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https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#1
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28192103/endoscopic-bariatric-and-metabolic-therapies-new-and-emerging-technologies
#2
Shelby Sullivan, Steven A Edmundowicz, Christopher C Thompson
Endoscopic Bariatric and Metabolic Therapies (EBMT) are a new addition to the treatment arsenal for obesity. These include devices which are placed or removed via flexible endoscopy, and procedures which utilize instruments that require flexible endoscopy for the indications of weight loss or treatment of glucose intolerance (from pre-diabetes to diabetes). The EBMTs are generally divided into gastric and small bowel categories, and although individual EBMTs may have unique mechanisms of action, similar themes in proposed mechanism of action are seen in the gastric and small bowel EBMTs respectively...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28182021/procedural-moderate-sedation-with-ketamine-in-pediatric-critical-care-unit
#3
Tarek R Hazwani, Hala Al-Alem
OBJECTIVE: To evaluate the safety and efficacy of moderate sedation in the Pediatric Intensive Care Unit (PICU) settings according to moderate sedation protocol using ketamine and midazolam and to determine areas for the improvement in our clinical practice. SETTINGS AND DESIGN: A retrospective study was conducted in the PICU. MATERIALS AND METHODS: Retrospective chart review was performed for patients who had received moderate sedation between January and the end of December 2011 and who are eligible to inclusion criteria...
January 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28176512/respiratory-adverse-events-during-upper-digestive-endoscopies-in-children-under-ketamine-sedation
#4
Jose C Flores-González, Alfonso M Lechuga Sancho, Mónica Saldaña Valderas, Gema Jimenez Gonzalez, Maria D Cruzado Garcia, Cristina Perez Aragon, Jose A Blanca Garcia
BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28161449/outcomes-and-quality-of-life-assessment-after-gastric-per-oral-endoscopic-pyloromyotomy-with-video
#5
Sunil Dacha, Parit Mekaroonkamol, Lianyong Li, Nikrad Shahnavaz, Sonali Sakaria, Steven Keilin, Field Willingham, Jennifer Christie, Qiang Cai
BACKGROUND AND AIM: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is emerging as a promising option for the treatment of gastroparesis. This study assessed outcomes and quality-of-life after GPOEM for gastroparesis, performed in an endoscopy unit at a major tertiary referral center. METHODS: We performed a retrospective review of patients who had undergone GPOEM during June 2015 to July 2016. Data were collected from electronic medical records including patient demographics, endoscopy records, hospitalization records, clinic visits, and electronic messages...
February 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28159539/continued-midazolam-versus-diphenhydramine-in-difficult-to-sedate-patients-a-randomized-double-blind-trial
#6
Hamita Sachar, Nipaporn Pichetshote, Kavitha Nandigam, Keta Vaidya, Loren Laine
BACKGROUND AND AIMS: Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine to continued midazolam in such patients. METHODS: Patients undergoing elective colonoscopy with moderate sedation were eligible. Sedation was measured with the modified observer's assessment of alertness/sedation (MOAA/S) score with adequate sedation defined as 3 on a 0 to 5 scale...
January 31, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28152569/changing-pattern-of-biliary-complications-in-an-evolving-liver-transplant-unit
#7
A Rammohan, S Govil, J Vargese, V Kota, M S Reddy, M Rela
BACKGROUND: Biliary complications remain a significant cause of morbidity following liver transplantation. This series of 640 Liver transplant recipients with a blend of living and deceased donor transplants was analyzed to determine the incidence, risk factors, management protocol and outcomes in these patients. METHODS: Review of a prospectively collected database of transplant recipients operated between Aug 2009 and June 2016 was performed. Patients were divided into those with and without biliary complications and data was analyzed...
February 2, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28134715/disposal-of-endoscopic-accessories-after-use-do-we-know-and-do-we-care
#8
Deepak Agrawal, Valerie Shoup, Amy Montgomery, Jedrek Wosik, Don C Rockey
Significant amounts of medical waste are generated in endoscopy units. Improper disposal has significant health, cost, and environmental implications. The aim of this study was to better understand the appropriateness of handling of medical waste in the endoscopy unit. This is a validated survey completed online and in person by endoscopy staff and gastroenterologists. Main outcome measurements include the method of disposal of endoscopic accessories (snares, dilating balloons, endoscopic retrograde cholangiopancreatography wires, and sphincterotomes) and nasogastric tubes and whether or not in the appropriate disposal bin (i...
