scholarly journals The role of rigid bronchoscopy in complex airway disorders

2021 ◽  
Keyword(s):  
Airway Obstruction ◽  
Assisted Ventilation ◽  
Rigid Bronchoscopy ◽  
Morbidity Rate ◽  
Metal Stents ◽  
Close Cooperation ◽  
Endoluminal Stent ◽  
Adequate Oxygenation

Rigid bronchoscopy is a diagnostic and therapeutic tool used to treat complex airways disorders. It plays a central role in the management of central airway obstruction caused by benign or malignant diseases; and requires close cooperation between the bronchoscopist and the anesthesiologist as they share the same operative field. Rigid bronchoscopy requires deep sedation or general anesthesia, intubation with the rigid bronchoscope and adequate oxygenation and ventilation during the procedure. The choice of ventilation techniques include apneic oxygenation, spontaneous assisted ventilation, controlled ventilation and jet ventilation. Rigid bronchoscopy is used to relieve respiratory symptoms due to airway obstruction by dilation for a tracheal stenosis or the mechanical debulking of endoluminal tumours, and supporting the airway by the placement of an endoluminal stent. Two types of stents are currently in use: silicone stents and metal stents with different lengths, diameters and shape configurations. They can significantly improve patients symptoms and their quality of life. Therapeutic rigid bronchoscopy, performed in appropriately selected patients and by skilled operators is effective and has a low morbidity rate.

scholarly journals ROLE OF AMALAKYADI RASAYANA IN LOWERING DOWN THE MORBIDITY RATE IN CHILDREN: A REVIEW

2020 ◽  
Vol 11 (5) ◽  
pp. 121-127
Author(s):  
Ajay Kushwaha ◽  
Nisha Kumari Ojha
Keyword(s):  
Immune System ◽  
Experimental Studies ◽  
Anthelmintic Activity ◽  
The Body ◽  
Morbidity Rate ◽  
Tissue Quality ◽  
Tissue Degeneration ◽  
Age Related

Children are more susceptible to various infections because of underdeveloped immune system as compared to adults. Strengthening the immune system is a natural way to help the body fight against the disease-causing pathogens and immunomodulators can play a major role in this context. Various Ayurveda classics and studies published in journals related to Ayurveda drugs for improving immunity are reviewed and analysed. In Ayurveda, the objective of immune enhancement is achieved through the use of the Amalakyadi Rasayana (an Immunomodulators), as it increases longevity of life, memory, intellect, luxture, complexion, voice, strength of the body functions, strength of all senses and provides the resistance to disease, improves glow and power. Analysis of classical references and various experimental studies show that Amalakyadi Rasayana posse immuno-modulatory, Antioxidant, Anti-inflammatory, Antimicrobial, Anthelmintic activity. Present paper is a review to update knowledge on pharmacological properties, therapeutic actions and possible mode of action of the selected formulation, Amalakyadi rasayana from Yogaratnakara (Rasayanadhikara/17) to enhance the immunity in children. Rasayana is an important part of Ayurvedic therapeutics used to improve the quality of life by strengthening the tissue quality and by reducing the age-related tissue degeneration. This study reveals that Amalakyadi Rasayana have potential to improve or strengthen the immune system in children and thereby can lower down the morbidity rate in children.

The Role of Drug-coated Balloons in Infrapopliteal Intervention

2012 ◽  
Vol 9 (2) ◽  
pp. 112-114
Author(s):  
Gary M Ansel ◽  
Peter A Schneider
Keyword(s):  
Endovascular Therapy ◽  
Metal Stents ◽  
Below The Knee ◽  
Straight Line ◽  
Improved Outcomes ◽  
Line Flow ◽  
Drug Eluting ◽  
One Year

The goal of infrapopliteal endovascular therapy is the re-establishment of straight-line flow to the foot with adequate perfusion of tissue. This treatment should be the first method in properly selected patients to relieve ischemic rest pain, heal ulcers and prevent limb loss, improving quality of life. Percutaneous angioplasty (PTA) continues to be the cornerstone of infrapopliteal therapy. Metal stents are reserved for suboptimal PTA. Although data are accumulating that may eventually guide the use of alternative devices such as lasers, excisional, and rotational atherectomy, drug-eluting stents or drug-coated balloons, we currently lack adequate evidence demonstrating improved outcomes. Endovascular therapy has expanded to include patients with severe co-morbidities such as renal failure and complex occlusive disease. Despite advances in below-the-knee (BTK) angioplasty balloons and a focus on angioplasty technique, current PTA results demonstrate one-year restenosis rates up to 80 %, depending on lesion complexity. Drug-coated balloons have demonstrated superior patency in the superficial femoral artery and it is yet to be determined if this technology can achieve improved patency and the clinical outcomes in the infrapopliteal region.

