1.Clinicodemographic profile and treatment outcomes of patients with upper aerodigestive tract foreign bodies in the Southern Philippines Medical Center: A five-year retrospective review
John Michael P. Tagsa ; Donnie Jan D. Segocio
Philippine Journal of Otolaryngology Head and Neck Surgery 2024;39(1):26-30
Objective:
This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes.
Methods:
Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies
Results:
Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (<19 years) and 93 (31%) the adult population. The most common foreign bodies reported were coins (63.5%), food (18.1%), and dentures (11.5%). Most esophageal foreign bodies (244/291; 83%) were seen at the cricopharyngeal level in all age groups. The foreign body was removed successfully in 288/291 (98%) of ingestion cases. All 13 cases of foreign body aspiration were successfully removed by bronchoscopy. All patients were discharged improved.
Conclusion
Most upper aerodigestive tract foreign bodies involved the pediatric age group.
Predisposing conditions were mainly due to accidental ingestion and aspiration while playing in the pediatric population and negligence in eating among adults. Almost all ingestion cases were successfully treated with esophagoscopy, while all aspirations were treated successfully with bronchoscopy. Most intraoperative and postoperative complications who were managed conservatively by observation, although some cases required referral to other surgical departments and were treated surgically. All patients were discharged improved.
Foreign Bodies
;
Eating
;
Esophagoscopy
;
Bronchoscopy
3.Bronchoscopic transparenchymal nodule access in the diagnosis and management of pulmonary nodules.
Quncheng ZHANG ; Xuan WU ; Huizhen YANG ; Ya SUN ; Ziqi WANG ; Li YANG ; Nan WEI ; Yihua ZHANG ; Yuanjian YANG ; Xingru ZHAO ; Felix Jf HERTH ; Xiaoju ZHANG
Chinese Medical Journal 2023;136(13):1615-1617
4.Ergonomic issues during bronchoscopy: A local case study and review of literature
Joel M. Santiaguel, MD ; Mithi Kalayaan S. Zamora, MD
Acta Medica Philippina 2023;57(8):85-98
Objective:
This single-subject case study was done to evaluate the presence and evaluate the risk factors for the development of Work-Related Musculoskeletal Disorders (WMSDs) among the staff performing bronchoscopy in the bronchoscopy suite.
Methods:
A single-subject case study to describe the ergonomic issues in bronchoscopy including identifying multiple factors that can potentially, either singly or in combination, affect physical work capacity. The study focused on the evaluation and control of occupational factors during bronchoscopy to improve awareness of ergonomic issues in bronchoscopy using the following data collection tools: 1) hierarchical task analysis, 2) activity sampling, 3) direct observation of the procedure (walk-around), 5) structured interview of the subject, and 5) utilization of checklists.
Results:
During the process of bronchoscopy, identified factors that can cause pain in the wrists, fingers, and shoulders include repetitive movement and awkward positions of the hands and wrists coming from the need to move the directional controls and position the bronchoscope. For the back, prolonged standing with awkward postures is a concern. For the neck, the need to look at the monitor which is situated at the side of the patient and frequent shifting of the eyes and head from the monitor to the patient can cause neck pain and stiffness. Aside from the above, other factors would include job stress from the workload, inadequate time for rest and recovery, and the possibility of an uncomfortable environment due to poor air quality. Chronic exposure and repeated injury followed by inflammation and repair lead to structural and biochemical changes in the tissues affected by Cumulative Trauma Disorders (CTDs) leading to the development of WMSDs.
Conclusion
Although CTDs do not account for work-related deaths, they do account for a significant amount of
human suffering, loss of productivity, and economic burden on the compensation system. Thus, ergonomic concerns must be addressed early to prevent WMSDs/CTDs.
