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https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#1
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
September 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28895370/eosinophilic-esophagitis-current-evidence-based-diagnosis-and-treatment-in-children-and-adults
#2
Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a disease caused by an immune response to food antigens in contact with the esophageal mucosa that has arisen as a common disorder in current clinical practice. Its diagnosis is defined by the combination of symptoms of esophageal dysfunction and inflammation of the esophageal mucosa predominantly by eosinophils. Its chronic course and frequent progression to subepithelial fibrosis leading to strictures and narrow-caliber esophagus indicate the need for treatment. Information provided by recent clinical trials and systematic reviews allowed for the development of new clinical guidelines, endorsed by several European scientific societies...
September 11, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28894611/cigarette-lighter-fluid-induced-gastric-ulcer-a-severe-complication-of-delayed-foreign-body-removal
#3
Ciel Harris, Lauren Stemboroski, Asim Shuja
The majority of foreign bodies ingested pass uneventfully through the gastrointestinal tract without endoscopic intervention. Nevertheless, certain ingested objects pose a greater risk for complications and are more challenging to remove than others. This case report describes a 49-year-old male who swallowed a cigarette lighter causing a gastric ulcer. The lighter was successfully removed by flexible endoscopy using a polypectomy snare. Urgent removal is required due to the shape of the object and its hazardous contents...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28886480/intelligent-visual-localization-of-wireless-capsule-endoscopes-enhanced-by-color-information
#4
George Dimas, Evaggelos Spyrou, Dimitris K Iakovidis, Anastasios Koulaouzidis
Wireless capsule endoscopy (WCE) is performed with a miniature swallowable endoscope enabling the visualization of the whole gastrointestinal (GI) tract. One of the most challenging problems in WCE is the localization of the capsule endoscope (CE) within the GI lumen. Contemporary, radiation-free localization approaches are mainly based on the use of external sensors and transit time estimation techniques, with practically low localization accuracy. Latest advances for the solution of this problem include localization approaches based solely on visual information from the CE camera...
September 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28871560/oesophageal-coins-invisible-on-chest-radiography-a-case-report
#5
Jin Takahashi, Takashi Shiga, Hiraku Funakoshi
BACKGROUND: Coins are made of metal, which is generally radiopaque, and so physicians often have the misconception that all coins are detectable by radiography. Here, we report a case of intentionally swallowed coins in the oesophagus of an adult; the coins could not be detected on chest radiography but were detected using computed tomography (CT). CASE PRESENTATION: A 46-year-old woman with a history of depression presented to the emergency department after an intentional medication overdose and ingestion of two Japanese 1-yen coins...
September 5, 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28871497/safety-and-efficacy-of-a-new-swallowable-intragastric-balloon-not-needing-endoscopy-early-italian-experience
#6
A Genco, I Ernesti, R Ienca, G Casella, S Mariani, D Francomano, E Soricelli, M Lorenzo, M Monti
PURPOSE: The aim of this study was to evaluate the safety and efficacy of a new intragastric balloon (Elipse™ Balloon, Allurion Technologies, Natick, MA USA) not needing endoscopy. MATERIALS AND METHODS: The balloon was swallowed under fluoroscopy in 38 consecutive patients (F/M 28/10, mean age 46.4 ± 10.6 years, mean weight 109.7 ± 21.9 kg, and mean body mass index (BMI) 38.6 ± 6.7 kg/m(2)). After 4 months, the balloon spontaneously emptied and it was excreted through the digestive tract without upper endoscopy...
September 4, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28858893/button-battery-ingestion-in-children
#7
Michael J Eliason, Robert L Ricca, Thomas Q Gallagher
PURPOSE OF REVIEW: As the demand for small electronics continues to grow so does the risk of oesophageal ingestion of button batteries. These small but powerful sources of energy are ubiquitous in every household and when swallowed, especially in small children, have been shown to create significant injury in a short amount of time leading to long-term morbidity and possible death. This review highlights the latest findings regarding epidemiology, pathophysiology, diagnosis and management of ingested button batteries...
