11,451 results match your criteria Gastrostomy Tube Replacement


Predictors of Direct Enteral Tube Placement After Acute Stroke.

J Stroke Cerebrovasc Dis 2019 Jan 24;28(1):191-197. Epub 2018 Oct 24.

Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada; Department of Medicine, Division of General Internal Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Objective: To determine predictors of direct enteral tube (DET) placement after acute stroke.

Methods: We used the Ontario Stroke Registry to identify patients who received direct enteral tubes (gastrostomy or jejunostomy) during hospital stay after acute ischemic stroke or intracerebral hemorrhage from July 1, 2003 to March 31, 2013. We used multivariable logistic regression to identify predictors of receiving DET after stroke. Read More

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January 2019

Management of Acute Gallstone Cholangitis after Roux-en-Y Gastric Bypass with Laparoscopic Transgastric Endoscopic Retrograde Cholangiopancreatography.

Obes Surg 2018 Dec 11. Epub 2018 Dec 11.

Service de Chirurgie Générale et Endocrinienne, CHU Lille, Hôpital Huriez, Rue Michel Polonowski, 59000, Lille, France.

Background: The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy. Read More

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December 2018

[Gastric intramural pseudocyst in a heterotopic pancreas causing gastric outlet obstruction. Report of one case].

Rev Med Chil 2018 Aug;146(8):933-937

Servicio de Cirugía, Clínica Alemana, Santiago, Chile.

Heterotopic pancreas is a silent gastrointestinal malformation that may become clinically evident when complicated by inflammation and pseudocyst formation. We report a 26 year-old male presenting with vomiting, pain and abdominal distention. An abdominal CT scan showed an important gastric distention secondary to a 4-cm cystic lesion located in the antrum wall. Read More

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Suture fistula revisited for long gap esophageal atresia.

J Pediatr Surg 2018 Nov 11. Epub 2018 Nov 11.

Division of Pediatric Surgery, Department of Surgery, Boonshoft School of Medicine, Dayton Children's Hospital, Dayton, OH. Electronic address:

Background: Long gap esophageal atresia presents a challenge to pediatric surgeons due to the variability in surgical management when primary anastomosis is not feasible. Mechanical traction procedures enhance tissue growth that allows early anastomosis, before delayed primary closure (DPC) would be attempted to allow for rapid oral feeding, or when operative discoveries require flexibility of the surgical plan. The Suture Fistula procedure, first published by Alan Shafer and Tirone David in 1974, is a simple, effective, but underutilized single-stage procedure which results in spontaneous fistulization of approximated, non-anastomosed esophageal segments using tension sutures. Read More

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November 2018

Quantitative Assessment of the Blood Perfusion of the Gastric Conduit by Indocyanine Green Imaging.

J Surg Res 2019 Feb 23;234:303-310. Epub 2018 Oct 23.

Division of Gastroenterological Surgery, Chiba Cancer Center, 260-8717 Chiba, Japan.

Background: Indocyanine green (ICG) fluorescence imaging has been used to assess the blood perfusion of the gastrointestinal tract in surgery. Especially, it was used to determine the best anastomotic site. However, in previous studies, ICG fluorescence was judged subjectively based on the visual appearance. Read More

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February 2019

Prophylactic versus reactive gastrostomy tube placement in advanced head and neck cancer treated with definitive chemoradiotherapy: A systematic review.

Oral Oncol 2018 Dec 25;87:77-81. Epub 2018 Oct 25.

Department of Radiation Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States. Electronic address:

Although chemoradiotherapy (CRT) has improved disease outcomes in advanced head and neck cancer (aHNC), toxicity remains a major concern. Treatment interruptions and decreased quality of life (QOL) can occur due to malnutrition, secondary to mucositis, dysphagia and odynophagia. Gastrostomy tubes are used in many patients to improve nutrition during CRT. Read More

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December 2018
1 Read

Patient and carer experience of blended diet via gastrostomy: a qualitative study.

Authors:
G Phillips

J Hum Nutr Diet 2018 Dec 2. Epub 2018 Dec 2.

