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https://www.readbyqxmd.com/read/28100064/a-risk-stratifying-tool-to-facilitate-safe-late-stage-percutaneous-endoscopic-gastrostomy-in-als
#1
Alexander G Thompson, Victoria Blackwell, Rachael Marsden, Emma Millard, Clare Lawson, Annabel H Nickol, James E East, Kevin Talbot, Philip J Allan, Martin R Turner
BACKGROUND: The safety of percutaneous endoscopic gastrostomy (PEG) insertion in amyotrophic lateral sclerosis (ALS) patients with significant respiratory compromise has been questioned. OBJECTIVES: To review the characteristics of an ALS clinic patient cohort undergoing PEG, and the introduction of a risk stratification tool with procedural adaptations for higher-risk individuals. METHODS: Patients undergoing PEG insertion were analysed (n = 107)...
January 19, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28077159/concurrent-chemoradiotherapy-combined-with-enteral-nutrition-support-a-radical-treatment-strategy-for-esophageal-squamous-cell-carcinoma-patients-with-malignant-fistulae
#2
Li Ma, Guang-Yu Luo, Yu-Feng Ren, Bo Qiu, Hong Yang, Chun-Xia Xie, Song-Ran Liu, Shi-Liang Liu, Zhao-Lin Chen, Qun Li, Jian-Hua Fu, Meng-Zhong Liu, Yong-Hong Hu, Wen-Feng Ye, Hui Liu
BACKGROUND: Concurrent chemoradiotherapy (CCRT) significantly increases the survival rate of esophageal squamous cell carcinoma (ESCC) patients with malignant fistulae. Recent clinical evidence has shown the benefits of enteral nutrition for malnourished cancer patients. In this study, we aimed to validate that, with the support of enteral nutrition, ESCC patients who develop malignant fistulae might be able to complete CCRT and achieve long-term survival. METHODS: We reviewed the medical records of 652 patients with ESCC who received definitive CCRT at Sun Yat-sen University Cancer Center between January 2010 and December 2012...
January 11, 2017: Chinese Journal of Cancer
https://www.readbyqxmd.com/read/28076984/percutaneous-endoscopic-gastrostomy-body-weight-loss-and-survival-in-amyotrophic-lateral-sclerosis-a-population-based-registry-study
#3
Antonio Fasano, Nicola Fini, Diana Ferraro, Laura Ferri, Marco Vinceti, Jessica Mandrioli
OBJECTIVE: To assess the role of percutaneous endoscopic gastrostomy (PEG) insertion, and its timing, on ALS survival, and to study prognostic factors of survival before and after PEG placement in a population-based setting. METHODS: In this observational population-based, registry study, we enrolled patients with newly- diagnosed ALS, according to the El Escorial revised criteria, who were resident in the Emilia Romagna Region, and who developed severe dysphagia needing enteral nutritional support...
January 11, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28065535/gastric-necrosis-secondary-to-prolapse-of-a-percutaneous-gastrostomy
#4
David Fernández-SanMillán, Eudaldo López-Tomassetti Fernández, Juan Ramón Hernández Hernández
No abstract text is available yet for this article.
January 5, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28054280/successful-bypass-operation-for-esophageal-obstruction-after-acute-esophageal-necrosis-a-case-report
#5
Yayoi Sakatoku, Masahide Fukaya, Kazushi Miyata, Masato Nagino
BACKGROUND: Acute esophageal necrosis (AEN) is a rare clinical disorder. Esophageal stenosis or obstruction is one of severe complications, but there are a few reports about surgical treatments. In such a situation, it still remains controversial which to choose, esophagectomy or bypass operation. CASE PRESENTATION: A 61-year-old woman was admitted to the local hospital for septic shock with diabetic ketoacidosis due to necrotizing fasciitis of the right thigh. Three days later, she had hematemesis, and gastrointestinal endoscopy revealed black mucosal coloration throughout the entire esophagus...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28046941/su-g-iep3-13-real-time-patient-and-staff-dose-monitoring-in-fluoroscopy-guided-interventions
#6
L Vergoossen, A Sailer, L Paulis, J Wildberger, C Jeukens
PURPOSE: Interventional radiology procedures involve the use of X-rays, which can pose a large radiation burden on both patients and staff. Although some reports on radiation dose are available, most studies focus on limited types of procedures and only report patient dose. In our cathlabs a dedicated real-time patient and staff monitoring system was installed in November 2015. The aim of this study was to investigate the patient and staff dose exposure for different types of interventions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28040717/predictors-of-the-use-of-specific-critical-care-therapies-in-patients-with-metastatic-cancer
#7
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
OBJECTIVE: Understanding which factors are associated with the use of critical care therapies (CCTs) can help with clinical decision-making and goals of care discussion. The goal of this study was to describe the predictors of CCT use (eg, mechanical ventilation, tracheostomy, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, acute use of dialysis) in hospitalized patients with metastatic cancer. METHODS: We used the 2010 California State Inpatient Databases sponsored by the Agency for Healthcare Research and Quality to identify all hospitalizations with a diagnosis of metastatic cancer (patients aged ≥18 years)...
