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https://www.readbyqxmd.com/read/28228206/low-abdominal-wall-thickness-may-predict-percutaneous-endoscopic-gastrostomy-complications
#1
Melissa K James, Vanessa P Ho, Simon P Tiu, Richard J Tom, Taylor R Klein, Gloria M Melnic, Sebastian D Schubl
Although percutaneous endoscopic gastrostomy (PEG) tube placement is a common and safe procedure to provide enteral feeding, some patients develop complications. The aim of this study was to identify risk factors for the development of post-PEG complications. We hypothesized that patients with low albumin, diabetes, higher body mass index (BMI), thicker abdominal walls, or psychomotor agitation would have more complications. A 2-year retrospective review was performed on patients who received a PEG tube at a single institution...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28218495/design-and-evaluation-of-a-variable-stiffness-manual-operating-platform-for-laparoendoscopic-single-site-surgery-less
#2
Jinhua Li, Xuejie Li, Jianchen Wang, Yuan Xing, Shuxin Wang, Xiangyun Ren
BACKGROUND: Most of the existing robotic platforms for LESS have workspace and load capacity weaknesses, because of the limitation of one single incision. We have developed a LESS manual operating platform of which the stiffness of the insertion tube is controllable. METHODS: The system included two dexterous tool manipulators, a stereo-vision module and a variable stiffness insertion tube (VSIT), which was designed using phase-change material (mixed indium, gallium and stannum)...
February 20, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28204979/one-year-swallowing-outcomes-in-patients-treated-with-prophylactic-gabapentin-during-radiation-based-treatment-for-oropharyngeal-cancer
#3
Heather M Starmer, WuYang Yang, Christine G Gourin, Rachit Kumar, Bronwyn Jones, Todd McNutt, Sierra Cheng, Harry Quon
Recent investigations by our study team have demonstrated patients using gabapentin for pain management during chemoradiotherapy (CRT) do well maintaining swallowing during treatment with less need for narcotic pain medication, PEG dependence, weight loss, and short-term swallowing morbidity. The purpose of this investigation was to characterize the long-term swallowing function of these patients 1-year following treatment. Sequential patients receiving CRT for oropharyngeal cancer and concurrent gabapentin were evaluated 1-year following treatment for swallowing outcomes...
February 15, 2017: Dysphagia
https://www.readbyqxmd.com/read/28198100/enteroatmospheric-fistula-management-by-endoscopic-gastrostomy-peg-tube
#4
Luiz Ec Miranda, Ana Cg Miranda
Management of small-bowel fistulas which are in an open abdomen and have no soft tissue overlay or a fistula tract involves many complications and challenges. Controlling the local leakage of enteric contents has a central role in the success of medical treatment. There are several methods to deal with fistula discharge but unfortunately, the technical solutions only partially address such problems and a definitive management of fistula discharge still remains an insoluble challenge. We describe a simple and cheap method to control fistula leakage by using a percutaneous endoscopic gastrostomy tube...
February 15, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28177326/supracricoid-laryngectomy-for-recurrent-laryngeal-cancer-after-chemoradiotherapy-a-systematic-review-and-meta-analysis
#5
C A Leone, P Capasso, D Topazio, G Russo
Residual or recurrent laryngeal cancer after irradiation is a difficult clinical problem with a rate that ranges from 13% to 36% of cases. Supracricoid laryngectomy (SCL) with cricohyoidopexy (CHP) or cricohyoidoepiglottopexy (CHEP) provide reliable oncological and functional results for selected primary and recurrent patients with glottic and supraglottic carcinomas. We conducted a systematic review and meta-analysis to assess the oncological and functional outcomes of patients treated with open partial horizontal laryngectomy types IIa and IIb (CHEP, CHP) in terms of the recurrence of squamocellular cancer of the larynx after radiotherapy failure...
December 2016: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28174655/a-forgotten-nasogastric-feeding-tube-that-refuses-to-get-out
#6
Michail Galanopoulos, Athanasios Tsigaridas, Lazaros Varytimiadis, Apostolis Papaefthymiou, Lazaros Kalampalikis, Spyridon Ladias, Gerassimos J Mantzaris
Nasogastric tubes (NGT) are extensively used and generally harmless, yet loop formation and malpositioning are often reported especially when using thin NGT for enteral feeding which placed blindly; therefore, diligent follow-up of NGT is required with confirmation of right placement, changing it to PEG if long use of NGT needed.