Leicestershire Partnership NHS Trust, Leicester, Leicestershire, UK.

Background: Home enteral feeding is becoming increasingly prevalent within the UK. The use of commercial prescription formula is considered best practice; however, increasingly, patients are choosing to use blended diet via gastrostomy. There is anecdotal evidence suggesting both physical and social benefits, although there are concerns regarding the safety and efficacy of this method of feeding. Read More

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December 2018

Outcomes associated with robotic approach to pancreatic resections.

J Gastrointest Oncol 2018 Oct;9(5):936-941

Department of Gastrointestinal Oncology, Sarasota Memorial Hospital, Sarasota, FL, USA.

Minimally invasive techniques have improved post-operative outcomes, however, the majority of pancreatic surgery, known for its complexity, is still performed via open approaches. The development of robotics has improved dexterity which may allow for application in more complex surgeries. We queried a prospectively maintained robotic database to identify patients who underwent robotic pancreatic resection by a single surgeon between 2012 and 2016. Read More

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October 2018
7 Reads

Hypernatremia is associated with poorer outcomes following aneurysmal subarachnoid hemorrhage: a nationwide inpatient sample analysis.

J Neurosurg Sci 2018 Dec 5. Epub 2018 Dec 5.

Department of Neurosurgery, State University of New York Upstate, Syracuse, NY, USA.

Background: Hypernatremia is one of the most common electrolyte disturbances following aneurysmal subarachnoid hemorrhage (aSAH) and has been correlated with increased mortality in single institution studies. We investigated this association using a large nationwide healthcare database.

Methods: We performed a retrospective analysis of adults between 2002 and 2011 with a primary diagnosis of aSAH using the Nationwide Inpatient Sample (NIS). Read More

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December 2018

Stomach Ulcer as a Rare Cause of Pancreatitis: An Unusual Complication of a Displaced Percutaneous Endoscopic Gastrostomy Tube.

Cureus 2018 Jul 5;10(7):e2926. Epub 2018 Jul 5.

Gastroenterology, Mercy St. Vincent Medical Center, Toledo, USA.

A 33-year-old man was admitted to the hospital with upper abdominal pain and melena. Laboratory tests were suggestive of pancreatitis. Computed tomography (CT) of the abdomen showed peripancreatic fat stranding but showed no free air in the peritoneal cavity. Read More

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July 2018
1 Read

Perceptions of Gastrostomy Buttons Among Caregivers of Children With Special Health Care Needs.

J Pediatr Health Care 2018 Nov 26. Epub 2018 Nov 26.

Introduction: Children with special health care needs (CSHCN) have chronic conditions that generally are classified as developmental disabilities. Children with developmental disabilities are at high risk of malnutrition. Gastrostomy buttons are frequently used to provide enteral nutrition for children with developmental disabilities. Read More

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November 2018

The Cambridge experience with buried bumpers.

J Pediatr Surg 2018 Nov 7. Epub 2018 Nov 7.

Department of Paediatric Surgery, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK. Electronic address:

Aim: Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric surgery that avoids laparotomy. Read More

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November 2018
2 Reads

Gastrostomy tube placement increases the risk of ventriculoperitoneal shunt infection: a multiinstitutional study.

Authors:

J Neurosurg 2018 Nov 1:1-6. Epub 2018 Nov 1.

OBJECTIVEGastrostomy tube placement can temporarily seed the peritoneal cavity with bacteria and thus theoretically increases the risk of shunt infection when the two procedures are performed contemporaneously. The authors hypothesized that gastrostomy tube placement would not increase the risk of ventriculoperitoneal shunt infection. The object of this study was to test this hypothesis by utilizing a large patient cohort combined from multiple institutions. Read More

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November 2018
1 Read

Non-indicated acid-suppression prescribing in a tertiary paediatric hospital: An audit and costing study.

J Paediatr Child Health 2018 Nov 28. Epub 2018 Nov 28.

Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.

