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[PMID]:29369192
[Au] Autor:Chen H; Siwo EA; Khu M; Tian Y
[Ad] Endereço:Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
[Ti] Título:Current trends in the management of Mirizzi Syndrome: A review of literature.
[So] Source:Medicine (Baltimore);97(4):e9691, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mirizzi Syndrome is a rare and challenging clinical entity to manage. However, recent advances in technology have provided surgeons with new options for more effective diagnosis and treatment of this condition. This paper reviews these new diagnostic modalities and treatment approaches for the management of Mirizzi Syndrome.An online search language was performed using PubMed and Web of Science for literature published in English between 2012 and 2017 using the search terms "Mirizzi Syndrome" and "Mirizzi." In total, 16 case series and 11 case reports were identified and analyzed.The most frequently used diagnostic modalities were ultrasound, computed tomography (CT); magnetic resonance cholangiopancreaticography (MRCP); endoscopic retrograde cholangiopancreaticography (ERCP). A combination of ≥2 diagnostic modalities was frequently used to detect Mirizzi Syndrome. Literature shows that the specific type of Mirizzi Syndrome determined the type of treatment chosen. Open surgery was the preferred option, although there are documented cases of the use of minimally-invasive techniques, even in advanced cases. Laparoscopic, endoscopic or robot-assisted surgery, used individually or in combination with lithotripsy, were all associated with a favorable outcome.As yet, there are no internationally-accepted guidelines for the management of Mirizzi Syndrome. Laparotomy is the preferred surgical technique of choice, although an increasing number of surgeons are beginning to opt for minimally-invasive techniques. The number of papers in the existing literature describing diagnostic and treatment procedures is relatively small at present, thus making it difficult to reasonably propose an evidence-based standard of care for Mirizzi Syndrome.
[Mh] Termos MeSH primário: Técnicas de Diagnóstico do Sistema Digestório/tendências
Procedimentos Cirúrgicos do Sistema Digestório/tendências
Gerenciamento Clínico
Síndrome de Mirizzi/diagnóstico
Síndrome de Mirizzi/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009691


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[PMID]:28682052
[Au] Autor:Wang W; Zhu Y; Chen X
[Ad] Endereço:College of Chemistry and Molecular Engineering, ‡Peking-Tsinghua Center for Life Sciences, §Synthetic and Functional Biomolecules Center, and ∥Key Laboratory of Bioorganic Chemistry and Molecular Engineering of Ministry of Education, Peking University , Beijing 100871, China.
[Ti] Título:Selective Imaging of Gram-Negative and Gram-Positive Microbiotas in the Mouse Gut.
[So] Source:Biochemistry;56(30):3889-3893, 2017 Aug 01.
[Is] ISSN:1520-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The diverse gut microbial communities are crucial for host health. How the interactions between microbial communities and between host and microbes influence the host, however, is not well understood. To facilitate gut microbiota research, selective imaging of specific groups of microbiotas in the gut is of great utility but remains technically challenging. Here we present a chemical approach that enables selective imaging of Gram-negative and Gram-positive microbiotas in the mouse gut by exploiting their distinctive cell wall components. Cell-selective labeling is achieved by the combined use of metabolic labeling of Gram-negative bacterial lipopolysaccharides with a clickable azidosugar and direct labeling of Gram-positive bacteria with a vancomycin-derivatized fluorescent probe. We demonstrated this strategy by two-color fluorescence imaging of Gram-negative and Gram-positive gut microbiotas in the mouse intestines. This chemical method should be broadly applicable to different gut microbiota research fields and other bacterial communities studied in microbiology.
