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https://www.readbyqxmd.com/read/28535154/randomised-controlled-trial-of-early-prophylactic-feeding-vs-standard-care-in-patients-with-head-and-neck-cancer
#1
Teresa E Brown, Merrilyn D Banks, Brett G M Hughes, Charles Y Lin, Lizbeth M Kenny, Judith D Bauer
BACKGROUND: Weight loss remains significant in patients with head and neck cancer, despite prophylactic gastrostomy and intensive dietary counseling. The aim of this study was to improve outcomes utilising an early nutrition intervention. METHODS: Patients with head and neck cancer at a tertiary hospital in Australia referred for prophylactic gastrostomy prior to curative intent treatment were eligible for this single centre randomised controlled trial. Exclusions included severe malnutrition or dysphagia...
May 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28531451/new-laparoscopic-assisted-percutaneous-gastrostomy-description-and-comparison-with-others-gastrostomy-types
#2
Pilar Serrano Aguayo, Noelia Gros Herguido, Juana Parejo Campos, Antonio Barranco Moreno, María Del Castillo Tous Romero, José Luis Pereira Cunill, Isaías Alarcón Del Agua, María Socas Macias, Pedro Pablo García Luna, Salvador Morales Conde
INTRODUCTION: Gastrostomy feeding tube insertion has become a common procedure as it enables patients who require long term enteral feeding. Conventional surgical gastrostomies were the only way of gaining enteral access in patients in which it is not possible to pass an endoscope or a nasogastric tube required for endoscopic or radiological gastrostomies, and in patients in which certain anatomical abnormalities contraindicate performing these techniques. As conventional surgical gastrostomies are associated with high morbidity, especially gastric leakage around the tube, percutaneous laparoscopic assisted gastrostomy (PLAG) may be a better way to gain enteral access...
December 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28509623/gastrostomy-in-patients-with-prion-disease
#3
Yasushi Iwasaki, Keiko Mori, Masumi Ito, Yoshinari Kawai, Ken-Ichiro Hoshino, Yuko Kawabata, Maya Mimuro, Mari Yoshida
Patients with prion diseases can live for long periods of time in a state of akinetic mutism given appropriate management of their symptoms. To study symptom support in these cases, we performed gastrostomies on three patients with V180I genetic Creutzfeldt-Jakob disease (CJD) who had become akinetic and mute, and compared them to 14 other similar patients being fed by tube. In the three gastrostomy cases, there were no direct complications due to the gastrostomy or tube feeding, nor were there episodes of discontinuation of tube feeding or initiation of continuous drip infusion due to severe complications...
May 16, 2017: Prion
https://www.readbyqxmd.com/read/28507748/comparison-of-the-pull-and-introducer-percutaneous-endoscopic-gastrostomy-techniques-in-patients-with-head-and-neck-cancer
#4
Felipe A Retes, Fabio S Kawaguti, Marcelo S de Lima, Bruno da Costa Martins, Ricardo S Uemura, Gustavo A de Paulo, Caterina Mp Pennacchi, Carla Gusmon, Adriana Vs Ribeiro, Elisa R Baba, Sebastian N Geiger, Mauricio P Sorbello, Marco A Kulcsar, Ulysses Ribeiro, Fauze Maluf-Filho
BACKGROUND AND STUDY AIMS: Percutaneous endoscopic gastrostomy (PEG) in head and neck cancer (HNC) patients is associated with higher complication and mortality rates when compared to a general patient population. The pull technique is still the preferred technique worldwide but it has some limitations. The aim of this study is to compare the pull and introducer PEG techniques in patients with HNC. PATIENTS AND METHODS: This study is based on a retrospective analysis of a prospectively collected database of 309 patients with HNC who underwent PEG in the Cancer Institute of São Paulo...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28505050/unsedated-in-office-transgastrostomy-esophagoscopy-tge-to-monitor-therapy-in-pediatric-esophageal-disease
#5
Caroline H T Hall, Nathalie Nguyen, Glenn T Furuta, Jeremy Prager, Emily Deboer, Robin Deterding, Calies Menard-Katcher, Kelley E Capocelli, Robert E Kramer, Joel A Friedlander
Monitoring therapy in esophageal inflammatory disorders such as eosinophilic esophagitis (EoE) and reflux esophagitis often requires frequent endoscopic evaluation. We recently reported the effective use of unsedated in office Transnasal Esophagoscopy (TNE) that significantly decreased costs and anaesthetic exposure associated with pediatric esophagoscopy in EoE. Here we report a series of pediatric patients with esophagitis with gastrostomy tubes who underwent unsedated transgastrostomy esophagoscopy (TGE) in an office setting...