Aim: To quantify (i) indicated versus non-indicated prescribing of acid-suppression therapies (AST) in a tertiary paediatric hospital; (ii) patient, provider and hospital factors associated with non-indicated prescribing; and (iii) medication costs.

Methods: This was a prospective, electronic medical audit conducted at The Royal Children's Hospital (RCH) Melbourne in August-September 2016. Proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H RA) prescriptions were extracted, with relevant patient, provider and hospital data. Read More

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November 2018

Assessment of swallowing function after circumferential pharyngolaryngectomy. A multicenter study by the GETTEC group.

Eur Ann Otorhinolaryngol Head Neck Dis 2018 Oct 25. Epub 2018 Oct 25.

Service d'ORL et de CCF, CHU Bichat, 75877 Paris, France.

Objective: Circumferential pharyngolaryngectomy is performed for advanced pharyngeal tumor or in a context of postradiation recurrence. Several free or pedicle flaps have been described for pharyngeal defect reconstruction, with choice at the surgeon's discretion. The aim of this study was to evaluate long-term swallowing function according to the type of flap used for reconstruction. Read More

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October 2018

Model to estimate abdominal wall thickness in children undergoing placement or replacement of gastrostomy devices.

J Pediatr Surg 2018 Sep 13. Epub 2018 Sep 13.

Pediatric Surgery, Children's Hospital Colorado, 13123 E.16th Avenue, Aurora, CO 80045; University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO 80045.

Objectives: Abdominal wall thickness (AWT) is a key measurement when placing or replacing low profile gastrostomy devices. This measurement varies, depending on nutritional status and body habitus. We developed a mathematical model to estimate AWT using a compendium of body measurements. Read More

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September 2018

Endoscopic Dilation of Pharyngoesophageal Strictures: There Are More Dimensions than a Diameter.

GE Port J Gastroenterol 2018 Nov 8;25(6):291-298. Epub 2018 Feb 8.

Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal.

Background/aims: Dysphagia due to benign pharyngoesophageal strictures (PES) often requires repeated dilations; however, a uniform definition for the therapeutic efficacy of this technique has not been yet established. We aimed to assess the overall efficacy of endoscopic dilation of pharyngoesophageal anastomotic or post-radiotherapy (post-RT) strictures.

Methods: The data of 48 patients with post-RT ( = 29) or anastomotic PES ( = 19) submitted to endoscopic dilation during a 3-year period were retrospectively assessed. Read More

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November 2018
1 Read

Three-Dimensional Printing Facilitates Creation of a Biliary Endoscopy Phantom for Interventional Radiology-Operated Endoscopy Training.

Curr Probl Diagn Radiol 2018 Aug 29. Epub 2018 Aug 29.

Department of Interventional Radiology, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095. Electronic address:

Purpose: To create a three-dimensional endoscopic model of the biliary tract from magnetic-resonance cholangiopancreatography imaging and to evaluate its effectiveness as a tool for training in endoscopic biliary interventions.

Materials And Methods: A magnetic-resonance cholangiopancreatography study was performed on a patient with biliary obstruction secondary to a distal bile duct cholangiocarcinoma. Using Vitrea, a three-dimensional volume-rendered image was created, and exported as a standard tessellated language file. Read More

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August 2018
1 Read

Disease caused by non-tuberculous mycobacteria in children with cystic fibrosis.

Paediatr Respir Rev 2018 May 19. Epub 2018 May 19.

Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, NSW, Australia; Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

Non-tuberculous mycobacterial (NTM) (especially M. abscessus complex) infections pose a considerable challenge in the management of lung disease in patients with cystic fibrosis (CF). The apparent increase in prevalence is likely multifactorial. Read More

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May 2018
3 Reads

Helping Patients with Gastroparesis.