August 30, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28844038/unrestricted-faecal-calprotectin-testing-performs-poorly-in-the-diagnosis-of-inflammatory-bowel-disease-in-patients-in-primary-care
#8
Samantha Conroy, Melissa F Hale, Simon S Cross, Kirsty Swallow, Reena H Sidhu, Ravishankar Sargur, Alan J Lobo
BACKGROUND: Faecal calprotectin (FC) measurement distinguishes patients with inflammatory bowel disease (IBD) from those with irritable bowel syndrome but evidence of its performance in primary care is limited. AIMS: To assess the yield of IBD from FC testing in primary care. METHODS: Retrospective review of hospital records to assess the outcome following FC testing in primary care. Investigations for all patients undergoing FC testing in a single laboratory for 6 months from 1 October 2013 to 28 February 2014 were reviewed...
August 26, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#9
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28815025/oesophageal-candidiasis-and-squamous-cell-cancer-in-patients-with-gain-of-function-stat1-gene-mutation
#10
Sara Koo, Deepak Kejariwal, Tariq Al-Shehri, Anjan Dhar, Desa Lilic
BACKGROUND: Oesophageal candidiasis is a common, usually self-limiting opportunistic infection, but long-term infection with Candida is known to predispose to oral and oesophageal squamous cell cancer (SCC). Permissive factors that lead to immune deficiencies can underlie persistent or recurring candidiasis, called chronic mucocutaneous candidiasis (CMC). Secondary immune deficiencies are most often due to human immunodeficiency virus (HIV) infection, antibiotic use and immunosuppressive treatment (steroids, chemotherapy)...
August 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28809387/accuracy-and-safety-of-the-cytosponge-for-assessing-histologic-activity-in-eosinophilic-esophagitis-a-two-center-study
#11
David A Katzka, Thomas C Smyrk, Jeffrey A Alexander, Debra M Geno, RoseMary A Beitia, Audrey O Chang, Nicholas J Shaheen, Rebecca C Fitzgerald, Evan S Dellon
OBJECTIVES: Management of eosinophilic esophagitis (EoE) requires repeated endoscopic mucosal sampling to assess disease activity. A less invasive and expensive means of monitoring of EoE is required. The objective of this study was to assess the accuracy, safety, and tolerability of the cytosponge compared to endoscopy and biopsy for histologic assessment of EoE. METHODS: In this prospective two-center cross-sectional study, patients with known EoE underwent cytosponge sampling followed by endoscopy and biopsy...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28765480/tuberculosis-presenting-as-broncho-oesophageal-fistula-in-a-young-healthy-man
#12
Ahmed Sayeed, Eid Humaid Alqurashi, Adnan B Alzanbagi, Nabil Abdulwadod Badr Ghaleb
A 21-year-old Saudi man presented with a history of dysphagia and choking. CT scan of the chest showed clear evidence of chronic recurrent aspiration pneumonia in the left lung. It also showed a fistula connecting the left main bronchus to the oesophagus. Endoscopy showed clear opening on the oesophageal side. Bronchoscopy also confirmed the presence of a broncho-oesophageal fistula on the left bronchial side with the presence of secretions on swallowing. Bronchoalveolar lavage (BAL) was done and sent for mycobacterial tuberculosis culture...
