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End-to-end anastomosis in the management of laryngotracheal defects.

OBJECTIVE: To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection. METHODS: A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis. RESULTS: Length of stenosis was 1.7-4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures

[Xanthoma disseminatum: a rare case involving the upper extremity].

We describe a dramatic case of class II non-Langerhans cell histiocytosis, xanthoma disseminatum, in a 30-year-old male patient with progressive involvement of the skin, vocal cords, eyes, bones and nerves in spite of chemotherapy with Vespesid and immunotherapy with interferon-gamma. At the age of 43 years, the patient required surgical clearance of airways, eyelids and peripheral nerves, but at present exhibits stable disease on a combination of lipid-lowering drugs including thiazolidinedione.

Prognostic Value of Systemic Inflammation, Nutritional Status and Sarcopenia in Patients With Amyotrophic Lateral Sclerosis.

BACKGROUND: Nutritional status, systemic inflammatory responses and muscle mass are associated with the prognosis of patients with amyotroph … mean age of 54.2 ± 10.5 years. Among these ALS patients, 334 cases (68.0%) either died or underwent tracheotomy. In univariate Cox proportional hazards regression, 11 indicators were significantly associated with ALS survival (p < 0.05). And systemic immune inflammation (SII), platelet-to-lymphocyte ratio (PLR), modified geriatric nutritional risk index (mGNR …

Early Diagnosis and Treatment of Nine Patients with Severe Multiple Injuries Accompanied by Traumatic Aortic Dissection during Emergency Treatment.

OBJECTIVE: This study is aimed at investigating the early diagnosis and efficacy of emergency treatments of nine patients with severe multip … racic closed drainage (n = 5), haemothoracotomy (n = 3), second-stage fracture surgery (n = 4), and tracheotomy (n = 1). Postinjury complications included haemorrhagic shock, coagulation disorders, hyoxaemia, pulmonary infection, renal insufficiency, and hypoproteinaemia; however, all patients recovered after intensive care treatment. Aortic CTA after EVGE re …

Combined chemotherapy with sequential allogeneic hematopoietic stem cell transplantation successfully treats primary plasma cell leukemia: a case report.

Primary plasma cell leukemia (pPCL) is an extremely aggressive and rare subtype of plasma cell neoplasm with extremely poor prognosis, and optimal treatment strategies remain controversial due to its low incidence. This case is unique in that it reports long-term disease-free survival after combination chemotherapy followed by allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT), which provides valuable real-world evidence supporting the potential curative role of this sequential therapeutic approach for pPCL, a disease where long-term survival is rarely achieved wi

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… Admission physical examination: the general condition was extremely poor, in a critical state, with mild anemia; tracheotomy and a tracheotrocar were seen in the neck. … The patient was diagnosed as pPCL with extramedullary infiltration, and had undergone tracheotomy and placement of a tracheotrocar. Bortezomib-based chemotherapy followed by transplantation was recommended, but the patient refused the regimen for economic reasons. …

Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial.

IMPORTANCE: Acetazolamide has been used for decades as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD … primary outcome was the duration of invasive mechanical ventilation via endotracheal intubation or tracheotomy. Secondary outcomes included changes in arterial blood gas and respiratory parameters, weaning duration, adverse events, use of noninvasive ventilation after extubation, successful weaning, the duration of ICU stay, and in-ICU mortality. RESULTS: A …

[Clinical amalysis of left subclavian artery revascularization by stented trunk fenestration for acute Stanford type A aortic dissection].

OBJECTIVE: To summarize the results and methods of left subclavian artery revascularization by stented trunk fenestration for acute Stanford … n for root bleeding. Transient neurology dysfunction developed in 6 patients. Six patients received tracheotomy and prolonged ventilation due to pulmonary infection. All patients discharged from the hospital were followed up for 1 to 5 years. During long-term follow-up, the survival rate was 100% and 89.8% at 1 and 5 years, respectively. CT angiography was pe …

Value of open horizontal glottectomy in the treatment for T1b glottic cancer with anterior commissure involvement.

