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Journal of Pediatric Nursing 2023The aim of this study was to evaluate the risks of self-feeding, transition to early solid food and family meals, choking risk, anemia risk and obesity risk in... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The aim of this study was to evaluate the risks of self-feeding, transition to early solid food and family meals, choking risk, anemia risk and obesity risk in 6-12-month-old infants who were introduced to complementary feeding using the traditional complementary feeding (TCF) and baby-led weaning (BLW) methods/training.
DESIGN AND METHODS
Mothers of infants who had not yet transitioned to complementary feeding were included in this randomized study. The mothers of 62 infants included in the study were randomized into the intervention groups as TCF and BLW, classified according to the number of children and education level. The research was carried out according to the CONSORT-2010 guidelines after randomization and was concluded with 52 infants and their mothers.
RESULTS
It was found in the study that self-feeding and transition to solid foods in infants fed with the BLW method was higher than the infants fed with the TCF method (p < 0.05). A significant increase was observed in the hemoglobin level of infants fed with the BLW method over time (p < 0.001).
CONCLUSIONS
It was concluded that the BLW method did not lead to risks of obesity, anemia and iron deficiency in transition to complementary feeding. Secondary results indicated that feeding with the BLW method promoted self-feeding and early transition to solid foods and did not lead to the risk of choking.
PRACTICE IMPLICATIONS
Complementary feeding with the BLW method can be safely used by both mothers, healthcare professionals and researchers.
TRIAL REGISTRATION
register.
CLINICALTRIALS
gov; Identifier: NCT05771324.
Topics: Infant; Female; Child; Humans; Weaning; Feeding Behavior; Infant Food; Infant Nutritional Physiological Phenomena; Obesity; Airway Obstruction; Anemia; Breast Feeding
PubMed: 37714048
DOI: 10.1016/j.pedn.2023.09.006 -
Facial Plastic Surgery : FPS Jun 2024
Topics: Humans; Nasal Obstruction
PubMed: 38301717
DOI: 10.1055/s-0044-1779482 -
Facial Plastic Surgery : FPS Dec 2023
Topics: Humans; Rhinoplasty; Esthetics, Dental; Nasal Obstruction; Treatment Outcome
PubMed: 37500077
DOI: 10.1055/s-0043-1771290 -
Mediastinum (Hong Kong, China) 2023Malignant central airway obstruction (MCAO) impacts many patients with advanced primary lung cancers and metastatic disease to the thorax and may cause substantial... (Review)
Review
Malignant central airway obstruction (MCAO) impacts many patients with advanced primary lung cancers and metastatic disease to the thorax and may cause substantial symptoms and functional limitations in those affected. Making the diagnosis may be challenging as symptoms are often non-specific but identification is improved with a heightened level of suspicion and newer thoracic imaging modalities. Bronchoscopy plays a crucial role in the diagnosis and management of MCAO and therapeutic interventions may be lifesaving and result in palliation of symptoms. This may ultimately improve a patient's candidacy to receive additional systemic or local cancer therapies or potential tumor resection. After initial stabilization, it is important that patients with MCAO undergo prompt evaluation and treatment. Multiple bronchoscopic instruments are available for management depending on tumor characteristics, location of the obstruction, and viability of distal airways, and may be utilized in combination during therapeutic procedures. These modalities include dilation, endobronchial stent placement, thermal and non-thermal ablation, mechanical debulking, and novel endobronchial therapies. While these procedures are not without risk, there is ample evidence showing improvements in patient symptoms, quality of life, and survival following therapeutic bronchoscopy. This review article provides a general overview of the diagnosis and management of MCAO with a focus on bronchoscopic interventions.
PubMed: 38090036
DOI: 10.21037/med-22-44 -
Oral and Maxillofacial Surgery Clinics... Feb 2024Vascular anomalies of the head and neck frequently involve the upper aerodigestive tract and can cause some level of airway obstruction. It is important to fully... (Review)
Review
Vascular anomalies of the head and neck frequently involve the upper aerodigestive tract and can cause some level of airway obstruction. It is important to fully evaluate the extent of a lesion and resultant functional impairment with a flexible fiberoptic laryngoscopy. Treating these lesions is difficult and considering how to manage the airway during a procedure is critical. A multidisciplinary approach should be used for airway management with alternative intubation plans established prior to induction of anesthesia. Edema and hemorrhage are expected complications from the treatment of vascular anomalies and should be considered when planning for extubation at the end of a procedure.
Topics: Humans; Airway Management; Anesthesia, Dental; Anesthesiology; Neck
PubMed: 37981345
DOI: 10.1016/j.coms.2023.09.002 -
The Veterinary Clinics of North... Jul 2024This article discusses the laser-assisted turbinectomy (LATE) procedure and indications for its performance in dogs suffering from brachycephalic obstructive airway... (Review)
Review
This article discusses the laser-assisted turbinectomy (LATE) procedure and indications for its performance in dogs suffering from brachycephalic obstructive airway syndrome (BOAS). The article summarizes landmark works that reported, for the first time, endoscopic-assisted identification and treatment of structures within the brachycephalic nose that contribute to intranasal obstruction and resistance to breathing, specifically hypertrophic and aberrant nasal turbinates. Brachycephaly is discussed in the context of how these aberrations form and how definitive treatments such as LATE and adjunctive treatments such as ala vestibuloplasty, folded flap palatoplasty, and others may ameliorate the negative effects and improve patient outcomes associated with aberrant intranasal conchal configurations.