May 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28496536/percutaneous-endoscopic-gastrostomy-in-a-patient-with-continuous-intrathecal-baclofen-infusion-therapy
#6
Ezekiel Wong Toh Yoon, Masuki Kobayashi
Percutaneous endoscopic gastrostomy (PEG) is the method of choice in patients requiring long-term enteral tube feeding. In patients with intrathecal baclofen infusion therapy (IBT) pump implantation, infection via the skin and soft tissue may be an issue of concern. The introducer technique for gastrostomy tube insertion may be useful in reducing the risk of peristomal infection. Although the presence of a PEG tube has been reported as a risk factor for implantation site infection (for newly inserted IBT pumps), whether existing IBT pumps are at risk for infection during or after the placement of a PEG tube is not clear...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28491330/duodenal-perforation-as-a-complication-of-gastrostomy-tube-migration
#7
Avery C Rossidis, Steven E Raper, Kristoffel R Dumon
Gastrostomy tube placement is a routinely safe procedure; however, this report and its accompanying images highlight a rare but serious complication of tube migration - duodenal perforation.
April 2017: JRSM Open
https://www.readbyqxmd.com/read/28489671/closer-look-at-the-nutritional-outcomes-of-patients-after-primary-repair-of-congenital-diaphragmatic-hernia
#8
Lan T Vu, Carrie McFarland, Barbara Bratton, Hanmin Lee
OBJECTIVES: We hypothesize that the patients after primary repair of congenital diaphragmatic hernia (CDH) can have poor nutritional outcomes and plan to identify risk factors to further stratify these patients. METHODS: Retrospective cohort of patients who had primary repair of CDH between 2000 and 2014 and had follow-up at our institution. Z-scores (weight for age and weight for length) were calculated using the WHO and CDC growth standards. RESULTS: For the 67 patients in the cohort, the median age at the time of repair was 3 days (IQR 2-5) and at the time of discharge was 20...
May 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28484930/heart-shaped-bilateral-medullary-pyramidal-infarction-as-a-pathognomonic-finding-of-anterior-spinal-artery-occlusion
#9
Sammy Searcy, Oluwaseun O Akinduro, Andrew Spector, Jang W Yoon, Benjamin L Brown, William D Freeman
BACKGROUND: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS: Case reports and literature review. RESULTS: A 57-year-old man rapidly had severe vomiting and diarrhea 2 h after a meal. Examination revealed bulbar weakness and areflexic tetraplegia...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28475746/feeding-catheter-gastrostomy-with-the-round-ligament-of-the-liver-prevents-mechanical-bowel-obstruction-after-esophagectomy
#10
R Kawai, T Abe, N Uemura, M Fukaya, T Saito, K Komori, Y Yokoyama, M Nagino, M Shinoda, Y Shimizu
Jejunostomy, which requires the fixation of the jejunum to the abdominal wall, is commonly used as an enteral feeding access after esophagectomy. However, this procedure sometimes causes severe complications, such as mechanical bowel obstruction. In 2009, we developed a modified approach to insert an enteral feeding tube through the reconstructed gastric tube using the round ligament of the liver. The aim of this study is to investigate the usefulness of this approach as compared to the approach through jejunostomy...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28469499/a-case-of-statin-associated-autoimmune-myopathy
#11
Alexander J Sweidan, Anthony Leung, Cassandra J Kaiser, Sarah J Strube, Andrei N Dokukin, Stephen Romansky, Sassan Farjami
