Safety of bronchoscopic guided percutaneous dilatational tracheostomy in ICU patients in Tabriz City

BACKGROUND Tracheostomy is one of the most frequently performed procedures in intensive care units. The widespread attraction of percutaneous dilatational tracheostomy (PDT) is increasing in modern intensive care units (ICU). Bronchoscopic guidance seems to secure the safety of the technique. Multiple studies done to explain characterize differences in complications and cost-effectiveness of open and percutaneous tracheotomy. The objective of this study was to evaluate the benefits of percutaneous dilatational tracheostomy (PDT) using the Ciaglia technique with bronchoscopic guidance. METHODS A total of 100 elective percutaneous dilatational tracheostomies using the Ciaglia technique with a little modification were performed under flexible fiber optic bronchoscopic guide. The demographic variables were recorded, the underlying cause for patient’s referred to the center for PDT, and intraoperative as well as early postoperative complications. Patients followed for several days after tracheostomy for early complications. RESULTS No severe complications related to percutaneous dilatational tracheostomy were noticed during and after the procedure. Three patients had bleeding during incision and two led to subcutaneus hematoma. There were no other complications such as infection, emphysema and puncture of  posterior wall. CONCLUSIONS We recommended the use of endoscopic guidance bedside percutaneous tracheostomy using the Ciaglia technique with a little modification because it is safe and simple to do without significant complications. PDT with bronchoscopic guidance is a safe and easy procedure that can be done at the bedside setting

Association of Helicobacter pylori Infection with Coronary Artery Disease: Is Helicobacter pylori a Risk Factor?

Background. Helicobacter pylori (HP) infection is the most common infection in the world and coronary artery disease (CAD) is probably associated with it. The aim of this prospective study was to evaluate the association between HP infection and CAD in suspected patients referred for coronary angiography. The coronary angiography was performed using Judkins method and patients were assigned to participate in CAD positive (>50% luminal diameter stenosis) and negative groups. The serum HP IgG antibody was checked. Results. Positive and negative CAD groups consisted of 62 and 58 patients, respectively. HP was more prevalent among CAD+ patients, and with increasing the number of coronary arteries with stenosis, the HP seropositivity increased so that 76.3% of patients with multiple vessel diseases (MVD) and 70% of patients with single vessel diseases (SVD) were HP seropositive versus 50% in control group (P=0.006). Positive CAD was significantly associated with HDL level (P=0.01) and ESR level (P=0.006). Also, CAD+ patients had higher CRP levels than controls and it was statistically different between SVD group and controls (P<0.05). Conclusion. HP infection is more prevalent in CAD positive patients and, in case of proving causal relationship, it can be considered as a reversible risk factor for CAD

Association of Helicobacter pylori Infection with Coronary Artery Disease: Is Helicobacter pylori a Risk Factor?

Background. Helicobacter pylori (HP) infection is the most common infection in the world and coronary artery disease (CAD) is probably associated with it. The aim of this prospective study was to evaluate the association between HP infection and CAD in suspected patients referred for coronary angiography. The coronary angiography was performed using Judkins method and patients were assigned to participate in CAD positive (&gt;50% luminal diameter stenosis) and negative groups. The serum HP IgG antibody was checked. Results. Positive and negative CAD groups consisted of 62 and 58 patients, respectively. HP was more prevalent among CAD+ patients, and with increasing the number of coronary arteries with stenosis, the HP seropositivity increased so that 76.3% of patients with multiple vessel diseases (MVD) and 70% of patients with single vessel diseases (SVD) were HP seropositive versus 50% in control group ( = 0.006). Positive CAD was significantly associated with HDL level ( = 0.01) and ESR level ( = 0.006). Also, CAD+ patients had higher CRP levels than controls and it was statistically different between SVD group and controls ( &lt; 0.05). Conclusion. HP infection is more prevalent in CAD positive patients and, in case of proving causal relationship, it can be considered as a reversible risk factor for CAD