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Chizu Kameda, Hideaki Miwa, Ryohei Kawabata, Daiki Marukawa, Masahiro Murakami, Shingo Noura, Junzo Shimizu, Junichi Hasegawa
An inflammatory fibroid polyp (IFP) is a mesenchymal tumor of the gastrointestinal tract. IFPs in the small intestine are the most frequently detected with symptoms, such as abdominal pain and tarry stool due to intussusception. Accordingly, few studies have reported jejunal IFP as a cause of occult gastrointestinal bleeding (OGIB) diagnosed via both of capsule endoscopy (CE) and double-balloon enteroscopy (DBE). A 68-year-old woman presented with a progression of anemia and a positive fecal occult blood test result...
March 20, 2018: Clinical Endoscopy
Tom Kreft, Thomas Hachenberg
Traditionally the double-lumen-tube (DLT) is considered the gold standard for lung separation. Despite being equally feasible for standard situations, there are special populations and circumstances requiring the use of a bronchial blocker (BB) to establish one-lung ventilation. Children under 8 years of age and patients without a patent orotracheal airway necessitate the use of a bronchial blocker in most cases, as well as those requiring selective lobar blockade or a rapid sequence induction. Surgery with predicted postoperative mechanical ventilation or in tracheotomized patients at least favors their use by avoiding the complications of a tube exchange...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Abdulla Shehab, Khalid F AlHabib, Akshaya Srikanth Bhagavathul, Ahmad Hersi, Hussam Alfaleh, Mostafa Q Alshamiri, Anhar Ullah, Khadim Sulaiman, Wael Almahmeed, Jassim Al Suwaidi, Alwai A Alsheikh-Ali, Haitham Amin, Mohammed Al Jarallah, Amar M Salam
BACKGROUND: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIM: To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries...
March 14, 2018: Current Vascular Pharmacology
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Frederike Beyer, Nura Sidarus, Stephen Fleming, Patrick Haggard
Social contexts substantially influence individual behavior, but little is known about how they affect cognitive processes related to voluntary action. Previously, it has been shown that social context reduces participants' sense of agency over the outcomes of their actions and outcome monitoring. In this fMRI study on human volunteers, we investigated the neural mechanisms by which social context alters sense of agency. Participants made costly actions to stop inflating a balloon before it burst. On "social" trials, another player could act in their stead, but we analyzed only trials in which the other player remained passive...
January 2018: ENeuro
Iraj GoliKhatir, Farzad Bozorgi, Seyyedeh Masoume Pashaei
During medical devices evolution many modalities and techniques like Computerized tomography, magnetic resonance imaging, wireless capsule endoscopy and double-balloon endoscopy were applied to provide enough evidences for final detection of diseases. As well as current procedures, sonography is a method that individuals are satisfied with it because of various conditions like non-invasive and cheap. Ultrasound is one of the procedures which can be used in diagnosis of fractures and has its own unique feature including different views at the same time with no radiation effects...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Shunichi Matsuoka, Yoichiro Yamana, Tomotaka Ishii, Mariko Kumagawa, Taku Mizutani, Shinya Kamimura, Naoki Matsumoto, Hitomi Nakamura, Kazushige Nirei, Kanda Tatsuo, Mitsuhiko Moriyama
A 70-year-old woman with hepatitis C cirrhosis underwent balloon-occluded retrograde transvenous obliteration for hepatic encephalopathy due to spleno-renal shunt. Because the shunt was thick, long, and winding, we used a coaxial and double interruption system, which enables the effective occlusion of the drainage route, and shape-memory coils, which are more physically stable than conventional metallic coils because they form three-dimensional loops. The patient was successfully treated with the combined usage of these devices, resulting in a normal serum ammonia level...
February 28, 2018: Internal Medicine
Hiroyuki Nakayama, Masanao Toma, Taishi Kobayashi, Nobuhisa Ohno, Tatsuji Okada, Go Ueno, Yukihito Sato
PURPOSE: Mortality in patients with ruptured abdominal aortic aneurysms (rAAAs) has remained high despite advances in interventions. Endovascular aneurysm repair (EVAR) was recently developed for treatment of rAAAs. In this study, we assessed our endovascular strategy including a double-balloon technique for rAAA. METHODS: We analyzed 12 consecutive patients with rAAAs who were treated by our double-balloon technique and endovascular strategy from March 2013 to July 2016...
March 1, 2018: Annals of Thoracic and Cardiovascular Surgery
Hongrou Ye, Chunxiao Chen
OBJECTIVE: To compare the diagnostic value of double-balloon endoscopy (DBE) and multi-detector row computed tomography (MDCT) for small intestinal tumors. METHODS: The clinical data of 88 patients with small intestinal tumor who underwent DBE and MDCT examinations during January 2010 and December 2016 was retrospectively analyzed. The diagnostic value of DBE and MDCT for small intestinal tumor was compared. RESULTS: The positive rate of small intestinal tumors by DBE (92...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Ravi Nara Srinivasa, Matthew L Osher, Douglas A Murrey, Jordan Bruce Fenlon, Charles Brewerton, Wael E Saad, Jeffrey Forris Beecham Chick
Patients with a Roux-en-Y gastric bypass may be challenging diagnostic and therapeutic dilemmas for gastroenterologists and endoscopists due to anatomic considerations. Pancreaticobiliary limb pathology is particularly difficult to diagnose from standard endoscopic approaches as it often requires double balloon enteroscopy. Percutaneous access and gastrostomy placement into the gastric remnant, however, is a commonly performed procedure by interventional radiology. This report describes the identification of duodenal perforation and Graham patch dehiscence in the pancreaticobiliary limb of a patient with a prior Roux-en-Y gastric bypass who had failed traditional endoscopic measures, using transgastric remnant interventional duodenoscopy and confirmed with methylene blue injection into a periduodenal abscess...