Med Clin North Am 2019 Jan;103(1):71-87

Department of Medicine, Division of Gastroenterology and Hepatology, Stanford University, 300 Pasteur Drive, MC 5244, Stanford, CA 94305, USA. Electronic address:

Gastroparesis is an increasing concern and options remain limited. Diagnosis hinges on recognition of delayed gastric emptying in the absence of mechanical obstruction. Nontransit studies evaluating gastric motility serve a complementary role and may help guide therapy. Read More

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January 2019

Comparing Outcomes Between "Pull" Versus "Push" Percutaneous Endoscopic Gastrostomy in Acute Care Surgery: Under-Reported Pull Percutaneous Endoscopic Gastrostomy Incidence of Tube Dislodgement.

J Surg Res 2018 Dec 3;232:56-62. Epub 2018 Jul 3.

Division of Acute Care Surgery, Department of Surgery, University of Arizona, Tucson, Arizona.

Background: Percutaneous endoscopic gastrostomy (PEG) complications are often under-reported in the literature, especially regarding the incidence of tube dislodgement (TD). TD can cause significant morbidity depending on its timing. We compared outcomes between "push" and "pull" PEGs. Read More

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December 2018
2 Reads

Outcomes After Laparoscopic Gastrostomy Suture Techniques in Children.

J Surg Res 2018 Dec 30;232:26-32. Epub 2018 Jun 30.

Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah. Electronic address:

Background: There are various suture techniques used during laparoscopic gastrostomy to secure the stomach to the anterior abdominal wall. However, it remains unclear whether temporary fixation or subcutaneous absorbable sutures predispose pediatric patients to fewer postoperative complications. Our goal was to determine if a particular suture technique resulted in an increased risk for the development of postoperative complications. Read More

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December 2018
1 Read

Best interest versus advance decisions to refuse treatment in advance care planning for neurodegenerative illness.

Authors:
Chris Lennard

Br J Nurs 2018 Nov;27(21):1261-1267

Registered mental health nurse, Pirton Grange Specialist Care Centre, Pirton, Worcestershire.

This article describes the role of nurses assisting people with degenerative illness in advance care planning (ACP) for a time when they may lose decision-making capacity. It looks at the concept of advance decisions to refuse treatment (ADRT), as defined in the Mental Capacity Act 2005 , exploring the legal, ethical and philosophical ramifications of carrying out, or overriding, formerly expressed wishes of someone who has subsequently lost decision-making capacity. It uses an illustrative composite case study of an individual with Huntington's disease whose prognosis includes future deterioration in swallowing, together with consideration of whether to have or refuse a percutaneous endoscopic gastrostomy. Read More

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November 2018
1 Read

Palliative care after stroke.

Acta Neurol Belg 2018 Nov 19. Epub 2018 Nov 19.

Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Numune Training and Research Hospital, Ankara, Turkey.

Stroke is the leading cause of disability and one of the most common reasons of death around the world. Information is not sufficient on the palliative care (PC) needs of stroke patients and factors affecting their prognosis. In this study, we have investigated the demographics and comorbidities of stroke patients followed-up in a PC center (PCC), and the factors efficient on their prognosis. Read More

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November 2018
3 Reads

Complications in children with percutaneous endoscopic gastrostomy (PEG) placement.

World J Pediatr 2018 Nov 19. Epub 2018 Nov 19.

Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster NHS Fdn Trust, Imperial College London, London, UK.

Introduction: The aim of this study was to analyze the complication rates and mortality in association with different operative techniques of percutaneous endoscopic gastrostomy (PEG), age, underlying diseases and other risk factors. Moreover, analysis of the indications of PEG insertion and the underlying comorbidities was also performed.

Methods: This study performs a literature analysis of PEG-related complications in children. Read More

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November 2018
2 Reads

Neutropenia in Barth syndrome: characteristics, risks, and management.

Curr Opin Hematol 2019 Jan;26(1):6-15

Department of Medicine, University of Washington, Seattle, Washington, USA.

Purpose Of Review: Barth syndrome (BTHS) is an X-linked disease characterized by defective remodeling of phospholipid side chains in mitochondrial membranes. Major features include neutropenia, dilated cardiomyopathy, motor delay and proximal myopathy, feeding problems, and constitutional growth delay. We conducted this review of neutropenia in BTHS to aid in the diagnosis of this disease, and to improve understanding of both the consequences of neutropenia and the benefits of treatment with granulocyte colony-stimulating factor (G-CSF). Read More

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January 2019
7 Reads

'Candy Sign' in EUS guided cysto-gastrostomy of pancreatic fluid collection with metal stent.

