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https://www.readbyqxmd.com/read/29429053/program-of-gastrointestinal-rehabilitation-and-early-postoperative-enteral-nutrition-a-prospective-study
#1
Frank Daniel Martos-Benítez, Anarelys Gutiérrez-Noyola, Andrés Soto-García, Iraida González-Martínez, Ilionanys Betancourt-Plaza
Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January-2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit...
February 10, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29414895/a-case-of-spontaneous-pneumomediastinum-with-subcutaneous-emphysema-in-children
#2
Said Benlamkaddem, Mohamed Adnane Berdai, Smael Labib, Mustapha Harandou
Spontaneous pneumomediastinum is defined as free air or gas contained within the mediastinum, which almost invariably originates from the alveolar space or the conducting airways. It is rare in pediatric patients; however, occasional cases are reported to result from forced Valsalva's maneuver due to cough, emesis, a first attack of wheeze, or asthma exacerbations. We report the case of a 7-year-old previously healthy girl, with a history of persistent dry cough one day before, who was brought to our unit with face, neck and chest swelling...
February 7, 2018: Children
https://www.readbyqxmd.com/read/29404935/the-effect-of-obesity-on-anti-xa-concentrations-in-bariatric-patients
#3
W Schijns, M J Deenen, E O Aarts, J Homan, I M C Janssen, F J Berends, K A H Kaasjager
BACKGROUND: Morbidly obese patients are at increased risk to develop venous thromboembolism (VTE), especially after bariatric surgery. Adequate postoperative thrombosis prophylaxis is of utmost importance. It is assumed that morbidly obese patients need higher doses of low molecular weight heparin (LMWH) compared to normal-weight patients; however, current guidelines based on relative efficacy in obese populations are lacking. OBJECTIVES: First, we will evaluate the relationship between body weight descriptors and anti-Xa activity prospectively...
February 5, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29318504/oral-vitamin-b12-supplementation-after-roux-en-y-gastric-bypass-a-systematic-review
#4
Kamal K Mahawar, Alastair Reid, Yitka Graham, Lindes Callejas-Diaz, Chetan Parmar, William Rj Carr, Neil Jennings, Rishi Singhal, Peter K Small
BACKGROUND: Many respectable guidelines recommend lifelong vitamin B12 injections for Roux-en-Y gastric bypass (RYGB) patients in the absence of lack of consensus on the efficacy of oral route of prophylaxis and the appropriate doses needed for this purpose. The purpose of this review was to examine the published English language scientific literature in accordance with PRISMA principles to find out if orally given vitamin B12 is adequate for prophylactic purposes in RYGB patients and the appropriate dosages needed for this purpose if it is...
January 9, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29234961/risk-and-incidence-of-perioperative-deep-vein-thrombosis-in-patients-undergoing-gastric-cancer-surgery
#5
Tomohiro Osaki, Hiroaki Saito, Yoji Fukumoto, Yusuke Kono, Yuki Murakami, Yuji Shishido, Hirohiko Kuroda, Tomoyuki Matsunaga, Kengo Sato, Yasuaki Hirooka, Yoshiyuki Fujiwara
BACKGROUND AND PURPOSE: Venous thromboembolism (VTE) is a potentially fatal perioperative complication. Understanding the risk factors for deep vein thrombosis (DVT) and initiating appropriate prophylaxis is pivotal for reducing the risk of VTE. The purpose of this study was to clarify the perioperative risk factors for DVT in patients undergoing surgery for gastric cancer. METHODS: We reviewed the findings of lower limb ultrasonography performed in 160 patients who underwent gastrectomy for gastric cancer...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29201630/avoidance-of-harm-from-treatment-for-anca-associated-vasculitis
#6
REVIEW
Catherine King, Lorraine Harper
Purpose of review With established immunosuppressant treatment regimens for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV), prognosis has significantly improved. The mainstay of treatment still comprises high-dose corticosteroids and cyclophosphamide for severe forms, although rituximab is being increasingly utilised instead of cyclophosphamide as induction therapy. AAV patients experience an excess of infections, malignancies and cardiovascular events as compared to the general population, which is a combination of the systemic inflammatory process associated with vasculitis and the adverse events from treatment...
