scholarly journals Application of Montgomery T-Tube Placement in Treating Cotton-Myer IV Subglottic Airway Atresia after Bi-Level Airway Recanalization

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Fengjie Wu ◽  
Yangwei Yao ◽  
Yangyang Gu ◽  
Meng Yang ◽  
Enguo Chen ◽  
...  

Objective. The purpose of this study is to explore the effectiveness and safety of Montgomery T-tube placement in treating Cotton-Myer IV subglottic airway atresia after bi-level airway recanalization. Methods. This study is a retrospective study. 11 patients who were treated for IV subglottic airway atresia between January 2017 and January 2019 in the Second Affiliated Hospital of Jiaxing University were involved in this study. The 11 patients all had undergone tracheotomies at our hospital, and they were transferred to the Department of Pulmonary and Critical Care Medicine for Montgomery T-tube placement after bi-level airway recanalization when their subglottic airway was atretic. Patients were observed for their clinical manifestations after placement. The effectiveness of T-tube placement after bi-level airway recanalization was assessed. The incidence of short-term and long-term complications after surgery was assessed. Patients were followed up for 3 to 24 months for evaluating their airway recovery. Results. T-tubes were successfully placed in 11 patients. The atretic airways of all patients were recanalized after treatment. Eight patients got restoration of vocal ability, and 3 patients could only say simple words. None of the patients needed assisted oxygen inhalation. The SpO2 average level was increased from 95 ± 2 % before treatment to 97 ± 3 % after treatment. Patients had significant relief of cough or sputum, and they had less difficulty in dyspnea. All short- or long-term complications were self-relieved or controlled without further malignant progression after treatment by doctors. The average postoperative extubating time was ( 14.86 ± 3.62 ) months. Conclusion. The application of Montgomery T-tube placement in treating Cotton-Myer IV subglottic airway atresia after bi-level airway recanalization is well effective and safe for patients, and it can be promoted in clinical treatment.

2020 ◽  
pp. 31-39
Author(s):  
S.Y. Borodashkina ◽  
◽  
K.V. Protasov ◽  

Patients with myocardial infarction (MI) and atrial fibrillation (AF), the number of which is progressively increasing every year, make up a high-risk group for both recurrent cardiovascular events and bleeding; they require special attention from clinicians. The literature review provides data on features of pathogenesis and clinical manifestations of MI in patients with AF. The analysis of data on AF effect observational studies on short-term and long-term prognosis in patients with myocardial infarction was carried out. Mechanisms of occurrence, clinical features and prognostic value of postinfarction AF are considered. From the standpoint of modern clinical guidelines, information is presented on features of MI invasive treatment in combination with AF. Algorithms of anticoagulant and antiarrhythmic therapy in patients of this category are considered.


Cephalalgia ◽  
2017 ◽  
Vol 38 (9) ◽  
pp. 1554-1563 ◽  
Author(s):  
Hsing-Yu Weng ◽  
Anna S Cohen ◽  
Christoph Schankin ◽  
Peter J Goadsby

Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are two rare headache syndromes classified broadly as Trigeminal Autonomic Cephalalgias (TACs). Methods Here, 65 SUNCT (37 males) and 37 SUNA (18 males) patients were studied to describe their clinical manifestations and responses to treatment. Results Pain was almost always unilateral and side-locked. There were three types of attack: Single stabs, stab groups, and a saw-tooth pattern, with some patients experiencing a mixture of two types. As to cranial autonomic symptoms, SUNA patients mainly had lacrimation (41%) and ptosis (40%). Most cases of the two syndromes had attack triggers, and the most common triggers were touching, chewing, or eating for SUNCT, and chewing/eating and touching for SUNA. More than half of each group had a personal or family history of migraine that resulted in more likely photophobia, phonophobia and persistent pain between attacks. For short-term prevention, both syndromes were highly responsive to intravenous lidocaine by infusion; for long-term prevention, lamotrigine and topiramate were effective for SUNCT, and lamotrigine and gabapentin were efficacious in preventing SUNA attacks. A randomized placebo-controlled cross-over trial of topiramate in SUNCT using an N-of-1 design demonstrated it to be an effective treatment in line with clinical experience. Conclusions SUNCT and SUNA are rare primary headache disorders that are distinct and very often tractable to medical therapy.