Dig Endosc 2018 Nov 18. Epub 2018 Nov 18.

Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.

A 40-year-old male underwent EUS guided drainage for symptomatic large WON (15 x 9 cm) due severe acute pancreatitis 6 months ago. The initial steps of EUS guided cysto-gastrostomy with BFMS (needle puncture, passage of guidewire, creation of fistula using co-axial 6Fr cystotome and dilation of track with 4mm balloon) were uneventful. However, there was significant resistance to cross the wall of WON while passing the stent assembly (NAGI stent, Taewoong Medical) over the guidewire. Read More

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November 2018
6 Reads

Early higher dosage of alglucosidase alpha in classic Pompe disease.

J Pediatr Endocrinol Metab 2018 Dec;31(12):1343-1347

Department of Pediatrics, University of Torino, Torino, Italy.

Background With conventional enzyme replacement therapy (ERT), the clinical prognosis of classic Pompe disease is often unsatisfactory. About half the patients treated with ERT at the recommended dosage (20 mg/kg every other week) require ventilatory support within the first years of life. The heterogeneous response to ERT has been related to different factors, including cross-reactive immunologic material (CRIM) status and age at ERT initiation. Read More

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December 2018
1 Read

Percutaneous endoscopic gastrostomy. Indications, care and complications.

Med Clin (Barc) 2018 Nov 10. Epub 2018 Nov 10.

UGC Aparato Digestivo, Hospital de Poniente, El Ejido, Almería, España.

Percutaneous endoscopic gastrostomy (PEG) is an effective and safe method for nutritional support in patients with malnutrition and impossibility of oral intake with an estimated survival higher than the months that require enteral nutrition beyond four weeks. The main indications include neoplasms of the upper air-digestive tract and neurological diseases, with dementia currently considered a controversial indication. Anatomical alterations and infectious diseases are the most frequent contraindications. Read More

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November 2018
1 Read

Long-term quality of life in older patients with HPV-related oropharyngeal cancer.

Head Neck 2018 Nov 13. Epub 2018 Nov 13.

Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Background: We explored if age affects quality of life (QOL) in survivors of locally advanced human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC).

Methods: In a cross-sectional survey of 185 patients, at least 12 months from radiation, we evaluated generic (EuroQOL-5D questionnaire [EQ-5D]) and head and neck specific (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck 35-questions [EORTC-QLQ-H&N35]) QOL questionnaires and compared differences between younger (<65) and older (≥65) patients.

Results: The median age was 57. Read More

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November 2018
4 Reads

Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database.

Oral Oncol 2018 Nov 21;86:132-140. Epub 2018 Sep 21.

University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.

Objective: To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database.

Materials And Methods: We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005-2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006.

Results: 2135 beneficiaries were identified. Read More

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November 2018
5 Reads

Development and Pilot Testing of a Simulation to Study How Physicians Facilitate Surrogate Decision-Making Based on Critically Ill Patients' Values and Preferences.

J Pain Symptom Manage 2018 Nov 5. Epub 2018 Nov 5.

Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, PA, USA; Palliative and Supportive Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Context: There are no evidence-based programs to train physicians to facilitate shared decision-making based on incapacitated intensive care unit (ICU) patients' values and preferences.

Objectives: To develop a high-fidelity simulation to fill this gap.

Methods: Case development involved 6 steps: 1) drafting a case about an elderly patient receiving prolonged mechanical ventilation; 2) engaging an expert advisory board to optimize case content; 3) revising the case based on advisory board input; 4) training actors to portray the case patient's daughter; 5) obtaining physician feedback on the simulation; 6) revising the case based on their feedback. Read More

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November 2018
4 Reads

Laparoscopic Magnet-Assisted Percutaneous Endoscopic Gastrostomy Placement.

