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Bowel management for spinal patient

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https://www.readbyqxmd.com/read/29778545/a-descriptive-model-for-a-multidisciplinary-unit-for-colorectal-and-pelvic-malformations
#1
Alejandra Vilanova-Sanchez, Devin R Halleran, Carlos A Reck-Burneo, Alessandra C Gasior, Laura Weaver, Meghan Fisher, Andrea Wagner, Onnalisa Nash, Kristina Booth, Kaleigh Peters, Charae Williams, Sarah Mayer Brown, Peter Lu, Molly Fuchs, Karen Diefenbach, Jeffrey R Leonard, Geri Hewitt, Kate McCracken, Carlo Di Lorenzo, Richard J Wood, Marc A Levitt
INTRODUCTION: Patients with anorectal malformations (ARM), Hirschsprung disease (HD), and colonic motility disorders often require care from specialists across a variety of fields, including colorectal surgery, urology, gynecology, and GI motility. We sought to describe the process of creating a collaborative process for the care of these complex patients. METHODS: We developed a model of a devoted center for these conditions that includes physicians, psychologists, social workers, nurses, and advanced practice nurses...
April 19, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29771898/symptoms-of-bowel-dysfunction-and-their-management-after-spinal-cord-injury-in-a-new-zealand-centre
#2
Edwin P Arnold, Giovanni Losco, Sharon English, Frank Frizelle, Angelo Anthony
AIM: To document the symptoms of bowel dysfunction, and how the bowels are managed, in a cohort of patients following a spinal cord injury. To relate these to the level of the spinal injury and to examine the relationship between bowel symptoms and bladder dysfunction. METHOD: Participants were identified from the discharge data from the Burwood Spinal Unit, one of two national Spinal Units in New Zealand, in two two-year sets from 1-3 years post-injury and from 20-21 years post-injury...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29765592/an-unusual-cause-for-small-bowel-obstruction-as-a-complication-of-an-ileostomy-formation
#3
Noel Ramdwar, Daniel Cox, Thair Aldujaili
Ileostomy formation is a fundamental component in the surgical management of many gastrointestinal diseases and like all intra-abdominal surgeries, small bowel obstruction is a recognized complication. In this paper we discuss a case of a 44-year-old female who previously had a loop ileostomy for slow bowel transit in the presence of spinal bifida. She presented for subsequent total colectomy because of ongoing pain due to chronic colonic dilation. At surgery, the stoma was not revised and the efferent loop was divided at the peritoneal level of the anterior abdominal wall...
May 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29753705/spinal-cord-injury-how-could-acupuncture-help
#4
REVIEW
Qianqian Fan, Omer Cavus, Lize Xiong, Yun Xia
Spinal cord injury (SCI) is one of the most common causes of death and disability worldwide, and it can result in both permanent disability and serial complications in patients. Research shows that patients with SCI complications are often interested in acupuncture for symptomatic relief. Therefore, the issue of physicians advising their patients regarding the use of acupuncture to alleviate SCI complications becomes pertinent. We review and summarize two types of relevant publications: (1) literature concerning acupuncture for SCI and its complications and (2) underlying mechanisms of acupuncture therapy for SCI...
May 10, 2018: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/29707238/open-surgery-for-haemorrhoids-in-persons-with-spinal-cord-injury
#5
J G Previnaire, N De Bont, H Bordi, N Senal, P E Mortier
Study design: Pilot retrospective study on the outcome of open surgery for grade III and IV haemorrhoids in patients with SCI. Objective: Haemorrhoids and anal fissures are common in patients with spinal cord injury (SCI). Grade I to III haemorrhoids are usually managed medically or by surgical ligation. Grade III and IV haemorrhoids are treated with surgical haemorrhoidectomy in the general population, but not in patients with SCI, most probably due to fear of complications...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29439906/dermoid-cysts-of-the-conus-medullaris-clinical-review-case-series-and-management-strategies
#6
Salah G Aoun, Mary Ashley Liu, Megan Still, Tarek Y El Ahmadieh, Mazin Al Tamimi, Wayne Gluf
BACKGROUND: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris. OBJECTIVE: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris. METHODS: Two clinical cases of dermoid cysts of the conus are presented, as well as a commented surgical video...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29425323/long-term-effectiveness-of-gross-total-resection-for-symptomatic-spinal-cord-cavernous-malformations
#7
Tej D Azad, Anand Veeravagu, Amy Li, Michael Zhang, Venkatesh Madhugiri, Gary K Steinberg
BACKGROUND: Intramedullary spinal cord cavernous malformations (CMs) account for 5% of all CMs in the central nervous system and 5% to 12% of all spinal cord vascular lesions, yet their optimal management is controversial. OBJECTIVE: To identify factors associated with the clinical progression of spinal cord CMs and quantify the range of surgical outcomes. METHODS: Retrospective observational cohort study of 32 patients who underwent open surgical resection for spinal CMs, the majority of which presented to a dorsal or lateral pial surface, from 1996 to 2017 at a single institution...
