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2 results

  • Tracheostomy in neurologically compromised paediatric patients: role of starplasty

  • A Gupta, J Stokken, P Krakovitz, P Malhotra, S Anne
  • Journal:
    The Journal of Laryngology & Otology / Volume 129 / Issue 10 / October 2015
    Published online by Cambridge University Press:
    17 August 2015, pp. 1009-1012
    Print publication:
    October 2015
  • Objectives:

    Starplasty tracheostomy is an alternative to traditional tracheostomy. This paper reviews neurologically compromised paediatric patients with tracheostomies and discusses the role of starplasty tracheostomy.

    Method:

    A retrospective review was conducted of paediatric patients with a neurological disorder who underwent tracheostomy between 1997 and 2011.

    Results:

    Forty-eight patients, with an average age of 7.3 years, were identified. The most common indications for tracheostomy were: ventilator dependence (39.6 per cent), an inability to tolerate secretions or recurrent aspiration pneumonia (33.3 per cent), and upper respiratory obstruction or hypotonia (12.5 per cent). The most common underlying neurological diagnosis was cerebral palsy. There were no early complications. Eighteen (43 per cent) of 42 patients with follow up experienced at least 1 delayed complication. Only 12 patients (28.6 per cent) were decannulated.

    Conclusion:

    Patients with primary neurological diagnoses have low rates of decannulation; starplasty tracheostomy should be considered for these patients. Patients with seizure disorder or acute neurological injury tended to have a higher short-term decannulation rate; traditional tracheostomy is recommended in these patients.

  • Endorsement of self-report neurovegetative items of depression is associated with multiple sclerosis disease symptoms

  • JOE E. BEENEY, PETER A. ARNETT
  • Journal:
    Journal of the International Neuropsychological Society / Volume 14 / Issue 6 / November 2008
    Published online by Cambridge University Press:
    27 October 2008, pp. 1057-1062
    • Article
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  • Some researchers have suggested that general self-report depression scales may be inadequate for assessing depression among individuals with Multiple Sclerosis (MS), because many of such items represent MS disease symptoms. However, research has been mixed on this issue: whereas some studies provide support for symptom overlap, others have found opposing evidence. We investigated this issue in two different MS samples with three different strategies. We (1) examined reliable change in depression symptom categories at two time points over three years, (2) assessed the relationship between variables associated with depression and different depression symptom subscales, and (3) assessed the relationship between symptom subscales and physical disability. In each instance we found significant evidence that items meant to assess vegetative symptoms of depression may be influenced by presence of MS disease symptoms or were not associated with other core elements or central correlates of depression. (JINS, 2008, 14, 1057–1062.)