February 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28152219/effect-of-prophylactic-percutaneous-endoscopic-gastrostomy-tube-on-swallowing-in-advanced-head-and-neck-cancer-a-randomized-controlled-study
#7
Lars Axelsson, Ewa Silander, Jan Nyman, Mogens Bove, Leif Johansson, Eva Hammerlid
BACKGROUND: Dysphagia is common in head and neck cancer. A percutaneous endoscopic gastrostomy (PEG) tube is used to facilitate nutrition; however, some retrospective studies have indicated that the PEG tube causes dysphagia. METHODS: A randomized study of patients with head and neck cancer was conducted with up to 10 years of follow-up. Patients were randomized to either the prophylactic PEG tube group (study group) or the common clinical nutritional support group (control group)...
February 2, 2017: Head & Neck
https://www.readbyqxmd.com/read/28149569/how-should-this-patient-with-repeated-aspiration-pneumonia-be-managed-and-treated-a-proposal-of-the-percutaneous-endoscopic-gastrostomy-and-tracheostomy-penlight-procedure
#8
REVIEW
Zhongheng Zhang, Jason Akulian, Yucai Hong, Ning Liu, Yuhao Chen
Cerebrovascular accident (CVA) is commonly seen among the elderly with a substantial proportion of patients suffering from long-term dysphagia and/or an inability to protect their airway. This potentially imposes on them an increased risk of malnutrition and aspiration pneumonia. In this article, we present a patient with malnutrition and dysphagia secondary to CVA. We propose a procedure for which we will name the Percutaneous ENdoscopIc Gastrostomy and Tracheostomy (PENlIGhT) procedure for placement of percutaneous endoscopic gastrostomy (PEG) and tracheostomy tube (TT) at the same time...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28139230/comparison-of-operative-outcomes-between-surgical-gastrostomy-and-percutaneous-endoscopic-gastrostomy-in-infants
#9
Shin Miyata, Fanglong Dong, Olga Lebedevskiy, Hanna Park, Nam Nguyen
PURPOSE: Safety profile of different gastrostomy procedures in small children has not been well studied. This study was conducted to investigate whether complication and mortality rates differ between surgical gastrostomy (G-tube) and percutaneous endoscopic gastrostomy (PEG) in infants and neonates. METHODS: In this retrospective study utilizing the Kids' Inpatient Database, all infants who underwent either G-tube or PEG as a sole procedure were identified. Variables included age, gender, race, presence of neurological impairment, prematurity, complex chronic condition, and severity of illness/risk of mortality subclasses...
January 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28131057/compatibility-study-of-a-parenteral-microdose-polyethylene-glycol-formulation-in-medical-devices-and-identification-of-degradation-impurity-by-2d-lc-ms
#10
Lulu Dai, Geoffrey K Yeh, Yingqing Ran, Peter Yehl, Kelly Zhang
Polyethylene glycol (PEG) based formulation and polyvinylchloride (PVC) tubing are frequently used for drug delivery and administration. The compatibility of a parenteral drug microdose formulation in intravenous infusion (IV) devices was studied to support the clinical determination of absolute bioavailability by the microdosing method. The investigational microdose formulation containing PEG was found prone to significant loss of potency within hours of storage in the PVC IV tubing due to degradation. Degradation occurred only when both PEG and PVC tubing were present...
January 18, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28052457/changes-in-in%C3%A2-vitro-ruminal-and-post-ruminal-degradation-of-tropical-tannin-rich-legumes-due-to-varying-levels-of-polyethylene-glycol
#11
M M Knowles, M L Pabón, H D Hess, J E Carulla
We evaluated the effects of tannins from Flemingia macrophylla (CIAT 17403) and Calliandra calothyrsus (San Ramón CIAT 22310 and Patulul CIAT 22316) on in vitro ruminal and post-ruminal dry matter and apparent protein degradation. For each tannin source (legumes), different dosages of polyethylene glycol (PEG) (8000 Da) in McDougall buffer were added to achieve ratios of 0:3, 1:3, 2:3 and 3:3 PEG:condensed tannin (CT). Ruminal fluid mixed with McDougall buffer (1:4) was added to tubes containing only legume foliage (control) or PEG-treated legume foliage...
January 4, 2017: Journal of Animal Physiology and Animal Nutrition
https://www.readbyqxmd.com/read/28039644/incidence-of-abdominal-wall-metastases-following-percutaneous-endoscopic-gastrostomy-placement-in-patients-with-head-and-neck-cancer
#12
Eleanor Fung, David S Strosberg, Edward L Jones, Rebecca Dettorre, Andrew Suzo, Michael P Meara, Vimal K Narula, Jeffrey W Hazey
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) tubes are an effective modality for enteral nutrition in patients with head and neck cancer; however, there have been documented case reports of "seeding" of the abdominal wall by the theoretic risk of dragging the tube along the tumor during PEG placement. The objective of this study is to determine the incidence and contributing risk factors leading to metastasis to the abdominal wall following PEG placement in patients with head and neck cancer...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28009454/direct-estimation-for-adaptive-treatment-length-policies-methods-and-application-to-evaluating-the-effect-of-delayed-peg-insertion
#13
Xin Lu, Brent A Johnson
Dysphagia is a primary cause of death among patients diagnosed with amyotrophic lateral sclerosis (ALS), and percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a tube into the stomach to assist or replace oral feeding. It is believed that PEG is beneficial and, generally, earlier insertion is preferable to later. However, gathering clinical evidence to support these beliefs on the use and timing of PEG is challenging because controlled clinical trials are not feasible and clinical endpoints are confounded with PEG in observational data...