J Laparoendosc Adv Surg Tech A 2018 Nov 8. Epub 2018 Nov 8.

2 Division of Pediatric Surgery, UCSF Benioff Children's Hospitals , Oakland, California.

Background: There are various methods to place a gastrostomy tube. We report a laparoscopic method to place a standard percutaneous endoscopic gastrostomy (PEG) tube without the use of endoscopy.

Methods: Laparoscopic magnet-assisted PEG placement was carried out using an orogastric tube attached with a magnet that is used to retrieve the PEG wire that has been percutaneously placed into the stomach. Read More

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November 2018
4 Reads

Commentary on Charles Foster's 'The rebirth of medical paternalism: an NHS Trust v Y'.

Authors:
Derick T Wade

J Med Ethics 2018 Oct 31. Epub 2018 Oct 31.

OxINMAHR, Oxford Brookes University Faculty of Health and Life Sciences, Oxford, UK.

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October 2018

The efficacy of a novel percutaneous endoscopic gastrostomy simulator using three-dimensional printing technologies.

J Gastroenterol Hepatol 2018 Oct 29. Epub 2018 Oct 29.

Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Background And Aim: We developed a novel training simulator for percutaneous endoscopic gastrostomy (PEG) and determined its efficacy and realism in PEG insertion training.

Methods: The gastrostomy simulator was made using three-dimensional printing and silicone molding technology. The simulator is of two types: pull type and introducer type. Read More

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October 2018
6 Reads

Hospitalizations of Children with Huntington's Disease in the United States.

Mov Disord Clin Pract 2017 Sep-Oct;4(5):682-688. Epub 2017 Sep 11.

Department of Neurology University of Pennsylvania School of Medicine Philadelphia Pennsylvania.

Background: Juvenile Huntington's disease (JHD) is a childhood-onset neurodegenerative disorder. Although it is caused by the same pathologic expansion of CGA repeats as adult-onset Huntington's disease, JHD has distinct clinical features. Most clinical research in HD focuses in the adult-onset disease; therefore, little is known about acute care outcomes for patients with JHD. Read More

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September 2017
4 Reads

Safety and efficacy of Early injection laryngoplasty in pediatric patients.

Laryngoscope 2018 Oct 23. Epub 2018 Oct 23.

Division of Otolaryngology-Head and Neck Surgery, Children's Hospital of Los Angeles, Keck School of Medicine of the University of Southern California, Los Angeles, California, U.S.A.

Objective: The major morbidity of unilateral vocal fold immobility (UVFI) in children is due to aspiration. Early injection laryngoplasty (IL) can decrease aspiration risk; however, this has not been well studied in pediatric otolaryngology. This study examines safety and efficacy of early IL in children. Read More

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October 2018
4 Reads

Reducing the Unintended Dislodgement of Gastrostomy Tubes in a Long-Term Acute Care Hospital: A QA/QI Pilot Study.

Gastroenterology Res 2018 Oct 1;11(5):369-373. Epub 2018 Oct 1.

Department of Medicine, Henry J. Carter Specialty Hospital and Nursing Facility, 1752 Park Avenue, New York, NY 10035, USA.

Background: Since their introduction in 1980, gastrostomy tubes have become effective means of providing both short-term and long-term enteral access and nutritional support. These feeding tubes are ubiquitous in many health care facilities that care for the elderly, but carry high rates of unintended dislodgement - a complication that, if not detected promptly, is associated with substantial morbidity and health care costs. This study determined the dislodgment rate of gastrostomy tubes at 90 days in a cohort of 221 patients and tested the hypothesis that the implementation of a concise protocol to care for patients' gastrostomy tubes would reduce these unintended dislodgements. Read More

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October 2018
7 Reads

Dysphagia unveiling systemic immunoglobulin light-chain amyloidosis with multiple myeloma.

BMJ Case Rep 2018 Oct 21;2018. Epub 2018 Oct 21.

Internal Medicine, McLaren Health Care Corp, Flint, Michigan, USA.