The Role of Drug-coated Balloons in Infrapopliteal Intervention

2012 ◽  
Vol 7 (1) ◽  
pp. 63 ◽  
Author(s):  
Gary M Ansel ◽  
Peter A Schneider ◽  
◽  
Keyword(s):  
Endovascular Therapy ◽  
Metal Stents ◽  
Below The Knee ◽  
Straight Line ◽  
Improved Outcomes ◽  
Line Flow ◽  
Drug Eluting ◽  
One Year

The goal of infrapopliteal endovascular therapy is the re-establishment of straight-line flow to the foot with adequate perfusion of tissue. This treatment should be the first method in properly selected patients to relieve ischaemic rest pain, heal ulcers and prevent limb loss, improving quality of life. Percutaneous angioplasty (PTA) continues to be the cornerstone of infrapopliteal therapy. Metal stents are reserved for suboptimal PTA. Although data are accumulating that may eventually guide the use of alternative devices such as lasers, excisional and rotational atherectomy, drug-eluting stents or drug-coated balloons, we currently lack adequate evidence demonstrating improved outcomes. Endovascular therapy has expanded to include patients with severe co-morbidities such as renal failure and complex occlusive disease. Despite advances in below-the-knee (BTK) angioplasty balloons and a focus on angioplasty technique, current PTA results demonstrate one-year restenosis rates up to 80 %, depending on lesion complexity. Drug-coated balloons have demonstrated superior patency in the superficial femoral artery and it is yet to be determined if this technology can achieve improved patency and the clinical outcomes in the infrapopliteal region.

scholarly journals A first-aid fast track channel for rescuing critically ill children with airway foreign bodies: our clinical experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yong-chao Chen ◽  
Zhi-xiong Xian ◽  
Sai-hong Han ◽  
Lan Li ◽  
Yi-shu Teng
Keyword(s):  
Medical Records ◽  
Fast Track ◽  
Foreign Bodies ◽  
First Aid ◽  
Rigid Bronchoscopy ◽  
Common Type ◽  
Critically Ill Children ◽  
Laryngeal Oedema

Abstract Objective To explore the role of a first-aid fast track channel in rescuing children with airway foreign bodies and to analyse and summarize the experience and lessons of the first-aid fast track channel in rescuing airway foreign bodies from patients in critical condition. Methods We retrospectively reviewed the medical records of children with airway foreign bodies rescued by first-aid fast track channels admitted to our hospital from January 2017 to December 2020. The corresponding clinical features, treatments, and prognoses were summarized. Results Clinical data from 21 cases of first-aid fast track channel patients were retrospectively collected, including 12 males and 9 females aged 9–18 months. Cough was the most frequently exhibited symptom (100.0%), followed by III inspiratory dyspnoea (71.4%). Regarding the location of foreign bodies, 5 cases (23.8%) had glottic foreign bodies, 10 cases (47.6%) had tracheal foreign bodies, and 6 cases (28.6%) had bilateral bronchial foreign bodies. The most common type of FB was organic. FB removal was performed by rigid bronchoscopy in every case, and there were no complications of laryngeal oedema, subcutaneous emphysema, or pneumothorax. No tracheotomy was performed in any of the children. Conclusion The first-aid fast track channel for airway foreign bodies saves a valuable time for rescue, highlights the purpose of rescue, improves the success rate of rescue and the quality of life of children, and is of great value for the treatment of critical tracheal foreign bodies. It is necessary to regularly summarize the experience of the first-aid fast track channel of airway foreign bodies and further optimize the setting of the first-aid fast track channel.

Cognitive Health Counseling 40+

2013 ◽  
Vol 21 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Anne Eschen ◽  
Franzisca Zehnder ◽  
Mike Martin
Keyword(s):  
Outcome Variable ◽  
Pilot Phase ◽  
Subjective Memory ◽  
Cognitive Health ◽  
Health Counseling ◽  
Agents Of Change ◽  
Main Outcome Variable ◽  
Further Development

This article introduces Cognitive Health Counseling 40+ (CH.CO40+), an individualized intervention that is conceptually based on the orchestration model of quality-of-life management ( Martin & Kliegel, 2010 ) and aims at improving satisfaction with cognitive health in adults aged 40 years and older. We describe the theoretically deduced characteristics of CH.CO40+, its target group, its multifactorial nature, its individualization, the application of subjective and objective measures, the role of participants as agents of change, and the rationale for choosing participants’ satisfaction with their cognitive health as main outcome variable. A pilot phase with 15 middle-aged and six older adults suggests that CH.CO40+ attracts, and may be particularly suitable for, subjective memory complainers. Implications of the pilot data for the further development of the intervention are discussed.

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