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https://www.readbyqxmd.com/read/29458229/primary-closure-versus-bedside-silo-and-delayed-closure-for-gastroschisis-a-truncated-prospective-randomized-trial
#1
Ashwini S Poola, Pablo Aguayo, Jason D Fraser, Richard J Hendrickson, Katrina L Weaver, Katherine W Gonzalez, Shawn D St Peter
BACKGROUND: We report a prospective randomized trial comparing primary closure (PC) to bedside silo and delayed closure (DC) for babies with gastroschisis. METHODS: Patients were randomized to PC versus DC. We excluded those with atresia/necrosis, <34 weeks' gestation, or congenital anomalies. The primary outcome was length of stay (LOS). RESULTS: A total of 38 patients were included from August 2011 to August 2016; 18 patients underwent DC and 20 PC...
February 19, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29457051/signet-ring-cell-carcinoma-ileal-crohn-disease-or-both-a-case-of-diagnostic-challenge
#2
Joana R Carvalho, Joana Tavares, Inês Goulart, Paula Moura Dos Santos, Emília Vitorino, Cristina Ferreira, Fátima Serejo, José Velosa
Signet ring cell carcinoma is a rare form of adenocarcinoma that predominantly affects the stomach. Signet ring cell carcinoma originated from the ileum is extremely rare and the prognosis is poor. We present a case of small bowel obstruction with features suggesting Crohn disease of the ileum. The symptoms were chronic diarrhea and abdominal pain with a family history of inflammatory bowel disease. The patient underwent surgery and histopathology revealed both aspects of signet ring cell carcinoma and Crohn disease of the ileum...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29457049/intestinal-obstruction-of-uncommon-cause-and-point-of-care-ultrasonography-where-do-we-stand
#3
Tiago Capela, Paula Sousa, Ana Caldeira, Eduardo Pereira
Malignant neoplasms of the small bowel, especially from the jejunum, are among the rarest types of cancer. Given its location, a delayed diagnosis is frequent and sometimes only made in an emergency context. The authors present a case of intestinal obstruction, where ultrasonography was pivotal in establishing a diagnosis. Point-of-care ultrasonography seems to be particularly sensitive in assessing emergency patients with abdominal pain, allowing effective orientation and saving human and technical resources...
January 2018: GE Portuguese Journal of Gastroenterology
https://www.readbyqxmd.com/read/29456410/split-dose-bowel-preparation-improves-adequacy-of-bowel-preparation-and-gastroenterologists-adherence-to-national-colorectal-cancer-screening-and-surveillance-guidelines
#4
Stacy Bartnik Menees, H Myra Kim, Philip Schoenfeld
AIM: To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps (< 10 mm). METHODS: A retrospective chart review of all endoscopy reports was undertaken in average-risk individuals > 50 years old with a normal screening colonoscopy and 1-2 small polyps. Data were abstracted from two time periods, pre and post-split-dose bowel preparation institution...
February 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29456092/indications-for-and-diagnostic-yield-of-capsule-endoscopy-in-the-elderly
#5
E Pérez-Cuadrado-Robles, L E Zamora-Nava, V A Jiménez-García, E Pérez-Cuadrado-Martínez
INTRODUCTION AND AIMS: The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients. MATERIALS AND METHODS: All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed...
February 15, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29456091/frequency-of-human-papillomavirus-infection-in-patients-with-gastrointestinal-cancer
#6
F Roesch-Dietlen, A D Cano-Contreras, Y J Sánchez-Maza, J M Espinosa-González, M Á Vázquez-Prieto, E J Valdés-de la O, F Díaz-Roesch, M Á Carrasco-Arroniz, A Cruz-Palacios, P Grube-Pagola, A Sumoza-Toledo, H Vivanco-Cid, G Mellado-Sánchez, A Meixueiro-Daza, C S Silva-Cañetas, M G Carrillo-Toledo, R Lagunes-Torres, M Amieva-Balmori, P C Gómez-Castaño, J U Reyes-Huerta, J M Remes-Troche
INTRODUCTION AND AIM: Cancer is the result of the interaction of genetic and environmental factors. It has recently been related to viral infections, one of which is human papillomavirus. The aim of the present study was to describe the frequency of human papillomavirus infection in patients with digestive system cancers. MATERIALS AND METHODS: A prospective, multicenter, observational study was conducted on patients with gastrointestinal cancer at 2public healthcare institutes in Veracruz...
February 15, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29455011/hybrid-retrograde-celiac-artery-stenting-for-acute-mesenteric-ischemia-after-gastric-surgery
#7
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29453164/perforated-giant-meckel-diverticulitis-in-an-elderly-patient-case-report-and-review-of-the-literature
#8
Ryan J Malcom, Izaskun M Iglesias, Eduardo Smith-Singares
INTRODUCTION: Giant Meckel's diverticula are a relatively rare form of Meckel's, and henceforth their natural history is not clearly defined. They're currently thought of as an infrequent form of ileal dysgenesis. Noted complications include perforation, torsion and bowel obstruction. A much rarer presentation is Giant Meckel's diverticulitis. CASE: A 71 year old white female presented herself to the Emergency Department of a small urban community hospital, complaining of severe abdominal pain, nausea & vomiting...