[Mh] Termos MeSH primário: Técnicas de Diagnóstico do Sistema Digestório
Disbiose/diagnóstico por imagem
Microbioma Gastrointestinal
Trato Gastrointestinal/diagnóstico por imagem
Bactérias Gram-Negativas/isolamento & purificação
Bactérias Gram-Positivas/isolamento & purificação
[Mh] Termos MeSH secundário: Animais
Azidas/análise
Azidas/química
Azidas/metabolismo
Azidas/farmacologia
Carbocianinas/análise
Parede Celular/química
Química Click
Disbiose/microbiologia
Corantes Fluorescentes/análise
Corantes Fluorescentes/química
Corantes Fluorescentes/metabolismo
Corantes Fluorescentes/farmacologia
Trato Gastrointestinal/microbiologia
Bactérias Gram-Negativas/citologia
Bactérias Gram-Negativas/crescimento & desenvolvimento
Bactérias Gram-Negativas/metabolismo
Bactérias Gram-Positivas/citologia
Bactérias Gram-Positivas/crescimento & desenvolvimento
Bactérias Gram-Positivas/metabolismo
Lipopolissacarídeos/análise
Lipopolissacarídeos/biossíntese
Lipopolissacarídeos/química
Camundongos Endogâmicos C57BL
Viabilidade Microbiana/efeitos dos fármacos
Imagem Óptica
Projetos Piloto
Porfobilinogênio/análogos & derivados
Porfobilinogênio/análise
Porfobilinogênio/química
Rodaminas/análise
Rodaminas/química
Organismos Livres de Patógenos Específicos
Açúcares Ácidos/análise
Açúcares Ácidos/química
Açúcares Ácidos/metabolismo
Açúcares Ácidos/farmacologia
Vancomicina/análogos & derivados
Vancomicina/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (3-anilino difluoroboron dipyrromethene); 0 (5-carboxytetramethylrhodamine succinimidyl ester); 0 (8-azido-3,8-dideoxyoctulosonate); 0 (Alexa Fluor 647); 0 (Azides); 0 (Carbocyanines); 0 (Fluorescent Dyes); 0 (Lipopolysaccharides); 0 (Rhodamines); 0 (Sugar Acids); 1069-03-0 (2-keto-3-deoxyoctonate); 6Q205EH1VU (Vancomycin); 74KHC72QXK (Porphobilinogen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170811
[Lr] Data última revisão:
170811
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1021/acs.biochem.7b00539


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[PMID]:28233016
[Au] Autor:Cantemir S; Laubert A
[Ad] Endereço:Hals-Nasen-Ohrenklinik, Kath. Krankenhaus Hagen gGmbH, Universität Witten/Herdecke, Dreieckstr. 15, 58097, Hagen, Deutschland. s.cantemir@kkh-hagen.de.
[Ti] Título:[The physiologic and the pathologic swallowing process].
[Ti] Título:Der physiologische und der pathologische Schluckvorgang..
[So] Source:HNO;65(3):261-270, 2017 Mar.
[Is] ISSN:1433-0458
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.
[Mh] Termos MeSH primário: Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Deglutição/fisiologia
Técnicas de Diagnóstico do Sistema Digestório
Modelos Biológicos
Faringe/fisiopatologia
[Mh] Termos MeSH secundário: Transtornos de Deglutição/terapia
Medicina Baseada em Evidências
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE
[do] DOI:10.1007/s00106-017-0333-0


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[PMID]:28170133
[Au] Autor:Trinh SA; Echenique IA; Penugonda S; Angarone MP
[Ad] Endereço:Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
[Ti] Título:Optimal strategies for the diagnosis of community-onset diarrhea in solid organ transplant recipients: Less is more.
[So] Source:Transpl Infect Dis;19(2), 2017 Apr.
