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https://www.readbyqxmd.com/read/28703786/fistulizing-crohn-s-disease
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28643073/endoscopic-resection-of-giant-fibrovascular-esophageal-polyps
#6
Marc A Ward, Kristin W Beard, Ezra N Teitelbaum, Ahmed M Sharata, Christy M Dunst, Lee L Swanstrom, Kevin M Reavis
BACKGROUND: Giant fibrovascular esophageal polyps are rare benign intraluminal tumors that originate from the submucosa of the cervical esophagus [Owens et al. (JAMA 103: 838-842, 1994), Totten et al. (JAMA 25:606-622, 1953)]. Due to their indolent course, these tumors tend to reach enormous proportions before patients develop symptoms. Accurately diagnosing these tumors is difficult, as endoscopy may miss 25% of these lesions because these polyps exhibit normal intact esophageal mucosa [Levine et al...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28639045/passing-the-fundamentals-of-endoscopic-surgery-fes-exam-linking-specialty-choice-and-attitudes-about-endoscopic-surgery-to-success
#7
Aimee K Gardner, Michael B Ujiki, Brian J Dunkin
INTRODUCTION: Previous work has shown that up to 30% of graduating surgery residents fail the fundamentals of endoscopic surgery (FES) exam. This study investigated the extent to which FES pass rates differ in a specific sample of individuals who have chosen a career in GI surgery and to examine the relationships between FES performance and confidence in performing flexible endoscopy. METHODS: Fellows attending the 2016 SAGES Flexible Endoscopy Course were invited to complete the FES manual skills examination...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28633127/successful-endoscopic-treatment-of-gastric-phytobezoar-a-case-report
#8
Ippazio Ugenti, Elisabetta Travaglio, Elpiniki Lagouvardou, Onofrio Caputi Iambrenghi, Gennaro Martines
INTRODUCTION: Gastric bezoars are a rare condition associated with situations of gastric dysmotility and prior gastric surgery, though sometimes they can present without any risk factor. We describe the first successful treatment in medical literature of a large gastric bezoar in the outpatient setting through endoscopic fragmentation. CASE PRESENTATION: A 76-year-old man was referred to our outpatient endoscopy clinic because of dyspepsia and epigastric pain. Upper GI endoscopy with a standard endoscope revealed a 10-cm-diameter gastric phytobezoar with necrotic pressure ulcer of the angulus...
June 15, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28599492/histological-evaluations-of-primary-lesions-are-independently-associated-with-prognosis-in-patients-with-gastric-cancer-who-receive-neoadjuvant-chemotherapy
#9
Tomomitsu Tahara, Tomoyuki Shibata, Masaaki Okubo, Dai Yoshida, Tomohiko Kawamura, Noriyuki Horiguchi, Takamitsu Ishizuka, Mitsuo Nagasaka, Yoshihito Nakagawa, Naoki Ohmiya
Neoadjuvant chemotherapy may improve outcomes for patients with locally advanced gastric cancer (GC). To explore useful predictive factors for the response of advanced GC to neoadjuvant chemotherapy, tumor responses were assessed using computed tomography (CT) with histological based criteria. A total of 78 patients with advanced GC undergoing neoadjuvant chemotherapy were included. CT-based response assessment was performed following 2 courses of treatment. Histological evaluation of resected specimens was also performed according to the Japanese classification of gastric carcinoma...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28596986/international-core-curriculum-for-capsule-endoscopy-training-courses
#10
Ignacio Fernandez-Urien, Simon Panter, Cristina Carretero, Carolyn Davison, Xavier Dray, Evgeny Fedorov, Richard Makins, Miguel Mascarenhas, Mark McAlindon, Deirdre McNamara, Hansa Palmer, Jean Francoise Rey, Jean Christophe Saurin, Uwe Seitz, Cristiano Spada, Ervin Toth, Felix Wiedbrauck, Martin Keuchel
Capsule endoscopy (CE) has become a first-line noninvasive tool for visualisation of the small bowel (SB) and is being increasingly used for investigation of the colon. The European Society of Gastrointestinal Endoscopy (ESGE) guidelines have specified requirements for the clinical applications of CE. However, there are no standardized recommendations yet for CE training courses in Europe. The following suggestions in this curriculum are based on the experience of European CE training courses directors. It is suggested that 12 hours be dedicated for either a small bowel capsule endoscopy (SBCE) or a colon capsule endoscopy (CCE) course with 4 hours for an introductory CCE course delivered in conjunction with SBCE courses...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28592756/cea-producing-multiple-myeloma-with-meningeal-invasion-during-relapse
#11
Mayumi Hatsuse, Shin-Ichi Fuchida, Akira Okano, Satoshi Murakami, Chihiro Shimazaki
Here we describe the case of a 62-year-old woman diagnosed with multiple myeloma (IgA-κ type) who had a high serum CEA level of 27.7 ng/ml. Upper and lower gastrointestinal endoscopy and PET/CT scan showed no abnormality. After two courses of VAD therapy, the serum CEA level decreased to 5.7 ng/ml, with a decrease in the IgA level, suggesting the diagnosis of CEA-producing myeloma. After 4 years and 1 month, she had a relapse with an increase in the LDH level and myeloma cells in the blood, followed by cognitive loss and convulsion...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28579581/a-nasal-osteoma-with-an-acute-course-in-a-japanese-black-heifer
#12
Reiichiro Sato, Yumi Une, Hiroo Madarame, Hyougo Hanami, Eiichi Kanai, Hironobu Murakami, Atsushi Tsukamoto, Takehito Suzuki, Hideharu Ochiai, Masato Kikuchi, Hidekazu Tanaka, Ken Onda
A 14-month-old Japanese Black heifer presented with unilateral epistaxis and mild swelling of the right face. Radiography revealed a mass with increased radiopacity on the right side of the nasal bridge, extending to the left side. Intranasal endoscopy confirmed a large tumor-like structure protruding into the nasal cavity. Following euthanasia, cranial computed tomography (CT) was performed, revealing a tumor 24.3 × 17.5 × 14.8 cm in size. The tumor occupied the entire right nasal cavity and the frontal and sphenoid sinuses...
