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November 2016: American Journal of Physical Medicine & Rehabilitation
Nir Hirshoren, Olivia Ruskin, Tsien Fua, Stephen Kleid, Matthew Magarey, Benjamin Dixon
BACKGROUND: Transoral robotic surgery (TORS) is now a well-validated technique for resection of head and neck cancers. Benefits include reduced patient morbidity, swallowing preservation and rationalization of adjuvant therapies. METHODS: This was a single-centre, retrospective review of 35 patients who underwent TORS of oro-, retro- and parapharyngeal tumours between March 2014 and August 2015. Outcome measures included resection margins, swallowing function and impact on post-operative radiotherapy...
October 21, 2016: ANZ Journal of Surgery
Gonçalo Nunes, Carla Adriana Santos, Miguel Grunho, Jorge Fonseca
BACKGROUND: Dysphagia is common in amyotrophic lateral sclerosis (ALS) and may result in malnutrition. Endoscopic gastrostomy (PEG) is recommended when oral feeding is unsafe. This work aims to assess the effectiveness and safety of PEG feeding on improving nutritional and prognostic parameters in ALS patients. METHODS: Observational and retrospective study using records from ALS patients referred for gastrostomy. Age, gender and mortality data were collected. NRS 2002, body mass index (BMI), serum albumin, transferrin and total cholesterol were recorded at the time of PEG (T0) and repeated after 3 months (T3)...
September 20, 2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Wednesday Marie A Sevilla, Barbara McElhanon
Enteral nutrition is delivered via the gastrointestinal tract when oral intake is not sufficient to maintain nutrition status. There is evidence that long-term home enteral nutrition (HEN) can be advantageous to pediatric patients by improving quality of life and function. Data from pediatric patients receiving either nasogastric tube or gastrostomy tube feeds indicate good outcomes in terms of maintaining and improving nutrition status as evidenced by anthropometric measurements. As the number of pediatric patients requiring HEN increases, development of an effective program to allow smooth transition to the home is necessary...
October 18, 2016: Nutrition in Clinical Practice
John F Gamble, Dinesh J Kurian, Andrea G Udani, Nathaniel H Greene
We present a case of a 3-month-old female with Wolf-Hirschhorn syndrome (WHS) undergoing general anesthesia for laparoscopic gastrostomy tube placement with a focus on airway management. WHS is a rare 4p microdeletion syndrome resulting in multiple congenital abnormalities, including craniofacial deformities. Microcephaly, micrognathia, and glossoptosis are common features in WHS patients and risk factors for a pediatric airway that is potentially difficult to intubate. We discuss anesthesia strategies for airway preparation and management in a WHS patient requiring general anesthesia with endotracheal intubation...
2016: Case Reports in Pediatrics
Jésus Gonzalez-Bermejo, Capucine Morélot-Panzini, Marie-Laure Tanguy, Vincent Meininger, Pierre-François Pradat, Timothée Lenglet, Gaëlle Bruneteau, Nadine Le Forestier, Philippe Couratier, Nathalie Guy, Claude Desnuelle, Hélène Prigent, Christophe Perrin, Valérie Attali, Catherine Fargeot, Marie-Cécile Nierat, Catherine Royer, Fabrice Ménégaux, François Salachas, Thomas Similowski
BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder associated with respiratory muscle weakness and respiratory failure. Non-invasive ventilation alleviates respiratory symptoms and prolongs life, but is a palliative intervention. Slowing the deterioration of diaphragm function before respiratory failure would be desirable. We aimed to assess whether early diaphragm pacing could slow down diaphragm deterioration and would therefore delay the need for non-invasive ventilation...
November 2016: Lancet Neurology
Sebastian Pollandt, Bichun Ouyang, Thomas P Bleck, Katharina M Busl
PURPOSE: Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH). METHODS: Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between 01/2009 and 03/2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy (PEG) placement and length of stay (LOS) were assessed...
