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Pediatric gastrostomy

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https://www.readbyqxmd.com/read/29454502/prevalence-and-side-effects-of-pediatric-home-tube-feeding
#1
Hilde Krom, Suzanne M C van Zundert, Marie-Anne G M Otten, Liesbeth van der Sluijs Veer, Marc Alexander Benninga, Angelika Kindermann
BACKGROUND & AIMS: Tube feeding ensures growth, but can have negative effects on health and psychosocial functioning, resulting in health related costs. The aims of this study were to determine the prevalence of pediatric home tube feeding in the Netherlands and to assess the clinical characteristics of tube fed children and side effects of tube feeding. METHODS: The prevalence of pediatric home tube feeding was calculated using data (2010-2014) of both the Medicines and Devices Information Project of the National Health Care Institute, and Statistics Netherlands...
February 14, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29404734/hospital-variation-in-rates-of-concurrent-fundoplication-during-gastrostomy-enteral-access-procedures
#2
Anne M Stey, Charles D Vinocur, R Lawrence Moss, Bruce L Hall, Mark E Cohen, Kari Kraemer, Clifford Y Ko, Brian D Kenney, Loren Berman
BACKGROUND: This study aimed to determine whether (1) the propensity for concurrent fundoplication during gastrostomy varies among hospitals, and (2) postoperative morbidity differs among institutions performing fundoplication more or less frequently. METHODS: Children who underwent gastrostomy with or without concurrent fundoplication were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-P). A hierarchical multivariate regression modeled the excess effects that hospitals exerted over propensity for concurrent fundoplication adjusting for preoperative clinical variables...
February 5, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29399615/initial-experience-with-percutaneous-endoscopic-gastrostomy-with-t-fastener-fixation-in-pediatric-patients
#3
Morten Kvello, Charlotte Kristensen Knatten, Gøri Perminow, Hans Skari, Anders Engebretsen, Ole Schistad, Ragnhild Emblem, Kristin Bjørnland
Background and study aims:  Insertion of a percutaneous endoscopic gastrostomy (PEG) with push-through technique and T-fastener fixation (PEG-T) has recently been introduced in pediatric patients. The T-fasteners allow a primary insertion of a balloon gastrostomy. Due to limited data on the results of this technique in children, we have investigated peri- and postoperative outcomes after implementation of PEG-T in our department. Patients and methods:  This retrospective chart review included all patients below 18 years who underwent PEG-T placement from 2010 to 2014...
February 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29346232/use-of-point-of-care-ultrasound-to-guide-pediatric-gastrostomy-tube-replacement-in-the-emergency-department
#4
Toby C Myatt, Anthony J Medak, Samuel H F Lam
The presentation of a pediatric patient to the emergency department for a malfunctioning or dislodged gastrostomy tube (G-tube) is not uncommon. As such, these tubes are often replaced at the bedside. Improper placement can result in a number of complications, including perforation, fistula tract formation, peritonitis, and sepsis. The current criterion standard method to confirm proper G-tube placement is contrast-enhanced radiography. However, point-of-care ultrasound may be an alternative method to guide and confirm pediatric G-tube replacement in the emergency department...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29338077/blenderized-enteral-nutrition-diet-study-feasibility-clinical-and-microbiome-outcomes-of-providing-blenderized-feeds-through-a-gastric-tube-in-a-medically-complex-pediatric-population
#5
Kelsey Gallagher, Annika Flint, Marialena Mouzaki, Andrea Carpenter, Beth Haliburton, Louise Bannister, Holly Norgrove, Lisa Hoffman, David Mack, Alain Stintzi, Margaret Marcon
BACKGROUND: Chronically ill children often require feeding via gastrostomy tubes (G-tubes). Commercial formula is most commonly used for enteral feeding; however, caregivers have been requesting blenderized tube feeds (BTFs) as an alternative. The objective of this study was to evaluate the feasibility of using BTFs in a medically complex pediatric population and assess their impact on clinical outcomes, as well as the microbiota. METHODS: Twenty pediatric participants were included...