[Is] ISSN:1399-3062
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Diarrhea, a common complication after solid organ transplant (SOT), is associated with allograft failure and death. No evidence-based guidelines exist for the evaluation of diarrhea in SOT recipients. We performed a cost analysis to derive a testing algorithm for the diagnosis of community-onset diarrhea that minimizes costs without compromising diagnostic yields. DESIGN: A cost analysis was performed on a retrospective cohort of 422 SOT admissions for community-onset diarrhea over an 18-month period. A stepwise testing model was applied on a population level to assess test costs relative to diagnostic yields. RESULTS: Over an 18-month period, 1564 diagnostic tests were performed and 127 (8.1%) returned positive. Diagnostic testing accounted for $95 625 of hospital costs. The tests with the lowest cost per decrease in the false-omission rate (FOR) were stool Clostridium difficile polymerase chain reaction (PCR) ($156), serum cytomegalovirus quantitative PCR ($1529), stool norovirus (NV) PCR ($4673), and stool culture ($6804). A time-to-event analysis found no significant difference in the length of hospital stay between patients with and without NV testing (P=.520). CONCLUSIONS: A stepwise testing strategy can reduce costs without compromising diagnostic yields. In the first-stage testing, we recommend assessment for C. difficile, cytomegalovirus, and food-borne bacterial pathogens. For persistent diarrheal episodes, second-stage evaluation should include stool NV PCR, Giardia/Cryptosporidium enzyme immunoassay, stool ova and parasite, reductions in immunosuppressive therapy, and possibly endoscopy. Although NV testing had a relatively low cost per FOR, we recommend NV testing during second-stage evaluation, as an NV diagnosis may not lead to changes in clinical management or further reductions in length of hospital stay.
[Mh] Termos MeSH primário: Infecções Comunitárias Adquiridas/diagnóstico
Técnicas de Diagnóstico do Sistema Digestório/economia
Diarreia/diagnóstico
Medicina Baseada em Evidências/economia
Rejeição de Enxerto/complicações
Hospitalização/economia
Transplante de Órgãos/efeitos adversos
[Mh] Termos MeSH secundário: Clostridium difficile
Infecções Comunitárias Adquiridas/complicações
Infecções Comunitárias Adquiridas/microbiologia
Infecções Comunitárias Adquiridas/virologia
Custos e Análise de Custo
Citomegalovirus/isolamento & purificação
Técnicas de Diagnóstico do Sistema Digestório/normas
Diarreia/complicações
Diarreia/microbiologia
Diarreia/virologia
Endoscopia Gastrointestinal
Medicina Baseada em Evidências/normas
Fezes/microbiologia
Fezes/parasitologia
Fezes/virologia
Doenças Transmitidas por Alimentos/diagnóstico
Doenças Transmitidas por Alimentos/microbiologia
Rejeição de Enxerto/mortalidade
Seres Humanos
Técnicas Imunoenzimáticas/economia
Norovirus/isolamento & purificação
Transplante de Órgãos/mortalidade
Reação em Cadeia da Polimerase/economia
Guias de Prática Clínica como Assunto
Estudos Retrospectivos
Transplantados
Transplante Homólogo/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1111/tid.12673


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[PMID]:28105617
[Au] Autor:Wang Y; Wang J; Liu W; Zhang G
[Ad] Endereço:Department of Nursing, Chinese PLA General Hospital, Beijing 100853, China.
[Ti] Título:[Establishment of prediction model of acute gastrointestinal injury classification of critically ill patients based on digital gastrointestinal sounds monitoring].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;20(1):34-39, 2017 Jan 25.
[Is] ISSN:1671-0274
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To develop the prediction model of acute gastrointestinal injury (AGI) classification of critically ill patients. METHODS: The binary channel gastrointestinal sounds (GIS) monitor system was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of PLA General Hospital from April 2015 to November 2015 (patients with chronic gastrointestinal disease or history of gastrointestinal surgery were excluded). Meanwhile, the AGI grades were evaluated according to the ESICM guidelines of AGI grading system. Correlations between GIS and AGI classification were examined with Spearman rank correlation. Then principal component analysis was performed on the significantly correlated parameters after standardization. The top 3 post-normalized main components were selected for back-propagation (BP) neural network training to establish primary AGI grade model of critically ill patients based on the neural network model. RESULTS: A total of 1 132 GIS and 333 AGI were collected from 60 patients. The number (P = 0.0005), percentage of time (P = 0.0004), mean power (P = 0.0088), maximum power (P = 0.0101) and maximum time (P = 0.0025) of GIS wave from the channel located at the stomach were negatively correlated with the AGI grades, while the parameters of GIS wave from the channel located at the intestine had no significant correlation with the AGI grades(all P > 0.05). Three main components were selected after principal component analysis of these five correlated parameters. An AGI grade network model including 9 hide layers, with a fitting degree of 0.981 64 was built by BP artificial neural network based on the analysis of these three main components of GIS. The accuracy rate of the model to predict the AGI grade was 70.83%. CONCLUSION: The preliminary model based on GIS in classifying AGI grade is established successfully, which can help predict the classification of AGI grade of critically ill patients.