BACKGROUND: The aim of the study was to evaluate the treatment outcomes in the group of 108 T1b glottic cancer patients with the anterior commissure involvement treated with open horizontal glottectomy and to compare them with transoral laser microsurgery (TLM) or primary radiotherapy (XRT) results from the literature review. METHODS: Status of surgical margins, local and nodal recurrence, organ preservation and survival rates, functional outcomes were major end points of interest. RESULTS: Recurrence rate was 16.7% and was correlated with histologically confirmed prelaryngeal node metastase

Laryngotracheal reconstruction with autogenous rib cartilage graft for complex laryngotracheal stenosis and/or anterior neck defect.

To study the effectiveness of laryngotracheal reconstruction with rib cartilage graft for complex laryngotracheal stenosis and/or anterior neck defect, 62 patients with complex laryngotracheal stenosis and/or anterior neck defect underwent laryngotracheal reconstruction with autogenous rib cartilage graft. The surgical procedures were laryngotracheotomy with rib cartilage graft interposition and silicon-tube stent placed in the region of laryngotracheal stenosis and/or anterior neck defect for the period of between 10 days and 12 months. Three patients with complex subglottic stenosis and ante…

Laryngotracheal stenosis and restenosis. What has the influence on the final outcome?

The aim of this study is to analyze the impact of various parameters on the course and treatment outcome in patients with laryngotracheal stenosis and recurrent stenosis. Two groups of patients were compared: Group I included 29 patients with primary stenosis, and Group II included 22 patients with recurrent stenosis. The most frequent etiological factor for the development of stenosis was prolonged endotracheal intubation (79.3:77.3%), with subglottic-tracheal (44.8:45.5%) and tracheal (48.3:36.4%) localization being the most affected. Subglottic-tracheal stenosis was more common in men. Ther

History of Mechanical Ventilation. From Vesalius to Ventilator-induced Lung Injury.

Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. This article is a short history of mechanical ventilation, tracing its origins over the centuries to the present day. One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator

Elevated serum autoantibody against high mobility group box 1 as a potent surrogate biomarker for amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a complicate and progressive onset devastating neurodegenerative disease. Its pathogenic mechanisms remain unclear and there is no specific test for diagnosis. For years, researchers have been vigorously searching for biomarkers associated with ALS to assist clinical diagnosis and monitor disease progression. Some specific inflammatory processes in the central nervous system have been reported to participate in the pathogenesis of ALS. As high mobility group box 1 (HMGB1) is elevated in spinal cord tissues of patients with ALS, we hypothesized, therefore,

[Airway involvement in relapsing polychondritis].

Relapsing Polychondritis (RP) is an uncommon, chronic, and potentially life-threatening multisystem disorder characterized by recurrent inflammatory episodes affecting the cartilaginous tissues of the external ears, nose, peripheral joints, larynx and tracheobronchial tree, sometimes leading to their destruction. RP can also inflame other proteoglycan-rich structures, such as the eye, heart, blood vessels and inner ears. Systemic symptoms are common, and vasculitis affecting skin or internal organs may occur. The etiology of RP is still unknown, but the pathogenetic role of the autoimmunity is

Staged bilateral stereotactic pallidothalamotomy for life-threatening dystonia in a child with Hallervorden-Spatz disease.

Hallervorden-Spatz disease (HSD) is a rare disorder characterized by progressive motor dysfunction and dementia. Dystonia is the most prominent and disabling symptom, responding only to a modest extent to pharmacological therapy. At the moment, only a few cases have been reported to improve dystonia and even fewer to resolve status dystonicus for a longer period in children. The authors present the case of a 10-year-old boy who had progressive generalized dystonia, resulting in spontaneous femur fracture and life-threatening swallowing and respiratory disability. As a rescue solution, staged b

The influence of long-term treatment with povidone-iodine on thyroid function.

Povidone-iodine (PVP-I) is generally very safe, but cases of thyroid dysfunction induced by PVP-I have been reported. The effect of long-term treatment with PVP-I on thyroid function was to be assessed. In 40 inpatients of the department of neurology, the status of the use of PVP-I preparations and their effects on serum inorganic iodine levels and thyroid functions were investigated. In 27 patients treated with PVP-I for a long term, inorganic iodine levels were significantly increased as compared to those in 13 patients without PVP-I treatment. Out of 27 patients treated with PVP-I in the lo