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https://www.readbyqxmd.com/read/28915861/informed-decision-making-with-and-for-people-with-dementia-efficacy-of-the-prodecide-education-program-for-legal-representatives-protocol-of-a-randomized-controlled-trial-prodecide-rct
#1
Julia Lühnen, Burkhard Haastert, Ingrid Mühlhauser, Tanja Richter
BACKGROUND: In Germany, the guardianship system provides adults who are no longer able to handle their own affairs a court-appointed legal representative, for support without restriction of legal capacity. Although these representatives only rarely are qualified in healthcare, they nevertheless play decisive roles in the decision-making processes for people with dementia. Previously, we developed an education program (PRODECIDE) to address this shortcoming and tested it for feasibility...
September 15, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28913488/bilateral-thoracic-paravertebral-nerve-blocks-for-placement-of-percutaneous-radiologic-gastrostomy-in-patients-with-amyotrophic-lateral-sclerosis-a-case-series
#2
Arun Kalava, Steven Clendenen, J Mark McKinney, Elird Bojaxhi, Roy A Greengrass
BACKGROUND AND AIMS: To assess the efficacy of bilateral thoracic paravertebral nerve blocks (PVB) in providing procedural anesthesia and post-procedural analgesia for placement of percutaneous radiologic gastrostomy tubes (PRG) in patients with amyotrophic lateral sclerosis (ALS). METHODS: We prospectively observed 10 patients with ALS scheduled for PRG placement that had bilateral thoracic PVBs at thoracic 7, 8, and 9 levels with administration of a mixture of 3 mL of 1% ropivacaine, 0...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912913/paraneoplastic-dermatomyositis-syndrome-presenting-as-dysphagia
#3
Emmanuel Ofori, Daryl Ramai, Mel Ona, Madhavi Reddy
Dermatomyositis (DM) is a rare autoimmune condition which predominantly affects females in the fifth and sixth decades of life. DM presents acutely or progressively as painless proximal skeletal muscle weakness and can be associated with a heliotropic rash around the eyes, and Gottron's papules on extensor surfaces of the hands. While the pathophysiology of DM is still unclear, abnormal T- and B-cell immune activity has been reported. DM has been associated with malignancy and has been shown to appear before, concurrently with, or after diagnosis of cancer...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28906274/flexible-bronchoscope-use-by-pulmonologists-in-collaboration-with-gastroenterologists-for-placement-of-percutaneous-endoscopic-gastrostomy-via-transnasal-route-in-patients-with-head-and-neck-cancer-a-10-year-experience-in-a-single-cancer-institution
#4
Paulo J L Mota, Jorge Dionísio, José Duro da Costa, Sandra Faias
This study was conducted with the aim of evaluating a 10-year experience in the Pulmonology Department of a cancer center for percutaneous endoscopic gastrostomy through transnasal route (TN-PEG) in patients with head and neck cancer whose oral access is precluded. This study was a retrospective analysis of 40 consecutive head and neck cancer patients referred for PEG placement, between 2005 and 2014, using a transnasal route because of the impossibility of intubation through the oral cavity. Demographics, outcome of TN-PEG procedure, indications for bronchoscopic approach (prophylactic/palliative), clinical need for bronchoscopy (trismus, oropharyngeal obstruction), location of cancer, complications, and overall survival were reviewed...
September 12, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28898918/insertion-of-percutaneous-endoscopic-gastrostomy-tubes-with-jejunal-extensions-using-the-wedge-technique-a-novel-method-to-prevent-retrograde-tube-migration-into-the-stomach
#5
Michael S L Sey, Hannah Gregor, Jamie Gregor, Brian Yan
Background and study aim In percutaneous endoscopic gastrostomy (PEG) with jejunal extension (PEGJ) procedures, retrograde migration of the jejunal extension tube into the stomach during endoscope withdrawal is a frustrating problem. We describe the novel "wedge" technique for inserting the jejunal extension tube, utilizing single-balloon enteroscopy to anchor it in place. Patients and methods Prospective 1-year study of consecutive patients undergoing PEGJ insertion at a single tertiary care center. The primary outcome was number of pyloric intubations required to place the jejunal extension tube...
September 12, 2017: Endoscopy
https://www.readbyqxmd.com/read/28898315/-morbimortality-associated-to-nutritional-status-and-feeding-path-in-children-with-cerebral-palsy
#6
M J Figueroa, C Rojas, S Barja
INTRODUCTION: Children and adolescents with cerebral palsy (CP) have a high prevalence of malnutrition associated to poor prognosis. For an adequate nutritional assessment, new growth curves (Brooks, 2011) are available, in which precise cut-off points in Weight/Age index correlate to increased morbidity and mortality rate. OBJECTIVE: To evaluate risk of hospitalization and death in patients with CP, according to nutritional risk (NR). PATIENTS AND METHOD: Observational and prospective cohort study of patients with CP in an outpatient referral center...
