sistema Respiratório/epidemiologia
Fatores de Risco
Traqueostomia/estatística & dados numéricos
Traqueotomia/estatística & dados numéricos
Proteína Supressora de Tumor p53/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (CDKN1A protein, human); 0 (Cyclin-Dependent Kinase Inhibitor p21); 0 (TP53 protein, human); 0 (Tumor Suppressor Protein p53)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417720221



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