February 6, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29424675/intradural-spinal-arachnoid-cyst-resection-implications-of-duraplasty-in-a-large-case-series
#8
Ziev B Moses, Gabriel N Friedman, David L Penn, Isaac H Solomon, John H Chi
OBJECTIVE Optimal diagnosis and management strategies for intradural spinal arachnoid cysts (SACs) are still unresolved given the rare nature of this entity, with few large case series and virtually no statistical analyses of patient characteristics in the literature. Here, the authors studied a large patient cohort with these lesions to determine whether pre- or postoperative attributes could be used to aid in either diagnosis or prognosis. METHODS A chart review was completed at a single institution for the period from 2002 to 2016 to determine the preoperative characteristics and postoperative outcomes of 21 patients with exclusively intradural SACs...
May 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29244035/interprofessional-collaboration-and-peer-mentors-for-bowel-education-in-spinal-cord-injury-a-case-consultation
#9
Ralph D Cabigon, Elizabeth Wojciechowski, Lisa Rosen, David Miller, Cristina Mix, David Chen
BACKGROUND: Evidence shows that having a bowel management program prevents rehospitalization postacute rehabilitation discharge for persons with a spinal cord injury (SCI). Peer mentors have been used to assist patients in managing their care. PURPOSE: The aim of the study was to illustrate how interprofessional collaboration led to utilizing resources of the inpatient rehabilitation facility's peer mentor program and incorporating peer mentors into bowel education for persons with SCI...
December 13, 2017: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
https://www.readbyqxmd.com/read/29180933/implementation-of-an-enhanced-recovery-after-surgery-eras-protocol-in-a-gynaecology-department-the-follow-up-at-1-year
#10
Tomasz Nikodemski, Agnieszka Biskup, Aleksandra Taszarek, Małgorzata Albin, Anita Chudecka-Głaz, Aneta Cymbaluk-Płoska, Janusz Menkiszak
Aim of the study: An ERAS protocol provides the latest perioperative care principles, whose primary aim is to reduce complication rates, and therefore mortality. The aim of this study is to establish the progress of the ERAS pathway implementation in our gynaecology department. Material and methods: This was a retrospective analysis of two sets of 100 consecutive medical records: patients treated before (PRE-ERAS) and after (ERAS) introduction of the ERAS protocol...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/29155253/the-association-of-inflammatory-bowel-disease-and-immediate-postoperative-outcomes-following-lumbar-fusion
#11
Joseph E Tanenbaum, Stephanie T Kha, Edward C Benzel, Michael P Steinmetz, Thomas E Mroz
BACKGROUND CONTEXT: The United States Centers for Disease Control and Prevention estimates the prevalence of inflammatory bowel disease (IBD) at more than 3.1 million people. As diagnostic techniques and treatment options for IBD improve, the prevalence of IBD is expected to increase. For spine surgeons, patients with IBD have a unique complication profile because patients with IBD may present with poor nutritional status and because the medications used to manage IBD have been associated with poor vertebral bone mineralization and immunosuppression...
November 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#12
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28893706/hypertension-acute-stent-thrombosis-and-paraplegia-6-months-after-thoracic-endovascular-aortic-repair-for-blunt-thoracic-aortic-injury-in-a-22-year-old-patient
#13
Ombretta Martinelli, Federico Faccenna, Alban Malaj, Jihad Jabbour, Salvatore Venosi, Roberto Gattuso, Bruno Gossetti, Luigi Irace
Thoracic endovascular aortic repair (TEVAR) is a less invasive option for managing traumatic injuries of the descending aorta in polytraumatized patients. Concerns arise when treating young patients with TEVAR. A 22-year-old male was admitted to the emergency department following a high-impact road traffic collision. Whole-body computed tomography (CT) scan documented multiple injuries, including rupture of descending thoracic aorta just below the isthmus. There was no evidence of paraplegia or stroke. We decided to treat him in an endovascular fashion with a Zenith Cook (Cook Incorporated, Bloomington, IN) endograft...
