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https://www.readbyqxmd.com/read/29660354/novel-treatment-for-anastomotic-leak-following-ivor-lewis-esophagectomy
#1
Joseph Costa, Lyall A Gorenstein, Frank D'Ovidio
Intra-thoracic anastomotic leaks following esophagogastrostomy occur frequently, often resulting in prolonged hospitalization and delays in advancing oral nutrition and hydration. Management of anastomotic esophageal leaks vary based on time of occurrence to the intervention, condition of the patient and location. Conservative approaches such as endo-clips and endo-stents have gained momentum in addressing esophageal leaks and fistulas, replacing the original paradigm of surgical approach as initial management...
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29660086/how-to-improve-success-rates-of-endoscopic-management-for-buried-bumper-syndrome
#2
Markus Casper, Frank Lammert
Background: Buried bumper syndrome is a rare complication of percutaneous endoscopic gastrostomy. Complete BBS without visible parts of the inner bumper is a challenge for endoscopic treatment. Methods and Aims: Data base analysis of all procedures performed at our tertiary university endoscopy center between 2000 and 2015 was conducted. Our aim was to improve success rates of endoscopic treatment by using a standardized approach and a pull-modification of the papillotome-based extraction technique in a prospective cohort...
April 12, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29650890/-patient-factors-enabling-the-decannulation-of-the-gastrostomy-tube-after-superselective-intra-arterial-chemoradiation-therapy-for-locally-advanced-oral-cancer-a-retrospective-study
#3
Yasushi Honda, Takaomi Kessoku, Akihiko Kusakabe, Tetsuya Matsuura, Asuka Yoshimi, Ayumu Goto, Haruhisa Yoshida, Akiko Sukegawa, Chiaki Hata, Yukie Saito, Yoko Miyashita, Ryoko Yashiro, Tomoya Komori, Sachiko Arai, Yohei Kamata, Tomoko Shimizu, Kenji Mitsudo, Toshiyuki Koizumi, Iwai Tohnai, Atsushi Nakajima, Yasushi Ichikawa
Superselective intra-arterial chemoradiation therapy for locally advanced oral cancer induces complications such as mucositis, which impedes oral intake. Thus, at our hospital, a gastrostomy is performed in almost all patients during the treatment period to ensure the presence of an alternative administration route for nutrition and drugs. The purpose of this study was to calculate the mean number of days from completion of superselective intra-arterial chemoradiation therapy to the decannulation of gastrostomy, and extract patient factors for the decannulation...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650060/gastrostomy-versus-nasogastric-tube-feeding-for-chemoradiation-patients-with-head-and-neck-cancer-the-tube-pilot-rct
#4
Vinidh Paleri, Joanne Patterson, Nikki Rousseau, Eoin Moloney, Dawn Craig, Dimitrios Tzelis, Nina Wilkinson, Jeremy Franks, Ann Marie Hynes, Ben Heaven, David Hamilton, Teresa Guerrero-Urbano, Rachael Donnelly, Stewart Barclay, Tim Rapley, Deborah Stocken
BACKGROUND: Approximately 9000 new cases of head and neck squamous cell cancers (HNSCCs) are treated by the NHS each year. Chemoradiation therapy (CRT) is a commonly used treatment for advanced HNSCC. Approximately 90% of patients undergoing CRT require nutritional support via gastrostomy or nasogastric tube feeding. Long-term dysphagia following CRT is a primary concern for patients. The effect of enteral feeding routes on swallowing function is not well understood, and the two feeding methods have, to date (at the time of writing), not been compared...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29643089/physicians-political-preferences-and-the-delivery-of-end-of-life-care-in-the-united-states-retrospective-observational-study
#5
Anupam B Jena, Andrew R Olenski, Dhruv Khullar, Adam Bonica, Howard Rosenthal
OBJECTIVES: To compare the delivery of end of life care given to US Medicare beneficiaries in hospital by internal medicine physicians with Republican versus Democrat political affiliations. DESIGN: Retrospective observational study. SETTING: US Medicare. PARTICIPANTS: Random sample of Medicare beneficiaries, who were admitted to hospital in 2008-12 with a general medical condition, and died in hospital or shortly thereafter...
April 11, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29613966/acute-paraesophageal-hernia-laparoscopic-repair-with-adjunct-t-fastener-gastropexy-for-the-high-operative-risk-patient
#6
Gabriel Arevalo, Jordan Wilkerson, Jonathan Saxe
BACKGROUND: In the emergent setting, most paraesophageal hernia (PEH) repairs are done by laparotomy with adjunct gastropexy or gastrostomy tube (GT) placement. This adjunct to the repair can be performed expeditiously by a laparoscopic approach by utilizing T-fasteners. We present our case series of patients with PEHs and acute gastric volvulus that were managed with laparoscopy and how patient characteristics can influence the repair technique. METHODS: Patients with high operative risk who underwent laparoscopic hiatal hernia repair with adjunct T-fastener gastropexy in the emergent setting between July 2014 and July 2016 were included in this study...