December 2017: Radiology Case Reports
Masaya Iwamuro, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Seiji Kawano, Sakiko Hiraoka, Yoshitaka Kondo, Takehiro Tanaka, Hiroyuki Okada
A 40-year-old Japanese man with abdominal pain was referred to our hospital. The patient had been diagnosed with Crohn's disease at the age of 21 years and had since then received treatment with mesalazine and had been advocated an elemental diet. About 30 months before his visit to the hospital, he had swallowed a patency capsule, the retention of which in the ileum was subsequently detected on abdominal ultrasonography. The patient was advised to undergo the evaluation of stenosis, but he refused further investigation at that time...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Annelisse Ashton, Ricardo Soares, Venkata Ramana Murthy Kusuma, Dimitrios Moschonas, Matthew Perry, Krishna Patil
We aim to outline our technique of performing a robotic-assisted bladder diverticulectomy at our institution and report our surgical outcomes. We report the cases of three robotic-assisted bladder diverticulectomies, performed at the Royal Surrey County Hospital during the period of January 2014 to December 2015. Patient was positioned in low dorsal lithotomy position. A 6Fr double-J stent was prophylactically inserted at the start of the procedure. Foley catheter was placed over guide wire into the diverticulum and balloon inflated on the diverticulum neck...
February 16, 2018: Journal of Robotic Surgery
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
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
Héctor Lajusticia, Samuel J Martínez-Domínguez, Gonzalo R Pérez-Roncero, Peter Chedraui, Faustino R Pérez-López
OBJECTIVE: To compare the efficacy of single- versus double-balloon catheter (SBC vs. DBC) for cervical ripening and labor induction with an unfavorable cervix. METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) or quasi-RCTs (qRCT) regarding the use of SBC or DBC for labor induction of live singleton cephalic pregnancies (≥ 35 weeks) of any parity with an unripe cervix (Bishop score ≤ 6). Nine research databases were searched for original articles published in all languages up to November 2017 comparing both devices for labor induction...
February 14, 2018: Archives of Gynecology and Obstetrics
Mami Tokunaga, Sohachi Nanjo, Hiroki Yoshita, Haruka Fujinami, Tohru Watanabe, Yoko Ishii, Saito Kobayashi, Momoko Akashi, Hiroaki Takagi, Hiroshi Mihara, Shinya Kajiura, Takayuki Ando, Isaya Hashimoto, Shozo Hojo, Tomoyuki Okumura, Toshiro Sugiyama
A 77-year-old patient was admitted to our hospital for the further examination of melena. A computed tomography scan detected two submucosal tumors (SMTs) in the stomach and jejunum. Double-balloon endoscopy revealed the presence of a delle on the jejunal SMT, suggesting that the SMT was the origin of the gastrointestinal bleeding. Both tumors were surgically resected and subsequently diagnosed via histology as gastrointestinal stromal tumors (GISTs). Furthermore, the two GISTs had different mutations in the c-kit gene, suggesting that they were derived from different clonal origins...
February 9, 2018: Internal Medicine
Takeshi Yamashina, Yoshikazu Hayashi, Hirotsugu Sakamoto, Tomonori Yano, Yoshimasa Miura, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
BACKGROUND:  Colorectal endoscopic submucosal dissection (ESD) can be technically difficult in some situations, such as paradoxical movement of the proximal colon. The double-balloon endoscope provides stable endoscopic maneuvering, even in the small intestine. The aim of this study was to assess the outcomes of balloon-assisted endoscopic submucosal dissection (BAESD) of colonoscopically difficult superficial proximal colon tumors. METHODS:  We retrospectively reviewed the records of patients who underwent BAESD of superficial proximal colon tumors where colonoscopic difficulties were encountered, from January 2011 to September 2016...
February 12, 2018: Endoscopy
Debbie Grønlund, Jakob L Poulsen, Klaus Krogh, Christina Brock, Donghua Liao, Hans Gregersen, Asbjørn M Drewes, Anne E Olesen
BACKGROUND AND AIMS: Opioid treatment interferes with anal sphincter function and its regulation during defecation. This may result in straining, incomplete evacuation, and contribute to opioid-induced bowel dysfunction (OIBD). Employing an experimental model of oxycodone-induced OIBD, we hypothesized that co-administration of the peripherally acting μ-opioid antagonist naloxegol would improve anal sphincter function in comparison to placebo. METHODS: In a double-blind randomized crossover trial, 24 healthy males were assigned to a six-day treatment of oral oxycodone 15 mg twice daily in combination with either oral naloxegol 25 mg once daily or placebo...
February 9, 2018: European Journal of Pharmaceutical Sciences
Alberto Murino, Nikolaos Koukias, Laura Gaeta, Edward J Despott
No abstract text is available yet for this article.
December 26, 2017: Digestive and Liver Disease
Shogo Miura, Hiroyuki Kuroda, Ken Sato, Michiko Yamada, Ryo Itou, Michihiro Ono, Tomoyuki Abe, Shigeyuki Fujii, Masahiro Maeda, Masahiro Yoshida, Wataru Jomen, Masayoshi Kobune, Junji Kato, Miri Fujita
The gastrointestinal tract is a common site for the occurrence of non-Hodgkin's lymphoma (NHL). NHL with gastrointestinal lesions may lead to clinically relevant intestinal complications such as obstruction, perforation, and exsanguination during the course of the disease. Consequently, patients with NHL are often examined by means of upper and lower gastrointestinal endoscopy at the initial visit. There are no clear guidelines regarding which patients should undergo capsule endoscopy (CE) and balloon enteroscopy for detecting small intestinal lesions...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
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