2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28884711/-clinical-polymorphism-of-amyotrophic-lateral-sclerosis
#7
E A Kovrazhkina, O D Razinskaya, L V Gubsky
AIM: To clarify clinical polymorphism of amyotrophic lateral sclerosis (ALS). MATERIAL AND METHODS: The study was based on records of a hospital personalized register. Ninety-four patients, aged from 25 to 81 years, diagnosed with ALS according to El Escorial criteria were included. Electromyography and, if necessary, transcranial magnetic stimulation and magnetic-resonance tomography were used to confirm the diagnosis. Disease progression was assessed with the ARSFRS...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28884310/radiation-induced-acute-dysphagia-prospective-observational-study-on-42%C3%A2-head-and-neck-cancer-patients
#8
D Alterio, M A Gerardi, L Cella, R Spoto, V Zurlo, A Sabbatini, C Fodor, V D'Avino, M Conson, F Valoriani, D Ciardo, R Pacelli, A Ferrari, P Maisonneuve, L Preda, R Bruschini, M Cossu Rocca, E Rondi, S Colangione, G Palma, S Dicuonzo, R Orecchia, G Sanguineti, B A Jereczek-Fossa
PURPOSE: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. METHODS: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis...
September 7, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28877786/a-newly-developed-mask-facilitates-management-during-percutaneous-endoscopic-gastrostomy-introduction-in-patients-with-respiratory-compromise
#9
Hizuru Amano, Kazuhiro Imamura, Fumihiko Hatao, Toshio Shimizu, Shinsuke Tobisawa, Kentaro Hayashi, Jun Matsumoto, Kensuke Adachi
No abstract text is available yet for this article.
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28877087/percutaneous-endoscopic-gastrostomy-under-conscious-sedation-in-patients-with-amyotrophic-lateral-sclerosis-is-safe-an-observational-study
#10
Denise Strijbos, José Hofstede, Daniel Keszthelyi, Ad A M Masclee, Lennard P L Gilissen
OBJECTIVES: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes muscle weakness with respiratory and swallowing dysfunction, eventually leading to death. Permanent enteral feeding is indicated in almost all patients. A percutaneous endoscopic gastrostomy (PEG) tube is considered the first choice, usually performed under conscious sedation (intravenous midazolam). Guidelines are very cautious with respect to sedation in ALS because of the risk for respiratory complications...
September 4, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28877007/creation-of-an-esophageal-atresia-animal-model-using-a-bifurcated-esophagus-to-maintain-digestive-tract-continuity
#11
Ian C Glenn, Nicholas E Bruns, Steve J Schomisch, Todd A Ponsky
INTRODUCTION: We previously developed a porcine model of long gap pure esophageal atresia (EA) to aid in the creation of novel devices and techniques for treatment of EA. Shortcomings of the model included difficulty decompressing the proximal esophageal pouch (leading to recurrent aspiration) and a requirement for gastrostomy tube (G-tube) feeds. Therefore, we sought to create a porcine model with a bifurcated esophagus wherein one portion of the esophageal lumen retained patency and the other part mimicked EA...
September 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28876571/duodenectomy-managing-the-fistula
#12
M Govender, O Matsevych, F Ghoor, N Singh, C Molenaar
BACKGROUND: Duodenectomy is rarely indicated, however, in certain circumstances may have be performed. Enterocutaneous fistula (ECF) is the main cause of serious adverse outcomes. Its management remains challenging. METHOD: Two cases of emergency duodenectomy are presented. The management of ECF is described and discussed. RESULTS: Case 1: A 22-year-old male presented in septic shock with perforated duodenal ulcer, suffered two cardiac arrests before index surgery...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28874418/therapeutic-endoscopy-related-gi-bleeding-and-thromboembolic-events-in-patients-using-warfarin-or-direct-oral-anticoagulants-results-from-a-large-nationwide-database-analysis
#13
Naoyoshi Nagata, Hideo Yasunaga, Hiroki Matsui, Kiyohide Fushimi, Kazuhiro Watanabe, Junichi Akiyama, Naomi Uemura, Ryota Niikura
OBJECTIVE: To compare the risks of postendoscopy outcomes associated with warfarin with direct oral anticoagulants (DOACs), taking into account heparin bridging and various types of endoscopic procedures. DESIGN: Using the Japanese Diagnosis Procedure Combination database, we identified 16 977 patients who underwent 13 types of high-risk endoscopic procedures and took preoperative warfarin or DOACs from 2014 to 2015. One-to-one propensity score matching was performed to compare postendoscopy GI bleeding and thromboembolism between the warfarin and DOAC groups...
