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ICU GI

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95 papers 25 to 100 followers
https://www.readbyqxmd.com/read/27931630/infectious-complications-in-gastrointestinal-endoscopy-and-their-prevention
#1
REVIEW
Julia Kovaleva
Gastrointestinal endoscopes are medical devices that have been associated with outbreaks of health care-associated infections. Because of the severity and limited treatment options of infections caused by multidrug-resistant Enterobacteriaceae and Pseudomonas aeruginosa, considerable attention has been paid to detection and prevention of these post-endoscopic outbreaks. Endoscope reprocessing involves cleaning, high-level disinfection/sterilization followed by rinsing and drying before storage. Failure of the decontamination process implies the risk of settlement of biofilm producing species in endoscope channels...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27875032/management-of-renal-failure-in-end-stage-liver-disease-a-critical-appraisal
#2
REVIEW
Xingxing S Cheng, Jane C Tan, W Ray Kim
Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This review seeks to summarize and critically appraise common therapies used in this setting, including pharmacologic agents, procedures (transjugular intrahepatic portosystemic shunt, renal replacement therapy), and simultaneous liver-kidney transplantation. More experimental extracorporal modalities, eg, albumin dialysis or bioartificial livers, will not be discussed...
December 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27931631/complications-of-diagnostic-colonoscopy-upper-endoscopy-and-enteroscopy
#3
REVIEW
Idan Levy, Ian M Gralnek
Endoscopy is an inherent and an invaluable tool in every gastroenterologist's armamentarium. The prerequisite for quality and safety remains foremost. Adverse events should be minimized and proactive steps should taken before, during and after the endoscopic procedure. Upper endoscopy and colonoscopy are part of basic endoscopy and their major complications will be reviewed here, together with those of enteroscopy. The most common of all endoscopy related complications are cardiopulmonary and thus they will be addressed in detail first...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931632/complications-of-therapeutic-gastroscopy-colonoscopy-other-than-resection
#4
REVIEW
Zaheer Nabi
Gastrointestinal (GI) endoscopy is profoundly utilized for diagnostic and therapeutic purposes. The therapeutic potential of GI endoscopy has amplified many folds with the evolution of novel techniques as well as equipments. However, with the augmentation of therapeutic endoscopy, the extent, likelihood and severity of adverse events have increased as well. The attendant risks and adverse events with therapeutic endoscopy are many folds that of diagnostic endoscopy. Besides endoscopic resection, therapeutic endoscopy is widely utilized for hemostasis in GI bleeds, dilatation of stenosis, enteral stenting, foreign body removal, ablation of Barrett's esophagus etc...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931634/complications-of-endoscopic-polypectomy-endoscopic-mucosal-resection-and-endoscopic-submucosal-dissection-in-the-colon
#5
REVIEW
Michael X Ma, Michael J Bourke
Endoscopic resection (ER), including endoscopic polypectomy (EP), endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used to remove superficial neoplasms from the colon. Snare resection is used for EP and EMR, whereas endoscopic knives are used to perform dissection in the submucosal space in ESD. 80-90% colonic polyps are <10 millimetres (mm) and are effectively managed by conventional EP. Increasingly cold snare polypectomy is preferred. Large laterally spreading lesions (LSLs) and sessile polyps ≥20 mm are primarily removed by EMR...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931633/complications-of-endoscopic-resection-techniques-for-upper-gi-tract-lesions
#6
REVIEW
D Libânio, P Pimentel-Nunes, M Dinis-Ribeiro
Adverse events can occur during and after the endoscopic resection of upper gastrointestinal lesions. Their incidence can be minimized through the adoption of preventive measures and their final outcomes can be optimized through prompt identification and adequate treatment. In this evidence-based review we describe the risk factors for adverse events, preventive measures to avoid them and their management when they occur. Algorithms of action are also provided. Oesophageal strictures can be prevented with corticosteroids (either locally injected or systemically administered) and treated with endoscopic dilatation...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931635/complications-of-percutaneous-endoscopic-gastrostomy
#7
REVIEW
Tomas Hucl, Julius Spicak
Percutaneous endoscopic gastrostomy (PEG) has become the method of choice for mid-to long-term enteral feeding. The majority of complications that occur are minor, but the rare major complications may be life threatening. Some complications occur soon after tube placement, others develop later, when the gastrostomy tract has matured. Older patients with comorbidities and infections appear to be at a greater risk of developing complications. Apart from being aware of indications and contraindications, proper technique of PEG placement, including correct positioning of the external fixation device, and daily tube care are important preventive measures...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931637/complications-of-ercp
#8
REVIEW
Rupjyoti Talukdar
Even though considered safe, endoscopic retrograde cholangiopancreatography (ERCP) is among the endoscopic procedures associated with the highest rate of complications. Post ERCP pancreatitis (PEP) is the most common complication of ERCP. Several independent risk factors have been associated with PEP. Prophylactic PD stenting has been shown to be highly effective in preventing PEP. More recent studies have suggested that NSAIDs, especially rectal indomethacin, could by itself be effective in preventing PEP...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931640/the-role-of-surgery-in-the-treatment-of-endoscopic-complications
#9
REVIEW
Peter Dixon, Gopal C Kowdley, Steven Clark Cunningham
As the number, diversity, and complexity of endoscopic complications has increased, so too has the number, diversity, and complexity of operative interventions required to treat them. The most common complications of endoscopy in general are bleeding and perforation, but each endoscopic modality has specific nuances of these and other complications. Accordingly, this review considers the surgical complications of endoscopy by location within the gastrointestinal tract, as opposed to by complication types, since there are many complication types that are specific for only one or few locations, such as buried-bumper syndrome after percutaneous endoscopic gastrostomy and pancreatitis after endoscopic retrograde cholangiopancreatography, and since the management of a given complication, such as perforation, may be vastly different in one area than in another area, such as perforations of the esophagus versus the retroperitoneal duodenum versus the intraperitoneal duodenum...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27931638/complications-of-diagnostic-and-therapeutic-endoscopic-ultrasound
#10
REVIEW
Sundeep Lakhtakia
Endoscopic Ultrasound (EUS) provides the unique opportunity to visualize, interrogate and intervene gastrointestinal (GI) luminal, mural or peri-luminal structures and pathology with negligible adverse effects. Diagnostic, upper GI and rectal EUS is feasible, extremely safe, and efficacious. Most EUS guided interventions are safe, effective and minimally invasive, compared to peers in the percutaneous radiological or surgical procedures. As with any endoscopic procedure, EUS and its guided interventions may be accompanied by adverse events...