January 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28039644/incidence-of-abdominal-wall-metastases-following-percutaneous-endoscopic-gastrostomy-placement-in-patients-with-head-and-neck-cancer
#8
Eleanor Fung, David S Strosberg, Edward L Jones, Rebecca Dettorre, Andrew Suzo, Michael P Meara, Vimal K Narula, Jeffrey W Hazey
INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) tubes are an effective modality for enteral nutrition in patients with head and neck cancer; however, there have been documented case reports of "seeding" of the abdominal wall by the theoretic risk of dragging the tube along the tumor during PEG placement. The objective of this study is to determine the incidence and contributing risk factors leading to metastasis to the abdominal wall following PEG placement in patients with head and neck cancer...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28009454/direct-estimation-for-adaptive-treatment-length-policies-methods-and-application-to-evaluating-the-effect-of-delayed-peg-insertion
#9
Xin Lu, Brent A Johnson
Dysphagia is a primary cause of death among patients diagnosed with amyotrophic lateral sclerosis (ALS), and percutaneous endoscopic gastrostomy (PEG) is a procedure to insert a tube into the stomach to assist or replace oral feeding. It is believed that PEG is beneficial and, generally, earlier insertion is preferable to later. However, gathering clinical evidence to support these beliefs on the use and timing of PEG is challenging because controlled clinical trials are not feasible and clinical endpoints are confounded with PEG in observational data...
December 23, 2016: Biometrics
https://www.readbyqxmd.com/read/27995184/semi-solid-feeds-may-reduce-the-risk-of-aspiration-pneumonia-and-shorten-postoperative-length-of-stay-after-percutaneous-endoscopic-gastrostomy-peg
#10
Ezekiel Wong Toh Yoon, Kaori Yoneda, Kazuki Nishihara
Background and study aims: Feeding-related adverse events after percutaneous endoscopic gastrostomy (PEG) such as aspiration pneumonia may result in prolonged hospitalization and postoperative mortality. This study evaluated the efficacy of using semi-solid feeds to reduce feeding-related adverse events and improve clinical outcomes. Patients and methods: Patients who received PEG for enteral nutrition at our hospital between January 2014 and December 2015 were allocated to a postoperative feeding protocol that used either liquid feed or semi-solid feed...
December 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27990013/intraoperative-gastric-intramural-hematoma-a-rare-complication-of-percutaneous-endoscopic-gastrostomy
#11
Chi Chan Lee, Sharmila Ravindranathan, Vivek Choksi, Jestin Pudussery Kattalan, Uday Shankar, Steven Kaplan
BACKGROUND Intramural hematomas primarily present in the esophagus or duodenum. We report a case of intramural hematoma in the gastric wall (GIH) secondary to percutaneous endoscopic gastrostomy (PEG) tube placement in a setting of platelet dysfunction. CASE REPORT This case study reviews the hospitalization of a 73-year-old male with a history of chronic kidney disease who was admitted for coronary artery bypass graft surgery and mitral valve repair. During his complicated hospital course, he inadvertently required the placement of a PEG tube...
December 19, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27981935/percutaneous-endoscopic-gastrostomy-in-situs-inversus-totalis
#12
Nazish Butt, Sehrish Reema
No abstract text is available yet for this article.