December 23, 2016: Biometrics
https://www.readbyqxmd.com/read/27990013/intraoperative-gastric-intramural-hematoma-a-rare-complication-of-percutaneous-endoscopic-gastrostomy
#14
Chi Chan Lee, Sharmila Ravindranathan, Vivek Choksi, Jestin Pudussery Kattalan, Uday Shankar, Steven Kaplan
BACKGROUND Intramural hematomas primarily present in the esophagus or duodenum. We report a case of intramural hematoma in the gastric wall (GIH) secondary to percutaneous endoscopic gastrostomy (PEG) tube placement in a setting of platelet dysfunction. CASE REPORT This case study reviews the hospitalization of a 73-year-old male with a history of chronic kidney disease who was admitted for coronary artery bypass graft surgery and mitral valve repair. During his complicated hospital course, he inadvertently required the placement of a PEG tube...
December 19, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27986517/comparison-of-nutritional-and-clinical-outcomes-in-patients-with-head-and-neck-cancer-undergoing-chemoradiotherapy-utilizing-prophylactic-versus-reactive-nutrition-support-approaches
#15
Teresa E Brown, Merrilyn D Banks, Brett G M Hughes, Charles Y Lin, Lizbeth M Kenny, Judith D Bauer
BACKGROUND: The optimal method of tube feeding for patients with head and neck cancer remains unclear. A validated protocol is available that identifies high-nutritional-risk patients who would benefit from prophylactic gastrostomy tube placement. Adherence to this protocol is ultimately determined by clinical team discretion or patient decision. OBJECTIVE: The study aim was to compare outcomes after adherence and nonadherence to this validated protocol, thus comparing a prophylactic and reactive approach to nutrition support in this patient population...
December 13, 2016: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/27965711/the-buried-bumper-syndrome-external-bumper-extraction-after-radial-mini-incisions-and-replacement-through-an-adjacent-tract
#16
M A Benatta
Although considered as a safe method to provide long-term nutritional support, percutaneous endoscopic gastrostomy (PEG) may be complicated by a buried bumper syndrome (BBS), a life-threatening condition. Removal of the PEG tube with its buried bumper and reinsertion of a new PEG tube is often necessary. Since its description in 1988, less than 50 cases of BBS managed by external extraction of the buried bumper have been reported. We report a case of buried bumper that was removed by external traction without the need for endoscopic or laparoscopic treatment but with the need of two radial millimeter skin incisions after abdominal CT study and finally immediate PEG replacement but through an adjacent site...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27965430/timing-of-percutaneous-endoscopic-gastrostomy-for-acute-ischemic-stroke-an-observational-study-from-the-us-nationwide-inpatient-sample
#17
Benjamin P George, Adam G Kelly, George P Albert, David Y Hwang, Robert G Holloway
BACKGROUND AND PURPOSE: Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke. METHODS: We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission...
December 13, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#18
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27928446/gastrostomy-with-peritoneal-collar-versus-percutaneous-endoscopic-gastrostomy
#19
Tudor C, Branescu C, Savlovschi C, El-Khatib A, Pantu H, Nica A, Dascalu Am, Masoumeh B, Tudor As, Oprescu Sm, Serban D
Aim. The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. Materials and method. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27925010/the-effects-of-a-simple-method-for-cryopreservation-and-thawing-procedures-on-cord-blood-derived-dc-based-esophageal-carcinoma-vaccine
#20
J Yu, L Xie, S Chen, J Zhang, G Guo, B Chen
BACKGROUND: Producing sufficient numbers of DCs at one time point and subsequently cryopreserving the generated DCs in ready-for-use aliquots for clinical application is useful in cancer treatment. OBJECTIVE: To study the effects of a simplified cryopreservation method and thawing procedures acting on the biological characteristics and specific cytotoxic activity of cord blood derived DC-based esophageal carcinoma vaccine. MATERIALS AND METHODS: CD34+ hematopoietic stem cells were isolated from cord blood using CD34+ Progenitor Cell Isolation Kit by magnetic cell sorting system (MACS)...
July 2016: Cryo Letters
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