Stridor after Extubation

Author(s):  
Cheryl Gore ◽  
Junzheng Wu ◽  
C. Dean Kurth

Postextubation stridor arises from glottic and subglottic edema caused by ischemia of the tracheal mucosa from pressure by the endotracheal tube. Multiple risk factors have been described; preventive measures include appropriate tube sizing, air leak tests, administration of steroids, and smooth airway management techniques, such as atraumatic intubation. When stridor does occur, cool humidified air as well as racemic epinephrine may be used as treatment. The patient is safe for discharge once symptoms have dramatically improved and the window for potential “rebound effect” from racemic epinephrine has passed with no further stridor.

2013 ◽  
Vol 12 (4) ◽  
pp. 79-81
Author(s):  
E. O. Taratukhin

The paper focuses on the important issue of cardio-cerebral interactions, cardiac comorbidities, and the need for complex therapeutic approaches. While stroke is traditionally regarded as a neurologic problem, cardiologists play an important role in its prevention, via modification of multiple risk factors. One of the key preventive measures is arterial hypertension treatment. New calcium channel blockers are a promising group of modern antihypertensive medications. 


1989 ◽  
Vol 28 (01) ◽  
pp. 14-19 ◽  
Author(s):  
J. F. Dartigues ◽  
Ph. Peytour ◽  
E. Puymirat ◽  
P. Henry ◽  
M. Gagnon ◽  
...  

Abstract:When studying the possible effects of several factors in a given disease, two major problems arise: (1) confounding, and (2) multiplicity of tests. Frequently, in order to cope with the problem of confounding factors, models with multiple explanatory variables are used. However, the correlation structure of the variables may be such that the corresponding tests have low power: in its extreme form this situation is coined by the term “multicollinearity”. As the problem of multiplicity is still relevant in these models, the interpretation of results is, in most cases, very hazardous. We propose a strategy - based on a tree structure of the variables - which provides a guide to the interpretation and controls the risk of erroneously rejecting null hypotheses. The strategy was applied to a study of cervical pain syndrome involving 990 subjects and 17 variables. Age, sex, head trauma, posture at work and psychological status were all found to be important risk factors.


2021 ◽  
pp. bjophthalmol-2020-318092
Author(s):  
Rashmi Deshmukh ◽  
Sridevi Nair ◽  
Darren Shu Jeng Ting ◽  
Tushar Agarwal ◽  
Jacqueline Beltz ◽  
...  

Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft. Management of a detached graft involves secondary interventions such as rebubbling, suturing and regrafts. In this review, we discuss graft detachment in different types of endothelial keratoplasty techniques including Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty; with emphasis on incidence, risk factors, preventive measures and their management.


2021 ◽  
pp. 912-917
Author(s):  
Zainub Ajmal ◽  
Abdul Moiz Khan ◽  
Lezah McCarthy ◽  
Allison Lupinetti ◽  
Syed Mehdi

Leiomyosarcoma (LMS) of the trachea is an extremely rare malignancy with only a few reported cases in English literature. As such the diagnosis can be frequently missed or delayed. We present a case of a 69-year-old male who underwent tracheostomy for airway obstruction secondary to glottic squamous cell carcinoma and treated definitely with radiation therapy. Subsequently, the patient developed LMS of the tracheostomy site. The case further details multiple risk factors that could contribute to development of LMS including radiation exposure, prior malignancy, and chronic inflammation. These risk factors have been well established for LMS in other sites but less so in the head and neck region, which is the subject of our discussion. We also review the current guidelines for head and neck as well as limb sarcomas and discussed role of surgery or radiation and their accompanying challenges in management of this rare malignancy.


2021 ◽  
pp. 1-11
Author(s):  
C. Lemvigh ◽  
R. Brouwer ◽  
R. Hilker ◽  
S. Anhøj ◽  
L. Baandrup ◽  
...  