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27965711/the-buried-bumper-syndrome-external-bumper-extraction-after-radial-mini-incisions-and-replacement-through-an-adjacent-tract
#13
M A Benatta
Although considered as a safe method to provide long-term nutritional support, percutaneous endoscopic gastrostomy (PEG) may be complicated by a buried bumper syndrome (BBS), a life-threatening condition. Removal of the PEG tube with its buried bumper and reinsertion of a new PEG tube is often necessary. Since its description in 1988, less than 50 cases of BBS managed by external extraction of the buried bumper have been reported. We report a case of buried bumper that was removed by external traction without the need for endoscopic or laparoscopic treatment but with the need of two radial millimeter skin incisions after abdominal CT study and finally immediate PEG replacement but through an adjacent site...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27965430/timing-of-percutaneous-endoscopic-gastrostomy-for-acute-ischemic-stroke-an-observational-study-from-the-us-nationwide-inpatient-sample
#14
Benjamin P George, Adam G Kelly, George P Albert, David Y Hwang, Robert G Holloway
BACKGROUND AND PURPOSE: Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke. METHODS: We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission...
December 13, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27942927/real-time-patient-and-staff-radiation-dose-monitoring-in-ir-practice
#15
Anna M Sailer, Leonie Paulis, Laura Vergoossen, Axel O Kovac, Geert Wijnhoven, Geert Willem H Schurink, Barend Mees, Marco Das, Joachim E Wildberger, Michiel W de Haan, Cécile R L P N Jeukens
PURPOSE: Knowledge of medical radiation exposure permits application of radiation protection principles. In our center, the first dedicated real-time, automated patient and staff dose monitoring system (DoseWise Portal, Philips Healthcare) was installed. Aim of this study was to obtain insight in the procedural and occupational doses. MATERIALS AND METHODS: All interventional radiologists, vascular surgeons, and technicians wore personal dose meters (PDMs, DoseAware, Philips Healthcare)...
December 9, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#16
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#17
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27930732/adjuvant-radiation-therapy-alone-for-hpv-related-oropharyngeal-cancers-with-high-risk-features
#18
William Su, Jerry Liu, Brett A Miles, Eric M Genden, Krzysztof J Misiukiewicz, Marshall Posner, Vishal Gupta, Richard L Bakst
BACKGROUND: Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification. OBJECTIVE: To investigate the outcomes of HPV+ patients treated with adjuvant radiotherapy alone when chemoradiotherapy was indicated based on high risk pathological features. They were compared with high risk HPV+ patients treated with adjuvant chemoradiotherapy...
2016: PloS One
https://www.readbyqxmd.com/read/27929572/what-does-stop-igan-tell-us-about-how-to-treat-iga-nephropathy
#19
S Piracha, J Gnanapragasam, S M Tariq
Bronchoesophageal fistulae are a rare complication of tuberculosis. Traditionally they are managed by either thoracotomy with resection and closure of the fistulous tract or by taking a more conservative approach of giving standard treatment for tuberculosis while ensuring nutritional support through a nasogastric tube. We report a young student with disseminated tuberculosis complicated by a bronchoesophageal fistula. He was managed conservatively with anti-tuberculous chemotherapy and nutrition administered through a percutaneous endoscopic gastrostomy tube...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27928446/gastrostomy-with-peritoneal-collar-versus-percutaneous-endoscopic-gastrostomy
#20
Tudor C, Branescu C, Savlovschi C, El-Khatib A, Pantu H, Nica A, Dascalu Am, Masoumeh B, Tudor As, Oprescu Sm, Serban D
Aim. The present study aimed to perform a medico-surgical comparative analysis of the 2 most widely used techniques: gastrostomy with peritoneal collar versus percutaneous endoscopic gastrostomy, based on the vast clinical experience in an Upper Digestive Surgery Clinic. Materials and method. A retrospective study was carried out between January 2010 and January 2015 on the patients admitted for a surgical solution for feeding. The indications, preoperative preparation, surgical techniques, and postoperative outcomes were analyzed...
October 2016: Journal of Medicine and Life
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