January 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28126349/full-spectrum-endoscopy-improves-surveillance-for-dysplasia-in-patients-with-inflammatory-bowel-diseases
#9
Rupert W Leong, Marie Ooi, Crispin Corte, Yunki Yau, Melissa Kermeen, Peter H Katelaris, Charles McDonald, Meng Ngu
BACKGROUND & AIMS: Inflammatory bowel diseases (IBD) increase the risk of colorectal cancer. Surveillance colonoscopy with chromoendoscopy is recommended, but conventional forward-viewing colonoscopy (FVC) detects dysplasia with low levels of sensitivity. Full-spectrum endoscopy (FUSE) incorporates 2 additional lateral cameras to the forward camera of the colonoscope, allowing endoscopists to view behind folds and in blind spots, which might increase dysplasia detection. We compared FUSE vs FVC in the detection of dysplasia in patients with IBD...
January 23, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28125828/characteristics-and-outcomes-of-fasting-orders-among-medical-inpatients
#10
Atsushi Sorita, Charat Thongprayoon, John T Ratelle, Ruth E Bates, Katie M Rieck, Aditya P Devalapalli, Adil Ahmed, Deanne T Kashiwagi
While many hospitalized patients have orders to fast in preparation for interventions, the extent to which these orders are necessary or adhere to evidence-based durations is unknown. In this study, we analyzed the length, indication, and associated outcomes of nil per os (NPO) orders for general medicine patients at an academic institution in the United States, and compared them to the best available evidence for recommended length of NPO. Of 924 NPO orders assessed, the indicated intervention was not performed for 183 (19...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28125399/prevalence-of-cancer-screening-among-adults-with-disabilities-united-states-2013
#11
C Brooke Steele, Julie S Townsend, Elizabeth A Courtney-Long, Monique Young
INTRODUCTION: Many studies on cancer screening among adults with disabilities examined disability status only, which masks subgroup differences. We examined prevalence of receipt of cancer screening tests by disability status and type. METHODS: We used 2013 National Health Interview Survey data to assess prevalence of 1) guideline-concordant mammography, Papanicolaou (Pap) tests, and endoscopy and stool tests; 2) physicians' recommendations for these tests; and 3) barriers to health-care access among adults with and without disabilities (defined as difficulty with cognition, hearing, vision, or mobility)...
January 26, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28118177/home-based-drainage-of-refractory-ascites-by-a-permanent-tunneled-peritoneal-catheter-can-safely-replace-large-volume-paracentesis
#12
Philipp Solbach, Christoph Höner Zu Siederdissen, Richard Taubert, Szilvia Ziegert, Kerstin Port, Andrea Schneider, Katja Hueper, Michael P Manns, Heiner Wedemeyer, Elmar Jaeckel
BACKGROUND AND AIM: Refractory ascites has a poor prognosis. Recurrent large-volume paracentesis is the current standard of care; however, it results in circulatory dysfunction and renal dysfunction, and hospitalization is commonly required. Transjugular intrahepatic portosystemic shunt placement is not an option in a substantial number of patients because of contraindications. The placement of a tunneled peritoneal drainage catheter has been shown to be effective in patients with malignant ascites...
January 21, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28116788/columnar-islands-in-barrett-s-esophagus-do-they-impact-prague-c-m-criteria-and-dysplasia-grade
#13
Jeremy A Epstein, Hilary Cosby, Gary W Falk, Mouen A Khashab, Ralf Kiesslich, Elizabeth A Montgomery, Jean S Wang, Marcia Irene Canto
BACKGROUND AND AIM: The standard for classifying Barrett's metaplasia on endoscopy, the Prague C&M criteria, ignore all islands of metaplastic-appearing tissue. The aim of the present study was to measure the prevalence of columnar islands, quantify their impact on metaplasia extent, and determine if they harbor advanced dysplasia. METHODS: Data from two prospective patient cohorts were retrospectively analyzed. They included adults who underwent upper endoscopy to evaluate for gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), dysplasia, or adenocarcinoma between 2003-2012 at tertiary care centers in the United States and Germany...