June 2, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28570883/terminal-ileostomy-and-on-table-enteroscopy-a-case-report-describing-a-novel-approach-for-retrieval-of-foreign-bodies-in-the-difficult-abdomen
#13
Shadi Al-Bahri, Esther Cha, Gregory Burgoyne
INTRODUCTION: With any abdominal surgery in a difficult abdomen, the procedure is filled with potential hazards. In addition to a prolonged operative time, there is a risk of enterotomy or damage to blood vessels and ureters. An irradiated pelvis increases this risk and may cause additional morbidity such as delayed healing. An impacted foreign body can also be a challenging problem to deal with alone but when combined with a difficult abdomen can make the problem impossible. PRESENTATION OF CASE: A 67 year-old male presented with a small bowel obstruction secondary to a foreign body impacted in the distal...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28567378/capsule-retention-prevention-diagnosis-and-management
#14
REVIEW
Emanuele Rondonotti
Capsule retention (CR) has been defined as capsule remaining in the digestive tract for a minimum of two weeks. CR occurs approximately in 2% of all patients undergoing small bowel capsule endoscopy (CE). Prompt diagnosis of CR is important, as it has relevant clinical implications. CR should be suspected in (I) all asymptomatic patients who do not report capsule excretion within 15 days from capsule ingestion; and (II) patients with obstructive or perforation-related symptoms in which the capsule has not been excreted, regardless of the time between the onset of symptoms and capsule ingestion...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28550655/primary-malignant-melanoma-of-esophagus-following-chemoradiotherapy-for-esophageal-squamous-cell-carcinoma-report-of-a-case
#15
Shinichiro Imai, Akira Suzuki, Yuta Yamamoto, Makoto Koyama, Satoshi Sugiyama, Masato Kitazawa, Yusuke Miyagawa, Shinichi Miyagawa
Primary malignant melanoma of the esophagus (PMME) is a rare neoplasm. We observed a case of PMME that had occurred at an irradiated site in the thoracic esophagus. The patient was a 74-year-old man who had received definitive chemoradiotherapy for esophageal squamous cell carcinoma at the age of 68, and had completely recovered. Six years later, via periodic upper gastrointestinal endoscopy, he had been diagnosed with esophageal tumors. After the patient underwent esophagectomy, the removed esophageal tumors were immunohistologically diagnosed as PMME, and most of the tumor was observed to be located within the irradiated area corresponding to the previous radiotherapy...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28549957/three-stage-esophagectomy-combined-with-abdominal-aortic-aneurysm-repair-first-case-in-the-literature
#16
Chris Klonaris, Dimitrios Schizas, Georgios Karaolanis, Dimitrios Athanasiadis, Andreas Alexandrou, Theodore Liakakos
The purpose of this report is to describe the synchronous surgical treatment of an abdominal aortic aneurysm (AAA) with concomitant esophageal cancer with a 3-stage esophagectomy, a real management challenge especially in establishing the therapeutic priorities and the ideal treatment approach. A 65-year-old male was referred for treatment in our hospital with the diagnosis of AAA. He complained of general fatigue, weight loss, and intermittent dysphagia. Contrast-enhanced computed tomography and upper endoscopy showed the AAA and a large gastroesophageal junction tumor, respectively...
May 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#17
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
May 25, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28527963/clinical-significance-of-spontaneous-pneumomediastinum
#18
Brittany A Potz, Linda H Chao, Thomas T Ng, Ikenna C Okereke
BACKGROUND: Spontaneous pneumomediastinum (SPM) is classified as free air in the mediastinum in the absence of any precipitating cause. It is relatively uncommon, and the clinical significance and risk associated with SPM is not well understood and has not been widely documented in the literature. Our goals were to determine the outcomes of patients who presented with SPM and to determine predictors of severe pathology associated with SPM. METHODS: From 2004 through 2013, a retrospective review was conducted of patients who presented with SPM to our institution...
May 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28522952/clinical-outcomes-of-sigmoid-colon-volvulus-identification-of-the-factors-associated-with-successful-endoscopic-detorsion
#19
Tomoya Iida, Suguru Nakagaki, Shuji Satoh, Haruo Shimizu, Hiroyuki Kaneto, Hiroshi Nakase
BACKGROUND/AIMS: Although multiple treatment options exist for the management of sigmoid colon volvulus, no study has examined the factors associated with successful endoscopic detorsion. This study aimed to examine the clinical course of patients with sigmoid colon volvulus and to identify factors related to successful endoscopic detorsion. METHODS: This study included 30 cases (21 patients) of sigmoid volvulus from among 545 cases of intestinal obstruction at a single center...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#20
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
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