January 16, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29287857/a-novel-technique-for-unilateral-supraglottoplasty
#6
Harry H Ching, Alycia G Spinner, Nathaniel H Reeve, T J O-Lee
OBJECTIVES: Traditional supraglottoplasty for pediatric laryngomalacia is most commonly conducted with either CO2 laser or cold steel instruments. While the procedure enjoys high success rates, serious complications such as excessive bleeding, supraglottic stenosis and aspiration can occur. Unilateral coblation supraglottoplasty may reduce this risk, but data on respiratory and swallowing outcomes are lacking. This study reports our experiences with unilateral coblation supraglottoplasty...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29261527/preoperative-evaluation-is-not-predictive-of-transpyloric-feeding-conversion-in-gastrostomy-dependent-pediatric-patients
#7
Maireade McSweeney, Jessica Kerr, Janine Amirault, Eliza Fishman, Margot Lurie, Maria I Peinado-Fabregat, Paul D Mitchell, Rachel Rosen
OBJECTIVES: Limited literature exists as to whether preoperative gastrostomy (GT)evaluation may predict which patients will go onto require gastrojejunostomy tube (GJ) feeding. The goal of this study was to compare the preoperative evaluations between patients maintained on GT feeds versus patients who required conversion to GJ feeds. METHODS: We identified patients at Boston Children's Hospital who underwent GT placement and required GJ feeding between 2006-2012...
December 19, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29224755/factors-associated-with-30-day-all-cause-hospital-readmission-after-tracheotomy-in-pediatric-patients
#8
Helena Yu, Mary Rose Mamey, Christopher J Russell
OBJECTIVE: To determine factors associated with post-tracheotomy hospital readmission within 30 days of discharge. METHODS: Children 18 years and younger who underwent tracheotomy at Children's Hospital Los Angeles (CHLA) between 1/1/2005 and 12/31/2013 with at least 30 days of follow-up at CHLA were identified through ICD-9 procedure codes. Patient characteristics and covariates were obtained by linking manual chart review and administrative data. We used multivariate logistic regression to identify the independent association between risk factors and the primary outcome of 30-day all-cause same-hospital readmission...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#9
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29219857/a-literature-review-of-percutaneous-endoscopic-gastrostomy-dealing-with-complications
#10
Hatice Pars, Hicran Çavuşoğlu
Sufficient energy and essential nutrients are vital for normal growth and development in childhood. Ideally, nutrition should be provided orally. However, if the gastrointestinal system is functional, enteral tube feeding can be used when nutritional requirements cannot be provided orally, thus providing nutritional benefits and enabling positive disease management in pediatric patients. Postoperative care in children allows monitoring of the position and functionality of the tube; performing nutrition intolerance, growth, hydration, and nutritional assessments; and performing metabolic and complication follow-ups...
December 6, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29201636/laryngotracheoesophageal-cleft-type-3-and-severe-laryngotracheomalacia-delayed-surgical-repair-a-treatment-challenge-with-an-excellent-outcome
#11
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29180216/pediatric-gastrostomy-tubes-and-techniques-making-safer-and-cleaner-choices
#12
COMPARATIVE STUDY
Cabrini Sutherland, Benjamin Carr, Kassia Zalewski Biddle, Marcus Jarboe, Samir K Gadepalli
BACKGROUND: Gastrostomy tube placement is a common procedure that can be accomplished with a variety of techniques, each with its attendant complications. In an effort to standardize practice at our institution, we retrospectively evaluated complications including early dislodgement requiring operative repair, leaks, and granulation tissue to determine the optimal technique. MATERIALS AND METHODS: A retrospective cohort study (June 2008-July 2014) evaluating children (<18) receiving gastrostomy tubes was completed...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29162216/treatment-regimens-by-pediatric-nephrologists-in-children-with-congenital-nephrogenic-diabetes-insipidus-a-mwpnc-study%C3%A2
#13
Cynthia D'Alessandri-Silva, Melinda Carpenter, John D Mahan
BACKGROUND: Congenital nephrogenic diabetes insipidus (NDI) is a rare genetic disorder affecting urinary concentration. Clinicians have varied medication regimens as well as nutritional plan approaches for these children. MATERIALS AND METHODS: An electronic survey was distributed to member pediatric nephrologists of the Midwest Pediatric Nephrology Consortium via email (n = 179). Questions included types of drugs prescribed, factors contributing to drug choice, common drug combinations given, and dietary/failure to thrive interventions used...
