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At least 181 records · Page 10Linked to original sources
PubMed1995

Transbronchial needle aspiration and percutaneous needle aspiration for staging and diagnosis of lung cancer.

In summary, knowledge of the exact location of lymph nodes in mediastinum and hilar areas and their relationship to the puncture site of TBNA is the first step to a successful TBNA. The necessity to determine the N3 status and multistation status of patients with bronchogenic carcinoma being evaluated for surgery and the current financial restraint of the medical care system further highlight the potential of this simple, effective, and safe procedure. TBNA can markedly enhance the diagnostic yield of flexible bronchoscopy. TBNA and PCNA are complimentary procedures.

Biopsy, Needle↗
PubMed1998

[The consultation with the candidate couple for intracytoplasmic sperm injection (ICSI) using microsurgical epididymal sperm aspiration (MESA) or testicular sperm aspiration (TESA). The experience of the MATRIS (Medici Associati per la Terapia e la Ricerca dell'Infertilità e Sterilità) center of Milan].

The authors examine the relationship between doctor and patient during the consultation for the therapeutic decision for those couples who have to undergo a medical procreation, especially the ICSI by MESA and TESA. The couple's psycho-emotional involvement and the medical terminology hinder the real possibility of communication between doctor and patient. The data relating to a study of 80 couples done by the authors are presented. They show the need to improve the quality of communication between doctor and patient during the consultation. For this purpose, on the basis of the research conducted, modification of the language used and the support of audio-visual media are suggested during the consultation in order to reduce the percentage of the couple's doubts and uncertainties.

Adult↗
PubMed2006

A review of patients with pulmonary aspiration of gastric contents during anesthesia reported to the Departmental Quality Assurance Committee.

STUDY OBJECTIVE: Preoperative risk factors for pulmonary aspiration of gastric contents during anesthesia are well studied. There is lack of information as to factors or circumstances leading to aspiration. DESIGN: A retrospective review of cases of pulmonary aspiration reported to the Departmental Quality Assurance (QA) Committee was undertaken. SETTING: This study took place at a large tertiary care university hospital based in a metropolitan city. PATIENTS: The study identified all patients reported to the QA Committee as having pulmonary aspiration during January 1991 to December 1994 and July 1996 to December 2000. INTERVENTIONS: No interventions were done. MEASUREMENTS: The medical records of all patients thus identified were reviewed to see if they had pulmonary aspiration according to strict criteria. Presence of preoperative known risk factors, prophylactic measures used against pulmonary aspiration, and perioperative events were noted. MAIN RESULTS: A total of 47 patients were reported to the QA Committee as having pulmonary aspiration during this period. Upon review, 23 patients had pulmonary aspiration (definite aspiration, n = 12; probable aspiration, n = 11) and 24 patients did not meet the criteria for pulmonary aspiration of gastric contents. The incidence of pulmonary aspiration overall was 1 per 8671 anesthetics and 1 per 4385 anesthetics in patients younger than 16 years. If all 47 cases reported to QA Committee are presumed to have had pulmonary aspiration, then the overall incidence of aspiration is 1 in 4243 anesthetics. Eighteen of 23 patients had a preoperative risk factor, but preventive measures against aspiration had been used in only 4 patients. Five patients did not have any apparent preoperative risk factor. CONCLUSIONS: This study confirms that pulmonary aspiration of gastric contents is a rare complication during modern anesthesia. Preoperative risk factor was present in most patients who had pulmonary aspiration. A clear understanding of risk factor/s is needed to prevent further cases of pulmonary aspiration.

Adolescent↗
PubMed2006

The ability of paramedics to predict aspiration in patients undergoing prehospital rapid sequence intubation.

One of the purported benefits to invasive prehospital airway management is the prevention of aspiration; however, aspiration events may occur before the arrival of prehospital personnel. We explore the timing of aspiration in patients with severe traumatic brain injury (TBI) undergoing paramedic rapid sequence intubation (RSI). Severely head-injured (Glasgow Coma Scale [GCS] score 3-8) adults were prospectively enrolled into the San Diego Paramedic RSI Trial. As part of the prehospital data collection tool, paramedics prospectively assessed for clinical evidence of aspiration before RSI (pre-intubation), aspiration events occurring during RSI (peri-RSI), and regurgitation of vomitus or blood after intubation (post-intubation). Data were abstracted from work sheets used during the RSI procedure, a telephone debriefing by one of the principal investigators immediately after delivery of the patient, and San Diego County prehospital and trauma databases. The incidence of pre-intubation aspiration, peri-RSI aspiration, and post-intubation regurgitation of vomitus or blood were determined. Patients with and without pre-intubation aspiration were compared with regard to pre- and post-intubation hypoxia and the rate of aspiration pneumonia. Logistic regression was used to explore the association between pre-intubation aspiration and various demographic and clinical factors. The results showed that pre-intubation aspiration was noted by paramedics in 72/269 patients in whom complete data were available. Peri-RSI aspiration was reported in one patient; there were no reported cases of post-intubation regurgitation of vomitus or blood. Patients in the pre-intubation aspiration group required more intubation attempts, had a higher incidence of desaturations and lower pre- and post-intubation SaO(2) values, and were more frequently diagnosed with aspiration pneumonia. Pre-intubation aspiration was associated with severe TBI, GCS score of 3, younger age, and the absence of alcohol intoxication despite controlling for age, gender, GCS, Head AIS (Abbreviated Injury Score), and serum ethanol. It is concluded that paramedics seem to be able to accurately assess for aspiration in patients undergoing prehospital RSI. The vast majority of aspiration events seem to occur before the arrival of prehospital personnel. Alteration in consciousness from TBI may carry a higher risk of aspiration than with other causes, such as alcohol intoxication.

Abbreviated Injury Scale↗