Prevention of tracheal cartilage injury with modified Griggs technique during percutaneous tracheostomy - Randomized controlled cadaver study

Introduction: Tracheal stenosis is the most common severe late complication of percutaneous tracheostomy causing significant decrease in quality of life. Applying modified Griggs technique reduced the number of late tracheal stenoses observed in our clinical study. The aim of this study was to investigate the mechanism of this relationship. Materials and methods: Forty-six cadavers were randomized into two groups according to the mode of intervention during 2006-2008. Traditional versus modified Griggs technique was applied in the two groups consequently. Wider incision, surgical preparation, and bidirectional forceps dilation of tracheal wall were applied in modified technique. Injured cartilages were inspected by sight and touch consequently. Age, gender, level of intervention, and number of injured tracheal cartilages were registered. Results: Significantly less frequent tracheal cartilage injury was observed after modified (9%) than original (91%) Griggs technique (p<0.001). A moderate association between cartilage injury and increasing age was observed, whereas the level of intervention (p=0.445) and to gender (p=0.35) was not related to injury. Risk of cartilage injury decreased significantly (OR: 0.0264, 95%, CI: 0.005-0.153) with modified Griggs technique as determined in adjusted logistic regression model. Discussion: Modified Griggs technique decreased the risk of tracheal cartilage injury significantly in our cadaver study. This observation may explain the decreased number of late tracheal stenosis after application of the modified Griggs method. © 2012 Akadémiai Kiadó, Budapes

Comparison of the ingestion of fibre rich foods in different countries

Introduction: The ingestion of fruits, vegetables and cereals, especially whole grain, is associated with a healthy lifestyle and has been recognized as having multiple health benefits, associated, among others, to the ingestion of adequate amounts of dietary fibre. Objective: The aim of this work was to evaluate some eating habits related to fibre rich foods in six different countries: Argentina, Croatia, Hungary, Latvia, Portugal and Romania. Methods: A cross-sectional descriptive study was carried out by means of questionnaire survey applied to a sample of 4905 participants, all over the age of 18 years old. The preparation and application of the questionnaire followed the necessary ethical guidelines and the treatment was made by SPSS. Results: The results showed that for the global sample was observed a low ingestion of salads and vegetables (78.2%), being this particularly problematic for Croatia (86.6%). Regarding the consumption of fruits, for the whole sample the great majority also showed a low consumption (92.3%), and for Latvian participants the percentage is very much expressive (98.3%). As for the consumption of whole cereals, most participants also showed a low consumption, either for the global sample (72.6%) or in the different countries, and particularly for Latvia (90.0%). Some eating habits were also studied and it was observed that for the whole sample 71.9% showed a low frequency of meals ate out of home, while 88.6% revealed acceptable frequency of eating fast food, i.e, only once or twice a week. Conclusions: The results indicated that in the countries at study the ingestion of foods rich in dietary fibre is very low, and therefore it is necessary to implement strategies to increase the consumption of such foods.info:eu-repo/semantics/publishedVersio

Level of information about dietary fibre: a study involving 10 Countries

Introduction: Dietary fibre (DF) is recognized as healthy for long, so that health claims are allowed by the European Food Safety Authority (EFSA) due to its proved benefits, extended but not only confined to many diseases of the gastrointestinal tract. Objective: This work intended to analyse the level of information about DF in 10 countries, situated in Europe, Africa and South America. Methods: A descriptive cross-sectional study was undertaken through a survey based on a questionnaire of self-response applied to a sample of 6010 participants. The data were lately treated by factor and cluster analyses, including validation methodologies. Results: Factor analysis showed that ten of the twelve items used to assess the knowledge about DF could be arranged into two factors: one related to health effects (α =0.854) and the other to the sources (α =0.644). Furthermore, cluster analysis showed that the participants could be divided into three groups: 1) Good knowledge about sources and health effects of DF; 2) Good knowledge about the sources of DF but poor knowledge about the health effects; 3) Poor knowledge about the sources and health effects of DF. Conclusions: The results clearly allowed identifying two factors and three clusters, and the variables that most influenced cluster membership were country, living environment and level of education.info:eu-repo/semantics/publishedVersio

Invasive vascular catheterisation in the critically ill

In order to identify potential problems and thereby minimise the risk of invasive vascular catheterisation, we conducted an analysis of these procedures in our medical intensive care unit with the aid of a computer database. During the 9-month study period 114 patients underwent 247 invasive vascular catheterisations, including pulmonary arterial (PA), central venous (CV) and arterial catheter insertions. Complications unique to PA catheterisation included burst catheter balloons (6%) and one serious episode of arrhythmia. The incidence of pneumothorax (2.8%) and inadvertent arterial puncture (2.2%) with PA and CV lines and our sepsis rate of 3.6% for all types of catheters are consistent with other studies. Arterial catheterisation proved to be relatively free of complications. Our study confirmed the safety of invasive vascular catheterisation. However, we review the precautions needed to limit potential complications