June 20, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Ezekiel Wong Toh Yoon, Kazuki Nishihara, Hirohiko Murata
For nutritional support of critically ill patients, the enteral route is preferred over the parenteral route. Although nasojejunal feeding can be superior to gastric feeding when gastrointestinal symptoms occur, it does not necessarily solve the problem of large gastric residual volumes. We report the successful use of a newly developed nasojejunal feeding tube with gastric decompression function in an 84-year-old man with severe pneumonia. After gastric feeding was considered not well tolerated, the use of this tube improved the delivery of nutrition until the patient was stable enough to undergo percutaneous endoscopic gastrostomy...
2016: Internal Medicine
Ajay Gupta, Siddhartha Baxi, Christopher Hoyne
INTRODUCTION: Comprehensive oncology services have recently been introduced in the Northern Territory (NT) enabling delivery of concurrent chemo-radiotherapy (CCRT) in locally advanced head and neck squamous cell carcinoma (LAHNSC). The purpose of this study is to assess feasibility, compliance and toxicity of CCRT in remote Australia. METHODS: Chart review was conducted for all patients >18 years, with biopsy-proven LAHNSC, receiving curative intent CCRT between January 2010 and September 2012...
July 1, 2016: Journal of Medical Radiation Sciences
Pamela Sarkar, Alice Cole, Neil J Scolding, Claire M Rice
Background/Aims: With the notable exceptions of dementia, stroke, and motor neuron disease, relatively little is known about the safety and utility of percutaneous endoscopic gastrostomy (PEG) tube insertion in patients with neurodegenerative disease. We aimed to determine the safety and utility of PEG feeding in the context of neurodegenerative disease and to complete a literature review in order to identify whether particular factors need to be considered to improve safety and outcome...
October 13, 2016: Clinical Endoscopy
Jason Misurac
Neonatal chronic kidney disease (CKD) occurs with an estimated incidence of 1 in 10,000 live births, whereas the incidence of neonatal end-stage renal disease (ESRD) is about 7.1 per million age-related population. The most frequent etiologies are renal hypoplasia/dysplasia, posterior urethral valves, and other congenital anomalies of the kidney and urinary tract. Other etiologies include polycystic kidney disease, cortical necrosis, and renal vascular thrombosis. Management of CKD focuses primarily on replacing renal functions such as erythropoietin, 1,25-hydroxylation of vitamin D, electrolyte homeostasis/excretion, and, in ESRD, waste product removal...
October 9, 2016: Seminars in Fetal & Neonatal Medicine
Hong Shi, Su-Yu Chen, Yong-Guang Wang, Sheng-Jun Jiang, He-Li Cai, Kai Lin, Zhao-Fei Xie, Fen-Fang Dong
AIM: To introduce natural orifice transgastric endoscopic surgery (NOTES) tube ileostomy using pelvis-directed submucosal tunneling endoscopic gastrostomy and endoscopic tube ileostomy. METHODS: Six live pigs (three each in the non-survival and survival groups) were used. A double-channeled therapeutic endoscope was introduced perorally into the stomach. A gastrostomy was made using a 2-cm transversal mucosal incision following the creation of a 5-cm longitudinal pelvis-directed submucosal tunnel...
October 7, 2016: World Journal of Gastroenterology: WJG
Anna Wiernicka, Małgorzata Matuszczyk, Agnieszka Szlagatys-Sidorkiewicz, Ewa Toporowska-Kowalska, Katarzyna Popińska, Urszula Chlebowczyk-Grzybowska, Ewa Hapyn, Jarosław Kierkuś
BACKGROUND: The appropriate time to initiate enteral nutrition after the placement of a percutaneous endoscopic gastrostomy (PEG) tube has been an area of limited research. There are no sufficient randomised prospective controlled trials in the paediatric population comparing the safety and tolerance of early feeding (3 h) after PEG placement. In order to reduce the period of fasting, inadequate nutritional support, and hospitalisation time, we decided to devise this study. METHODS/DESIGN: This study is a multicentre, randomised, open-label trial designed to evaluate the tolerance and safety of early enteral nutrition after PEG placement in children...
October 7, 2016: BMC Pediatrics
Anna M Follent, Anna F Rumbach, Elizabeth C Ward, Jeanne Marshall, Pamela Dodrill, Peter Lewindon
PURPOSE: There is limited information regarding the nature of dysphagia and feeding difficulties following alkali ingestion injury to inform multidisciplinary intervention. The aim was to describe the history and nature of chronic dysphagia and feeding difficulties in two children following severe alkali ingestion injury. METHODS: Medical records, primary caregiver report, and clinical assessment were used to compile detailed case histories and assess current dysphagia and feeding skills...