Topics: Animals; Dogs; Turbinates; Dog Diseases; Laser Therapy; Nasal Obstruction
PubMed: 38521665
DOI: 10.1016/j.cvsm.2024.02.002 -
Current Opinion in Pulmonary Medicine Jan 2024In this review, we highlight the important anesthetic consideration that relate to interventional bronchoscopic procedures for the management of central airway... (Review)
Review
PURPOSE OF REVIEW
In this review, we highlight the important anesthetic consideration that relate to interventional bronchoscopic procedures for the management of central airway obstruction due to anterior mediastinal masses, endoluminal endobronchial obstruction, peripheral bronchoscopy for diagnosis and treatment of lung nodules, bronchoscopic lung volume reduction and medical pleuroscopy for diagnosis and management of pleural diseases.
RECENT FINDINGS
The advent of the field of Interventional Pulmonology has allowed for minimally invasive options for patients with a wide range of lung diseases which at times have replaced more invasive surgical procedures. Ongoing research has shed light on advancement in anesthetic techniques and management strategies that have increased the safety during peri-operative management during these complex procedures. Current evidence focusing on the anesthetic techniques is presented here.
SUMMARY
The field of Interventional Pulmonology requires a tailored anesthetic approach. Recent advancements and ongoing research have focused on expanding the partnership between the anesthesiologist and interventional pulmonologists which has led to improved outcomes for patients undergoing these procedures.
Topics: Humans; Pulmonary Medicine; Lung Diseases; Bronchoscopy; Pleural Diseases; Airway Obstruction; Anesthetics; Lung Neoplasms
PubMed: 37930637
DOI: 10.1097/MCP.0000000000001033 -
Internal Medicine Journal Feb 2024The first dedicated tracheobronchial silicone stent was designed by the French pulmonologist Jean-Paul Dumon. The most common indications for stenting are to minimise... (Review)
Review
The first dedicated tracheobronchial silicone stent was designed by the French pulmonologist Jean-Paul Dumon. The most common indications for stenting are to minimise extrinsic airway compression from mass effect, maintain airway patency due to intrinsic obstruction or treat significant nonmalignant airway narrowing or fistulae. Silicone stents require rigid bronchoscopy for insertion; however, they are more readily repositioned and removed compared with metallic stents. Metallic stents demonstrate luminal narrowing when loads are applied to their ends, therefore stents should either be reinforced at the ends or exceed the area of stenosis by a minimum of 5 mm. Nitinol, a nickel-titanium metal alloy, is currently the preferred material used for airway stents. Airway stenting provides effective palliation for patients with severe symptomatic obstruction. Drug-eluting and three-dimensional printing of airway stents present promising solutions to the challenges of the physical and anatomical constraints of the tracheobronchial tree. Biodegradable stents could also be a solution for the treatment of nonmalignant airway obstruction.
Topics: Humans; Bronchoscopy; Airway Obstruction; Silicones; Metals; Stents; Treatment Outcome; Nickel; Titanium
PubMed: 38140778
DOI: 10.1111/imj.16304 -
Current Opinion in Otolaryngology &... Dec 2023Pediatric decannulation failure can be associated with large morbidity and mortality, yet there are no published evidence-based guidelines for pediatric tracheostomy... (Review)
Review
PURPOSE OF REVIEW
Pediatric decannulation failure can be associated with large morbidity and mortality, yet there are no published evidence-based guidelines for pediatric tracheostomy decannulation. Tracheostomy is frequently performed in medically complex children in whom it can be difficult to predict when and how to safely decannulate.
RECENT FINDINGS
Published studies regarding pediatric decannulation are limited to reviews and case series from single institutions, with varying populations, indications for tracheostomy, and institutional resources. This article will provide a review of published decannulation protocols over the past 10 years. Endoscopic airway evaluation is required to assess the patency of the airway and address any airway obstruction prior to decannulation. There is considerable variability in tracheostomy tube modification between published protocols, though the majority support a capping trial and downsizing of the tracheostomy tube to facilitate capping. Most protocols include overnight capping in a monitored setting prior to decannulation with observation ranging from 24 to 48 h after decannulation. There is debate regarding which patients should have capped polysomnography (PSG) prior to decannulation, as this exam is resource-intensive and may not be widely available. Persistent tracheocutaneous fistulae are common following decannulation. Excision of the fistula tract with healing by secondary intention has a lower reported operative time, overall complication rate, and postoperative length of stay.
SUMMARY
Pediatric decannulation should occur in a stepwise process. The ideal decannulation protocol should be safe and expedient, without utilizing excessive healthcare resources. There may be variability in protocols based on patient population or institutional resources, but an explicitly described protocol within each institution is critical to consistent care and quality improvement over time. Further research is needed to identify selection criteria for who would most benefit from PSG prior to decannulation to guide allocation of this limited resource.
Topics: Child; Humans; Tracheostomy; Device Removal; Endoscopy; Polysomnography; Airway Obstruction
PubMed: 37751378
DOI: 10.1097/MOO.0000000000000929 -
BMJ (Clinical Research Ed.) Oct 2023
Topics: Humans; Nasal Obstruction; Rhinoplasty; Nose; Treatment Outcome; Nasal Septum
PubMed: 37852637
DOI: 10.1136/bmj.p2341