2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29133564/fungal-prophylaxis-with-a-gastro-resistant-posaconazole-tablet-for-patients-with-hematological-malignancies-final-result-of-the-posanantes-study
#7
Pierre Peterlin, Cécile Chauvin, Steven Le Gouill, Morgane Pere, Marie Dalichampt, Thierry Guillaume, Alice Garnier, Maxime Paré, Amandine Le Bourgeois, Philippe Moreau, Patrice Chevallier, Guillaume Deslandes, Thomas Gastinne
Posaconazole is an antifungal drug used in both prophylaxis and treatment of invasive fungal infections. Its oral formulation requires therapeutic drug monitoring. To overcome gastric acidity, a gastro-resistant posaconazole tablet has recently been developed. POSANANTES was a prospective non interventional study that aimed to monitor plasma concentration trough level (Cmin) of posaconazole tablets used prophylactically in patients with hematological malignancies. Fifty patients were included. Group A (n= 31) included patients receiving induction chemotherapy for myeloid malignancies and group B (n=19) included patients treated for graft versus host disease after allogeneic hematopoietic stem cells transplantation...
November 13, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29110128/endoscopic-treatments-for-portal-hypertension
#8
REVIEW
Gin-Ho Lo
Acute esophageal variceal hemorrhage is a dreaded complication of portal hypertension. Its management has evolved rapidly in recent years. Endoscopic therapy is often employed to arrest bleeding varices as well as to prevent early rebleeding. The combination of vasoconstrictor and endoscopic therapy is superior to vasoconstrictor or endoscopic therapy alone for control of acute esophageal variceal hemorrhage. After control of acute variceal bleeding, combination of banding ligation and beta-blockers is generally recommended to prevent variceal rebleeding...
November 7, 2017: Hepatology International
https://www.readbyqxmd.com/read/28663672/gastric-varices-in-cirrhosis-vs-extrahepatic-portal-venous-obstruction-and-response-to-endoscopic-n-butyl-2-cyanoacrylate-injection
#9
Barjesh C Sharma, Shivakumar Varakanahalli, Jatinder P Singh, Siddharth Srivastava
BACKGROUND: Gastric varices (GV) are found in patients with portal hypertension. Incidence of bleeding from GV is relatively low, but is severe, and associated with higher mortality. AIMS AND OBJECTIVES: To compare the types of GV in cirrhosis vs. extrahepatic portal venous obstruction (EHPVO) and the results of endoscopic N-butyl-2-cyanoacrylate (NBC, glue) injection. METHODS: Four hundred and fifty-four patients undergone glue injection of GV for primary prophylaxis or control of bleeding for first episode of bleeding from GV between August 2010 and August 2015 were analyzed...
June 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28656047/multicenter-phase-2-study-about-the-safety-of-no-antimicrobial-prophylaxis-use-in-low-risk-patients-undergoing-laparoscopic-distal-gastrectomy-for-gastric-carcinoma-ksweet-01-study
#10
Oh Jeong, Mi Ran Jung, Seong Yeob Ryu, Young-Kyu Park, Min Chan Kim, Ki Han Kim, Seung Wan Ryu, In Gyu Kwon, Young Gil Son
BACKGROUND: Recent studies have shown a lower risk of surgical site infections (SSI) after laparoscopic distal gastrectomy compared to open surgery. This is a phase 2 study aiming to determine the incidence of SSI after laparoscopic distal gastrectomy without using antimicrobial prophylaxis (AMP). METHODS: cT1N0 gastric cancers that were subject to laparoscopic distal gastrectomy were enrolled. Based on the unacceptable SSI incidence of ≥12.5% and the target SSI incidence of ≤5%, 105 patients were enrolled with an α of 0...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28634542/angioedema-perioperative-management
#11
Andrew A Maynard, Christina F Burger, Joseph J Schlesinger
OBJECTIVE: To describe the perioperative management of a patient with acquired angioedema (AAE). METHODS: A 66-year-old Caucasian male presented from an outside hospital with a history of acquired angioedema and gastrointestinal stromal tumor-related intractable urticaria and mastocytosis. He was admitted for urgent laparoscopic partial gastrectomy, secondary to gastric outlet obstruction symptomatology. Previous combined attacks were characterized by a widespread rash, abdominal pain and respiratory distress resulting in hospitalization...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/28612224/extrahepatic-portal-venous-obstruction-what-should-be-the-mainstay-of-treatment
#12
Richa Lal, Moinak Sen Sarma, Manish K Gupta
The two cornerstones of management for Extrahepatic portal vein obstruction (EHPVO) are endotherapy and surgery [Porto-systemic shunts (PSS)/Mesorex bypass (MRB)]. Endotherapy is the mainstay of treatment for acute variceal bleed control and has also been used extensively for secondary prophylaxis till variceal eradication is achieved. However, long-term follow-up beyond endoscopic eradication of esophageal varices (EEEV) indicates that there are numerous delayed bleed and non bleed sequelae of EHPVO, which merit surgery as a definitive procedure to decompress the hypertensive portal venous system...
