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https://www.readbyqxmd.com/read/28924528/near-fatal-gastrointestinal-hemorrhage-in-a-child-with-medulloblastoma-on-high-dose-dexamethasone
#1
Derek Yecies, Daniel Tawfik, Jennifer Damman, Chad Thorson, David S Hong, Gerald A Grant, Rachel Bensen, Mihaela Damian
A four-year-old female was admitted to a university-based children's hospital with a newly-diagnosed posterior fossa tumor. She was started on famotidine and high-dose dexamethasone and underwent gross total resection of a medulloblastoma. She was continued on dexamethasone and famotidine. She exhibited postoperative posterior fossa syndrome and was started on enteral feeds via the nasoduodenal tube. She had small gastrointestinal bleeds on postoperative days eight, 11, and 18, and was found to have a well-circumscribed posterior duodenal ulcer...
July 7, 2017: Curēus
https://www.readbyqxmd.com/read/28920016/comparison-of-t-tube-ileostomy-and-bishop-koop-ileostomy-for-the-management-of-uncomplicated-meconium-ileus
#2
Md Samiul Hasan, Ashrarur Rahman Mitul, Sabbir Karim, Kazi Md Noor-Ul Ferdous, M Kabirul Islam
BACKGROUND: Meconium ileus is a common cause of neonatal intestinal obstruction. Various surgical procedures are in practice for uncomplicated meconium ileus. Bishop Koop ileostomy allows distal passage of gut content and uses the distal absorptive area. T tube ileostomy avoids the need for gut resection and formal closure of stoma. The aim of this prospective interventional study was to compare the outcome of T-tube ileostomy and Bishop Koop ileostomy for the treatment of uncomplicated meconium ileus...
July 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28916211/diaphragmatic-fenestration-for-refractory-chylothorax-after-congenital-cardiac-surgery-in-infants
#3
T K Susheel Kumar, Kaitlin Balduf, Umar Boston, Christopher Knott-Craig
OBJECTIVE: Medically refractory chylous pleural effusion after congenital heart surgery is associated with significant morbidity and mortality, especially in infants. We reviewed our experience with diaphragmatic fenestration procedure in this group of patients. METHODS: A retrospective chart review of all patients who had diaphragmatic fenestrations for chylous effusion at our institution over a 2-year period was performed. RESULTS: A total of 9 diaphragmatic fenestration procedures were performed in 8 patients who had failed medical management of chylous pleural effusions...
August 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28901001/-early-versus-traditional-postoperative-oral-feeding-in-patients-undergoing-elective-colorectal-surgery-a-meta-analysis-of-safety-and-efficacy
#4
Kun Zhang, Sirong Cheng, Qi Zhu, Zhenguo Han
OBJECTIVE: To compare the outcomes of early oral feeding (EOF) and the traditional oral feeding (TOF) in postoperative patients with colorectal cancer using Meta-analysis. METHODS: The databases of PubMed, SCI, Ovid, The Cochrane Library, CNKI, CBM, VIP and Wanfang Data were searched to collect randomized controlled trial (RCT) about EOF versus TOF in patients undergoing elective colorectal surgery. The retrieval time span was from inception to June 1, 2016. The studies were screened according to the inclusion and exclusion criteria...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28881078/the-effects-of-nurse-led-clinical-pathway-in-coronary-artery-bypass-graft-surgery-a-quasi-experimental-study
#5
Ayda Kebapçı, Nevin Kanan
AIMS AND OBJECTIVE: Develop and evaluate the effects of a nurse-led clinical pathway (CP) for patients undergoing CABG (Coronary Artery Bypass Graft Surgery). BACKGROUND: A CP is a multidisciplinary care plan, based on evidence and guidelines to provide consistent, quality care to patients and improve outcomes. DESIGN: Prospective, quasi-experimental design. METHODS: Patients hospitalized for CABG between April 2014 and November 2015 in a hospital in Turkey were studied...