February 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28840071/chronic-thoracolumbar-subdural-empyema-case-report-and-surgical-management
#14
Azam Basheer, Mohamed Macki, Morenikeji Buraimoh, Asim Mahmood
BACKGROUND: Spinal cord abscesses and spinal subdural empyemas are rare and difficult to treat. CASE DESCRIPTION: A 35-year-old male presented to an outside institution with 2 months of progressive low back pain, weakness, and bowel incontinence; he was diagnosed with an L4 epidural abscess that was poorly managed. When the patient presented to our institution, magnetic resonance imaging (MRI) revealed a well-organized chronic subdural abscess at the thoracolumbar junction...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28834891/interdisciplinary-rehabilitation-for-a-patient-with-incomplete-cervical-spinal-cord-injury-and-multimorbidity-a-case-report
#15
Robert D Vining, Donna M Gosselin, Jeb Thurmond, Kimberlee Case, Frederick R Bruch
RATIONALE: This report describes interdisciplinary rehabilitation for a 51-year-old male recovering from incomplete cervical spinal cord injury (SCI) and multiple comorbidities following an automobile accident. PATIENT CONCERNS: The patient was admitted to a rehabilitation specialty hospital approximately 2 months post SCI and 2 separate surgical fusion procedures (C3-C6). DIAGNOSES: Clinical presentation at the rehabilitation hospital included moderate to severe motor strength loss in both upper and lower extremities, a percutaneous endoscopic gastronomy tube (PEG), dysphagia, bowel/bladder incontinence, dependence on a mechanical lift and tilting wheelchair due to severe orthostatic hypotension, and pre-existing shoulder pain from bilateral joint degeneration...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28777282/intrawound-vancomycin-powder-associated-with-reduced-surgical-site-infection-in-rib-based-distraction-surgery
#16
Justin M Haller, John A Heflin, David A Hulet, Qian Ding, Angela P Presson, John T Smith
BACKGROUND: Despite clinical reports of improved pulmonary function and reduced spinal deformity with rib-based distraction surgery in early-onset scoliosis (EOS) patients, infection remains a common complication, reported as high as 32% in some studies. The purpose of this study was to evaluate intrawound vancomycin powder in pediatric patients managed with rib-based distraction for EOS. METHODS: This was a single institution retrospective cohort study of EOS patients treated with rib-based distraction...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28733159/the-impact-of-a-bladder-training-video-versus-standard-urotherapy-on-quality-of-life-of-children-with-bladder-and-bowel-dysfunction-a-randomized-controlled-trial
#17
N Brownrigg, L H Braga, M Rickard, F Farrokhyar, B Easterbrook, A Dekirmendjian, K Jegatheeswaran, J DeMaria, A J Lorenzo
INTRODUCTION: Bladder and bowel dysfunction (BBD) can negatively impact the quality of life (QoL) of children. Urotherapy is an accepted treatment option for BBD; however, literature that examines the impact of management options on QoL in this population is scarce. OBJECTIVE: To determine whether a bladder training video (BTV) is non-inferior to standard urotherapy (SU) in improving QoL in children with BBD. METHODS: Children aged 5-10 years and who scored ≥11 on the Vancouver Non-Neurogenic Lower Urinary Tract Dysfunction/Dysfunctional Elimination Syndrome Questionnaire (NLUTD/DES) were recruited from a pediatric tertiary care center...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28716325/peripheral-and-sacral-neuromodulation-in-the-treatment-of-neurogenic-lower-urinary-tract-dysfunction
#18
REVIEW
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28639937/a-multicentre-randomised-controlled-trial-of-intravenous-immunoglobulin-compared-with-standard-therapy-for-the-treatment-of-transverse-myelitis-in-adults-and-children-strive
#19
RANDOMIZED CONTROLLED TRIAL
Michael Absoud, Peter Brex, Olga Ciccarelli, Onyinye Diribe, Gavin Giovannoni, Jennifer Hellier, Rosemary Howe, Rachel Holland, Joanna Kelly, Paul McCrone, Caroline Murphy, Jackie Palace, Andrew Pickles, Michael Pike, Neil Robertson, Anu Jacob, Ming Lim
BACKGROUND: Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28547859/giant-cell-tumor-of-the-mobile-spine-occurring-in-pregnancy-a-case-report-and-literature-review
#20
Kai Zheng, Ming Xu, Bing Wang, Xiu-Chun Yu, Yong-Cheng Hu
Giant cell tumor (GCT) is a benign, locally aggressive tumor that rarely occurs in the spine. They usually occur in patients between 20 and 40 years of age; some patients with GCT present in hospital with pregnancy. The management of these patients can be challenging. The current study reports a case of GCT located in the sixth thoracic vertebra of a 31-year-old female at 34 weeks of gestation. An osteolytic lesion, 3.5 cm × 3.5 cm in diameter, was identified on CT. An MRI test of the lesion revealed a soft tissue mass involving the T 6-7 vertebrae, extending to the right pedicle of the T 6 vertebra and causing significant spinal cord compression...
May 2017: Orthopaedic Surgery
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