September 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#13
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
October 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28572098/prophylactic-acid-suppressive-therapy-in-hospitalized-adults-indications-benefits-and-infectious-complications
#14
Andrew C Faust, Kelly L Echevarria, Rebecca L Attridge, Lyndsay Sheperd, Marcos I Restrepo
Acid-suppressive therapy for prophylaxis of stress ulcer bleeding is commonly prescribed for hospitalized patients. Although its use in select, at-risk patients may reduce clinically significant gastrointestinal bleeding, the alteration in gastric pH and composition may place these patients at a higher risk of infection. Although any pharmacologic alteration of the gastric pH and composition is associated with an increased risk of infection, the risk appears to be highest with proton pump inhibitors, perhaps owing to the potency of this class of drugs in increasing the gastric pH...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#15
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
December 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28506028/comparison-of-the-hospital-acquired-clostridium-difficile-infection-risk-of-using-proton-pump-inhibitors-versus-histamine-2-receptor-antagonists-for-prophylaxis-and-treatment-of-stress-ulcers-a-systematic-review-and-meta-analysis
#16
Mohamed Azab, Loomee Doo, Daniel H Doo, Yousif Elmofti, Muazer Ahmed, John Jay Cadavona, Xibei B Liu, Amaan Shafi, Moon Kyung Joo, Ji Won Yoo
Background/Aims: Although proton pump inhibitors (PPIs) have been widely used for the prevention and treatment of stress gastric ulcers in hospital settings, there are concerns that PPIs increase the risk of Clostridium difficile infection (CDI). However, little is known about the risk of CDI following PPI and histamine-2 receptor antagonist (H2RA) use. We evaluated the comparative hospital-acquired CDI occurrence risk associated with the concurrent use of PPIs versus H2RAs. Methods: A systematic search of PubMed, MEDLINE/Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Google Scholar through August 19, 2016, identified 12 studies that reported the hospital-acquired CDI occurrence following H2RA and PPI use for the prevention and treatment of stress gastric ulcers...
November 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28496035/alleviating-effects-of-artificial-tear-instillation-on-s-1-induced-ocular-toxicity-in-dogs
#17
Shohei Kanie, Mitsuhiro Fujieda, Tomoaki Hitotsumachi, Satoshi Suzuki, Fumio Morita, Kazuo Hakoi, Hirofumi Yasui
S-1 is an anticancer agent that consists of tegafur, gimeracil, and oteracil potassium at a molar ratio of 1:0.4:1. S-1 is used to treat metastatic and resectable gastric cancer. However, the extensive use of S-1 in clinical practice results in watery eyes, a serious clinical problem, which worsens patients' quality of life. Although repeated instillation of artificial tears is recommended, therapy or prophylaxis against S-1-induced ocular toxicity has not been established. In the present study, we evaluated the alleviating effects of repeated artificial tear instillation on S-1-induced ocular toxicity in dogs...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#18
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28469042/systemic-treatment-strategies-for-patients-with-hereditary-breast-cancer-syndromes
#19
Amanda Parkes, Banu K Arun, Jennifer K Litton
Hereditary breast cancer syndromes are associated with an increased risk of breast cancer and constitute a unique patient population, making up approximately 5%-10% of breast cancer cases in the United States. By virtue of the germline mutations that define these syndromes, invasive breast cancers in these patients have unique mechanisms that can be rationally targeted for therapeutic opportunities distinct from standard of care treatments in nongermline mutation associated breast cancers. This review intends to describe existing data on several of the most common hereditary breast cancer syndromes, including BRCA-related breast cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome, Peutz-Jeghers syndrome, and hereditary diffuse gastric cancer syndrome, specifically focusing on rational therapeutics utilized in these distinct patient subgroups and completed or ongoing clinical trials evaluating their efficacy...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28461706/possibilities-for-modifying-risk-factors-for-the-development-of-hospital-acquired-pneumonia-in-intensive-care-patients-results-of-a-retrospective-observational-study
#20
Radovan Uvizl, Milan Kolar, Tomas Herkel, Michaela Vobrova, Katerina Langova
BACKGROUND: Hospital-acquired pneumonia (HAP) development is affected by a range of risk factors. METHODS: A retrospective, observational study processing data on all consecutive intensive care patients older than 18 years of age between 1 January 2011 and 31 December 2015. The aim was to determine the incidence of potential risk factors and their impact on the development of HAP. RESULTS: A total of 2229 patients. The overall mortality was 24...
September 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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