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Precise photographic documentation is of significant importance for proper diagnosis and management of physiological and pathological conditions of the larynx. Since the fiberscope serves an important role in the daily practice of laryngologists, its value is greatly enhanced when coupled with a video camera. Fiberoptic videolaryngoscopy permits instant and simultaneous voice and visual recordings for later study. ⋯ The procedure also allows investigation of various pathological conditions. The purpose of this paper is to present the authors' method of fiberscopic videolaryngoscopy and its relevant clinical implications. Advantages and disadvantages of the procedure are discussed.
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Advances in endovascular aneurysm repair now allow surgeons to treat high-risk patients with complex aortic aneurysms. Stringent selection criteria for repair exist from an anatomic and technical perspective; however, there is a paucity of literature examining frailty in patients being evaluated for fenestrated and branched endovascular aortic repair (FEVAR). As a marker of frailty well supported in the literature, we hypothesized that preoperative hypoalbuminemia would increase risk for short-term mortality after endovascular juxtarenal and thoracoabdominal aortic aneurysm repair. ⋯ Patients with hypoalbuminemia have significantly increased mortality risk. Albumin level is regulated by nutritional intake and inflammation due to chronic disease, which make it a useful part of a preoperative frailty assessment. Further studies are needed to identify whether optimizing nutrition status will affect albumin levels or decrease mortality.
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The current civilian Abbreviated Injury Scale (AIS), designed for automobile crash injuries, yields important information about civilian injuries. It has been recognized for some time, however, that both the AIS and AIS-based scores such as the Injury Severity Score (ISS) are inadequate for describing penetrating injuries, especially those sustained in combat. Existing injury coding systems do not adequately describe (they actually exclude) combat injuries such as the devastating multi-mechanistic injuries resulting from attacks with improvised explosive devices (IEDs). ⋯ Over a period of several years, the Military Combat Injury Scale and Military Functional Incapacity Scale were developed, tested and validated by teams of civilian and tri-service military expertise. MCIS shows significant promise in documenting the nature, severity and complexity of modern combat injury.
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Critical care medicine · Jul 2015
Review Meta AnalysisUltrasound-Guided Subclavian Vein Catheterization: A Systematic Review and Metaanalysis.
Use of ultrasound guidance for subclavian vein cannulation reduces the incidence of arterial puncture, pneumothorax, and hematoma.
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