2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 375-375 ◽  
Author(s):  
Reza-Thierry Elaidi ◽  
Benoit Beuselinck ◽  
Agnes Maj-HES ◽  
Delphine Carmier ◽  
Aristotelis Bamias ◽  
...  

375 Background: The question regarding the benefit of a TKI rechallenge versus switch to an mTOR inhibitor (mTORi) in mRCC pts who responded to a previous line of TKI remains unanswered and is a common dilemma in clinical practice. We report results of a retrospective study to address this question. Methods: This study retrospectively investigated Duration of Treatment (DT), best radiological response (OR) and predictive factors in pts treated with either TKI-TKI or TKI-mTORi sequences for clear-cell mRCC. Eligibility criteria: 1 TKI in 1st line (L1) followed by another TKI or mTORi as 2nd line (L2). Prior immunotherapy was allowed but not intermediate lines with other drugs. Pts characteristics and Heng’s prognostic factors were collected at each line initiation. Response (resp) was classified with regard to DT and OR using 2 different definitions: def1 = Non Responders (NR): < 4months (m) + PD; Short-Term responders (STR): [4–6]m + SD/PR, Long-term Responders (LTR): >6m + SD/PR, and def2 = NR: < 4m + PD, STR: [4–12]m + SD/PR, LTR: >12m + SD/PR. Results: 127 pts from 7 European centers were retrospectively analyzed. Based on def1, resp to L1 was: LTR=93, STR=20, NR=14; among LTR pts, 54 received a L2=TKI and 39 a L2=mTORi. Based on def2, resp to L1 was: LTR=59, STR=53, NR=15; among LTR pts, 35 received a L2=TKI and 24 a L2=mTORi. Whether def1 or def2, resp (L1 and L2) was never related to Heng’s score. Among LTR pts at L1, 26 out of 54 were LTR after L2=TKI vs 18 out of 39 after L2=mTORi (p=0.85, Z-test) for def1 and 9 out of 35 were LTR after L2=TKI vs 6 out of 24 after L2=mTORi (p=0.95) for def2 (see table). For both def1 and def2, median DT was 7.2m and 6.9m for L2=TKI and L2=mTORi, respectively (p=0.86 and p=0.95, Log-Rank). Conclusions: Results suggest that long-term responders on 1st line TKI could benefit both from TKI and mTORi as 2nd line and there is no evidence to favor one sequence over the other. [Table: see text]


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Baris Akdemir ◽  
Balaji Krishnan ◽  
Venkatakrishna Tholakanahalli ◽  
David Benditt ◽  
Jian-Ming Li

Introduction: SIMPLE trial showed that defibrillation testing (DT) is safe but does not improve shock efficacy or mortality. However, impact of DT on heart failure (HF) admission at 30 days is unclear. Objectives: The aim of this study was to compare mortality and HF admission of ICD recipients who underwent DT (DT+) compared with those who did not (DT-). Methods: In this retrospective study, we analyzed consecutive patients who received an ICD ( new implant or generator change ) with DT+ and DT- between January 2008 and May 2014 from our ICD registry. Primary endpoints were death ( 30 days and 1 year ) and HF admission ( 30 days) . Results: Of the 501 patients, 311 patients (62,1%) were in DT+ group vs 190 (37,9%) were in DT- group. The mean ages in DT+ and DT- were 66 ± 10 and 70 ± 10 respectively (p<0.0001). DT- group had more generator change than DT+ group ( 61,1% versus 30,9%, p < 0.0001). Other demographic features were not significantly different between two groups (Table 1). No significant difference in mortality was found between two groups at 30 days and 1 year. HF admission at 30 days was significantly higher in DT+ group than in DT- group ( 17,4 % versus 4,7%, p < 0.0001) (Table 2). Conclusion: No short-term and long-term mortality were associated with DT, but DT was associated with increased HF admission at 30 days. Future prospective studies are needed to prove this association.


