Acquired Stenosis of the Upper Airway in Neonates an Increasing Problem

1980 ◽  
Vol 89 (6) ◽  
pp. 512-514 ◽  
Author(s):  
Michael J. Papsidero ◽  
Nigel R. T. Pashley
Keyword(s):  
Distress Syndrome ◽  
Upper Airway ◽  
Subglottic Stenosis ◽  
University Of Michigan ◽  
Biphasic Pattern ◽  
Neurologic Disorders ◽  
The Mean ◽  
The University ◽  
Normal Speech

Thirty neonates with acquired airway stenosis were treated between 1975 and 1979 at the C. S. Mott Children's Hospital of the University of Michigan. Neonates surviving a period of ventilation are at risk of developing subglottic stenosis (8.3%). The stenosis is often severe. Children with respiratory distress syndrome and/or neurologic disorders were particularly prone to developing a stenosis (37 %). Following treatment, 43% were successfully decannulated and decannulation occurred in a biphasic pattern. Thirty-seven percent were still tracheostomy-dependent but had a voice and were developing normal speech patterns. The mean decannulation time was 92.5 weeks, confirming that acquired subglottic stenosis in the neonate is a serious problem with long-term disability.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

Effect of Antenatal Administration of Betamethasone on Hospital Costs and Survival of Premature Infants

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 633-637 ◽  
Author(s):  
Dana E. Johnson ◽  
David P. Munson ◽  
Theodore R. Thompson
Keyword(s):  
Premature Infants ◽  
Distress Syndrome ◽  
Hospital Costs ◽  
Glucocorticoid Therapy ◽  
Hospital Charges ◽  
Respiratory Morbidity ◽  
University Of Minnesota ◽  
Long Term Effects ◽  
The University

Prenatal administration of glucocorticoids has been shown to decrease the incidence and severity of respiratory distress syndrome in premature infants, but little is known regarding the immediate economic impact of this reduction in respiratory morbidity. This study retrospectively examined 342 infants born during 1978 and 1979 and hospitalized in the University of Minnesota Hospitals. Comparison of survival and the hospital charges for infants whose mothers had or had not received prenatal glucocorticoid therapy showed that administration of glucocorticoids had a significant effect in lowering mortality in infants with birth weights between 750 and 1,249 gm (27 to 29 weeks' gestation). Glucocorticoid therapy was also effective in decreasing morbidity as reflected by hospital charges of surviving infants with birth weights between 1,250 and 1,749 gm (30 to 32 weeks' gestation). In both steroid-treated and nontreated mothers, prolongation of gestation decreases hospital charges in a linear fashion. The noted decrease in hospital costs should not justify prenatal glucocorticoid administration but should stimulate examination of long-term effects of the drug on surviving infants.

Gamma Knife surgery for trigeminal schwannoma

2007 ◽  
Vol 106 (5) ◽  
pp. 839-845 ◽  
Author(s):  
Jason Sheehan ◽  
Chun Po Yen ◽  
Yasser Arkha ◽  
David Schlesinger ◽  
Ladislau Steiner
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Long Term Results ◽  
University Of Virginia ◽  
Trigeminal Schwannoma ◽  
The Mean ◽  
The University ◽  
Lost To Follow Up

Object Trigeminal schwannomas are rare intracranial tumors. In the past, resection and radiation therapy were the mainstays of their treatment. More recently, neurosurgeons have begun to use radiosurgery in the treatment of trigeminal schwannomas because of its successful use in the treatment of vestibular schwannomas. In this article the authors evaluate the radiological and clinical outcomes in a series of patients in whom Gamma Knife surgery (GKS) was used to treat trigeminal schwannomas. Methods Twenty-six patients with trigeminal schwannomas underwent GKS at the University of Virginia Lars Lek-sell Gamma Knife Center between 1989 and 2005. Five of these patients had neurofibromatosis and one patient was lost to follow up. The median tumor volume was 3.96 cm3, and the mean follow-up period was 48.5 months. The median prescription radiation dose was 15 Gy, and the median prescription isodose configuration was 50%. There was clinical improvement in 18 patients (72%), a stable lesion in four patients (16%), and worsening of the disease in three patients (12%). On imaging, the schwannomas shrank in 12 patients (48%), remained stable in 10 patients (40%), and increased in size in three patients (12%). These results were comparable for primary and adjuvant GKSs. No tumor growth following GKS was observed in the patients with neurofibromatosis. Conclusions Gamma Knife surgery affords a favorable risk-to-benefit profile for patients harboring trigeminal schwannomas. Larger studies with open-ended follow-up review will be necessary to determine the long-term results and complications of GKS in the treatment of trigeminal schwannomas.

