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https://www.readbyqxmd.com/read/28635876/-salivation-after-stroke
#1
Z A Zalyalova
Salivation after stroke (sialorrhea, hypersalivation, ptyalism) can be caused by the overproduction or a lack of utilization of saliva. Patients after stroke often have sialorrhea as a result of dysphagia. Neurogenic dysphagia in acute period after stroke occurs in 25-65% of patients. The mortality rate among people with post-stroke dysphagia and tube feeding ranges from 20 to 24%. Patients who suffering from profuse salivation have difficulties with articulation and swallowing, bad breath, irritation and maceration of perioral area, contamination of clothing and bed linen...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28623142/complication-of-newborn-circumcision-meatal-stenosis-or-meatal-web
#2
Mehmet Ali Özen, Gökhan Gündoğdu, Mehmet Taşdemir, Egemen Eroğlu
INTRODUCTION: Meatal stenosis (MS) is a known complication of newborn circumcision. Symptoms are usually masked in young kids with a diaper. Deflation of urinary stream, dysuria, urinary frequency, and incontinence are the most common reported symptoms. Diagnosis of MS is still controversial. A narrow pinpoint urethral meatus is the current accepted diagnostic criteria. OBJECTIVE: In our practice, we observed that our cases do not overlap to the classic definition and presentation of MS...
June 2, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28618137/the-impact-of-aspiration-pneumonia-and-nasogastric-feeding-on-clinical-outcomes-in-stroke-patients-a-retrospective-cohort-study
#3
Maria Schwarz, Anne Coccetti, Allison Murdoch, Elizabeth Cardell
AIMS AND OBJECTIVES: To determine presence of clinical complications related to dysphagia and to explore their operational outcomes. BACKGROUND: Dysphagia is a common complication of stroke. The management of post stroke dysphagia is multi-disciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28611568/two-anomalies-in-one-a-rare-case-of-an-intrahepatic-gallbladder-with-a-cholecystogastric-fistula
#4
Mohammad F Ali, David Friedel, Galina Levin
The gallbladder can be situated in a variety of anomalous positions. An intrahepatic gallbladder - the second most common ectopic location of the gallbladder - is one that is completely embedded within the liver parenchyma. Described in the literature as early as 1935, intrahepatic gallbladders predominantly result from a developmental anomaly but in some instances have been reported to be secondary to chronic inflammation. The significance of an intrahepatic gallbladder lies in the fact that 60% of the cases are associated with gallstones and may present a challenge for the general surgeon during cholecystectomy and other biliary operations in addition to causing misdiagnosis on imaging...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28603716/optimizing-nutrition-in-preterm-low-birth-weight-infants-consensus-summary
#5
REVIEW
R Kishore Kumar, Atul Singhal, Umesh Vaidya, Saswata Banerjee, Fahmina Anwar, Shashidhar Rao
Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants...
2017: Frontiers in Nutrition
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#6
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#7
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28599662/a-randomized-controlled-pilot-study-to-evaluate-the-effect-of-an-enteral-formulation-designed-to-improve-gastrointestinal-tolerance-in-the-critically-ill-patient-the-spirit-trial
#8
Stephan M Jakob, Lukas Bütikofer, David Berger, Michael Coslovsky, Jukka Takala
BACKGROUND: Diarrhea is frequent in patients in intensive care units (ICU) and is associated with discomfort and complications and may increase the length of stay and nursing workload. METHODS: This was a prospective, double-blind, randomized, controlled single-center pilot study to assess the incidence and frequency of diarrhea and the respective effects of a modified enteral diet (intervention: Peptamen® AF, rich in proteins, medium chain triglycerides and fish oil) compared to a standard diet (control: Isosource® Energy) in 90 randomized adult patients (intervention, n = 46; control, n = 44) with an ICU stay ≥5 days and tube feeding ≥3 days...
