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https://www.readbyqxmd.com/read/28925290/differences-in-the-clinical-course-of-516-japanese-patients-with-upper-gastrointestinal-bleeding-between-weekday-and-weekend-admissions
#1
Minoru Fujita, Noriaki Manabe, Takahisa Murao, Motoyasu Osawa, Shinsuke Hirai, Shinya Fukushima, Yo Shogen, Rui Nakato, Manabu Ishii, Hiroshi Matsumoto, Jiro Hata, Akiko Shiotani
BACKGROUND AND AIMS: Patients suspected of having upper gastrointestinal bleeding (UGIB) admitted during the weekend tend to have a poor outcome in western countries. However, no Japanese studies have been reported on this matter. We aimed to evaluate differences in the clinical course of patients with UGIB between weekday and weekend admissions in Japan. METHODS: Medical records of patients who had undergone emergency endoscopy for UGIB were retrospectively reviewed...
September 19, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28922257/endoscopic-and-histological-assessment-of-paediatric-inflammatory-bowel-disease-over-a-three-year-follow-up-period
#2
J J Ashton, Q Bonduelle, E Mossotto, T Coelho, A Batra, N A Afzal, B Vadgama, S Ennis, R M Beattie
OBJECTIVES: Discrepancies between Inflammatory bowel disease (IBD) endoscopic/histological extent are documented at diagnosis. It is unclear whether these differences persist through disease course, with potential impact on categorisation and management. We aimed to analyse the progression of disease over a 3-year period. METHODS: Patients aged < 17 years, diagnosed between 2010-2013 at Southampton Children's Hospital and followed-up for 3 years were eligible...
September 16, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28916889/teaching-peroral-endoscopic-myotomy-poem-to-surgeons-in-practice-an-into-the-fire-pre-post-test-curriculum
#3
Tomokazu Kishiki, Brittany Lapin, Chi Wang, Brandon Jonson, Lava Patel, Matthew Zapf, Matthew Gitelis, Maria A Cassera, Lee L Swanström, Michael B Ujiki
INTRODUCTION: With the increasing adoption of peroral endoscopic myotomy (POEM) as a first-line therapy for achalasia as well as a growing list of other indications, it is apparent that there is a need for effective training methods for both endoscopists in training and those already in practice. We present a hands-on-focused with pre- and post-testing methodology to teach these skills. METHODS: Six POEM courses were taught by 11 experienced POEM endoscopists at two independent simulation laboratories...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28895370/eosinophilic-esophagitis-current-evidence-based-diagnosis-and-treatment-in-children-and-adults
#4
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/28883296/multifocal-angiosarcoma-of-the-gastrointestinal-tract-a-case-report
#5
Yosho Fukita, Ikuma Yasuda, Hiroyuki Ishibashi, Tsutoshi Asaki, Seitaro Adachi, Michifumi Toyomizu, Takefumi Takeda, Naomi Suematsu
An 80-year-old man presented to our hospital with complaints of tarry stool and shortness of breath. A blood test confirmed marked anemia. On abdominal contrast-enhanced computed tomography, neither hemorrhagic lesions nor tumorous lesions could be pointed out. Upper gastrointestinal endoscopy revealed multiple erythematous flat elevated lesions, which were about 10mm in diameter, located between the stomach and the horizontal part of the duodenum. Colonoscopy revealed similar lesions throughout the entire colon...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28882938/imatinib-dramatically-alleviates-pulmonary-tumour-thrombotic-microangiopathy-induced-by-gastric-cancer
#6
Kana Kubota, Taro Shinozaki, Yasushi Imai, Kazuomi Kario
Pulmonary tumour thrombotic microangiopathy (PTTM) is a rare complication of cancer, which can be lethal due to progressive pulmonary hypertension (PH). Several case reports have demonstrated that imatinib, a platelet-derived growth factor receptor-tyrosine kinase inhibitor, can improve severe PH in patients with PTTM.We describe the case of a 56-year-old woman. Her mean pulmonary arterial pressure (mPAP) was 47 mm Hg, and her dyspnoea worsened rapidly over several days. Although pulmonary embolism was not observed on CT, enlargement of the para-aortic lymph nodes was detected...
