Innominate Artery Compression of the Trachea in Infants

1994 ◽  
Vol 103 (5) ◽  
pp. 347-350 ◽  
Author(s):  
Dwight T. Jones ◽  
Richard A. Jonas ◽  
Gerald B. Healy
Keyword(s):  
Innominate Artery ◽  
Respiratory Arrest ◽  
Feeding Problems ◽  
Tracheal Compression ◽  
Feeding Difficulties ◽  
The Past ◽  
Proper Patient Selection ◽  
Follow Up Care ◽  
Before And After

Innominate artery compression of the trachea in infants can cause severe biphasic stridor, cyanosis, and respiratory arrest. These episodes are sometimes referred to as “dying spells.” In the past, aortopexy has been used for the treatment of this problem, but since many have questioned its success, its use has not been popularized or generally accepted. Over the past 4 years, 12 children have been successfully treated for innominate artery compression of the trachea with aortopexy. These children all initially presented with significant respiratory and/or feeding difficulties. Preoperative and postoperative videos were obtained to document the degree of tracheal compression and/or lumen size before and after surgery. Since treatment, all patients have been without further feeding problems or cyanosis. When performed in selected patients, aortopexy is successful in relieving tracheal obstruction from innominate artery compression. This article discusses proper patient selection, operative technique, and follow-up care. The management of compression in patients with less severe symptoms will also be addressed.

scholarly journals Impact of the introduction of the active follow-up care of the third stage of childbirth in the prevention of delivery hemorrhage in the obstetrical gynecology department

2021 ◽  
Vol 11 (2) ◽  
pp. 227-236
Author(s):  
Jeremie Pagnol Bille Bonga ◽  
Michele Corneille Matchim Kamdem ◽  
Leila Sandra Nnanga ◽  
Ghislain François Eyimi Abessolo ◽  
Marcellin Ndoe Guiaro
Keyword(s):  
Data Collection ◽  
Regional Hospital ◽  
Prospective Data ◽  
The Third ◽  
Third Stage ◽  
Follow Up Care ◽  
Before And After ◽  
Study Participants ◽  
The Impact

Background: The majority of pregnancies and births proceed without complications. However, all pregnancies present risks of complications that could endanger the maternal prognosis. One of the most serious of these complications is the bleeding during delivery. It’s often unpredictable nature, when it occurs, involves an urgent obstetric situation which requires early diagnosis and rapid and effective follow-up. The general objective of this study was to assess the impact of the introduction of the active follow-up care of the third phase of childbirth in the prevention of bleeding during delivery with our place of study, the obstetrical gynecology department of Kindia regional hospital (Konacri Guinea), with the aim of optimizing the follow-up care of pregnant women during their childbirth. Methodology: We carried out a case-control study with both retrospective and prospective data collection on the records of participants with cases of hemorrhage during delivery in the gynecology department of the Kindia regional hospital. Retrospective data collection covered a period of 25 months before the active follow-up care of the third stage of childbirth and concerned the control group of study participants, while the one of prospective data covered a period of 19 months after the introduction of the active follow-up care of the third stage of childbirth from the 1st January 2019 to 30th September 2020 and concerned the cases group. The criteria for matching these two groups of study participants were the diagnosis and the follow-up of the delivery hemorrhage. Results: During our study period in the gynecology department of the Kindia regional hospital, we identified 223 cases of delivery hemorrhage out of 2198 deliveries before the period of introduction of the active follow-up care of the third stage. This represents an incidence of 10.14%, compared to 73 cases of delivery hemorrhage out of 2714 deliveries during the period of the active follow-up care of the third stage. For an incidence of 2.68%. We found that the hemorrhages during delivery did not spare any age group and were observed for all parities. There were common reasons for admission before and after the integration of the active follow-up care of the third stage of childbirth namely vulvar hemorrhage and physical asthenia, which were reflected in the clinical picture of all cases bleeding from the issue. In addition, headaches, dizziness, and thirst were found, but in different proportions and significantly less frequent since the introduction of the active follow-up care of the third stage of childbirth. This sign were in this context the consequence of the state of shock with respective frequencies of 46.63% and 28.76% before and after the introduction of the active follow-up care of the third stage of childbirth and anemia was present in all cases of delivery hemorrhage. Conclusion: The introduction of active follow-up care of the third stage of childbirth has reduced the frequency of delivery hemorrhages and may therefore help to reduce maternal morbidity and mortality.