February 10, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29453041/microrna-signature-of-regulatory-t-cells-in-health-and-autoimmunity
#9
REVIEW
Mehdi Soltanzadeh-Yamchi, Mehdi Shahbazi, Saeed Aslani, Mousa Mohammadnia-Afrouzi
MicroRNAs (miRNAs) are small RNA molecules with regulatory functions on the expression of genes through binding directly to target messenger RNA (mRNA) transcripts, eventuating in gene expression suppression via translational hindrance and/or target mRNA cleavage. These molecules have been established to participate in numerous critical cellular settings, including differentiation, development, and function of immune cells. As an important suppressor cell of immune system, regulatory T cells (Tregs) are important in modulating the immune homeostasis as well as tolerance to self-antigens...
February 13, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29452875/use-of-expanders-for-bowel-protection-in-pediatric-pelvic-tumor-radiation-therapy-15-years-of-tolerance-results
#10
Fernand Missohou
PURPOSE: Bowel is often the dose-limiting organ in curative pelvic irradiation because of radiation enteritis when dose exceeds 40 to 45 Gy. To limit radiation enteritis, a silicone tissue-expander prothesis (STEP) connected to a subcutaneous self-sealing valve was prospectively used in children undergoing pelvic or abdominal radiation therapy. This study reports the 15-year long-term outcomes of this prospective series. METHODS AND MATERIALS: Between 1987 and 2008, 29 children from 3 Paris institutions received pelvic radiation therapy after surgical placement of a STEP in the pelvis...
December 14, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29451701/phase-1b-study-of-pasireotide-everolimus-and-selective-internal-radioembolization-therapy-for-unresectable-neuroendocrine-tumors-with-hepatic-metastases
#11
Hyun S Kim, Walid L Shaib, Chao Zhang, Ganji Purnachandra Nagaraju, Christina Wu, Olatunji B Alese, Zhengjia Chen, Edith Brutcher, Meredith Renfroe, Bassel F El-Rayes
BACKGROUND: Neuroendocrine tumors (NETs) metastasize to the liver. Everolimus and selective internal radioembolization (SIRT) are approved treatments. Pasireotide is a somatostatin analogue with an affinity for somatostatin receptors 1, 2, 3, and 5. Everolimus and pasireotide may potentiate SIRT radiosensitization and inhibit rebound angiogenesis. This study evaluated the safety of pasireotide, everolimus, and SIRT. METHODS: This 3 + 3 phase 1 trial evaluated 3 dose levels of everolimus (2...
February 16, 2018: Cancer
https://www.readbyqxmd.com/read/29450803/a-rare-case-of-acute-presentation-of-trocar-site-hernia-from-robot-assisted-laparoscopic-partial-nephrectomy
#12
Zi Qin Ng, Richard Pemberton, Patrick Tan
Trocar site hernia is not a common acute complication encountered after robot-assisted surgery, especially in the urological cohort of patients. A few case reports of small bowel obstruction secondary to incarceration by trocar site hernia have been described in gynaecological surgery and prostatectomies. As the clinical presentation is non-specific, late diagnosis has significant implication on morbidity and mortality. Here, we present a rare case of a patient with recent robot-assisted laparoscopic partial nephrectomy for a renal cell carcinoma presented with features of impending bowel obstruction secondary to incarcerated small bowel in the trocar site...
February 15, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29450787/a-case-of-small-intestinal-neuroendocrine-carcinoma-diagnosed-using-double-balloon-endoscopy-with-long-term-survival
#13
Seiji Kawano, Yuichi Miyashima, Yoshio Miyabe, Yoshinari Kawai, Toshihiro Murata, Masashi Uda, Toshihiro Inokuchi, Hiroyuki Okada
Neuroendocrine neoplasms, including neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs), are rare epithelial tumors with a predominant neuroendocrine differentiation. Compared with NETs, NECs have been reported to be rarer and have a poorer prognosis. We present a rare case of small bowel NEC diagnosed using double-balloon endoscopy (DBE) and the long-term survival accomplished via intensive therapy. DBE revealed an ulcerative tumor in the deep jejunum, and biopsy specimens showed large and highly dysplastic tumor cells; immuno-histological synaptophysin and chromogranin A tests were positive, and the Ki-67 index was more than 90%...
February 15, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29449505/detection-of-crohn-disease-in-patients-with-spondyloarthropathy-the-space-capsule-study
#14
Uri Kopylov, Michael Starr, Craig Watts, Serge Dionne, Marc Girardin, Ernest G Seidman
OBJECTIVE: Inflammatory bowel disease (IBD) is generally reported to be associated with spondylarthropathies (SpA) in 5%-15% of cases. Systematic colonoscopic assessment by protocol demonstrated mucosal inflammation characteristic of Crohn disease (CD) in up to one-third of patients with SpA. Video capsule endoscopy (CE) is a superior diagnostic tool to detect small bowel mucosal disease. Our study compared the accuracy of CE to standard colonoscopy for detection of inflammatory bowel lesions in patients with SpA, and to describe predictors of small bowel inflammation (SBI) in this cohort...
