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https://www.readbyqxmd.com/read/28526499/gastric-conduit-revision-postesophagectomy-management-for-a-rare-complication
#1
Jessica Yu Rove, A Sasha Krupnick, Frank A Baciewicz, Bryan F Meyers
OBJECTIVE: Severe postesophagectomy gastric conduit dysfunction refractory to standard endoscopic intervention is rare, with few published reports discussing timing, technique, or results of reoperation. This case series examines assessment and management of severe conduit dysfunction and details techniques for conduit revision. METHODS: We retrospectively reviewed patients who underwent esophagectomy between September 2008 and October 2015 and studied patients who underwent conduit revision...
April 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#2
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
https://www.readbyqxmd.com/read/28502210/-esophageal-complications-of-gastroesophageal-reflux-disease-consequences-or-defensive-reactions
#3
Örs Péter Horváth, Laura Bognár, András Papp, András Vereczkei
Gastroesophageal reflux disease affects more than 10% of the adult population. Most patients can be effectively treated with lifestyle changes and adequate acid-reducing therapy. However, about 10% of the patients remain symptomatic despite treatment and severe complications may develop. Interestingly, some of these complications seem to be a sort of defensive mechanism that may either alleviate the patient's symptoms or prevent developing further complications. In Barrett's esophagus, which can be unambigously considered as a complication of gastroesophageal reflux disease, reflux symptoms ruining the quality of life may significantly improve, since the metaplastic Barrett epithelium is much more resistent to gastric acid, than the normal epithelial lining of the esophagus...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28491180/transbiliary-intravascular-ultrasound-guided-diagnostic-biopsy-of-an-inaccessible-pancreatic-head-mass
#4
Jeffrey Forris Beecham Chick, Benjamin B Roush, Minhaj S Khaja, Dennis Prohaska, Kyle J Cooper, Wael E Saad, Ravi N Srinivasa
Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28490246/evaluation-of-xpert-mtb-rif-assay-in-children-with-presumed-pulmonary-tuberculosis-in-papua-new-guinea
#5
Sharon Kasa Tom, Henry Welch, Cornelia Kilalang, Nakapi Tefuarani, John Vince, Evelyn Lavu, Karen Johnson, Ruth Magaye, Trevor Duke
BACKGROUND: The Gene Xpert MTB/ RIF assay (Xpert) is used for rapid, simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin resistance. This study examined the accuracy of Xpert in children with suspected pulmonary tuberculosis (PTB). METHODS: Children admitted to Port Moresby General Hospital with suspected PTB were prospectively enrolled between September 2014 and March 2015. They were classified into probable, possible and TB-unlikely groups...
May 11, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28475294/refractory-cytopenias-secondary-to-copper-deficiency-in-children-receiving-exclusive-jejunal-nutrition
#6
Amanda E Jacobson, Samir B Kahwash, Anjulika Chawla
Copper deficiency is a known cause of anemia and neutropenia that is easily remedied with copper supplementation. Copper is primarily absorbed in the stomach and proximal duodenum, so patients receiving enteral nutrition via methods that bypass this critical region may be at increased risk for copper deficiency. In pediatrics, postpyloric enteral feeding is increasingly utilized to overcome problems related to aspiration, severe reflux, poor gastric motility, and gastric outlet obstruction. However, little is known about the prevalence of copper deficiency in this population...
May 5, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28474243/-preoperative-fasting-period-of-fluids-in-bariatric-surgery
#7
P Simon, U-C Pietsch, R Oesemann, A Dietrich, H Wrigge
BACKROUND: Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. OBJECTIVES: The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation...
May 4, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28450167/gastrointestinal-behavior-of-itraconazole-in-humans-part-2-the-effect-of-intraluminal-dilution-on-the-performance-of-a-cyclodextrin-based-solution
#8
Philippe Berben, Raf Mols, Joachim Brouwers, Jan Tack, Patrick Augustijns
Hydroxypropyl-β-cyclodextrin (HP-β-CD) is known to enable absorption of the lipophilic drug itraconazole. Since the interaction between HP-β-CD and itraconazole is characterized by a non-lineair, AP-type phase-solubility diagram, the present study aimed to investigate the influence of intraluminal dilution (water intake) on the behavior and performance of an orally administered cyclodextrin-based solution of itraconazole. Subsequently, the in vivo behavior was simulated by combining in vitro dilution with permeation assessment...
April 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28446275/-acute-promyelocytic-leukemia-developed-during-imatinib-therapy-for-gastrointestinal-stromal-tumors
#9
Ya-Ping Yu, Ping Song, Jian-Gang Mei, Zhi-Ming An, Xiao-Gang Zhou, Feng Li, Li-Ping Wang, Yu-Mei Tang, Yong-Ping Zhai
OBJECTIVE: To investigate the clinicopathologic and molecular characteristics of acute promyelocytic leukemia(APL) developed during imatinib therapy for gastrointestinal stromal tumors(GIST). METHODS: A 49-year-old woman was hospitalized for abdominal pain. The abdominal CT revealed a gastric mass. Laparoscopic resection of the tumor was performed. The histopathologic analysis showed poorly differentiated malignant cell infiltration with epithelioid features. Immunohistochemistry staining of these cells was positive for CD117 and CD34...