June 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28588153/gastric-dilatation-and-abdominal-compartment-syndrome-in-a-child-with-prader-willi-syndrome
#9
Clara Blat, Elisenda Busquets, Teresa Gili, Assumpta Caixàs, Elisabeth Gabau, Raquel Corripio
BACKGROUND Prader-Willi syndrome (PWS) is a genetic disorder characterized by initial muscular hypotonia and feeding difficulties, and later an insatiable appetite, hyperphagia and obesity along with mild to moderate intellectual impairment. Affected individuals' food-seeking behavior and suspected delayed gastric emptying can lead to gastric dilatation with subsequent necrosis and perforation. CASE REPORT We present the case of a 5-year-old boy diagnosed with Prader-Willi syndrome at neonatal age due to muscular hypotonia, who started growth hormone therapy at 20 months...
June 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28580621/functional-outcomes-of-fasciocutaneous-free-flap-and-pectoralis-major-flap-for-salvage-total-laryngectomy
#10
Sally Nguyen, François Thuot
BACKGROUND: Pectoralis major muscle flaps (PMMFs) and fasciocutaneous free flaps (FFFs) are commonly used for reconstruction of the surgical defect after salvage total laryngectomy. This study compared swallowing function in patients who underwent reconstruction with either PMMF or FFF. METHODS: This study was based on a retrospective cohort of patients treated at the CHU de Québec between January 2000 and March 2015. Demographics, chemoradiation data, surgical protocol, pathologic results, complications, evolution, esophageal dilation, diet intake, and feeding tube dependence were documented...
June 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28572521/the-feeding-paradox-in-advanced-dementia-a-local-perspective
#11
J Kh Luk, F Hw Chan, E Hui, C Y Tse
Feeding problems are common in older people with advanced dementia. When eating difficulties arise tube feeding is often initiated, unless there is a valid advance directive that refuses enteral feeding. Tube feeding has many pitfalls and complications. To date, no benefits in terms of survival, nutrition, or prevention of aspiration pneumonia have been demonstrated. Careful hand feeding is an alternative to tube feeding with advanced dementia. In Hong Kong, the Hospital Authority has established clear ethical guidelines for careful hand feeding...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28556353/decreased-absorption-of-dolutegravir-and-tenofovir-disoproxil-fumarate-but-not-emtricitabine-in-an-hiv-infected-patient-following-oral-and-jejunostomy-tube-administration
#12
Kristina M Brooks, Katy L Garrett, Safia S Kuriakose, Jomy M George, Gayle Balba, Bria Bailey, Megan Anderson, H Clifford Lane, Frank Maldarelli, Alice K Pau
The use of enteral feeding tubes to administer antiretroviral medication administration is necessary in certain patients with human immunodeficiency virus (HIV) infection. However, adequacy of drug exposures after these administration routes are largely unknown, making dosing recommendations and the attainment of viral suppression challenging in this patient population. This report describes a patient with advanced HIV infection and a complicated medical history, including long-term intractable nausea/vomiting necessitating antiretroviral medication administration via a Roux-en-Y jejunostomy (J)-tube...
May 27, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28549684/primary-laparoscopic-gastrojejunostomy-tubes-as-a-feeding-modality-in-the-pediatric-population
#13
Chinwendu Onwubiko, Brent R Weil, Sigrid Bairdain, Amber M Hall, Julia M Perkins, Hariharan Thangarajah, Maireade E McSweeney, C Jason Smithers
PURPOSE: Outcomes associated with primary laparoscopic gastrojejunal (GJ) tube placement in the pediatric population were evaluated. METHODS: A single-institution, retrospective review examined patients undergoing laparoscopic GJ tube placement between June 2011 and December 2014. Outcomes included gastric feeding tolerance, subsequent fundoplication, complications, and mortality. RESULTS: Ninety laparoscopic GJ tubes were placed. Median follow-up was 342days (interquartile range [IQR]=141-561days)...