October 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27860293/thrombocytopenia-in-chronic-liver-disease
#11
REVIEW
Markus Peck-Radosavljevic
Thrombocytopenia is a common haematological disorder in patients with chronic liver disease. It is multifactorial and severity of liver disease is the most influential factor. As a result of the increased risk of bleeding, thrombocytopenia may impact upon medical procedures, such as surgery or liver biopsy. The pathophysiology of thrombocytopenia in chronic liver disease has long been associated with the hypothesis of hypersplenism, where portal hypertension causes pooling and sequestration of all corpuscular elements of the blood, predominantly thrombocytes, in the enlarged and congested spleen...
November 17, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27858375/diagnosis-of-non-occlusive-acute-mesenteric-ischemia-in-the-intensive-care-unit
#12
Simon Bourcier, Ammar Oudjit, Geoffrey Goudard, Julien Charpentier, Sarah Leblanc, Romain Coriat, Hervé Gouya, Bertrand Dousset, Jean-Paul Mira, Frédéric Pène
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a common complication and accounts for a major cause of death in critically ill patients. The diagnosis of NOMI with respect to the eventual indications for surgical treatment is challenging. We addressed the performance of the diagnostic strategy of NOMI in the intensive care unit, with emphasis on contrast-enhanced abdominal CT-scan. METHODS: This was a retrospective monocenter study. Patients with clinically suspected acute mesenteric ischemia were included if a comprehensive diagnostic workup was carried out including surgical and/or endoscopic digestive explorations...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27842769/drug-induced-acute-liver-failure
#13
REVIEW
Shahid Habib, Obaid S Shaikh
Drug-induced acute liver failure (ALF) disproportionately affects women and nonwhites. It is most frequently caused by antimicrobials and to a lesser extent by complementary and alternative medications, antiepileptics, antimetabolites, nonsteroidals, and statins. Most drug-induced liver injury ALF patients have hepatocellular injury pattern. Cerebral edema and intracranial hypertension are the most serious complications of ALF. Other complications include coagulopathy, sepsis, metabolic derangements, and renal, circulatory, and respiratory dysfunction...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27803765/nutritional-evaluation-in-cirrhosis-emphasis-on-the-phase-angle
#14
REVIEW
Sabrina Alves Fernandes, Angelo Alves de Mattos, Cristiane Valle Tovo, Claudio Augusto Marroni
Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA)...
October 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27786365/portal-hypertensive-bleeding-in-cirrhosis-risk-stratification-diagnosis-and-management-2016-practice-guidance-by-the-american-association-for-the-study-of-liver-diseases
#15
Guadalupe Garcia-Tsao, Juan G Abraldes, Annalisa Berzigotti, Jaime Bosch
No abstract text is available yet for this article.
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27753689/new-and-emerging-therapies-for-clostridium-difficile-infection
#16
Jessica Martin, Mark Wilcox
PURPOSE OF REVIEW: Clostridium difficile infection has attained high prominence given its prevalence and impacts on patients and healthcare institutions. Multiple new approaches to the prevention and treatment of C. difficile infection (CDI) are undergoing clinical trials. RECENT FINDINGS: Bezlotoxumab is a monoclonal antibody against toxin B that has successfully completed phase III studies, demonstrating a significant reduction in recurrent CDI when given with standard of care antibiotics...
December 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27677775/liver-injury-from-herbal-and-dietary-supplements
#17
REVIEW
Victor J Navarro, Ikhlas Khan, Einar Björnsson, Leonard B Seeff, Jose Serrano, Jay H Hoofnagle
Herbal and dietary supplements (HDS) are used increasingly both in the United States and worldwide, and HDS-induced liver injury in the United States has increased proportionally. Current challenges in the diagnosis and management of HDS-induced liver injury were the focus of a 2-day research symposium sponsored by the American Association for the Study of Liver Disease and the National Institutes of Health. HDS-induced liver injury now accounts for 20% of cases of hepatotoxicity in the United States based on research data...
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27678356/spontaneous-fungal-peritonitis-epidemiology-current-evidence-and-future-prospective
#18
REVIEW
Marco Fiore, Sebastiano Leone
Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease (ESLD); spontaneous fungal peritonitis (SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients, not even the antifungals used for the prophylaxis, neither optimal treatment...
September 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27610010/endoscopic-and-non-endoscopic-approaches-for-the-management-of-radiation-induced-rectal-bleeding
#19
REVIEW
Joseph Paul Weiner, Andrew Thomas Wong, David Schwartz, Manuel Martinez, Ayse Aytaman, David Schreiber
Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen...
August 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27635481/pantoprazole-or-placebo-for-stress-ulcer-prophylaxis-pop-up-randomized-double-blind-exploratory-study
#20
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
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