Dysphagia is an uncommon presentation of systemic immunoglobulin light-chain (AL) amyloidosis with multiple myeloma (MM). Gastrointestinal (GI) involvement usually manifests with altered motility, malabsorption or bleeding. Furthermore, patients identified with GI amyloidosis, without previous diagnosis of a plasma cell disorder, are extremely rare. Read More

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October 2018
7 Reads

Impact of disease-specific volume and hospital transfer on outcomes in gastroschisis.

J Pediatr Surg 2018 Oct 5. Epub 2018 Oct 5.

Center for Advanced Intestinal Rehabilitation, Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address:

Background: Gastroschisis, a surgical condition requiring complex interdisciplinary care, may benefit from treatment at higher volume centers. Recent studies on surgical volume and outcomes have conflicting findings.

Methods: Data were collected prospectively on newborns ≥1500 g with gastroschisis born 2009-2015, admitted to 159 US centers, and separated into terciles based on number of annual gastroschisis repairs. Read More

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October 2018
1 Read

External validation of the epidemiology-based mortality score in status epilepticus in an American intensive care population.

Epilepsy Res 2018 Dec 3;148:32-36. Epub 2018 Oct 3.

Department of Neurosurgery, UT Health San Antonio Lozano School of Medicine, United States.

Introduction: Although overall mortality of status epilepticus is high, baseline patient characteristics and co-morbidities may be helpful to predict outcomes and shape treatment decisions. Two previously published scoring systems exist to predict outcomes: the Status Epilepticus Severity Score (STESS) and the Epidemiology-based Mortality Score in Status Epilepticus (EMSE). However, a comparison of the two scores has not previously been completed in an American intensive care unit. Read More

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December 2018
1 Read

Percutaneous endoscopic gastrostomy (PEG), in elderly patients with dementia and anorexia. Medical and ethical issues regarding placement.

Ann Ital Chir 2018 ;89:305-308

Background And Aims: Ethical and medico-legal issues reviews of Percutaneous Endoscopic Gastrostomy (PEG) placement in elderly patients is an important topic of international medical literature. PEG is often inappropriately placed in patients with not spontaneous oral feeding intake, cause of unrealistic expectations. We performed a critical review of the literature for placement of PEG in geriatric patients. Read More

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January 2018
1 Read

Laparoscopic-thoracoscopic esophageal resection in the treatment of giant epiphrenic esophageal diverticulum (Ivor Lewis operation): Case report.

Int J Surg Case Rep 2018 8;52:89-94. Epub 2018 Oct 8.

NGHCI Railway Clinical Hospital at the "Rostov-Glavnyy" Station, OAO Russian Railways, Varfolomeeva Street 92, Rostov-on-Don, Russian Federation(1); FSBEI HE Rostov State Medical University of the Ministry of Health of the Russian Federation, Nakhichevansky Lane 19, Rostov-on-Don, Russian Federation(2).

Introduction: Complicated esophageal diverticulum is an extremely rare disease. The most widespread surgical tactic in such cases is drainage of the mediastinum and the position of a feeding gastrostomy or enterostomy. Our objective was to demonstrate the possibility of performing a one-step operation in case of giant esophageal diverticulum with necrotic diverticulitis and sepsis on the background of dilatation of the esophagus. Read More

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October 2018
1 Read

Hybrid endoluminal stapled pyloroplasty: an alternative treatment option for gastric outlet obstruction syndrome.

Surg Endosc 2018 Oct 17. Epub 2018 Oct 17.

IHU-Strasbourg, Institute of Image-Guided Surgery, 1, place de l'Hôpital, 67091, Strasbourg, France.

Background: Gastroparesis is a rapidly increasing problem with sometimes devastating consequences. While surgical treatments, particularly laparoscopic pyloroplasty, have recently gained popularity, they require general anesthesia, advanced skills, and can lead to leaks. Peroral pyloromyotomy is a less invasive alternative; however, this technique is technically demanding and not widely available. Read More

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October 2018
1 Read

Natural Language Processing to Assess End-of-Life Quality Indicators in Cancer Patients Receiving Palliative Surgery.