September 5, 2017: Gut
https://www.readbyqxmd.com/read/28872036/decision-making-for-gastrostomy-after-70-years-old-a-prospective-study-about-26-patients
#14
Angéline Mey, Amandine Devun, Marc Roussier, Régis Gonthier, Thomas Celarier
Management of undernutrition is based on young adults analysis. However, enteral nutrition is mainly discussed in the elderly. The aim of this study was to analyse factors related to laying gastrostomy, in geriatrics. A prospective, descriptive study, was conducted in the Loire department, from 2014 to 2016, in geriatric and palliative units. All patients over 70 years who had a theorical indication of gastrostomy were included. Decision-making process was analyzed from data affecting the reflection. Patients were followed for three months...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28869072/mid-upper-arm-circumference-and-powell-tuck-and-hennessy-s-equation-correlate-with-body-mass-index-and-can-be-used-sequentially-in-gastrostomy-fed-patients
#15
Rita Barosa, Lídia Roque Ramos, Carla Adriana Santos, Marta Pereira, Jorge Fonseca
BACKGROUND & AIMS: Body Mass Index (BMI) is a simple and widespread method to assess undernutrition. However its use may be limited in bedridden patients. AIMS: 1) compare BMI, Mid Upper Arm Circumference (MUAC) and Powell-Tuck and Hennessy's regression equation for BMI (BMIPTH) in gastrostomy fed patients, 2) validate its correlation for sequential use and 3) select the best cut-off of MUAC and BMIPTH to predict risk of undernutrition. METHODS: Prospective study including adult patients who underwent endoscopic gastrostomy (PEG)...
August 19, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28869025/-gastric-aspiration-therapy-is-a-possible-alternative-to-treatment-of-obesity
#16
Marie Møller Christensen, Tina Jorsal, Lars Peter Skat Naver, Tina Vilsbøll, Filip Krag Knop
Aspiration therapy with AspireAssist is a novel endoscopic obesity treatment. Patients aspirate approximately 30% of an ingested meal through a draining system connected to a percutanous endoscopic gastrostomy tube. AspireAssist was recently approved by the US Food and Drug Administration, and it induces weight loss comparable to the weight loss observed after bariatric surgery, but with a lower risk of complications. Few clinical studies about the efficacy and safety of AspireAssist have been carried out and published...
August 7, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28865046/prospective-experience-of-percutaneous-endoscopic-gastrostomy-tubes-placed-by-otorhinolaryngologist-head-and-neck-surgeons-%C3%A2-safe-and-efficacious
#17
Johanna Ruohoalho, Katri Aro, Antti A Mäkitie, Timo Atula, Aaro Haapaniemi, Harri Keski-Säntti, Leena Kylänpää, Annika Takala, Leif J Bäck
Percutaneous endoscopic gastrostomy (PEG) is often the treatment of choice in head and neck cancer (HNC) patients needing long-term nutritional support. Prospective studies on PEG tube placement in an otorhinolaryngologist service are lacking. At our hospital, otolaryngologist-head and neck (ORL-HN) surgeons-have performed PEG insertions for HNC patients since 2008. We prospectively analyzed 127 consecutive HNC patients who received their PEG tubes at the Department of Otorhinolaryngology-head and neck surgery, and evaluated the outcome of PEG tube insertions performed by ORL-HN surgeons...
September 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28864848/lessons-learned-from-300-consecutive-pancreaticoduodenectomies-over-a-25-year-experience-the-safety-net-improves-the-outcomes-beyond-surgeon-skills
#18
Roberto Santoro, Roberto Luca Meniconi, Pasquale Lepiane, Giovanni Vennarecci, Gianluca Mascianà, Marco Colasanti, Eugenio Santoro, Giuseppe Maria Ettorre
Pancreaticoduodenectomy (PD) is associated with high postoperative morbidity. The management of postoperative complications is paramount for reducing the mortality rate. The aim of this study was to evaluate the importance of surgical and hospital experience on outcomes by comparing postoperative results in three different hospitals with increasing resources for supporting the same surgical team. Patients data and surgical outcome of 300 consecutive patients undergoing PD were collected prospectively in the department database and divided into three periods (A = 1990-2000, B = 2001-March 2007, C = April 2007-2015)...
September 1, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28864678/the-yin-and-yang-of-gastrostomy-in-the-management-of-als-friend-or-foe
#19
EDITORIAL
Mamede de Carvalho, Clifton L Gooch
No abstract text is available yet for this article.
September 1, 2017: Neurology
https://www.readbyqxmd.com/read/28862805/vitamin-d-status-of-gastrostomy-fed-children-with-special-needs-a-cross-sectional-pilot-study
#20
H Kuter, G Das, M Z Mughal
AIM: To assess the vitamin D status of gastrostomy-fed children. METHODS: Vitamin D status was measured in 32 children aged five to 16 years recruited from special schools in Manchester, UK (53° 48(') N). All children were receiving a nutritionally complete, commercially prepared enteral feed via gastrostomy, and had been established on this regimen for over 12 months. Serum concentrations of 25 hydroxyvitamin D (25OHD) were measured at the end of winter. Children with serum concentrations of 25OHD >50nmol/L were considered to be sufficient, and those with concentrations <25nmol/L were considered to be deficient...
September 1, 2017: Acta Paediatrica
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