Bronchoscopy
;
occupational health
5.Diagnosis and treatment of disorders of laryngeal airway in children and prospect.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):939-942
This paper focuses on the diagnosis and treatment of disorders of laryngeal airway in children, including congenital anomalies, infection, and tumor of the larynx to provide a new technology for managing these diseases. Based on the characteristic of them, the pediatric upper airway is dedicated to the clinical evaluation of airway obstruction and the assessment of the compromised pediatric airway, including clinical evaluation of symptoms, diagnostic endoscopy, and imaging examination. Information on endoscopic techniques used for dealing with different degrees of pediatric airway comprised is provided, also this techniques could diagnose what kinds of airway disorder. For example, determining the a particular laryngeal cleft at the initial otolaryngology encounter, flexible laryngoscopy should be performed. In order to define the extent of any identified cleft, the rigid bronchoscopy should be completed to evaluate for classification of laryngeal cleft including typeⅠ, Ⅱ, Ⅲa, Ⅲb, Ⅳa, Ⅳb under general anesthesia. The decision to pursue any therapy for the disorders of laryngeal airway in children should be based on the severity of the patient's symptoms, endoscopic and imaging examination. There are two medical treatments including nonsurgical therapy and surgical therapy. For example the laryngeal cleft, approximately half of type 1 and select type 2 patients can be managed entirely with nonsurgical therapy. Medical management is multifaceted. Under recommendations from the feeding team, a modified diet with thickened feeds and possibly altered feeding position should be initiated. Endoscopic surgical repair is the current gold standard for definitive repair of type 1, the majority of type 2, and selected type 3 clefts. Finally, information on new techniques used into the future for dealing with the diagnosis and treatment of disorders of laryngeal airway in children in this paper.
Child
;
Humans
;
Infant
;
Larynx/surgery*
;
Laryngoscopy
;
Endoscopy
;
Bronchoscopy
;
Congenital Abnormalities/surgery*
7.Application of metagenomic next-generation sequencing of bronchoalveolar lavage fluid in the diagnosis and treatment of refractory pneumonia in children.
Rong-Guang FENG ; Li-Yan ZHOU ; Rui DOU ; Xue-Yuan ZHOU ; Li-Rong WANG ; Li-Hong HAN ; Yu-Min WANG
Chinese Journal of Contemporary Pediatrics 2023;25(12):1253-1258
OBJECTIVES:
To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children.
METHODS:
A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment.
RESULTS:
Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment.
CONCLUSIONS
Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.
Humans
;
Child
;
Bronchoalveolar Lavage Fluid
;
Retrospective Studies
;
Pneumonia/therapy*
;
High-Throughput Nucleotide Sequencing
;
Bronchoscopy
;
Sensitivity and Specificity
8.Comparison of Quality of Life of the Patients Three Months after Uniportal and Multiportal Thoracoscopic Lobectomy.
Qi ZHANG ; Wei DAI ; Xing WEI ; Run XIANG ; Hang GU ; Peihong HU ; Mingxin LIU ; Wei CHEN ; Huaijun GONG ; Yong LIANG ; Shichao ZHANG ; Weixing PENG ; Qiuling SHI ; Qiang LI ; Nanbin YU
Chinese Journal of Lung Cancer 2023;26(11):843-850
BACKGROUND:
The relationship between quality of life at three months after lung cancer surgery and different surgical approaches is remains unclear. This study aimed to compare the quality of life of patients three months after uniportal and multiportal thoracoscopic lobectomy.
METHODS:
Data from patients who underwent lung surgery at the Department of Thoracic Surgery, Sichuan Cancer Hospital between April 2021 and October 2021 were collected. The European Organization for Research and Treatment of Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and Quality of Life Questionnaire-Lung Cancer 29 (EORTC QLQ-LC29) were used to collect quality of life data of the patients. Potential confounding factors in the baseline data were included in a multivariate regression model for adjustment, and the quality of life of the two groups three months postoperatively was compared with traditional clinical outcomes.
RESULTS:
A total of 130 lung cancer patients were included, with 57 males (43.8%) and 73 females (56.2%), and an average age of (57.1±9.5) yr. In the baseline data of the two groups, there was a statistical difference in the number of chest drainage tubes placed (P<0.001). After adjustment with the regression model, at three months postoperatively, there were no significant differences in all symptoms and functional status scores between the two groups (all P>0.05). The multiportal group had longer surgery time (120.0 min vs 85.0 min, P=0.001), postoperative hospital stay (6.0 d vs 4.0 d, P=0.020), and a higher incidence of early ≥ grade 2 complications (39.0% vs 10.1%, P=0.011) compared to the uniportal group.
CONCLUSIONS
Patients undergoing uniportal and multiportal thoracoscopic lobectomy have similar quality of life at three months postoperatively. The uniportal group may have certain advantages in terms of traditional clinical outcome indicators such as operation time, postoperative hospital stay, and early postoperative complications.
Male
;
Female
;
Humans
;
Lung Neoplasms/surgery*
;
Quality of Life
;
Thoracic Surgery, Video-Assisted/adverse effects*
;
Pneumonectomy/adverse effects*
;
Postoperative Complications/surgery*
;
Retrospective Studies


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