October 7, 2016: Disability and Rehabilitation
Katherine N Adams, Rupali N Shah, Robert A Buckmire
OBJECTIVES/HYPOTHESIS: Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes...
September 26, 2016: Laryngoscope
Jarosław Szefel, Wiesław J Kruszewski, Mariusz Szajewski, Maciej Ciesielski, Ewa Sobczak, Maksymilian Czerepko, Wiesława Łysiak-Szydłowska
INTRODUCTION: Currently there are no established guidelines regarding the use of long-chain triglycerides (LCT) vs. medium-chain triglycerides medium-chain triglycerides (MCT)/long-chain triglycerides (LCT) in total parenteral nutrition (TPN). Severe malnutrition of patients with refractory cachexia (RC) often causes their disqualification from invasive methods of treatment thus decreasing their quality of life and survival time. AIM: To compare the changes in nutritional state of patients with RC receiving PN with LCT and LCT/MCT lipid emulsions and to assess the influence of enteral nutrition on their survival time...
2016: Przegla̜d Gastroenterologiczny
Kazuya Kato, Yoshiaki Iwasaki, Kazuhiko Onodera, Minoru Matsuda, Mineko Higuchi, Kimitaka Kato, Yurina Kato, Masahiko Taniguchi, Hiroyuki Furukawa
PURPOSE: Despite the widespread use of percutaneous endoscopic gastrostomy (PEG) tubes, their placement may be associated with a variety of complications, including gastrocolic fistula. MATERIALS AND METHODS: In total, seven high-risk individuals diagnosed using computed tomography (CT)-gastrocolonography (GC) underwent laparoscopic-assisted PEG (LAPEG) placement. Study endpoints included the success of LAPEG under local anesthetic and intravenous sedation, inability to thread the PEG tube, the eventual tube location, the number of tube adjustments needed, adverse events, the operating time, and PEG tube-related infection...
October 4, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Mei-Yu Hsu, Hsiao-Hui Hsu, Ji-Yan Lyu
Leakage is a common complication of gastrostomy. Exposure of the skin surrounding the gastrostomy tube to moisture or chemical irritants may cause moisture-associated skin damage (MASD) and seriously affect the patient's quality of life. This case study describes a nursing experience with gastrostomy leakage that resulted in MASD. An assessment conducted from July 29, 2015 to August 20, 2015 revealed that heavy gastronomy leakage had caused extensive skin erosion, ulceration, hyperplasia, and superficial infection...
October 2016: Hu Li za Zhi the Journal of Nursing
Mark L Montgomery, Noel K Miner, Michael J Soileau, Douglas K McDonald
The primary treatment for Parkinson's disease is dopaminergic stimulation. Although levodopa has historically been administered orally, maintaining a predictable plasma concentration of the drug is challenging. As a result, enteral administration of carbidopa/levodopa (Duopa) has emerged as a promising tool in the treatment of the disease. This requires placement of an enteric catheter, two of which have been approved by the Food and Drug Administration for delivery of Duopa. The approved tubes are placed using the "peroral" or "pull" technique, a method traditionally requiring endoscopy...
October 2016: Proceedings of the Baylor University Medical Center
Richard Nicollas, Eric Moreddu, Claire Le Treut-Gay, Stéphane Roman, Julien Mancini, Jean-Michel Triglia
INTRODUCTION: The goal of this retrospective study is to compare the management and outcome of surgical treatment of laryngotracheal stenosis in children and infants with and without an associated neurological disorder. PATIENTS AND METHOD: In a series of children operated on for subglottic stenosis (SGS), patients with an associated neurological disorder were identified. The following criteria were compared in children with and without neurological disease: grade of stenosis, age, technique (Crico-Tracheal Resection (CTR), Laryngo-Tracheo-Plasty (LTP) in single and 2 stage, laser), analyzing duration, preoperative tracheostomy, decannulation rate, preoperative gastrostomy, and number of days in intensive care unit and in hospital...
September 29, 2016: Annals of Otology, Rhinology, and Laryngology
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