May 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28549015/early-oral-feeding-following-mckeown-minimally-invasive-esophagectomy-an-open-label-randomized-controlled-noninferiority-trial
#14
Hai-Bo Sun, Yin Li, Xian-Ben Liu, Rui-Xiang Zhang, Zong-Fei Wang, Toni Lerut, Chia-Chuan Liu, Alfonso Fiorelli, Yin-Kai Chao, Daniela Molena, Robert J Cerfolio, Soji Ozawa, Andrew C Chang
OBJECTIVE: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. SUMMARY BACKGROUND DATA: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. METHODS: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28546717/intussusception-a-rare-complication-after-feeding-jejunostomy-a-case-report
#15
Shreyas Dholaria, Kamal Kishor Lakhera, Sanjeev Patni
Feeding jejunostomy (FJ) is a commonly done surgical procedure for enteral nutrition. Intussusception is one of the rare complications of FJ. Clinical presentation may be similar to other causes of small bowel obstruction. Intussusception should be suspected if a patient with jejunostomy tube develops upper gastrointestinal obstructive symptoms, which are relieved by nasogastric tube drainage. CT or ultrasonography (USG) can help to confirm the diagnosis. It can be relieved spontaneously or sometimes requires laparotomy...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28538385/surgical-outcomes-of-different-approaches-to-esophageal-replacement-in-long-gap-esophageal-atresia-a-systematic-review
#16
REVIEW
Jia Liu, Yifan Yang, Chao Zheng, Rui Dong, Shan Zheng
BACKGROUND: Esophageal replacement (ER) surgery has been widely used in long-gap esophageal atresia (LGEA) over the past few decades. The most commonly used surgical approaches in many pediatric surgical centers include colon interposition (CI), gastric pull-up (GPU), jejunal interposition (JI), and gastric tube reconstruction (GTR). However, there is no systematic evidence on which is the optimal conduit for the native esophagus. The aim of this systematic review was to evaluate the short- and long-term outcomes among these 4 replacement approaches in LGEA cases based on current evidence...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28531451/new-laparoscopic-assisted-percutaneous-gastrostomy-description-and-comparison-with-others-gastrostomy-types
#17
Pilar Serrano Aguayo, Noelia Gros Herguido, Juana Parejo Campos, Antonio Barranco Moreno, María Del Castillo Tous Romero, José Luis Pereira Cunill, Isaías Alarcón Del Agua, María Socas Macias, Pedro Pablo García Luna, Salvador Morales Conde
INTRODUCTION: Gastrostomy feeding tube insertion has become a common procedure as it enables patients who require long term enteral feeding. Conventional surgical gastrostomies were the only way of gaining enteral access in patients in which it is not possible to pass an endoscope or a nasogastric tube required for endoscopic or radiological gastrostomies, and in patients in which certain anatomical abnormalities contraindicate performing these techniques. As conventional surgical gastrostomies are associated with high morbidity, especially gastric leakage around the tube, percutaneous laparoscopic assisted gastrostomy (PLAG) may be a better way to gain enteral access...
December 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28509623/gastrostomy-in-patients-with-prion-disease
#18
Yasushi Iwasaki, Keiko Mori, Masumi Ito, Yoshinari Kawai, Ken-Ichiro Hoshino, Yuko Kawabata, Maya Mimuro, Mari Yoshida
Patients with prion diseases can live for long periods of time in a state of akinetic mutism given appropriate management of their symptoms. To study symptom support in these cases, we performed gastrostomies on 3 patients with V180I genetic Creutzfeldt-Jakob disease (CJD) who had become akinetic and mute, and compared them to 14 other similar patients being fed by tube. In the 3 gastrostomy cases, there were no direct complications due to the gastrostomy or tube feeding, nor were there episodes of discontinuation of tube feeding or initiation of continuous drip infusion due to severe complications...
May 4, 2017: Prion
https://www.readbyqxmd.com/read/28498058/endoscopic-endonasal-resection-of-the-odontoid-process-clinical-outcomes-in-34-adults
#19
Nathan T Zwagerman, Matthew J Tormenti, Zachary J Tempel, Eric W Wang, Carl H Snyderman, Juan C Fernandez-Miranda, Paul A Gardner
OBJECTIVE Treatment of odontoid disease from a ventral corridor has consisted of a transoral approach. More recently, the endoscopic endonasal approach (EEA) has been used to access odontoid pathology. METHODS A retrospective review was conducted of patients who underwent an EEA for odontoid pathology from 2004 to 2013. During our analysis, the mean follow-up duration was 42.6 months (range 1-80 months). Patient outcomes, complications, and postoperative swallowing function were assessed either by clinic visit or phone contact...
May 12, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#20
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
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