[Mh] Termos MeSH primário: Traumatismos Abdominais/classificação
Traumatismos Abdominais/diagnóstico
Auscultação/instrumentação
Auscultação/métodos
Auscultação/estatística & dados numéricos
Cuidados Críticos/métodos
Técnicas de Diagnóstico do Sistema Digestório/instrumentação
Técnicas de Diagnóstico do Sistema Digestório/estatística & dados numéricos
[Mh] Termos MeSH secundário: Simulação por Computador
Estado Terminal/classificação
Diagnóstico por Computador/instrumentação
Diagnóstico por Computador/métodos
Seres Humanos
Modelos Biológicos
Redes Neurais (Computação)
Valor Preditivo dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170121
[St] Status:MEDLINE


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[PMID]:28068730
[Au] Autor:Zizer E; Seufferlein T; Hänle MM
[Ti] Título:Impaired bolus clearance in combined high-resolution esophageal manometry and impedance measurement helps to differentiate between esophagogastric junction outflow obstruction and achalasia.
[Ti] Título:Eingeschränkte Bolusclearance in der Impedanzmessung stellt einen signifikanten diagnostischen Unterschied zwischen Patienten mit Achalasie und funktioneller Obstruktion dar..
[So] Source:Z Gastroenterol;55(2):129-135, 2017 Feb.
[Is] ISSN:1439-7803
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for esophagogastric junction outflow obstruction (EGJOO) in comparison to achalasia patients. The collected data were assessed in a retrospective analysis. After gastroscopy excluded a mechanical esophageal or gastric obstruction, 142 consecutive patients underwent combined HRM-impedance examination. The assessment and interpretation of the manometry results were done according to the Chicago Classification of esophageal motility disorders v3.0. After classifying the motility disorder, the evaluation of bolus clearance was done according to published studies. All patients with achalasia (n = 24) showed a significantly impaired bolus clearance (< 80 %). Patients with unaffected peristalsis (n = 56) or patients with EGJOO (n = 14) each showed impaired clearance in 7 %, respectively. The evidence of axial hernia was not associated with impaired clearance. Our results demonstrate a significant difference in impedance measurements between EGJOO and achalasia cases. This might be helpful as an additional tool to differentiate between achalasia and EGJOO patients. Furthermore, the role of the combined impedance-HRM investigation for early diagnosis of achalasia in "pre-achalasia" condition or in evaluation of potential progress of EGJOO to achalasia should be evaluated in a prospective study.
[Mh] Termos MeSH primário: Acalasia Esofágica/diagnóstico
Acalasia Esofágica/fisiopatologia
Estenose Esofágica/diagnóstico
Estenose Esofágica/fisiopatologia
Junção Esofagogástrica/fisiopatologia
Manometria/métodos
Pletismografia de Impedância/métodos
[Mh] Termos MeSH secundário: Diagnóstico por Computador/métodos
Diagnóstico Diferencial
Técnicas de Diagnóstico do Sistema Digestório
Feminino
Seres Humanos
Masculino
Meia-Idade
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-121267


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[PMID]:28012507
[Au] Autor:Nation J; Jiang W
[Ad] Endereço:Rady Children's Hospital San Diego Pediatric Otolaryngology, 3030 Children's Way Suite 402, San Diego, CA 92123, USA; University of California San Diego, Division of Otolaryngology, 200 West Arbor Drive, San Diego, CA 92103, USA. Electronic address: jnation@ucsd.edu.
[Ti] Título:The utility of a handheld metal detector in detection and localization of pediatric metallic foreign body ingestion.