April 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29603398/gastrostomy-tube-feeding-in-children-with-developmental-or-acquired-disorders-a-longitudinal-comparison-on-healthcare-provision-and-eating-outcomes-4-years-after-gastrostomy
#7
Ellen Backman, Ann-Kristin Karlsson, Lotta Sjögreen
BACKGROUND: Studies on long-term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding. METHODS: This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012...
March 30, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29588837/nasal-unsedated-seated-percutaneous-endoscopic-gastrostomy-nupeg-a-safe-and-effective-technique-for-percutaneous-endoscopic-gastrostomy-placement-in-high-risk-candidates
#8
Adam McCulloch, Ovishek Roy, Dunecan Massey, Rachel Hedges, Serena Skerratt, Nicola Wilson, Jeremy Woodward
Objective: Percutaneous endoscopic gastrostomy (PEG) tube placement is associated with a high risk of cardiorespiratory complications in patients with significant respiratory compromise. This study reports a case series of high-risk patients undergoing PEG placement using a modified technique-nasal unsedated seated PEG (nuPEG) placement. Design: Retrospective review of 67 patients at high risk of complications undergoing PEG placement between September 2012 and December 2016...
April 2018: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29582225/outcomes-in-children-treated-with-pentobarbital-infusion-for-refractory-and-super-refractory-status-epilepticus
#9
Jennifer Erklauer, Jeanine Graf, Mona McPherson, Anne Anderson, Angus Wilfong, Charles G Minard, Laura Loftis
BACKGROUND: Functional neurologic outcome for children with refractory and super-refractory status epilepticus has not been well defined. METHODS: Retrospective chart review including children age 0-17 years who received pentobarbital infusion from 2003 to 2016 for status epilepticus. Outcomes were defined in terms of mortality, need for new medical technology assistance at hospital discharge and functional neurologic outcome determined by pediatric cerebral performance category score (PCPC)...
March 26, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29570853/long-term-safety-and-efficacy-of-levodopa-carbidopa-intestinal-gel-in-advanced-parkinson-s-disease
#10
Hubert H Fernandez, James T Boyd, Victor S C Fung, Mark F Lew, Ramon L Rodriguez, John T Slevin, David G Standaert, Cindy Zadikoff, Arvydas D Vanagunas, Krai Chatamra, Susan Eaton, Maurizio F Facheris, Coleen Hall, Weining Z Robieson, Janet Benesh, Alberto J Espay
BACKGROUND: Levodopa-carbidopa intestinal gel (designated as carbidopa-levodopa enteral suspension in the United States) provides stable plasma levodopa concentrations and reduces motor fluctuations in advanced Parkinson's disease patients through continuous delivery of levodopa via percutaneous endoscopic gastrojejunostomy. We report long-term safety and efficacy outcomes from an open-label phase 3 treatment program. METHODS: PD patients (n = 262) who completed a 12-week double-blind study and its 52-week open-label extension or a separate 54-week open-label study were enrolled in this ongoing phase 3 open-label, multinational study (NCT00660673)...
March 23, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29570173/gastric-emptying-of-elemental-liquid-diets-versus-semisolid-diets-in-bedridden-gastrostomy-fed-patients
#11
Akira Horiuchi, Ryosei Sakai, Michio Tamaki, Masashi Kajiyama, Naoki Tanaka, Akio Morikawa
BACKGROUND: Aspiration is a common problem in bedridden gastrostomy-fed patients. We compared gastric emptying of an elemental liquid diet and a commercial semisolid diet in bedridden gastrostomy-fed patients. METHODS: Study 1: from January 2013 to December 2016, consecutive bedridden patients receiving percutaneous endoscopic gastrostomy (PEG) semisolid feeding hospitalized due to aspiration pneumonia were switched to elemental liquid diet feedings. The frequency of defecation, tube feed contents aspirated from the trachea, and aspiration pneumonia during hospitalization were retrospectively reviewed...