July 31, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28762460/successful-endoscopic-treatment-of-an-unusual-foreign-body-in-the-stomach-a-package-of-heroin
#13
Mehmet Asıl, Ramazan Dertli
Drug addiction is an important medical and social problem. "Body packing" is frequently used for concealed transportation of illegal drugs. The drug is packed in small plastic packages and swallowed or placed into body cavities, such as the rectum or the vagina. Another aspect is "body stuffing," in which the drug package is usually hastily swallowed in order to avoid arrest. Presently described is case of a body stuffer who ingested a package of heroin and was successfully treated with upper gastrointestinal endoscopy...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#14
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28688566/dysphagia-in-healthy-children-characteristics-and-management-of-a-consecutive-cohort-at-a-tertiary-centre
#15
Orysya Svystun, Wendy Johannsen, Rabin Persad, Justine M Turner, Carina Majaesic, Hamdy El-Hakim
OBJECTIVE: Whereas the literature is replete with reports on complex children with dysphagia (DP), the parameters characterizing non-neurologically impaired (NNI) children have been underreported, leaving a substantial knowledge gap. We set to characterize a consecutive cohort of NNI children, their management, and outcomes. METHODS: We undertook a retrospective case series. Children (<18 years old) attending a tertiary multidisciplinary swallowing clinic were eligible...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28676207/effects-of-allergen-sensitization-on-response-to-therapy-in-children-with-eosinophilic-esophagitis
#16
Robert D Pesek, Mallikarjuna Rettiganti, Erin O'Brien, Sarah Beckwith, Caroline Daniel, Chunqiao Luo, Amy M Scurlock, Peggy Chandler, Rebecca A Levy, Tamara T Perry, Joshua L Kennedy, Sheva Chervinskiy, Maryelle Vonlanthen, Helen Casteel, Stephen C Fiedorek, Troy Gibbons, Stacie M Jones
BACKGROUND: In children with eosinophilic esophagitis (EoE) foods are the most common disease triggers, but environmental allergens are also suspected culprits. OBJECTIVE: To determine the effects of environmental allergen sensitization on response to treatment in children with EoE in the southeastern United States. METHODS: Patients 2 to 18 years old who were referred to the Arkansas Children's Hospital Eosinophilic Gastrointestinal Disorders Clinic from January 2012 to January 2016 were enrolled in a prospective, longitudinal cohort study with collection of demographics, clinical symptoms, medical history, allergy sensitization profiles, and response to treatment over time...
August 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28660084/a-case-of-thermal-esophageal-injury-induced-by-sodium-picosulfate-with-magnesium-citrate
#17
Dong-Hyuk Yang, Byoung Wook Bang, Kye Sook Kwon, Hyung Kil Kim, Yong Woon Shin
Although thermal esophageal injuries caused by hot food or tea have been reported, thermal esophageal injury due to sodium picosulfate with magnesium citrate (PSMC) used for bowel preparation is rarely reported. We report the case of a 56-year-old man who presented with esophageal injury after ingestion of PSMC. Instead of dissolving the PSMC in water before ingestion, he drank water immediately after swallowing PSMC powder. As soon as he drank water, he developed severe chest pain and hematemesis. Upper endoscopy revealed severe hemorrhagic, ulcerative mucosal change from upper to mid-esophagus...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28637650/achalasia-leading-to-diagnosis-of-adenocarcinoma-of-the-oesophagus
#18
Jonathan Segal, Ayodele Lagundoye, Martyn Carter
A 50-year-old male with a 7 month history of progressive dysphagia to solids then subsequently to liquids. He underwent a diagnostic gastroscopy which was normal. A further barium swallow suggested achalasia. He was referred to a tertiary centre, where he underwent pH and manometry studies which confirmed a diagnosis of achalasia. He was referred for a laparoscopic cardiomyotomy, and at surgery there was a suspected tumour at the gastro-oesophageal junction. A follow-up endoscopy with biopsies was normal...
June 20, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28620597/feeding-problems-and-their-underlying-mechanisms-in-the-esophageal-atresia-tracheoesophageal-fistula-patient
#19
REVIEW
Lisa Mahoney, Rachel Rosen
Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28617448/diminishing-effectiveness-of-long-term-maintenance-topical-steroid-therapy-in-ppi-non-responsive-eosinophilic-esophagitis
#20
Swathi Eluri, Thomas M Runge, Jason Hansen, Bharati Kochar, Craig C Reed, Benjamin S Robey, John T Woosley, Nicholas J Shaheen, Evan S Dellon
OBJECTIVES: While topical corticosteroids are first-line therapy for eosinophilic esophagitis (EoE), the data regarding long-term effectiveness are lacking. We aimed to determine long-term histologic and endoscopic outcomes of maintenance therapy in EoE steroid responders. METHODS: We performed a retrospective study of adults with EoE at UNC Hospitals who had initial histologic response (<15 eos/hpf) after 8 weeks of topical steroids, and maintained on therapy...
June 15, 2017: Clinical and Translational Gastroenterology
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