[So] Source:Int J Pediatr Otorhinolaryngol;92:1-6, 2017 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To test the ability of a handheld metal detector (HHMD) to identify the presence and location of ingested metallic foreign bodies (MFBs) in children. METHODS: Prospective case series enrolling children suspected of metallic foreign body ingestion presenting to the Emergency Department. Thirty-eight children were enrolled and the HHMD was used to detect the presence and location of a MFB. Results were compared to standard radiographic studies. RESULTS: Thirty-seven of the 38 ingested foreign bodies were MFBs. Of the 37 MFBs, the HHMD positively identified 33, and 4 were missed by HHMD but identified on radiography. When positive, the location indicated by HHMD correlated 100% with radiograph. There were 33 true positives, 0 false positives, 4 false negatives, and 1 true negative. This resulted in a sensitivity of 89% (95% CI of 75%-96%) and specificity of 100% (95% CI of 2.5%-100%). CONCLUSION: Our study demonstrates the accuracy of HHMD in the identification and localization of metallic foreign bodies. We propose an emergency room foreign body protocol that uses HHMD as an early screening tool in triage in order to expedite the process of obtaining Otolaryngology consultation and potentially shorten the wait time to the operating room or discharge. In instances were outside films are previously performed, HHMD use may be able to minimize the overall radiation exposure to children by obviating the need for repeat radiographs. As the sensitivity is not 100%, a negative HHMD screening does not negate the need for a standard radiograph in order to avoid missed MFBs. HHMD is best suited for detection of coins, which accounts for the majority of the MFB ingestions, and may not be suitable for all metallic objects since the amount of metal may decrease its sensitivity.
[Mh] Termos MeSH primário: Corpos Estranhos/diagnóstico
Trato Gastrointestinal
Metais
Testes Imediatos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Técnicas de Diagnóstico do Sistema Digestório/instrumentação
Serviço Hospitalar de Emergência
Reações Falso-Negativas
Feminino
Corpos Estranhos/diagnóstico por imagem
Seres Humanos
Lactente
Masculino
Estudos Prospectivos
Radiografia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Metals)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161226
[St] Status:MEDLINE


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[PMID]:27938785
[Au] Autor:Maes S; Sharma P; Bisschops R
[Ad] Endereço:Catholic University of Leuven (KUL), University Hospitals Leuven, Department of Gastroenterology and Hepatology, Herestraat 49, 3000 Leuven, Belgium. Electronic address: sielte.maes@student.kuleuven.be.
[Ti] Título:Review: Surveillance of patients with Barrett oesophagus.
[So] Source:Best Pract Res Clin Gastroenterol;30(6):901-912, 2016 Dec.
[Is] ISSN:1532-1916
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:There has been a rapid increase in the incidence of oesophageal adenocarcinoma in most Western countries over the past thirty years. Barrett's oesophagus (BE) is a common premalignant lesion of oesophageal adenocarcinoma, although the risk of developing cancer in BE remains low. Therefore, screening is not recommended in the general population. Surveillance of BE is recommended to detect high grade dysplasia or carcinoma in an early stage, although there is no clear evidence that surveillance leads to a reduced mortality. This review discusses the several screening and surveillance techniques, including chromoendoscopy, narrow band imaging, autofluorescence imaging and confocal laser endomicroscopy, pointing out the areas that are well established as well as the new techniques that require more research.
[Mh] Termos MeSH primário: Esôfago de Barrett/diagnóstico
Técnicas de Diagnóstico do Sistema Digestório
[Mh] Termos MeSH secundário: Adenocarcinoma/diagnóstico
Biomarcadores Tumorais/metabolismo
Neoplasias Esofágicas/diagnóstico
Seres Humanos
Programas de Rastreamento/métodos
Imagem de Banda Estreita/métodos
Imagem Óptica/métodos
Vigilância da População
Lesões Pré-Cancerosas/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170119
[Lr] Data última revisão:
170119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


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[PMID]:27899409
[Au] Autor:Lind CH; Hall M; Arnold DH; Browning W; Johnson DP; Plemmons G; Zaman N; Williams DJ
[Ad] Endereço:Divisions of Hospital Medicine, and carrie.b.holloway@vanderbilt.edu.