scholarly journals Effectiveness and safety of pidotimod in recurrent respiratory infections in children: a pilot study

2019 ◽  
Vol 6 (5) ◽  
pp. 2012 ◽  
Author(s):  
T. C. Acharya ◽  
Kundan Nivangune ◽  
Snehal Muchhala ◽  
Rishi Jain
Keyword(s):  
Prospective Observational Study ◽  
Standard Treatment ◽  
Respiratory Infections ◽  
Single Centre ◽  
The Past ◽  
Recurrent Respiratory Infections ◽  
Before And After ◽  
Antibiotic Courses

Background: Recurrent respiratory infections (RRIs) are common in children especially in age 1 to 6 years. Pidotimod, an immunostimulant has been found to lower the recurrences of RRIs and improve the quality of life. The Objective of this study was to assess the efficacy and safety of pidotimod in children with recurrent respiratory infections (RRIs).Methods: In this single-centre, prospective, observational study, children aged 2 to 15 years diagnosed with RRIs were included. RRIs were defined as occurrence of 3 or more episodes of acute respiratory infections (ARIs) or more than 15 days of respiratory symptoms in the past 3 months. These children were treated with pidotimod in addition to standard care treatment. Treatment duration was two months and the follow-up continued for three months. Number of RRIs and severity of RRIs, antibiotic courses and rate of hospitalization before and after treatment were compared.Results: In total 25 children included in the study, mean age was 7.34±3.63 years. Among them, 68% were males. After treatment with pidotimod, there was significant reduction in mean number of ARI episodes (3.84±0.85 at baseline to 0.48±0.51 at follow-up, p<0.0001). Also, there was significant reduction in the duration of acute infectious episodes (p<0.0001), need of antibiotic courses (p<0.0001) and rates of hospitalization (p<0.0001). No safety concerns were identified and pidotimod was well tolerated.Conclusions: Addition of pidotimod to the standard treatment in children with RRIs significantly reduces the recurrence, duration of repeat infectious episodes, need of antibiotic treatments and future rates of hospitalizations. These findings support previous data.

scholarly journals Effect of Frenotomy on Maternal Breastfeeding Symptoms and the Relationship Between Maternal Symptoms and Problematic Infant Feeding

2022 ◽  
Vol 9 ◽  
pp. 2333794X2110728
Author(s):  
Rebecca R. Hill ◽  
Karen S. Lyons ◽  
Susan Kelly-Weeder ◽  
Britt F. Pados
Keyword(s):  
Infant Feeding ◽  
Feeding Problems ◽  
Feeding Difficulties ◽  
Time Points ◽  
Dental Office ◽  
The Relationship

The relationship between maternal symptoms and problematic infant feeding in the context of tongue-tie is unknown. In a sample of infants with tongue-tie undergoing frenotomy and their mothers, the aims of this study were to: (1) describe changes in maternal symptoms pre- and post-frenotomy, and (2) evaluate the relationships between maternal symptoms and symptoms of problematic feeding pre- and post-frenotomy. Mother-infant dyads were recruited from 1 pediatric dental office between July and November 2020. The sample included 102 mother-infant dyads; 84 completed the follow-up survey. Maternal symptoms of painful and difficult latch, creased/cracked nipples, bleeding, or abraded nipples, chewing of the nipple, and feelings of depression were significantly less common after tongue-tie revision. Poor latch onto the breast was associated with feeding difficulties at both time points. Frenotomy resulted in a decrease of symptoms in breastfeeding mothers. Maternal symptoms and feeding problems persisting post-frenotomy warrant further evaluation.