September 7, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#6
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
September 4, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28877001/total-laparoscopic-approach-for-transhiatal-esophagectomy-and-gavriliu-s-esophagoplasty-in-children-with-caustic-esophageal-injuries
#7
Louise Montalva, Jérôme Viala, Daphné Michelet, Fernanda Frade, Hubert Lardy, Christine Vitoux, Arnaud Bonnard
BACKGROUND: Esophageal repair after caustic injury is a surgical challenge in children. The aim of this study was to report the first results of a total laparoscopic approach in transhiatal esophagectomy and esophageal replacement by an anisoperistaltic gastric tube. PATIENTS AND METHODS: A retrospective review of data from children operated on with a laparoscopic approach for transhiatal esophagectomy and Gavriliu's esophagoplasty between 2011 and 2015 was performed...
September 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28875132/open-wound-management-of-esophagocutaneous-fistula-in-unstable-cervical-spine-after-corpectomy-and-multilevel-laminectomy-a-case-report-and-review-of-the-literature
#8
Hossein Elgafy, Mustafa Khan, Jacob Azurdia, Nicholas Peters
A 67-year-old female patient developed an esophagocutaneous fistula 4 mo after C4 and C5 partial corpectomy. Plain radiograph and computed tomography (CT) scan of cervical spine showed inferior screws pullout with plate migration that caused the esophageal perforation. Management included removal of anterior hardware, revision C4-5 corpectomy, iliac crest strut autograft and halo orthosis immobilization. The fistula was treated using antibiotics and a 10-french gauge rubber tube for daily irrigation and Penrose drain...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28864557/over-the-scope-clip-system-secured-nasojejunal-tube-feeding-in-refractory-hyperemesis-gravidarum
#9
Jan Kubovy, Agnieszka Them, Rees Cameron, Fali Langdana
Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It complicates up to 2% of all pregnancies and can be associated with adverse outcomes. Its management commonly involves a combination pharmacotherapy, however, the efficacy of such treatment is limited. Supplemental nutrition is often required in refractory cases. Enteral route is preferred over parenteral, given the high rate of intravenous catheter-related complications. Enteral feeding tube placement can be challenging and is commonly thwarted by dislodgement...
September 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28859370/management-of-recurrent-tracheoesophageal-fistula-after-esophageal-atresia-and-follow-up
#10
J Wang, M Zhang, W Pan, W Wu, W Yan, W Cai
Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical records of 35 patients with rTEF treated at a single institution from June 2012 to December 2015 were reviewed, and follow-up data were collected from all survivors...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28854775/gastrocolocutaneous-fistula-an-unusual-case-of-gastrostomy-tube-malfunction-with-diarrhea
#11
Junghwan Lee, Jinyoung Kim, Ha Il Kim, Chung Ryul Oh, Sungim Choi, Soomin Noh, Hee Kyong Na, Hwoon-Yong Jung
A gastrocolocutaneous fistula is a rare complication of percutaneous endoscopic gastrostomy (PEG). We report a case of a gastrocolocutaneous fistula presenting with intractable diarrhea and gastrostomy tube malfunction. A 62-year-old woman with a history of multiple system atrophy was referred to us because of PEG tube malfunction. Twenty days prior to presentation, the patient started developing sudden diarrhea within minutes after starting PEG feeding. Fluoroscopy revealed that the balloon of the PEG tube was located in the lumen of the transverse colon with the contrast material filling the colon...
August 31, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28839865/transnasal-endoscopy-no-gagging-no-panic
#12
Clare Parker, Estratios Alexandridis, John Plevris, James O'Hara, Simon Panter
BACKGROUND: Transnasal endoscopy (TNE) is performed with an ultrathin scope via the nasal passages and is increasingly used. This review covers the technical characteristics, tolerability, safety and acceptability of TNE and also diagnostic accuracy, use as a screening tool and therapeutic applications. It includes practical advice from an ear, nose, throat (ENT) specialist to optimise TNE practice, identify ENT pathology and manage complications. METHODS: A Medline search was performed using the terms "transnasal", "ultrathin", "small calibre", "endoscopy", "EGD" to identify relevant literature...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28836089/risk-factors-for-sodium-valproate-induced-renal-tubular-dysfunction
#13
Satoko Koga, Takahisa Kimata, Sohsaku Yamanouchi, Shoji Tsuji, Ken Yoshimura, Atsushi Araki, Kazunari Kaneko
OBJECTIVE: To explore the risk factors for the development of sodium valproate (VPA)-induced renal tubular dysfunction for early diagnosis and treatment. STUDY DESIGN: The subjects were selected from patients who were diagnosed with epilepsy and administered VPA. Blood and spot urine samples were collected and measured the concentration of VPA, the level of serum phosphorus, serum uric acid, serum free carnitine, serum cystatin-c, and urine β2-microglobulin (BMG)...