[Ti] Título:Variation in Diagnostic Testing and Hospitalization Rates in Children With Acute Gastroenteritis.
[So] Source:Hosp Pediatr;6(12):714-721, 2016 12.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Efeitos Psicossociais da Doença
Técnicas de Diagnóstico do Sistema Digestório/estatística & dados numéricos
Gastroenterite
Hospitalização
Hospitais Pediátricos
Administração dos Cuidados ao Paciente
[Mh] Termos MeSH secundário: Doença Aguda
Pré-Escolar
Feminino
Gastroenterite/diagnóstico
Gastroenterite/economia
Gastroenterite/epidemiologia
Gastroenterite/terapia
Hospitalização/economia
Hospitalização/estatística & dados numéricos
Hospitais Pediátricos/classificação
Hospitais Pediátricos/estatística & dados numéricos
Seres Humanos
Lactente
Tempo de Internação/estatística & dados numéricos
Masculino
Avaliação de Processos e Resultados (Cuidados de Saúde)
Administração dos Cuidados ao Paciente/métodos
Administração dos Cuidados ao Paciente/organização & administração
Administração dos Cuidados ao Paciente/estatística & dados numéricos
Estudos Retrospectivos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161201
[St] Status:MEDLINE


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[PMID]:27879283
[Au] Autor:Coon ER; Srivastava R; Stoddard GJ; Reilly S; Maloney CG; Bratton SL
[Ad] Endereço:Divisions of Pediatric Inpatient Medicine, and eric.coon@hsc.utah.edu.
[Ti] Título:Infant Videofluoroscopic Swallow Study Testing, Swallowing Interventions, and Future Acute Respiratory Illness.
[So] Source:Hosp Pediatr;6(12):707-713, 2016 12.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Tube feedings are commonly prescribed to infants with swallowing abnormalities detected by videofluoroscopic swallow study (VFSS), but there are no studies demonstrating efficacy of these interventions to reduce risk of acute respiratory illness (ARI). We sought to measure the association between swallowing interventions and future ARI, among VFSS-tested infants. METHODS: Retrospective cohort of all infants (<12 months) tested with VFSS at a children's hospital between January 1, 2010, and January 1, 2012. Hospital ARI encounters (emergency, observation, or inpatient status) in a 22-hospital integrated health care delivery system, between the first VFSS and age 3 years, were measured. VFSS results were grouped by normal, intermediate, and oropharyngeal aspiration (OPA), with OPA further subdivided by silent versus cough and thin versus thick liquid OPA. Cox regression modeled the association between swallowing interventions (thickened or nasal tube feedings) and ARI, accounting for changes in swallowing and interventions over time. RESULTS: 576 infants were tested with a VFSS in their first year of life, receiving a total of 1051 VFSSs in their first 3 years of life. More than 60% of infants received a measured feeding intervention. With the exception of infants with silent OPA who received thickened feedings, neither thickening nor nasal tube feedings, compared with no intervention, were associated with a decreased risk of subsequent ARI. CONCLUSIONS: Swallowing interventions and repeated testing are common among VFSS-tested infants. However, the importance of diagnosing and intervening on VFSS-detected swallowing abnormalities for the majority of tested infants remains unclear.
[Mh] Termos MeSH primário: Transtornos de Deglutição
Técnicas de Diagnóstico do Sistema Digestório
Aspiração Respiratória
Insuficiência Respiratória/prevenção & controle
[Mh] Termos MeSH secundário: Deglutição/fisiologia
Transtornos de Deglutição/complicações
Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Transtornos de Deglutição/terapia
Nutrição Enteral/métodos
Feminino
Fluoroscopia/métodos
Seres Humanos
Lactente
Masculino
Avaliação de Processos e Resultados (Cuidados de Saúde)
Reprodutibilidade dos Testes
Aspiração Respiratória/complicações
Aspiração Respiratória/diagnóstico
Aspiração Respiratória/fisiopatologia
Aspiração Respiratória/terapia
Insuficiência Respiratória/etiologia
Estudos Retrospectivos
Utah
Gravação de Videoteipe/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE



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