A 70-year-old previously independent man developed progressive proximal leg weakness resulting in a fall at home suffering traumatic brain injury. He was prescribed a statin medication two years prior, but this was discontinued on admission to the hospital due to concern for statin myopathy. His weakness continued to progress while in acute rehabilitation, along with the development of dysphagia requiring placement of gastrostomy tube and respiratory failure requiring tracheostomy. Corticosteroids and intravenous immunoglobulin were administered without response...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28469371/percutaneous-endoscopy-to-diagnose-malignancy-in-gastric-outlet-obstruction-of-excluded-stomach-after-gastric-bypass
#12
Waseem Ahmad, Joshua Rubin, Wilson Kwong
Gastric cancer in the excluded stomach after Roux-en-Y gastric bypass is a rare finding and most reported diagnoses are made via surgery. Endoscopic access to the excluded stomach is difficult, even with balloon-assisted enteroscopy. We present the case of a 74-year-old woman with malignant gastric outlet obstruction of the excluded stomach, 41 years after Roux-en-Y gastric bypass. Minimally invasive access to the excluded stomach was obtained by placement of a percutaneous gastrostomy tube, followed by insertion of a pediatric gastroscope through the gastrostomy tube tract...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28459083/midgut-volvulus-after-percutaneous-endoscopic-gastrostomy
#13
Diana Martins, Paula Sousa, Juliana Pinho, Joana Ruivo, Ricardo Araújo, Eugénia Cancela, António Castanheira, Paula Ministro, Américo Silva
We report a 47-year-old man who underwent endoscopic gastrostomy placement due to feeding refusal and regurgitation. Procedure was unremarkable. Two days later, the patient presented signs of intestinal obstruction. Computed tomography imaging showed a well-positioned gastrostomy tube, small pneumoperitoneum, and small bowel volvulus (SBV) in the upper right abdomen with proximal small bowel dilated loops. Exploratory laparotomy revealed mesenteric torsion, leading to SBV, with no evidence of intestinal malrotation...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28451498/a-multicenter-review-of-superior-laryngeal-nerve-injury-following-anterior-cervical-spine-surgery
#14
Zachary J Tempel, Justin S Smith, Christopher Shaffrey, Paul M Arnold, Michael G Fehlings, Thomas E Mroz, K Daniel Riew, Adam S Kanter
STUDY DESIGN: A retrospective multicenter case-series study; case report and review of the literature. OBJECTIVE: The anatomy and function of the superior laryngeal nerve (SLN) are well described; however, the consequences of SLN injury remain variable and poorly defined. The prevalence of SLN injury as a consequence of cervical spine surgery is difficult to discern as its clinical manifestations are often inconstant and frequently of a subclinical degree. A multicenter study was performed to better delineate the risk factors, prevalence, and outcomes of SLN injury...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28449220/survival-functional-status-and-eating-ability-after-percutaneous-endoscopic-gastrostomy-tube-placement-for-acute-stroke
#15
Karl Meisel, Robert M Arnold, Irena Stijacic Cenzer, John Boscardin, Alexander K Smith
OBJECTIVES: To determine the long-term survival and independence of individuals with stroke and percutaneous endoscopic gastrostomy (PEG) tube placement. DESIGN: Retrospective cohort study. SETTING: A longitudinal nationally representative community-based sample of older adults. PARTICIPANTS: Individuals with stroke who had a PEG tube placed (N = 174, mean age 79, 51% female, 29% African American). MEASUREMENTS: Functional status before incident stroke was determined based on data from the Health and Retirement Study (HRS), a national longitudinal survey of community-dwelling older adults, from 1993 to 2012...
