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https://www.readbyqxmd.com/read/28810958/multispecialty-synchronous-telehealth-utilization-and-patient-satisfaction-within-regional-health-command-europe-a-readiness-and-recapture-system-for-health
#1
Kirk H Waibel, Steven M Cain, Todd E Hall, Ronald S Keen
BACKGROUND: Telehealth implementation within the Military Healthcare System continues to advance toward the goal of a mature regional health platform; however, specialty-specific usage or patient satisfaction regarding synchronous or "real-time" telehealth at the regional military hospital level has not been described. METHODS: A retrospective review of synchronous telehealth encounters and patient satisfaction surveys from Landstuhl Regional Medical Center (LRMC) specialty clinics engaging in synchronous telehealth to regional Army Health Clinics (AHCs) during 2015 was conducted...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28807407/infrarenal-aorta-as-the-donor-site-for-bypasses-to-the-superior-mesenteric-artery-for-chronic-mesenteric-ischemia-a-prospective-clinical-series-of-24-patients
#2
Giulio Illuminati, Giulia Pizzardi, Francesco G Calio', Rocco Pasqua, Federica Masci, Francesco Vietri
BACKGROUND: Treatment of symptomatic, chronic mesenteric ischemia is indicated to relieve symptoms and prevent acute ischemia and death. Current therapeutic options include endovascular and open surgery. The purpose of this prospective study was to evaluate the results of bypasses to the superior mesenteric artery arising from the infrarenal aorta or infrarenal aortic grafts. METHODS: From January 1999 to December 2016, 24 consecutive patients with a mean age of 61 years underwent a prosthetic bypass to the superior mesenteric artery...
August 11, 2017: Surgery
https://www.readbyqxmd.com/read/28805088/the-current-therapeutic-options-for-crohn-s-disease-from-medical-therapy-to-intestinal-transplantation
#3
Augusto Lauro, Francesco D'Amico, Gabriel Gondolesi
Crohn's disease (CD) has an annual incidence per 100.000 person-year of 20.2 in North America and 12.7 in Europe, and the purpose of this review is to evaluate its medical management, from diagnosis to transplant. Pharmacologic manipulation with nutritional care aims to achieve and maintain remission, but more than half of patients will undergo an intestinal resection, very often repeated over time. They could experience short bowel syndrome (SBS) requiring total parenteral nutrition (TPN). Intestinal transplantation (ITx) represents an alternative in case of irreversible intestinal failure (IF) with life-threatening TPN complications...
August 14, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28804864/prescription-and-indication-for-oral-nutritional-supplements-in-a-swiss-university-hospital-a-prospective-survey
#4
Julie Mareschal, Jean Altwegg, Dimitri Berthet, Marinette Chikhi, Pierre Chopard, Séverine Graf, Christian Sierro, Claude Pichard, Laurence Genton
AIMS OF THE STUDY: Patients with an acute or chronically negative nutritional balance are at nutritional risk. Oral nutritional supplements (ONS) are simple and effective medical treatments of nutritional risk. In the ambulatory setting, in Switzerland, ONS are reimbursed by public insurance under conditions defined by Swiss Society for Clinical Nutrition. The reimbursement requires a medical prescription for ONS and their delivery at the patient's home by a homecare service. The indication for the ONS, defined as a Nutritional Risk Screening-2002 (NRS-2002) score ≥3, must also be present...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28803550/palliative-end-ileostomy-and-gastrojejunostomy-for-a-metastatic-distal-transverse-colonic-malignancy-complicated-by-a-proximal-duodenocolic-fistula-a-case-report
#5
Gnanaselvam Pamathy, Umesh Jayarajah, Yapa Hamillage Hemantha Gunathilaka, Sivasuriya Sivaganesh
BACKGROUND: Fistulae between the colon and upper gastrointestinal tract are distressing and uncommon complications of malignancies involving this region. We report a case of a middle-aged man with a locally advanced and metastatic distal transverse colon malignancy who presented with a duodenocolic fistula proximal to the primary tumor and underwent palliative surgery. CASE PRESENTATION: A 50-year-old Sri Lankan man presented to our hospital with a history of feculent vomiting of 1 week's duration preceded by worsening constipation and abdominal fullness of 2 months' duration...