February 15, 2018: Journal of Rheumatology
https://www.readbyqxmd.com/read/29449094/safety-and-efficacy-of-small-bowel-polypectomy-using-a-balloon-assisted-enteroscope-in-pediatric-patients-with-peutz-jeghers-syndrome
#15
G Blanco-Velasco, O V Hernández-Mondragón, J M Blancas-Valencia, V Paz-Flores, D Fuentes-Hernández, P Rodríguez-González, B González-Ortíz
INTRODUCTION AND AIMS: Peutz-Jeghers syndrome is an autosomal dominant inherited pathology characterized by gastrointestinal hamartomatous polyps, predominantly in the small bowel, and pigmented mucocutaneous lesions. Guidelines suggest polypectomy with a balloon-assisted enteroscope when polyps are larger than 10mm. Complications in adults can be as high as 6.8%, but there is little information on pediatric populations. Our aim was to describe the safety and efficacy of polypectomy in a group of pediatric patients with Peutz-Jeghers syndrome using balloon-assisted enteroscopy...
February 12, 2018: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/29448989/redefining-bowel-regimen-pharmacologic-strategies-and-nutritional-considerations-in-the-management-of-small-bowel-fistulas
#16
REVIEW
Sara E Parli, Carolyn Pfeifer, Douglas R Oyler, Barbara Magnuson, Levi D Procter
Enterocutaneous fistulae (ECF) and enteroatmospheric fistulae (EAF) are difficult complications that primarily arise after abdominal surgical procedures. Development of an ECF or EAF carries significant mortality and morbidity. Effective management of patients with these disease states requires a multidisciplinary approach, which includes surgical, pharmacotherapeutic, and nutritional interventions. This review focuses on the medical and nutritional management of ECF/EAF, providing background on drug agents and nutritional strategies that may be helpful in reducing effluent volume, optimizing fistula healing, and maintaining nutritional health...
February 12, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29447946/bladder-re-augmentation-in-classic-bladder-exstrophy-risk-factors-and-prevention
#17
Karl Benz, John Jayman, Karen Doersch, Mahir Maruf, Timothy Baumgartner, Matthew Kasprenski, John P Gearhart
OBJECTIVE: To characterize the causes of re-augmentation in patients with classic bladder exstrophy. METHODS: A prospectively-maintained institutional database of 1327 exstrophy-epispadias complex patients was reviewed for CBE patients who have undergone more than one AC procedure. Data regarding bladder capacities, complications following AC, and reasons for re-augmentation were evaluated. RESULTS: A total of 166 CBE patients underwent AC...
February 12, 2018: Urology
https://www.readbyqxmd.com/read/29447487/perianal-crohn-s-disease-association-with-significant-inflammatory-activity-in-proximal-small-bowel-segments
#18
Sofia Xavier, Tiago Cúrdia Gonçalves, Francisca Dias de Castro, Joana Magalhães, Bruno Rosa, Maria João Moreira, José Cotter
OBJECTIVES: Perianal Crohn's disease (CD) prevalence varies according to the disease location, being particularly frequent in patients with colonic involvement. We aimed to evaluate small bowel involvement and compare small bowel capsule endoscopy findings and inflammatory activity between patients with and without perianal disease. MATERIALS AND METHODS: Retrospective single-center study including 71 patients - all patients with perianal CD (17 patients) who performed a small bowel capsule endoscopy were included, and non-perianal CD patients were randomly selected (54 patients)...
February 15, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29447372/small-fiber-polyneuropathy-is-prevalent-in-patients-experiencing-complex-chronic-pelvic-pain
#19
Annie Chen, Elise De, Charles Argoff
Objective: To demonstrate the prevalence of small fiber polyneuropathy (SFPN) in patients with refractory chronic pelvic pain (CPP). Design: Retrospective study of prospective database. Subjects: Participants were complex CPP patients recruited from subspecity referral clinics defined as those who were refractory to initial treatment and/or exhibited comorbid pain syndromes at initial presentation. Methods: Comprehensive treatment history for CPP was obtained, and participants referred as above; 3-mm punch biopsies were obtained of the lower extremity and sent to diagnostic reference labs to evaluate for SFPN...
February 13, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29447146/health-risk-behaviors-and-chronic-conditions-among-adults-with-inflammatory-bowel-disease-united-states-2015-and-2016
#20
Fang Xu, James M Dahlhamer, Emily P Zammitti, Anne G Wheaton, Janet B Croft
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, involves chronic inflammation of the gastrointestinal tract. In 2015, an estimated 3.1 million adults in the United States had ever received a diagnosis of IBD (1). Nationally representative samples of adults with IBD have been unavailable or too small to assess relationships between IBD and other chronic conditions and health-risk behaviors (2). To assess the prevalence of health-risk behaviors and chronic conditions among adults with and without IBD, CDC aggregated survey data from the 2015 and 2016 National Health Interview Survey (NHIS)...
February 16, 2018: MMWR. Morbidity and Mortality Weekly Report
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