S183 – Intracordal Fat Assessment after Injection Laryngoplasty

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P137-P137
Author(s):  
Tuan-Jen Fang ◽  
Chao-Jan Wang ◽  
Hsueh-Yu Li
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Upper Airway ◽  
Fat Injection ◽  
Long Term Outcomes ◽  
Autologous Fat ◽  
The Mean ◽  
Fat Volume ◽  
Unilateral Vocal Cord Paralysis

Objectives Autologous fat injection for unilateral vocal cord paralysis is a popular procedure for immediate symptoms control, but uneven long-term outcomes were reported. Most authors believed that the continual resorption of injected fat was the cause of voice degradation. A long-term residual fat volume was evaluated. Methods We retrospectively reviewed the patients following autologous fat injection for symptomatic unilateral vocal cord paralysis from 2002 Aug to 2006 July. The patients accepted head and neck computed tomogragphy (CT) evaluation following surgery were included. A three-dimensional reconstruction of the images of larynx and upper airway was performed on the work station (Vitrea® 2, version 3.9). The volume of intracordal fat was then calculated. Results 5 males and 15 females of the mean age 49 were enrolled. The mean duration from lipoinjection surgery to the CT study is 23.0 months (12–50 months). The injection fat was found in all study cases. The estimated fat volume ranged from 0.01 to 0.75 ml with a mean 0.33 ml. Compare with the injected fat volume, a mean 27.5% fat survived. The correlation between residual fat volume rate and duration of follow-up is not significant. Conclusions The intracordal fat volume didn't decline from time. Long-term intracordal injected fat diminished but survived in all cases. The degradation may be caused by absorption or immediate extrusion from injection wound. An over-correction and prevention of extrusion postoperatively would improve the long-term outcomes.

Comparison of venous thromboembolism risk stratification models in a high risk otolaryngology patient cohort

2019 ◽  
Vol 29 (5) ◽  
pp. 129-134
Author(s):  
Tristan Tham ◽  
Peter Costantino
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Scoring Systems ◽  
Neck Surgery ◽  
Assessment Tools ◽  
University Of Michigan ◽  
Data Collection Process ◽  
The Mean ◽  
The University

Our objective was to compare the venous thromboembolism outcomes in two of the most commonly utilised venous thromboembolism assessment tools, the Caprini system and the University of Michigan system, in a high risk head and neck surgery population. Currently, there is a lack of data reporting the validation of well known scoring systems in this patient population. Established risk factors for venous thromboembolism were included in the data collection process. We retrospectively evaluated all patients with the Caprini Risk Assessment and the University of Michigan Health System (UMHS) Scores. Out of all the risk factors, only length of surgery was found to be associated with venous thromboembolism. The mean Caprini scores in those with and without venous thromboembolism were 8.00 ± 3.00 and 6.86 ± 1.45, respectively. The mean UMHS scores in those with and without venous thromboembolism were 6.85 ± 1.28 and 6.54 ± 1.20, respectively. Both scoring systems were not found to be associated with venous thromboembolism.

scholarly journals Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Ryan C. Case ◽  
John Schweinfurth
Keyword(s):  
Weight Loss ◽  
Airway Obstruction ◽  
Weight Reduction ◽  
Oxygen Demand ◽  
Upper Airway ◽  
Airway Disease ◽  
Disease Etiology ◽  
Obstructive Sleep ◽  
The Mean

Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology.Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI) and rate of decannulation from weight loss alone.Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2per patient.Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

scholarly journals Liver and COVID-19: possible mechanisms of damage

2021 ◽  
Vol 93 (4) ◽  
pp. 427-430
Author(s):  
Marina G. Mnatsakanyan ◽  
Aleksandr P. Pogromov ◽  
Aleksei S. Lishuta ◽  
Victor V. Fomin ◽  
Olga S. Volkova ◽  
...  
Keyword(s):  
Drug Exposure ◽  
Distress Syndrome ◽  
Chain Reaction ◽  
Global Epidemic ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Serum Aminotransferases ◽  
The University ◽  
Medical University