A pilot study of the “Continuation of Care” model in “revolving-door” patients

2012 ◽  
Vol 27 (4) ◽  
pp. 229-233 ◽  
Author(s):  
A. Juven-Wetzler ◽  
D. Bar-Ziv ◽  
S. Cwikel-Hamzany ◽  
A. Abudy ◽  
N. Peri ◽  
...  
Keyword(s):  
Pilot Study ◽  
Psychiatric Patients ◽  
Revolving Door ◽  
Index Hospitalization ◽  
Outpatient Services ◽  
Care Model ◽  
Traditional System ◽  
The Past ◽  
Before And After

AbstractPurpose:The efficiency of continuation of care (COC) treatment by inpatient caregivers as compared to treatment administered by outpatient services for “revolving door” psychiatric patients was tested in this study. Number and days of hospitalization were examined.Method:All patients who were hospitalized three times or more during the past 12months were offered continuing follow-up in the ward, by the same staff, instead of being referred to the outpatient department. Information on number and length of hospitalizations before and after initiation of this care model was retrieved from the hospital computerized database.Results:Of the 36 patients meeting the criteria, 35 patients agreed to participate. The number of hospitalizations in the 18months following the index hospitalization was 1.79±3.51 as compared to 4.67±1.79 before the index hospitalization (p = 0.0002), and the number of days of hospitalization 18months after was 24±41.65 as compared to 119.71±69.31 before (p<0.0001).Conclusion:COC via inpatient follow-up significantly reduces the number and length of hospitalizations in “revolving door” psychiatric patients as compared to the traditional system of follow-up in an outpatient clinic.

A Single Institutions First 100 Patients Undergoing Laparoscopic Anti-Reflux Fundoplications: Where are They 20 Years Later?

2015 ◽  
Vol 81 (8) ◽  
pp. 791-797 ◽  
Author(s):  
Benjamin D. Sadowitz ◽  
Kenneth Luberice ◽  
Ty A. Bowman ◽  
Alexandra M. Viso ◽  
Daniel E. Ayala ◽  
...  
Keyword(s):  
Laparoscopic Fundoplication ◽  
Symptomatic Relief ◽  
High Patient Satisfaction ◽  
Acid Therapy ◽  
The Past ◽  
Before And After ◽  
Symptom Frequency ◽  
Long Term Follow Up

Although anti-reflux surgery has been used liberally over the past decades for the treatment of gastroesophageal reflux disease (GERD), few studies report follow-up after 10 years. This study was undertaken to report follow-up on 100 consecutive GERD patients up to 22 years after utilizing a laparoscopic fundoplication. Hundred consecutive patients undergoing laparoscopic fundoplication for GERD were prospectively followed beginning in 1992. The frequency and severity of symptoms before and after laparoscopic fundoplication were scored on a Likert scale (1 = never/none to 10 = always/very bothersome). Median data are reported. Of the 100 patients who underwent laparoscopic fundoplication for their GERD, nine were reoperations. Twenty-six patients are deceased on average 11 years after their fundoplications. Seventy-four patients are alive, with 27 patients, actively followed for 19 years after their fundoplications. At most recent follow-up, patients experienced long-term amelioration of symptom frequency and severity after fundoplication (e.g., heartburn frequency = 8–2, severity = 8–1; P < 0.01 for each). Eighty-four per cent of patients rated their symptom frequency as less than once per month. Eighty-eight per cent of patients were satisfied with their postoperative results, and 95 per cent of patients confirmed they would have the operation again knowing what they know now. Long-term follow-up documents high patient satisfaction and durable symptomatic relief up to two decades after laparoscopic fundoplication for GERD. Patients should seek this operation not only for symptomatic relief, but to mitigate the deleterious effects of long-term acid exposure and anti-acid therapy.