September 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28879075/endobronchial-ultrasound-convex-probe-for-lymphoma-sarcoidosis-lung-cancer-and-other-thoracic-entities-a-case-series
#7
Paul Zarogoulidis, Haidong Huang, Chong Bai, Christoforos Kosmidis, Georgia Trakada, Lemonia Veletza, Theodora Tsiouda, Nikolaos Barbetakis, Dimitrios Paliouras, Evangelia Athanasiou, Dimitris Hatzibougias, Anastasios Kallianos, Nikolaos Panagiotopoulos, Liana Papaemmanouil, Wolfgang Hohenforst-Schmidt
Endobronchial ultrasound endoscopy is a state of the art diagnostic endoscopic procedure for the thorax. Firstly it was designed mainly for the staging of lung cancer and of course for the diagnosis of suspicious findings in large central airways. The main limitation of the equipment is the diameter of the instrument and therefore it can only be guided through large airways. However; the diameter of the working channel also provides a large tissue sample nowadays with the 19G biopsy needle. We will provide our experience with the 22G needle of the endobronchial convex-probe in several medical situations of the thorax...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28858739/spontaneous-non-traumatic-mediastinal-hematoma-associated-with-oral-anticoagulant-therapy-a-case-report-and-literature-review
#8
Masashi Mikubo, Dai Sonoda, Hirotsugu Yamazaki, Masahito Naito, Yoshio Matsui, Kazu Shiomi, Yukitoshi Satoh
INTRODUCTION: Mediastinal hematoma is usually caused by thoracic trauma or a ruptured aortic aneurysm. Spontaneous non-traumatic mediastinal hematomas are rare but potentially life-threatening conditions that can occur in patients taking anticoagulants. PRESENTATION OF CASE: We report a case of 72-year-old man with a massive mediastinal hematoma associated with anticoagulant therapy. He had complained of acute chest discomfort and subsequent tarry diarrhea. Because he had been taking warfarin for paroxysmal atrial fibrillation, an upper gastrointestinal hemorrhage was initially suspected, but no bleeding was detected by upper endoscopy...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#9
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#10
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 21, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28804658/extensive-causative-esophagitis-caused-by-thermal-injury-a-case-report-and-review-of-the-literature
#11
Cherng Harng Lim, Hsu-Heng Yen, Wei-Wen Su, Cherng-Jyr Lim, Hao-Chien Tsai, Shi-Ting Chen
Esophagus thermal injury is a rare case that can be easily overlooked by practitioners. We herein present a case of thermally induced diffuse corrosive esophagitis with complaints of dysphagia and retrosternal chest pain after having steamed pork. A thorough disease course was demonstrated by serials of endoscopy images and video. A comprehensive review of articles and a concise overview of esophageal thermal injury clinical manifestation, disease process, typical endoscopy features, pharmacomanagement option, and outcomes will be conducted in this article...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28799152/-gastric-schwannoma-rare-differenzial-diagnosis-of-acute-upper-gastrointestinal-gi-bleeding
#12
Orestis Lyros, Stephan Schickel, Katrin Schierle, Albrecht Hoffmeister, Ines Gockel
Schwannomas are benign tumors derived from Schwann cells and their typical site of origin is the subcutaneous tissue of the extremities. Gastrointestinal localization of Schwannomas is extremely rare and the stomach is the prevalent site. Gastric schwannomas primarily occur in the gastric submucosa and are usually asymptomatic.We present a rare case of a solitary gastric schwannoma in a 51-year old male, which initially manifested with hematemesis by acute upper gastrointestinal (GI) bleeding. The upper GI-Endoscopy revealed a gastric submucosal tumor, 7 cm in size, located in the proximal corpus and fundus...