April 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28440517/-efficacy-and-future-of-endoscopic-bariatric-surgery-in-the-treatment-of-obesity-and-metabolic-diseases
#10
Shangjia Huang, Junchang Zhang, Zhiyong Dong, Cunchuan Wang
The emerging endoscopic technologies are proved to be effective treatments for obesity in selected patients and to offer the potential advantages of reduced invasiveness, reversibility and repeatability. From the view of operation principle, endoscopic technologies can be classified as restrictive procedure, malabsorption procedure and endoscopic revision of gastric bypass. Restrictive procedures include intragastric balloon, aspiration therapy, endoscopic sleeve gastroplasty (ESG) and transoral gastroplasty...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#11
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28425145/prevalence-of-gastroesophageal-reflux-in-cats-during-anesthesia-and-effect-of-omeprazole-on-gastric-ph
#12
R S Garcia, P C Belafsky, A Della Maggiore, J M Osborn, B H Pypendop, T Pierce, V J Walker, A Fulton, S L Marks
BACKGROUND: Gastroesophageal reflux (GER) is poorly characterized in anesthetized cats, but can cause aspiration pneumonia, esophagitis, and esophageal stricture formation. OBJECTIVE: To determine whether pre-anesthetic orally administered omeprazole increases gastric and esophageal pH and increases serum gastrin concentrations in anesthetized cats, and to determine the prevalence of GER using combined multichannel impedance and pH monitoring. ANIMALS: Twenty-seven healthy cats undergoing elective dental procedures...
May 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28414135/gastrointestinal-behavior-of-itraconazole-in-humans-part-1-supersaturation-from-a-solid-dispersion-and-a-cyclodextrin-based-solution
#13
Joachim Brouwers, Sophie Geboers, Raf Mols, Jan Tack, Patrick Augustijns
This study evaluated the fasted state gastrointestinal behavior of the lipophilic drug itraconazole, orally administered to healthy volunteers as either a solid dispersion (Sporanox(®) capsules) or a cyclodextrin-based solution (Sporanox(®) solution). Following intake of the drug products, gastric and duodenal fluids were aspirated and analyzed for itraconazole concentration, total content and solubilizing capacity. Release of itraconazole from the solid dispersion generated high and metastable supersaturated levels in the stomach, but the dissolved fraction in the duodenum remained extremely low (median 2...
April 13, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28362573/ultrasound-assessed-gastric-antral-area-correlates-with-aspirated-tube-feed-volume-in-enterally-fed-critically-ill-patients
#14
Vibhu Sharma, Deepthi Gudivada, Renaud Gueret, John Bailitz
BACKGROUND: Enteral tube feed (ETF) intolerance occurs frequently in hospitalized patients and more so in critically ill patients. Most critical care nurses continue to assess gastric residual volume (GRV), especially among those with a history of ETF intolerance. We hypothesized that ultrasound assessment of GRV correlates directly with aspirated tube feed volume. METHODS: This was a prospective cohort study of a convenience sample of critically ill mechanically ventilated patients admitted to an intensive care unit receiving ETF...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28355374/qualitative-and-quantitative-ultrasound-assessment-of-gastric-content
#15
Flora Margarida Barra Bisinotto, Patrícia Luísa Pansani, Luciano Alves Matias da Silveira, Aline de Araújo Naves, Ana Cristina Abdu Peixoto, Hellen Moreira de Lima, Laura Bisinotto Martins
Objective: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. Method: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#16
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28331424/gastric-schwannoma-with-enlargement-of-the-regional-lymph-nodes-resected-using-laparoscopic-distal-gastrectomy-report-of-a-patient
#17
Shota Shimizu, Hiroaki Saito, Yusuke Kono, Yuki Murakami, Hirohiko Kuroda, Tomoyuki Matsunaga, Yoji Fukumoto, Tomohiro Osaki, Yoshiyuki Fujiwara
Preoperative differential diagnosis of gastric submucosal tumors has generally been difficult because they are covered with normal mucosa. However, recent advances in endoscopic ultrasound (EUS)-guided sampling of submucosal gastrointestinal lesions have made it possible to achieve preoperative differential diagnosis of gastric submucosal tumors. A 76-year-old woman was referred to our hospital with a gastric submucosal tumor. The tumor was observed in the antrum of the stomach. It was preoperatively diagnosed as a schwannoma after immunohistochemical evaluation of a biopsy specimen, obtained using endoscopic ultrasound-guided fine needle aspiration...
March 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#18
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28297827/-application-of-bedside-ultrasound-in-measuring-gastric-residual-volume-in-neurosurgical-critical-patients-with-enteral-nutrition-support
#19
L Cao, X H Ye, J Li, L N Zhang, L Li, W Y Zhang, L L Deng
Objective: To explore the effect of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support. Method: From March to August 2016, 70 critically neurological patients with continues enteral nutrition who admitted in Intensive Care Unit (ICU) were randomized into two groups. The observation group applied the bedside ultrasound monitoring gastric residual volume every day to guide the implementation of enteral nutrition. The control group used syringes withdrawing every 8 hours to measure the gastric residual volume...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28292405/selected-endoscopic-gastric-devices-for-obesity
#20
REVIEW
Kartik Sampath, Richard I Rothstein
This article focuses on the stomach target devices that are currently in various stages of development. Approved intragastric balloons, devices targeting small bowel and aspiration techniques, are described in other contributions to this issue. Bariatric endoscopic devices targeting the stomach directly alter gastric physiology and promote weight loss by potentially changing functional gastric volume, gastric emptying, gastric wall compliance, neurohormonal signaling, and, thereby, satiety. Many stomach-targeting devices are on the horizon for clinical use, and further study will determine the safety and efficacy for clinical use...
April 2017: Gastrointestinal Endoscopy Clinics of North America
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