J Palliat Med 2018 Oct 17. Epub 2018 Oct 17.

1 Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute , Boston, Massachusetts.

Background: Palliative surgical procedures are frequently performed to reduce symptoms in patients with advanced cancer, but quality is difficult to measure.

Objective: To determine whether natural language processing (NLP) of the electronic health record (EHR) can be used to (1) identify a population of cancer patients receiving palliative gastrostomy and (2) assess documentation of end-of-life process measures in the EHR.

Design/setting: Retrospective cohort study of 302 adult cancer patients who received a gastrostomy tube at a single tertiary medical center. Read More

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October 2018
3 Reads

The Burden of Pediatric Neurocritical Care in the United States.

Pediatr Neurol 2018 Dec 4;89:31-38. Epub 2018 Aug 4.

Oregon Health and Science University, Department of Pediatrics, Division of Pediatric Critical Care, Portland, Oregon.

Background: Disorders requiring pediatric neurocritical care (PNCC) affect thousands of children annually. We aimed to quantify the burden of PNCC through generation of national estimates of disease incidence, utilization of critical care interventions (CCI), and hospital outcomes.

Methods: We performed a retrospective cohort analysis of the Kids Inpatient Database over three years to evaluate pediatric traumatic brain injury, neuro-infection or inflammatory diseases, status epilepticus, stroke, hypoxic ischemic injury after cardiac arrest, and spinal cord injury. Read More

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December 2018
2 Reads

Commercial Claims-Based Comparison of Survival and Toxic Effects of Definitive Radiotherapy vs Primary Surgery in Patients With Oropharyngeal Squamous Cell Carcinoma.

JAMA Otolaryngol Head Neck Surg 2018 Oct;144(10):913-922

HealthCore, Wilmington, Delaware.

Importance: Definitive radiotherapy (RT) and primary surgery (PS) are considered to be equally viable local therapy modalities for oropharyngeal squamous cell carcinoma (OPSCC). The comparative effectiveness of these therapies is often debated, and treatment decisions are based on a paucity of comparative data.

Objective: To examine the differences in overall survival and key toxic effects in patients with OPSCC treated with RT and PS. Read More

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October 2018
6 Reads

Functional and Endoscopic Indicators for Percutaneous Endoscopic Gastrostomy (PEG) in Amyotrophic Lateral Sclerosis Patients.

J Clin Med 2018 Oct 14;7(10). Epub 2018 Oct 14.

Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal.

(1) Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative condition, whose bulbar involvement compromises language, swallowing, and airway protection. When oral nutrition is no longer adequate, percutaneous endoscopic gastroscopy (PEG) may be indicated. However, as exact timing is still debatable, we tried to find it. Read More

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October 2018
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Gastrostomy Tube Placement by Radiological Methods for Older Patients Requiring Enteral Nutrition: Not to be Forgotten.

Front Med (Lausanne) 2018 26;5:274. Epub 2018 Sep 26.

Ruth and Bruce Rappaport Faculty of Medicine, Technion-Isreal Istitute of Technology, Haifa, Israel.

The use of gastrostomy tubes for long-term nutritional support in older patients is frequent. Percutaneous gastrostomy tube placement may be performed using various techniques, including endoscopic, surgical, and radiologically-guided methods. While percutaneous endoscopic gastrostomy (PEG) placement is the most widely used and accepted approach, experience with the use of percutaneous radiological gastrostomy (PRG) is more limited. Read More

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September 2018
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[Usefulness of Nutritional Enforcement by Percutaneous Gastrostomy in Successful Omentoplasty for Empyema with Fistula].

Kyobu Geka 2018 Oct;71(11):903-905

Department of Thoracic Surgery, Nagara Medical Center, Gifu, Japan.

Omentoplasty has been accepted as an effective surgical procedure for fistulated empyema. However, it is difficult for patients with poor nutritional status because their omental volume is often too poor to be applied for omentoplasty. Percutaneous endoscopic gastrostomy(PEG) is useful for long-term nutritional management. Read More

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October 2018