April 27, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28445377/first-lower-two-thirds-osteomyocutaneous-facial-allograft-perfused-by-a-unilateral-facial-artery-outcomes-and-vascularization-at-1-year-after-transplantation
#16
Sebastian Fischer, Thomas C Lee, Nicco Krezdorn, Muayyad Alhefzi, Maximilian Kueckelhaus, Ericka M Bueno, Bohdan Pomahac
BACKGROUND: Facial allotransplantation provides a unique opportunity to restore facial form and function in severely disfigured patients. Using a single unilateral facial artery for vascularization can significantly reduce surgical duration and thus facilitate the practice of face transplantation. METHODS: A 33-year-old man with a history of high-energy ballistic trauma received a facial allograft comprising the lower two-thirds of the face, including maxilla and mandible...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28443270/brain-lesions-among-orally-fed-and-gastrostomy-fed-dysphagic-preterm-infants-can-routine-qualitative-or-volumetric-quantitative-magnetic-resonance-imaging-predict-feeding-outcomes
#17
Nasser H Kashou, Irfaan A Dar, Mohamed A El-Mahdy, Charles Pluto, Mark Smith, Ish K Gulati, Warren Lo, Sudarshan R Jadcherla
INTRODUCTION: The usefulness of qualitative or quantitative volumetric magnetic resonance imaging (MRI) in early detection of brain structural changes and prediction of adverse outcomes in neonatal illnesses warrants further investigation. Our aim was to correlate certain brain injuries and the brain volume of feeding-related cortical and subcortical regions with feeding method at discharge among preterm dysphagic infants. MATERIALS AND METHODS: Using a retrospective observational study design, we examined MRI data among 43 (22 male; born at 31...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28437204/drainage-percutaneous-endoscopic-gastrostomy-for-malignant-bowel-obstruction-in-gastrointestinal-cancers-prognosis-and-implications-for-timing-of-palliative-intervention
#18
Kerry-Ann Pinard, Tabitha N Goring, Barbara C Egan, Douglas J Koo
BACKGROUND: Malignant bowel obstruction (MBO) is a frequent complication in patients with advanced solid tumors. Palliative relief may be achieved by the use of a drainage percutaneous endoscopic gastrostomy (dPEG) tube, although optimal timing of placement remains unknown. OBJECTIVES: To determine median survival after diagnosis of MBO and dPEG placement, factors associated with worse survival in MBO, factors associated with receipt of dPEG, and association of timing of dPEG placement on survival...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436419/nontuberculous-mycobacteria-in-gastrostomy-fed-patients-with-cystic-fibrosis
#19
H Al-Momani, A Perry, R Jones, S Bourke, S Doe, J Perry, A Anderson, T Forrest, I Forrest, M Griffin, M Brodlie, J Pearson, C Ward
Multi-drug resistant Mycobacterium abscessus complex (MABSC) is a form of Nontuberculous mycobacteria (NTM) of special, international concern in Cystic Fibrosis (CF). We hypothesised that gastric juice and percutaneous endoscopic gastrostomy (PEG) feeding devices might yield MABSC isolates. Gastric juice and sputa from sixteen adult PEG fed CF patients and five replaced PEG tubes were studied. Bacterial and fungal isolates were cultured. Mycobacterium were identified by rpoB, sodA and hsp65 gene sequencing and strain typed using variable number tandem repeat...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28434660/reduced-dose-radiotherapy-for-human-papillomavirus-associated-squamous-cell-carcinoma-of-the-oropharynx-a-single-arm-phase-2-study
#20
Allen M Chen, Carol Felix, Pin-Chieh Wang, Sophia Hsu, Vincent Basehart, Jordan Garst, Phillip Beron, Deborah Wong, Michael H Rosove, Shyam Rao, Heather Melanson, Edward Kim, Daphne Palmer, Lihong Qi, Karen Kelly, Michael L Steinberg, Patrick A Kupelian, Megan E Daly
BACKGROUND: Head and neck cancers positive for human papillomavirus (HPV) are exquisitely radiosensitive. We investigated whether chemoradiotherapy with reduced-dose radiation would maintain survival outcomes while improving tolerability for patients with HPV-positive oropharyngeal carcinoma. METHODS: We did a single-arm, phase 2 trial at two academic hospitals in the USA, enrolling patients with newly diagnosed, biopsy-proven stage III or IV squamous-cell carcinoma of the oropharynx, positive for HPV by p16 testing, and with Zubrod performance status scores of 0 or 1...
April 20, 2017: Lancet Oncology
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