The Lived Experience of Cervical Cancer Screening as Perceived by Indigenous Maya Women in Guatemala

2019 ◽  
Vol 23 (4) ◽  
pp. 320-328 ◽  
Author(s):  
Rhonda Lynn Goodman
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Lived Experience ◽  
Cervical Cancer Screening ◽  
Opportunity To Learn ◽  
Medical Doctor ◽  
Culturally Appropriate ◽  
Follow Up Care ◽  
Before And After

Indigenous Maya women in Guatemala have little or no access to cervical cancer screening or follow-up care. Healthcare groups initiated a program to address this situation. This study collected the women's stories before and after screening. Screening was conducted by a licensed Guatemalan medical doctor. The participants had never experienced cervical cancer screening. They were given an opportunity to tell how they felt about the screening. The stories provide an opportunity to learn of the experience of cervical cancer screening as perceived by the indigenous Maya women and could assist to develop culturally appropriate approaches to this population.

Characteristcs associated with complementary and alternative medicine use among racially and ethnically diverse long-term cancer survivors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20532-e20532
Author(s):  
Stephanie Jean Sohl ◽  
Kathryn E. Weaver ◽  
Gurjeet Birdee ◽  
Erin E. Kent ◽  
Suzanne Danhauer ◽  
...  
Keyword(s):  
Alternative Medicine ◽  
Cancer Survivors ◽  
Complementary And Alternative Medicine ◽  
Ethnically Diverse ◽  
Need For Care ◽  
The Past ◽  
Follow Up Care ◽  
Cam Use

e20532 Background: To identify the prevalence and predisposing, enabling and need for care characteristics of long-term adult cancer survivors who use complementary and alternative medicine (CAM) modalities. Methods: We analyzed data from the Follow-up Care Use among Survivors (FOCUS) Survey, a cross-sectional population-based investigation of the follow-up care experiences among racially and ethnically diverse long-term (i.e., five years or more post-diagnosis) cancer survivors recruited from California NCI SEER registries. Ever and last year use of CAM modalities, as well as reasons for use, were assessed. Multivariable logistic regression models were applied to identify if predisposing, enabling and need for care characteristics described in the CAM Healthcare Model were associated with CAM use in the past year. Results: Long-term cancer survivors in the study (N=1,666) were predominately female (62%) and older (mean age=69.5), with breast (24%), prostate 26(%), colorectal (25%), ovarian (13%) and endometrial cancers (12%). Forty-two percent of survivors used CAM in the past year to relieve stress (28%), treat or prevent cancer from coming back (22%), relieve cancer-related symptoms (18%) and help deal with another medical condition (18%). Certain predisposing (i.e., female gender, higher optimism) and need for care factors (i.e., experienced cancer-related symptoms in the past two years, ever had depression/anxiety) were significantly associated with CAM use (p-values<0.05). Insurance coverage, financial resources, and receipt of cancer-related follow-up care were not associated with CAM use. Conclusions: Cancer survivors report a high prevalence of CAM use even years after their initial diagnosis. It is important for healthcare providers to be aware of the higher prevalence of CAM use among subgroups of cancer survivors (i.e., female, high in optimism, have experienced cancer-related symptoms, have a history of anxiety/depression) in order to communicate effectively about these modalities with their patients.

scholarly journals Patients’ perspective on emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christoph Ehlken ◽  
Constantin von Medem ◽  
Maya Lüdemann ◽  
Anna Maria Kirsch ◽  
Johann Baptist Roider
Keyword(s):  
Health Beliefs ◽  
Risk Groups ◽  
Questionnaire Study ◽  
Treatment Center ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Follow Up Care ◽  
Before And After