2008 ◽  
Vol 44 (6) ◽  
pp. 308-319 ◽  
Author(s):  
Jason A. Syrcle ◽  
Jennifer J. Bonczynski ◽  
Sebastien Monette ◽  
Philip J. Bergman

In this retrospective study of 42 cases of lingual tumors in dogs, 27 (64%) were malignant, and 15 (36%) were benign. Median survival time for dogs with benign tumors was &gt;1607 days, compared to 286 days for malignant tumors. Prognostic factors significantly associated with increased survival included complete histological margins (P=0.036), smaller tumor size (P=0.003), and benign tumor type (P=0.011). Smaller tumors were more likely to be completely resected (P=0.008) and were less likely to recur (P=0.001). Partial or subtotal glossectomies were performed in 13 cases. Short-term morbidity associated with glossectomy included ptyalism and dehiscence. Long-term morbidity included minor changes in eating and drinking habits.


2021 ◽  
Vol 25 (3) ◽  
pp. 165-173
Author(s):  
A. Yu. Razumovskiy ◽  
Z. B. Mitupov ◽  
N. V. Kulikova ◽  
N. S. Stepanenko ◽  
A. S. Zadvernyuk ◽  
...  

Introduction. The article presents the analysis of surgical treatment of children with choledochal malformations (CM) with mini-laparotomy and laparoscopy techniques.Purpose. The aim of the study is to improve outcomes of surgical treatment of choledochal malformations in children.Material and methods. For the last ten years (January 2010 - May 2020), 84 children with choledochal malformations (CM) (n = 84) were operated on with different surgical techniques in our hospitals. Group 1 - patients who had Roux-en-Y hepaticojejunoanastomosis (RYHJ, n = 68, 81%); Group 2 - patients who had hepaticoduodenoanastomosis (HD, n = 16, 19%). The authors compared outcomes because Roux-en-Y hepaticojejunostomosis and hepaticoduodenanastomosis were formed under mini-laparotomic (ML) and laparoscopic (LS) accesses. Surgical time, short-term and long-term postoperative outcomes were assessed.Results. The groups were comparable in gender, age, clinical manifestations, CM complications before surgery, comorbidities (p > 0.05). A statistically significant (p = 0.0000001, Mann–Whitney U-test) decrease in the surgical time was revealed when using mini-laparotomy access. Independent defecation appeared 3 times faster in the subgroup with mini-laparotomy and Roux-en-Y hepaticojejunostomy (ML RYHJ) than in the subgroup of laparoscopic Roux-en-Y hepaticojejunostomy (LS RYHJ) (p = 0.033, Mann–Whitney U-test), mainly due to early enteral loading in the first subgroup (on 0-1 postoperative day). Long-term postoperative outcomes in laparoscopic subgroups revealed a statistically insignificant (p> 0.05) prevalence of 4 anastomotic stenosis requiring repeated surgical interventions. Good outcomes were seen in 90% of patients after ML RYHJ (p = 0.002, Pearson’s Chi-square with Yates’ correction) versus 52.6% after LS RYHJ.Conclusion. Currently, laparoscopy is not a method of choice in children with CM due to the development of short-term and long-term postoperative complications. Minilaparotomy gives promising results in pediatric CM and can be “a gold standard” in the treatment of children with this pathology.


2019 ◽  
Vol 14 (12) ◽  
pp. 758-760
Author(s):  
Sanjay A Patel ◽  
Tiago Araujo ◽  
Luis Parra Rodriguez ◽  
Claudia Ramirez Sanchez ◽  
Ashley Snyder ◽  
...  

The risk of infectious and noninfectious complications associated with long peripheral catheters (LPCs) is unknown. In this retrospective study of 539 catheters, we found LPCs were often placed for the indications of difficult access and long-term antibiotics. Rates of deep vein thrombosis (1.7%) and catheter-related infection (0.6%) were low. LPCs may represent a novel and safe option for short-term venous access.


Sign in / Sign up

Export Citation Format

Share Document