Abstract Background Research has yielded evidence for genetic and environmental factors influencing the risk of schizophrenia. Numerous environmental factors have been identified; however, the individual effects are small. The additive and interactive effects of multiple risk factors are not well elucidated. Twin pairs discordant for schizophrenia offer a unique opportunity to identify factors that differ between patients and unaffected co-twins, who are perfectly matched for age, sex and genetic background. Methods Register data were combined with clinical data for 216 twins including monozygotic (MZ) and dizygotic (DZ) proband pairs (one or both twins having a schizophrenia spectrum diagnosis) and MZ/DZ healthy control (HC) pairs. Logistic regression models were applied to predict (1) illness vulnerability (being a proband v. HC pair) and (2) illness status (being the patient v. unaffected co-twin). Risk factors included: A polygenic risk score (PRS) for schizophrenia, birth complications, birth weight, Apgar scores, paternal age, maternal smoking, season of birth, parental socioeconomic status, urbanicity, childhood trauma, estimated premorbid intelligence and cannabis. Results The PRS [odds ratio (OR) 1.6 (1.1–2.3)], childhood trauma [OR 4.5 (2.3–8.8)], and regular cannabis use [OR 8.3 (2.1–32.7)] independently predicted illness vulnerability as did an interaction between childhood trauma and cannabis use [OR 0.17 (0.03–0.9)]. Only regular cannabis use predicted having a schizophrenia spectrum diagnosis between patients and unaffected co-twins [OR 3.3 (1.1–10.4)]. Conclusion The findings suggest that several risk factors contribute to increasing schizophrenia spectrum vulnerability. Moreover, cannabis, a potentially completely avoidable environmental risk factor, seems to play a substantial role in schizophrenia pathology.


Pathogens ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 1077
Author(s):  
Silvia Bellini ◽  
Alessandra Scaburri ◽  
Marco Tironi ◽  
Stefania Calò

In 2019, the area of the European Union (EU) affected by African swine fever (ASF) expanded progressively in a southwestern direction from Baltic and eastern countries. The disease can severely affect and disrupt regional and international trade of pigs and pork products with serious socioeconomic damages to the pig industry. Lombardy is one of the most important European pig producers and the introduction of ASF into the pig population could adversely affect the entire sector. A study was carried out to identify the farms and territories in the region most at risk of ASF introduction to plan preventive measures. The pig holdings were identified through a descriptive analysis of pig movements and Social Network Analysis (SNA), while, for the identification of the most exposed municipalities, an assessment of risk factors was carried out using the ranking of summed scores attributed to the Z-score. From the analysis, it was found that 109 municipalities and 297 pig holdings of the region were potentially more at risk, and these holdings were selected for target surveillance. This information was provided to veterinary authority to target surveillance in pig farms, in order to early detect a possible incursion of ASF and prevent its spread.


2014 ◽  
Vol 89 (4) ◽  
pp. 428-432 ◽  
Author(s):  
A.A. Marchioro ◽  
C.M. Colli ◽  
É.C. Ferreira ◽  
B.M. Viol ◽  
S.M. Araújo ◽  
...  

AbstractThis study investigated the epidemiological factors that contribute to the seroprevalence of Toxoplasma gondii and Toxocara spp. in children from Paraná state, Brazil. Immunoglobulin G (IgG) antibodies to T. gondii were detected using indirect immunofluorescence, and IgG antibodies to Toxocara were detected using an enzyme-linked immunosorbent assay. For each individual, a questionnaire was completed that contained epidemiological and clinical data. The data analysis was performed using multiple logistic regression. Of the 544 children investigated, 3.2% presented co-infection with T. gondii and Toxocara spp. Of this total, 7.4% were positive for antibodies to T. gondii, and 25% were positive for antibodies to Toxocara spp. The presence of antibodies to Toxocara spp. increased the risk of T. gondii infection (P= 0.029). Children who were 1–8 years of age were less infected by T. gondii than those who were 9–12 years of age. The variables that influenced positivity for anti-Toxocara spp. were the origin of the children and contact with sand. Children with positive serology for Toxocara spp. presented more eosinophilia compared with those with non-reactive serology. Infection with both parasites reveals the need for preventive measures, such as guidance about modes of infection, parasite control and monitoring recreational areas.


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