November 22, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29119032/cytomegalovirus-associated-duodenal-ulcer-and-duodenitis-in-a-malnourished-pediatric-patient
#14
Rachel Bernard, Ghanim Aljomah, Emily Klepper, Elizabeth McDonough
Cytomegalovirus (CMV) duodenitis is a rare occurrence, especially in pediatric patients. A thirteen-month-old female presented to the Emergency Department for a febrile seizure. She was incidentally admitted for severe malnutrition with an initial workup remarkable for only a slight elevation in her ALT at 48. The patient was found to have an oral aversion requiring nasogastric tube feeds for adequate caloric intake. She continued to fail to gain weight and underwent an EGD that demonstrated a duodenal ulcer...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28988288/effects-of-mechanical-complications-on-radiation-exposure-during-fluoroscopically-guided-gastrojejunostomy-exchange-in-the-pediatric-population
#15
Kevin S H Koo, Joseph Reis, Jodi Manchester, Gulraiz Chaudry, Brian Dillon
The purpose of the article is to evaluate the effects of mechanical complications, such as clogging or coiling, of gastrojejunostomy tubes on radiation exposure during exchange in the pediatric population. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed procedural records for patients undergoing gastrojejunostomy (GJ) tube exchange during a 4-month period in 2014. Success of the procedure, specifications of the tube, age, and sex of the patient as well as radiation exposure during the procedure were included...
October 7, 2017: Dysphagia
https://www.readbyqxmd.com/read/28983677/reduced-dose-c-arm-computed-tomography-applications-at-a-pediatric-institution
#16
Michael Acord, Sphoorti Shellikeri, Seth Vatsky, Abhay Srinivasan, Ganesh Krishnamurthy, Marc S Keller, Anne Marie Cahill
BACKGROUND: Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. OBJECTIVE: To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. MATERIALS AND METHODS: We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0...
December 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28983551/association-of-enrollment-in-an-aerodigestive-clinic-with-reduced-hospital-stay-for-children-with-special-health-care-needs
#17
Swathi Appachi, Anne Banas, Lisa Feinberg, Douglas Henry, Diane Kenny, Nathan Kraynack, Amy Rosneck, John Carl, Paul Krakovitz
Importance: Children with special health care needs (CSHCN) have disproportionate health care utilization. Previous studies have demonstrated that a primary medical home improves health care outcomes for this population. Objective: To elucidate if enrollment in a multidisciplinary aerodigestive clinic improves outcomes and reduces health care costs by decreasing admissions and inpatient days. Design, Setting, and Participants: A retrospective medical record review of 113 patients with aerodigestive disorders enrolled in a pediatric multidisciplinary clinic from June 2009 to December 2013 was performed...
November 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28969523/postoperative-feeding-regimens-after-laparoscopic-gastrostomy-placement
#18
Eric H Rosenfeld, Kirea Mazzolini, Annalyn DeMello, Yangyang R Yu, Timothy C Lee, Bindi Naik-Mathuria, Mark V Mazziotti, Sohail R Shah
PURPOSE: The objective of this study was to evaluate postoperative feeding regimens after laparoscopic gastrostomy placement and their effect on outcomes. METHODS: Children 18 years of age or younger, who underwent laparoscopic gastrostomy placement at a tertiary-care academic children's hospital between January 2014 and October 2016, were reviewed. Data collected included patient characteristics, postoperative feeding regimen, and clinical outcomes. Statistical analysis was performed using Chi-square, Fisher's exact, and Wilcoxon Rank-Sum tests...
November 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28964285/pediatric-leukodystrophies-the-role-of-the-otolaryngologist
#19
Emily Kay-Rivest, Léticia Khendek, Geneviève Bernard, Sam J Daniel
BACKGROUND: Leukodystrophies consist of degenerative neurogenetic diseases often associated with comorbidities that extend beyond the neurological system. Despite their impacts on patients' quality of life and risks of complications, head and neck symptomology is poorly reported in the literature. The objective of this study was to identify and quantify the main head and neck complaints among a cohort of patients diagnosed with leukodystrophies and define the role of the otolaryngologist as part of a multidisciplinary team for treating these patients...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28954047/comparative-study-on-gastrostomy-and-orally-nutrition-of-children-and-adolescents-with-tetraparesis-cerebral-palsy
#20
COMPARATIVE STUDY
Thaisa Barboza Caselli, Elizete Aparecida Lomazi, Maria Augusta Santos Montenegro, Maria Angela Bellomo-Brandão
BACKGROUND: Gastrostomy tube feeding (GTF) is indicated for children with feeding difficulties due to tetraspastic cerebral palsy, although there are no definitive conclusions about the benefits of GTF. OBJECTIVE: To compare nutritional status and diet of pediatric patients with tetraparesis cerebral palsy who are fed by GTF with those fed orally (PO). METHODS: A transversal and descriptive study on 54 patients with spastic tetraparesis was held...
December 2017: Arquivos de Gastroenterologia
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