August 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28737951/monitoring-of-small-bowel-crohn-s-disease
#13
Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
In recent years, the therapeutic paradigm in Crohn's disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such "treat-to-target" approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn's disease, the small bowel is affected in the majority of patients; frequently, Crohn's involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28734992/endoscopic-muscle-biopsy-sampling-of-the-duodenum-and-rectum-a-pilot-survival-study-in-a-porcine-model-to-detect-myenteric-neurons
#14
Elizabeth Rajan, Badr Al-Bawardy, Christopher J Gostout, Louis Michele Wong Kee Song, Jodie L Deters, Mary A Knipschield, Cheryl E Bernard, Gianrico Farrugia
BACKGROUND AND AIMS: Small bowel and colorectal muscle biopsy sampling requires a surgical approach. Advancing our understanding of the pathophysiology of motility disorders, such as functional bowel disorders, intestinal pseudo-obstruction, and slow-transit constipation, is hindered by our inability to noninvasively obtain muscularis propria (MP) for evaluation of multiple cell types, including myenteric neurons. The aims of this study were to determine (1) technical feasibility, reproducibility, and safety of performing duodenal endoscopic muscle biopsy sampling (dEMB) and rectal endoscopic muscle biopsy sampling (rEMB) using a clip-assist technique and (2) the presence of myenteric neurons in tissue samples...
July 20, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#15
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#16
Michael Scharl, Gerhard Rogler, Luc Biedermann
Fistulas still represent one of the most important complications in patients with Crohn's disease (CD). At least one third of CD patients suffer from fistulas during their disease course and amongst them longstanding remission of complex fistulas occurs only in about one third. So far, fistula pathogenesis is only partially understood. From a histopathological view, a fistula is a tube covered by flat epithelial cells. Current research suggests that the driving force for fistula development is epithelial-to-mesenchymal transition (EMT)...
July 13, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28698419/-aortoesophageal-fistula-due-to-aortic-aneurysm-report-of-a-case
#17
Satoshi Yuhara, Takuya Kimura, Hideyuki Okawa, Hiroki Hasegawa, Jun Yokote, Yukifusa Yokoyama, Syuji Tamaki
A 77-year-old woman presented with general fatigue, was found to have anemia, and was referred to our hospital. Upper gastrointestinal endoscopy revealed a submucosal elevated lesion with a bleeding site and debris at the middle thoracic esophagus. Enhanced computed tomography demonstrated a thoracic aortic aneurysm compressing the esophagus. She was diagnosed with an aorto-esophageal fistula due to the thoracic aortic aneurysm. Graft replacement was performed under partial extracorporeal circulation. Because the perforation of the esophagus was small, omental flap transposition was performed without esophagectomy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28654928/risk-stratification-of-patients-with-crohn-s-disease-a-retrospective-analysis-of-clinical-decision-making-and-its-impact-on-long-term-outcome
#18
Mahmoud Mosli, Hanadi Sabbahi, Hind Alyousef, Mada Abdulhaq, Afnan Hadadi, Emad Aljahdali, Hani Jawa, Salem Bazarah, Yousif Qari
BACKGROUND AND AIMS: Complications such as need for bowel resections and hospitalization due to Crohn's disease (CD) occur when disease activity persists due to ineffective therapy. Certain "high-risk" features require an early introduction of anti-tumor necrosis factor-α therapy to prevent such complications. We aim to evaluate the prevalence of "high-risk" features among a cohort of patients with CD and examine the association between discordance of early therapy with baseline risk stratification and disease outcome...
June 28, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28647751/chronic-rhinosinusitis-severity-is-associated-with-need-for-asthma-related-systemic-corticosteroids
#19
K M Phillips, L P Hoehle, R W Bergmark, A P Campbell, D S Caradonna, S T Gray, A R Sedaghat
BACKGROUND: Chronic rhinosinusitis (CRS) is highly prevalent in patients with asthma. However, no study has evaluated the effect of CRS severity on asthma-related oral corticosteroid use - a marker of poor asthma control and prognosis. We therefore sought to evaluate the association between CRS severity and asthma-related oral corticosteroid use. METHODOLOGY: Prospective cross-sectional study of 110 adult asthmatic CRS patients. CRS severity was measured using the 22-item Sinonasal Outcomes Test (SNOT-22) and Lund-Kennedy endoscopy score...
June 25, 2017: Rhinology
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#20
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
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