Fractured metallic tracheostomy tube in a child: a case report and review of the literature

<p>Abstract</p> <p>Introduction</p> <p>Tracheostomy is a common airway procedure for life support. The fracture of the tracheostomy tube is a rare complication. We report a case of a 14-year-old boy whose fractured stainless steel tracheostomy tube dislodged into the tracheobronchial tree. We include a literature review and proposed recommendations for tracheostomy care.</p> <p>Case presentation</p> <p>A 14-year-old Thai boy who had a stainless steel tracheostomy tube presented with a complaint of intermittent cough for 2 months. During tracheostomy tube cleaning, his parents found that the inner tube was missing. A chest X-ray revealed a metallic density foreign body in his right main bronchus. He underwent bronchoscopic removal of the inner tracheostomy tube and was discharged without further complications.</p> <p>Conclusion</p> <p>A fractured tracheostomy tube is a rare complication. Appropriate cleaning and scheduled replacement of the tracheostomy tube may prevent this complication.</p

Symbols of Power: The Firearm Paintings of Madjedbebe (Malakunanja II)

Depictions of firearms in Australian Aboriginal rock art provide a unique opportunity to archaeologically explore the roles that this type of material culture played in times of culture contact. From the earliest interactions with explorers to the buffalo shooting enterprises of the twentieth century—firearms played complex and shifting roles in western Arnhem Land Aboriginal societies. The site of Madjedbebe (sometimes referred to as Malakunanja II in earlier academic literature) in Jabiluka (Mirarr Country), offers the opportunity to explore these shifting roles over time with an unprecedented 16 paintings of firearms spanning the nineteenth and twentieth centuries. This rock art provides evidence for early firearms as objects of curiosity and threat to local groups, as well as evidence for later personal ownership and use of such weaponry. Moreover, we argue that the rock art suggests increasing incorporation of firearms into traditional cultural belief and artistic systems over time with Madjedbebe playing a key role in the communication of the cultural meanings behind this new subject matter.Arts, Education & Law Group, School of Humanities, Languages and Social SciencesFull Tex

A new stress sensor and risk factor for suicide: The T allele of the functional genetic variant in the GABRA6 gene

© 2017 The Author(s). Low GABA transmission has been reported in suicide, and GABRA6 rs3219151 T allele has been associated with greater physiological and endocrine stress response in previous studies. Although environmental stress also plays a role in suicide, the possible role of this allele has not been investigated in this respect. In our present study effect of rs3219151 of GABRA6 gene in interaction with recent negative life events on lifetime and current depression, current anxiety, as well as lifetime suicide were investigated using regression models in a white European general sample of 2283 subjects. Post hoc measures for phenotypes related to suicide risk were also tested for association with rs3219151 in interaction with environmental stress. No main effect of the GABRA6 rs3219151 was detected, but in those exposed to recent negative life events GABRA6 T allele increased current anxiety and depression as well as specific elements of suicide risk including suicidal and death-related thoughts, hopelessness, restlessness and agitation, insomnia and impulsiveness as measured by the STOP task. Our data indicate that stress-associated suicide risk is elevated in carriers of the GABRA6 rs3219151 T allele with several independent markers and predictors of suicidal behaviours converging to this increased risk

Surgical treatment of Zenker's diverticulum: transcutaneous diverticulectomy versus microendoscopic myotomy of the cricopharyngeal muscle with CO2 laser

In a retrospective study, we analyzed 97 patients who were treated by either transcutaneous diverticulectomy (n = 66) or microendoscopic myotomy of the cricopharyngeal muscle with CO(2) laser (n = 31). Two (6.4%) of 31 patients in the microendoscopic myotomy group had complications, compared with 10 (15%) of 66 patients in the diverticulectomy group. In addition, the complications observed in the microendoscopic myotomy group were less severe than those observed in the transcutaneous diverticulectomy group. The average length of hospitalization was shorter in the microendoscopic myotomy group than in the diverticulectomy group (8 days versus 11.4 days). We conclude that microendoscopic CO(2)-laser myotomy is a less invasive, more precise, and safer procedure, which results in a shortened period of hospitalization and complete relief of symptoms in the vast majority of cases