The global epidemic of a new coronavirus infection caused by SARS-CoV-2 is a major threat to human health. In the clinical picture, along with acute respiratory distress syndrome, liver lesions are also noted. The following mechanisms are currently being considered: direct damaging effects of SARS-CoV-2, immuno-mediated inflammation, hypoxia, drug exposure, and reactivation of pre-existing liver disease. We studied 150 patients with COVID-pneumonia who are under inpatient treatment at the University Clinical Hospital No. 1 of Sechenov First Moscow State Medical University. Of these, the presence of SARS-CoV-2 RNA was confirmed by polymerase chain reaction in 84 (56.0%) patients. In 55 (36.7%) patients, an increase in serum aminotransferases was registered, mainly alanine aminotransferase max. up to 572 U/L and aspartate aminotransferase up to a max. of 232 U/L. The long-term consequences are unknown and require monitoring of these patients.

scholarly journals Mucosal bacterial vaccines in clinical practice – a novel approach to an old problem?

2020 ◽  
Vol 66 (5) ◽  
pp. 659-665
Author(s):  
João Neiva Machado ◽  
José Coutinho Costa ◽  
Teresa Costa ◽  
Cidália Rodrigues
Keyword(s):  
Respiratory Disease ◽  
Bacterial Colonization ◽  
Chronic Respiratory Disease ◽  
Novel Approach ◽  
Standard Composition ◽  
The Mean ◽  
The University ◽  
Additional Therapy ◽  
Long Term Oxygen Therapy

SUMMARY OBJECTIVES To evaluate the efficacy of mucosal bacterial vaccines (MBV) in reducing the number of exacerbations in patients with chronic respiratory disease. METHODS A prospective cohort study of patients followed at the Pneumology Unit of the University and Hospital Centre of Coimbra, with frequent infectious exacerbations (3 or more) despite the best therapeutic strategies employed. MBV was used as additional therapy. The number of exacerbations 1 year before therapy and 1 year after it were analyzed. RESULTS A sample of 11 individuals, 45.5% male, mean age 62.5 years. Eight patients had non-cystic fibrosis bronchiectasis, 2 COPD (1 on long-term oxygen therapy), and 1 patient with Mounier Kuhn’s syndrome. Three patients were on azithromycin, 1 on inhaled colistin, and 2 on inhaled tobramycin. Out of the 11 patients, one presented complication (fever), which led to a suspension of therapy (excluded from results). Of the 10 patients who completed treatment, 5 had bacterial colonization and were submitted to a custom vaccine. The remaining 6 completed the standard composition. The average of infectious exacerbations in the previous year was 4.3 (0.7 with hospitalization). In the year after therapy, the mean number was 1.5 (0.5 with hospitalization). CONCLUSION The results obtained in this study favor the use of bacterial immunostimulation to reduce the frequency of RRIs in patients with chronic respiratory disease.

scholarly journals The Study of Radio Flux Density Variations of the Quasar OJ 287 by the Wavelet and the Singular Spectrum Methods

2016 ◽  
Vol 25 (2) ◽  
Author(s):  
Ganna Donskykh
Keyword(s):  
Flux Density ◽  
Singular Spectrum Analysis ◽  
Time Interval ◽  
Extragalactic Radio Source ◽  
University Of Michigan ◽  
Singular Spectrum ◽  
Vlbi Data ◽  
The University ◽  
Term Monitoring

AbstractFlux density variations of the extragalactic radio source OJ 287 are studied by applying the wavelet and the singular spectrum methods to the long-term monitoring data at 14.5, 8.0 and 4.8 GHz acquired at the University of Michigan Radio Astronomy Observatory during 40 years. This monitoring significantly supplements the episodic VLBI data. The wavelet analysis at all three frequencies revealed the presence of quasiperiods within the intervals 6.0–7.4 and 1.2–1.8 years. The singular spectrum analysis revealed the presence of quasiperiods within the intervals 6–10 and 1.6–4.0 years. For each quasiperiod the time interval of its existence was determined.

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