This study was conducted to review the abundance and diversity of radiopaque foreign bodies over a 25-year period. Overall records of 1,114 patients who underwent rigid bronchoscopy due to foreign body aspiration in the tertiary centres, Imam Khomeini and Apadana; over a 25-year period (1989-2014) were reviewed. History, clinical findings, plain radiography and bronchoscopic findings, foreign body (FB) aspiration (whether radiolucent or radiopaque), time from onset of symptoms until hospitalization, and delay time were all considered. The male/female ratio was 1.53. Most patients were aged 1-3 years (53.94 %). The most common location of foreign bodies was the right main bronchus (54.57 %). The most common type of radiopaque foreign body was meat, chicken and big fish bones (4.84 %) followed by metal objects (4.39 %). Coughing (70.82 %) and cyanosis (22.80 %) were the most common symptoms. The most common radiological findings were emphysema (32.31 %). Given that the radiological findings are highly specific as regards the detection of radiopaque FB, radiographic examination prior to bronchoscopy for FB localization and shortening the time of bronchoscopy in patients with a history of radiopaque FB aspiration can be helpful. Due to the high morbidity and mortality caused by prolong and repeated bronchoscopy, the use of newer techniques and equipment in shortening extraction time of the foreign bodies should be considered in future researches.
Context: Fluid therapy is the basis of resuscitation; however, there has been a heated debate on the choice of appropriate fluid. This study mainly aimed to determine which fluid is correlated with a decline in mortality rate and can be the most suitable choice for each group of patients. Evidence Acquisition: We conducted a systematic search on Google Scholar, Web of Science, Scopus, BMJ Journals, Thieme, Path Consult, BIDS Index, Embase, Medline, and Cochrane Controlled Trials up to April 2016. The relevant studies were those that provided a comparison between the effects of different fluids on the mortality rate of patients. Two independent authors participated in the evaluating methodological quality, selecting eligible studies, and extracting the relevant data from the studies. Results: We selected 26 out of 2724 potential randomized controlled trials (RCTs) from the databases for both quantitative and qualitative analyses resulting in a total of 22882 patients receiving either colloid or crystalloid fluids. The approximated pooled Relative risk (RR) for the death of patients who had been resuscitated with crystalloid fluid therapy rather than colloid fluid therapy was 1.008. This meta-analysis illustrated that there was a decline in the mortality rate with borderline significance in both traumatic and hypovolemic patients through utilizing colloid fluids. The mortality reduced more by using dextran and albumin than using crystalloid fluids.
Conclusions:The results of this meta-analysis show that colloid fluids can increase the successful resuscitation rate compared to crystalloid fluids especially in traumatic and hypovolemic patients.Some of the colloids like albumin and dextran have a positive effect on reducing the mortality rate but others like Hetastarch (HES) increase the mortality rate compared to normal saline (NS).
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