August 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28802290/postoperative-oral-nutritional-supplementation-after-major-gastrointestinal-surgery-a-randomized-controlled-clinical-trial
#6
Seong-Ho Kong, Jun Seok Park, In Kyu Lee, Seung-Wan Ryu, Young-Kyu Park, Han-Kwang Yang, Sang-Uk Han, Ki-Young Yoon, Seung-Yong Jeong, Mi Ran Jeong, Dae Wook Hwang, Yun-Suhk Suh, Yoo-Seok Yoon, Kyung Won Seo, Ji Won Park, Chul-Su Byun, Hoon Hur, Hojeong Won, Yunhee Choi, Hyuk-Joon Lee
BACKGROUND AND OBJECTIVES: This study aimed to evaluate the efficacy of post-operative oral nutrition supplementation after major gastrointestinal surgery. METHODS AND STUDY DESIGN: A prospective randomized controlled trial was conducted to evaluate 174 subjects who were discharged within 2 weeks after major gastrointestinal surgery. The subjects in the study group were prescribed 400 ml/day of Encover® from the day of discharge for 8 weeks, but no supplementation was allowed in the control group...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28802289/home-enteral-nutrition-s-effects-on-nutritional-status-and-quality-of-life-after-esophagectomy
#7
Jian Zeng, Jian Hu, Qixun Chen, Jianguo Feng
BACKGROUND AND OBJECTIVES: We aimed to characterize the effect of home enteral nutrition (HEN) on the nutritional status and the quality of life (QOL) of esophageal cancer patients who underwent Ivor Lewis esophagectomy for cancer. METHODS AND STUDY DESIGN: Sixty patients with esophageal cancer were assigned to receive either HEN (n=30) or standard care only (n=30) from 1 week to 24 weeks following surgery. Nutritional status was evaluated using The Mini Nutritional Assessment at 1 week preoperatively and at 12 and 24 weeks postoperatively...
2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28797671/pregnancy-after-bariatric-surgery-the-effect-of-time-to-conception-on-pregnancy-outcomes
#8
Patricia O Yau, Manish Parikh, John K Saunders, Patricia Chui, Tara Zablocki, Akuezunkpa Ude Welcome
BACKGROUND: At our medical center, female patients who have undergone bariatric surgery are advised to defer pregnancy for 2 years after surgery to avoid the following complications and their potential consequences for the fetus: inadequate gestational weight gain, inadequate postsurgical weight loss, hyperemesis gravidarum, nutritional deficiencies, gestational diabetes, and gestational hypertension. OBJECTIVES: To examine the effect of time from surgery to conception on pregnancy course and outcomes in bariatric patients...
July 17, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28794234/deep-immune-profiling-of-an-arginine-enriched-nutritional-intervention-in-patients-undergoing-surgery
#9
Nima Aghaeepour, Cindy Kin, Edward A Ganio, Kent P Jensen, Dyani K Gaudilliere, Martha Tingle, Amy Tsai, Hope L Lancero, Benjamin Choisy, Leslie S McNeil, Robin Okada, Andrew A Shelton, Garry P Nolan, Martin S Angst, Brice L Gaudilliere
Application of high-content immune profiling technologies has enormous potential to advance medicine. Whether these technologies reveal pertinent biology when implemented in interventional clinical trials is an important question. The beneficial effects of preoperative arginine-enriched dietary supplements (AES) are highly context specific, as they reduce infection rates in elective surgery, but possibly increase morbidity in critically ill patients. This study combined single-cell mass cytometry with the multiplex analysis of relevant plasma cytokines to comprehensively profile the immune-modifying effects of this much-debated intervention in patients undergoing surgery...
August 9, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28790296/-clinical-practice-of-enhanced-recovery-after-surgery-program-for-esophagectomy
#10
Masato Nishida, Yasuyuki Seto
Enhanced recover after surgery(ERAS) program is multimodal strategies to reduce the incidence of postoperative morbidity and mortality, and encourage early functional recovery from surgical insult. It consists of physical therapy to facilitate postoperative early mobilization, nutritional support, introduction of minimal invasive surgery, restrictive fluid therapy and early resumption of oral intake. Esophagectomy for esophageal cancer is a highly invasive procedure with high incidence of postoperative morbidity and mortality...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790295/-perioperative-management-team-in-esophageal-cancer-surgery
#11
Akihiko Okamura, Masayuki Watanabe
Esophagectomy for patients with esophageal cancer is one of the most invasive surgery. Despite advances in surgical techniques and perioperative management, both morbidity and mortality rates after esophagectomy still remains high. Recently, it was suggested that perioperative care bundle is effective for preventing postoperative complications after esophagectomy. Then, we introduced a perioperative multidisciplinary management team, which aimed at systematic perioperative care for patients undergoing esophagectomy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#12
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
August 3, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28776546/transarterial-embolization-for-treatment-of-symptomatic-polycystic-liver-disease-more-than-2-year-follow-up
#13
Jin-Long Zhang, Kai Yuan, Mao-Qiang Wang, Jie-Yu Yan, Hai-Nan Xin, Yan Wang, Feng-Yong Liu, Yan-Hua Bai, Zhi-Jun Wang, Feng Duan, Jin-Xin Fu
BACKGROUND: Currently, treatment of symptomatic polycystic liver disease (PLD) is still a challenging problem, especially for these patients who are not feasible for surgery. Minimally invasive options such as laparoscopic fenestration and percutaneous cyst aspiration with sclerotherapy demonstrated disappointing results due to multiple lesions. Because the cysts in PLD are mostly supplied from hepatic arteries but not from portal veins, transcatheter arterial embolization (TAE) of the hepatic artery branches that supply the major hepatic cysts can lead to shrinkage of the cyst and liver size, relieve symptoms, and improve nutritional status...