March 21, 2018: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29561342/effects-of-3-different-methods-of-care-on-the-peristomal-skin-integrity-of-children-with-percutaneous-endoscopic-gastrostomy-tubes-a-prospective-randomized-controlled-trial
#12
Hatice Pars, Hicran Çavuşoğlu
OBJECTIVE: There are a limited number of studies examining the effects of products used in stoma care. This study compares the effects of 3 different methods of care on the peristomal skin integrity of children with percutaneous endoscopic gastrostomy (PEG) tubes. METHODS: In this randomized controlled study, 60 children were allocated to the 3 study groups (group 1: hydrogel, group 2: soap and water, group 3: saline solution). Dressings were changed daily for all groups during the first week, then weekly for group 1 and daily for groups 2 and 3...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29557624/massive-hemorrhage-a-late-complication-of-replacement-percutaneous-endoscopic-gastrostomy-case-report
#13
Tamer Sekmenli, Metin Gündüz, Hikmet Akbulut, H Haldun Emiroglu, Mustafa Koplay, Ilhan Ciftci
Percutaneous endoscopic gastrostomy (PEG) is used as an alternative to enteral/nasoenteral feeding in situations where long-term oral feeding is ineffective or not tolerated. It is mostly preferred in patients with neurological conditions and also to support nutrition in patients with congenital heart diseases, cystic fibrosis, inflammatory bowel disease, and various oropharyngeal diseases. Although it is easily applicable compared to many invasive procedures, it has complications ranging from wound infection to death...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29549119/the-case-for-early-use-of-rapid-whole-genome-sequencing-in-management-of-critically-ill-infants-late-diagnosis-of-coffin-siris-syndrome-in-an-infant-with-left-congenital-diaphragmatic-hernia-congenital-heart-disease-and-recurrent-infections
#14
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29545430/aripiprazole-reversed-gastroparesis-in-a-child-with-1q21-1-q21-2-microdeletion
#15
Simon S Rabinowitz, Neha Ahuja, Jennifer Gottfried
An 11-year-old Caucasian boy, with a microdeletion in the 1q21.1-q21.2 region, had multiple medical conditions including gastroparesis documented initially at the age of 5. The patient had a history of poor feeding since infancy and had been treated for gastro-oesophageal reflux disease (GERD), constipation and multiple food allergies. As a consequence of the GERD and his concurrent immunoglobulin (IgG) subclass deficiency, the patient had multiple otolaryngologic (ENT) infections and required two sinus surgeries...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29543970/analysis-of-vocal-fold-motion-impairment-in-neonates-undergoing-congenital-heart-surgery
#16
Stephanie Elyse Ambrose, Julina Ongkasuwan, Kavita Dedhia, Gillian Ruth Diercks, Samantha Anne, Subhadra Shashidharan, Nikhila Raol
Importance: Vocal fold motion impairment (VFMI) is a known risk factor following congenital heart surgery (CHS). The impact of this diagnosis on utilization and outcomes is unknown. Objective: To evaluate the cost, postprocedure length of stay (PPLOS), and outcomes for neonates with VFMI after CHS. Design, Setting, and Participants: A cross-sectional analysis of the 2012 Kids' Inpatient Database (KID) of neonates who underwent CHS was carried out...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29526615/response-to-medical-and-a-novel-dietary-treatment-in-newborn-screen-identified-patients-with-ethylmalonic-encephalopathy
#17
M Boyer, M Sowa, I Di Meo, S Eftekharian, M R Steenari, V Tiranti, J E Abdenur
Ethylmalonic encephalopathy (EE) is a devastating neurodegenerative disease caused by mutations in the ETHE1 gene critical for hydrogen sulfide (H2 S) detoxification. Patients present in infancy with hypotonia, developmental delay, diarrhea, orthostatic acrocyanosis and petechiae. Biochemical findings include elevated C4, C5 acylcarnitines and lactic and ethylmalonic acid (EMA) in body fluids. Current treatment modalities include metronidazole and N-acetylcysteine (NAC) to lower the production and promote detoxification of toxic H2 S...
February 14, 2018: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/29526351/replacing-gastrostomy-tubes-with-collapsible-bumpers-in-pediatric-patients-is-it-safe-to-cut-the-tube-and-allow-the-bumper-to-pass-enterally
#18
Heather Thomas, Julia Yole, Michael H Livingston, Karen Bailey, Brian H Cameron, Lisa VanHouwelingen
PURPOSE: The "cut and push" technique for removal of percutaneous endoscopic gastrostomy (PEG) tubes with collapsible bumpers offers an alternative to the standard traction method of removal. This study compared the outcomes of these techniques. METHODS: We completed a research ethics board-approved retrospective cohort study, identifying all patients less than 18years of age who underwent PEG tube removal at a children's hospital between December 2013 and December 2016...
February 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29525511/mortality-risk-factors-after-percutaneous-gastrostomy-who-is-a-good-candidate
#19
Ana Agudo Tabuenca, Jara Altemir Trallero, José Antonio Gimeno Orna, María Julia Ocón Bretón
BACKGROUND: The percutaneous gastrostomy tube (PG) is an effective and safe way for the delivery of enteral nutrition. The aim of this study was to identify predictive factors for mortality after PG placement. MATERIAL AND METHODS: An observational and analytical cohort study was conducted. All endoscopic or radiological percutaneous gastrostomy tubes placed between January 2009 and July 2016 were evaluated. Mortality was the dependent variable. Initial clinical and analytical patient features and the development of complications during follow-up were recorded...
February 21, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29521651/preradiotherapy-tumor-volume-in-local-control-of-squamous-cell-carcinoma-of-the-supraglottic-larynx
#20
Sommer Nurkic, Tarik Nurkic, Christopher G Morris, Robert J Amdur, William M Mendenhall
OBJECTIVES: Examine the utility of pretreatment computed tomography in predicting local control (LC) in squamous cell carcinoma of the supraglottic larynx treated with primary radiotherapy (RT). METHODS: In total, 167 patients treated between 1983 and 2013 were reviewed. Patients had received pretreatment diagnostic computed tomographic imaging of the larynx and neck from which primary tumor volume (PrTV) was delineated. LC, larynx function at last follow-up, and RT complications were recorded...
March 8, 2018: American Journal of Clinical Oncology
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