January 23, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28104987/estimation-of-quality-of-life-in-cypriot-patients-with-inflammatory-bowel-disease
#14
Maria Tsoukka, Eleni Jelastopulu, Giagkos Lavranos, George Charalambous
AIM: To investigate the health-related quality of life (HRQoL) of patients suffering with idiopathic inflammatory bowel disease (IBD). METHODS: The Greek validated version of the Short Inflammatory Bowel Disease Questionnaire was used for evaluating the quality of life of IBD patients. The questionnaire was distributed to 100 consecutive patients suffering from IBD and presenting for a clinic appointment at the endoscopy unit of Larnaca General Hospital during the period from October to November 2012...
January 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#15
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100993/cdc-group-eo-4-and-candida-tropicalis-peritonitis-in-a-patient-on-peritoneal-dialysis-after-upper-endoscopy-colonoscopy-and-coil-embolization-of-the-gastroduodenal-artery
#16
Shameek Gayen, Yonah Ziemba, Shikha Jaiswal, Adam Frank, Yasmin Brahmbhatt
Peritoneal dialysis (PD) is an excellent form of renal replacement therapy for many patients with end-stage renal disease (ESRD). Over 10,000 patients receive PD in the United States [United States Renal Data System: 2015 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, 2015]. PD has superior outcomes compared to hemodialysis in the first 2 years of ESRD [Sinnakirouchenan and Holley: Adv Chronic Kidney Dis 2011;18: 428-432]. However, peritonitis is a known complication and may result in significant morbidity and necessitate transition to hemodialysis, which increases medical costs [Holley and Piraino: Semin Dial 1990;3: 245-248]...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28093564/postoperative-conversion-disorder-presenting-as-inspiratory-stridor-and-hemiparesis-in-a-pediatric-patient
#17
Erik J Nelson, Jennifer Y Wu
BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness...
January 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28078114/colorectal-cancer-anatomic-distribution-patterns-remain-the-same-after-sessile-serrated-adenoma-polyp-considered-cancer-precursor-a-9-year-comparison-study-from-community-based-endoscopy-centers
#18
Juliana F Yang, Amy E Noffsinger, Deepak Agrawal, Qing-Hua Yang
BACKGROUND: The overall incidence of colorectal cancer (CRC) in the United States has steadily decreased. However, the incidence of right-sided CRC remains unchanged for the past two decades. The serrated neoplastic pathway (sessile serrated adenoma/polyp, SSA/P) has been considered an important pathway of colorectal carcinogenesis, especially in the right-sided CRC. The aim of this study was to compare CRC anatomic distribution patterns in a 9-year interval in the general population before and after SSA/P was recognized and treated as a CRC precursor...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28076483/sedation-in-colonoscopy-by-using-three-different-propofol-infusion-methods-and-analysis-of-plasma-concentration-levels-a-prospective-comparative-study
#19
Paulo Henrique Boaventura de Carvalho, José Pinhata Otoch, Mohamad Ali Khan, Paulo Sakai, Hugo Gonçalo Guedes, Everson Luiz de Almeida Artifon
Background: The propofolemia becomes directly linked to the clinical effects of this anesthetic and is the focus for studies comparing propofol clinical use, in different administration methods routinely used in endoscopy units where sedation is widely administered to patients. Aim: To evaluate the effects of three different regimens of intravenous propofol infusion in colonoscopies. Methods: A total of 50 patients that underwent colonoscopies were consecutively assigned to three groups: 1) intermittent bolus infusion; 2) continuous manually controlled infusion; 3) continuous automatic infusion...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28075104/esophageal-cancer
#20
Matthew W Short, Kristina G Burgers, Vincent T Fry
Esophageal cancer has a poor prognosis and high mortality rate, with an estimated 16,910 new cases and 15,910 deaths projected in 2016 in the United States. Squamous cell carcinoma and adenocarcinoma account for more than 95% of esophageal cancers. Squamous cell carcinoma is more common in nonindustrialized countries, and important risk factors include smoking, alcohol use, and achalasia. Adenocarcinoma is the predominant esophageal cancer in developed nations, and important risk factors include chronic gastroesophageal reflux disease, obesity, and smoking...
January 1, 2017: American Family Physician
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