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28771242/pancreatic-and-intestinal-function-post-roux-en-y-gastric-bypass-surgery-for-obesity
#14
Stephen J D O'Keefe, Tina Rakitt, Junhai Ou, Ihab I El Hajj, Elizabeth Blaney, Kishore Vipperla, Jens-Jules Holst, Jens Rehlfeld
OBJECTIVES: Despite the fact that the most effective treatment for morbid obesity today is gastric bypass surgery, some patients develop life-threatening nutritional complications associated with their weight loss. METHODS: Here we examine the influence of the altered anatomy and digestive physiology on pancreatic secretion and fat absorption. Thirteen post Roux-en-Y gastric bypass (RYGB) patients who had lost >100 lbs in the first year following surgery and who gave variable histories of gastrointestinal (GI) dysfunction, were selected for study...
August 3, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28770185/intensive-nutrition-management-in-a-patient-with-short-bowel-syndrome-who-underwent-bariatric-surgery
#15
MeeRa Kweon, Dal Lae Ju, Misun Park, JiHyeong Choe, Yun-Suhk Suh, Eun-Mi Seol, Hyuk-Joon Lee
Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg...
July 2017: Clinical Nutrition Research
https://www.readbyqxmd.com/read/28770124/omphalocele-and-gastroschisis-in-newborns-over-16-years-of-experience-from-a-single-clinic
#16
Shunusuke Watanabe, Tatuya Suzuki, Fujio Hara, Toshihiro Yasui, Naoko Uga, Atuki Naoe
Infants born with potentially life-threatening conditions of omphalocele and gastroschisis may require long-term hospitalization. We aimed to compare the outcomes of these two conditions occurring over a 16-year period (2001-16). It is a retrospective study of 19 newborns undergoing surgery for these two abdominal wall defects (8 patients with omphalocele and 11 cases of gastroschisis). The average birth weights for the newborns with omphaloceles and gastroschisis were 2554.5 g and 2248.6 g respectively. Associated anomalies included trisomy 18, Beckwith-Wiedemann syndrome, congenital heart disease, Meckel's diverticulum, inguinal hernias, renal deformities, limb deformities, cryptorchidism, body stalk anomalies, and closed gastroschisis...
April 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28767802/parathyroidectomy-in-chronic-kidney-disease-effects-on-weight-gain-and-on-quality-of-life-improvement
#17
Henyse Gomes Valente-Da-Silva, Maria Cristina Araújo Maya, Annie Seixas Moreira
Objective: to evaluate the benefit of parathyroidectomy in patients on hemodialysis, regarding nutritional and biochemical statuses, body composition and the health-related quality of life. Methods: this is a longitudinal study involving 28 hemodialysis adult patients with severe secondary hyperparathyroidism evaluated before and one year after surgery. Inclusion criteria: parathyroid hormone levels exceeding ten times the upper normal range and end-stage renal disease in hemodialysis program...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28765690/diarrhea-after-bariatric-procedures-diagnosis-and-therapy
#18
REVIEW
Yves M Borbély, Alice Osterwalder, Dino Kröll, Philipp C Nett, Roman A Inglin
Diarrhea after bariatric procedures, mainly those with malabsorptive elements including Roux-Y Gastric Bypass and Biliopancreatic Diversion, is common and an essential determinant of quality of life and micro- and macronutrient deficiencies. Bariatric surgery is the only sustainably successful method to address morbid obesity and its comorbidities, particularly gaining more and more importance in the specific treatment of diabetic patients. Approximately half a million procedures are annually performed around the world, with numbers expected to rise drastically in the near future...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28755198/remaining-challenges-in-the-treatment-of-tyrosinemia-from-the-clinician-s-viewpoint
#19
Grant A Mitchell, Hao Yang
This chapter provides a clinical perspective on the challenges that stand between current clinical practice and a cure for hepatorenal tyrosinemia (HT1). HT1 has been transformed in the last 50 years from an aggressive often undiagnosed childhood disease causing liver failure or liver cancer, with infant death in most patients, to a condition that is detectable at birth, and for which treatment with nitisinone (NTBC) and diet can prevent detectable liver or kidney abnormalities. What challenges remain? The properties of the affected metabolic pathway and the broad spectrum of severity seen in untreated patients are incompletely understood but potentially important for patients...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28753885/gastrointestinal-complications-following-radical-cystectomy-using-enhanced-recovery-protocol
#20
Soroush T Bazargani, Hooman Djaladat, Hamed Ahmadi, Gus Miranda, Jie Cai, Anne K Schuckman, Siamak Daneshmand
BACKGROUND: The development of enhanced recovery after surgery (ERAS) protocols for patients undergoing radical cystectomy (RC) represents a significant advance in perioperative care. OBJECTIVE: To evaluate gastrointestinal (GI) complications following RC and urinary diversion (UD) using our institutional ERAS protocol. DESIGN, SETTING, AND PARTICIPANTS: We identified 377 consecutive cases of open RC and UD for which our ERAS protocol was used from May 2012 to December 2015...
April 25, 2017: European Urology Focus
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