August 23, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28835092/management-of-percutaneous-endoscopic-gastrostomy-site-gastric-ulcer-in-a-patient-with-an-esophageal-stricture-and-hiatus-hernia
#14
Clement C H Wu, James W Li, Keng Sin Ng, Daphne S Ang
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding difficulties, in patients suffering from complications of nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges in hemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically, followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidental dislodgement...
May 22, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#15
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820648/natural-bioactive-food-components-for-improving-enteral-tube-feeding-tolerance-in-adult-patient-populations
#16
Adam J Kuchnia, Beth Conlon, Norman Greenberg
Tube feeding (TF) is the most common form of nutrition support. In recent years, TF administration has increased among patient populations within and outside hospital settings, in part due to greater insurance coverage, reduced use of parenteral nutrition, and improved formularies suitable for sole source nutrition. With increasing life expectancy and improved access to TFs, the number of adults dependent on enteral nutrition is expected to grow. However, enteral TF intolerance (ETFI) is the most common complication of TFs, typically presenting with at least 1 adverse gastrointestinal event, including nausea, diarrhea, and constipation...
August 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28815083/routine-jejunostomy-tube-feeding-following-esophagectomy
#17
Teus J Weijs, Hanneke W J van Eden, Jelle P Ruurda, Misha D P Luyer, Elles Steenhagen, Grard A P Nieuwenhuijzen, Richard van Hillegersberg
BACKGROUND: Malnutrition is an important problem following esophagectomy. A surgically placed jejunostomy secures an enteral feeding route, facilitating discharge with home-tube feeding and long-term nutritional support. However, specific complications occur, and data are lacking that support its use over other enteral feeding routes. Therefore routine jejunostomy tube feeding and discharge with home-tube feeding was evaluated, with emphasis on weight loss, length of stay and re-admissions...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28815075/the-feeding-route-after-esophagectomy-a-review-of-literature
#18
REVIEW
Gijs H Berkelmans, Frans van Workum, Teus J Weijs, Grard A Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D Luyer
Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is essential in patients undergoing an esophagectomy. These patients often present with weight loss and their eating pattern is strongly altered by the procedure and reconstruction. Total parenteral nutrition (TPN) is associated with severe septic complications and enteral nutrition (EN) does not increase major complications...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28807987/use-of-noninvasive-ventilation-during-feeding-tube-placement
#19
REVIEW
Paolo Banfi, Eleonora Volpato, Chiara Valota, Salvatore D'Ascenzo, Chiara Bani Alunno, Agata Lax, Antonello Nicolini, Nicola Ticozzi, Vincenzo Silani, John R Bach
Parenteral nutrition is indicated in amyotrophic lateral sclerosis (ALS) when dysphagia, loss of appetite, and difficulty protecting the airways cause malnutrition, severe weight loss, dehydration, and increased risk of aspiration pneumonia. The aim of this review is to compare percutaneous endoscopic gastrostomy (PEG), radiologically inserted G-tube (RIG), and percutaneous radiologic gastrostomy (PRG) in patients with ALS, performed with or without noninvasive ventilation (NIV). We searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), the EBSCO Online Research Database, and Scopus up to December 2015...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28761868/standardizing-the-protocols-for-enhanced-recovery-from-colorectal-cancer-surgery-are-we-a-step-closer-to-ideal-recovery
#20
Mosab Shetiwy, Tamer Fady, Fayez Shahatto, Ahmed Setit
PURPOSE: Enhanced recovery protocols are being implemented into the standard of care in surgical practice. This study aimed to insert a steadfast set of elements into the perioperative care pathway to establish an improved recovery program for colorectal cancer patients. METHODS: Seventy patients planned for elective laparoscopic colorectal resection were randomized into 2 groups: conventional recovery group (n = 35) and enhanced recovery group (n = 35). The primary outcome was the length of hospital stay...
June 2017: Annals of Coloproctology
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