Abstract Background During the first wave of the COVID-19 pandemic, the need of treatment of urgent ophthalmological diseases and the possible risk of a SARS-CoV-2 infection had to be weighed against each other. In this questionnaire study, we aimed to analyze potential barriers and patients’ health beliefs during and after the lockdown early 2020 in a tertiary referral center in Kiel, Germany. Methods Patients admitted for the treatment of urgent ophthalmic diseases between March 1st, 2020, and June 3rd, 2020, were asked to participate in a questionnaire study. After informed consent was obtained, patients were interviewed using a standardized questionnaire which addressed aspects of their medical history, their health beliefs concerning the COVID-19 pandemic and barriers on their way to the treatment center. The study group was subdivided into two subgroups, depending on the occurrence of their symptoms, before and after the lockdown was ended on April 20th, 2020. Results Ninety-three patients were included, 43 in subgroup A (before April 20th) and 50 in subgroup B (April 20th or later). Retinal disorders were the most common causes for admission (approximately 60%).. Only 8 patients (8.6%) experienced a delay between their decision to visit a doctor until the actual examination. Every fourth patient was afraid of a COVID-19 infection, and expected a higher likelihood for an infection at the hospital. Patients with comorbidities tended to be more likely to be afraid of an infection (correlation coefficient 0.183, p = 0.0785) and were significantly more likely to be concerned about problems with organizing follow-up care (corr. Coefficient 0.222, p = 0.0328). Higher age was negatively correlated with fear of infection (corr. Coefficient − 0.218, p-value 0.034). Conclusion In this questionnaire study, only a minority of patients indicated a delay in treatment, regardless of whether symptoms occurred before or after the lockdown before April 20th, 2020. While patients with comorbidities were more concerned about infection and problems during follow-up care, patients of higher age – who have a higher mortality – were less afraid. Protection of high-risk groups should be prioritized during the SARS-CoV-2 pandemic. Trial registration The study was registered as DRKS00021630 at the DRKS (Deutsches Register Klinischer Studien) before the conduction of the study on May 5th, 2020.

Innominate Artery Compression of the Trachea in Infants with Reflex Apnea

1980 ◽  
Vol 89 (5) ◽  
pp. 401-405 ◽  
Author(s):  
Joseph M. Ardito ◽  
Robert H. Ossoff ◽  
Gabriel F. Tucker ◽  
Serafin Y. deLeon
Keyword(s):  
Innominate Artery ◽  
Vascular Anomaly ◽  
Respiratory Arrest ◽  
Surgical Correction ◽  
Memorial Hospital ◽  
Tracheal Compression ◽  
History Of ◽  
Rule Out

Compression of the trachea by an anomalous innominate artery in association with reflex apnea is a frequent cause of respiratory arrest in infants. Once considered, tracheoscopy is mandatory to rule out this disorder. Surgical correction of this condition by innominate arteriopexy has proven to be a very effective method of management. Seventy-eight patients with tracheal compression by an anomalous innominate artery managed by the authors at The Children's Memorial Hospital in Chicago between January 1977 and December 1979 are presented. In this series, 28 patients had a history of one or more episodes of reflex apnea; all of these patients underwent an innominate arteriopexy. A complete review of this syndrome and methods of its diagnosis are scrutinized. We agree with previous authors that reflex apnea is a definite indication for surgical correction of this vascular anomaly causing tracheal compression, but other indications are delineated.

TECHNOLOGY AND THE "NORMAL" IN THE CORONAVIRUS ERA

2021 ◽  
Keyword(s):  
Social Isolation ◽  
Personal Development ◽  
Professional Life ◽  
Digital Platforms ◽  
Wearable Technologies ◽  
Technological Growth ◽  
Follow Up Care ◽  
Before And After ◽  
The Moment

Pandemic, although devastating in some aspects, is spreading rapidly as is technological growth. In times of social isolation, so much has never been learned through digital platforms, jobs are reinvented at unparalleled speed. Patients are treated in telehealth, a technology that stands out at the moment, a useful tool for initial or follow-up care. Real-time monitoring with GPS, Google platforms, wearable technologies, a range of options still without legislation and correct coverage. Reflecting on your personal and professional life, the Coronavirus, for sure, will divide our existence into before and after, and what was “normal” before, will remain unchanged afterwards? Reflections on technology, management and personal development.

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