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[PMID]:28452905
[Au] Autor:Regidor I; Benita V; Del Álamo de Pedro M; Ley L; Martinez Castrillo JC
[Ad] Endereço:*Unit of Functional Neurosurgery, †Service of Neurophysiology, ‡Service of Gastroenterology, §Service of Neurosurgery, and ∥Service of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
[Ti] Título:Duodenal Levodopa Infusion for Long-Term Deep Brain Stimulation-Refractory Symptoms in Advanced Parkinson Disease.
[So] Source:Clin Neuropharmacol;40(3):103-107, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: This study assesses the effect of levodopa/carbidopa intestinal infusion gel (LCIIG) as an additional treatment in patients with advanced idiopathic Parkinson disease (PD) previously treated with deep brain stimulation (DBS). METHODS: Prospective study of advanced PD patients, satisfactorily treated with bilateral DBS of the subthalamic nucleus, who had developed refractory symptoms and LCIIG was added. Controls were advanced PD patients treated with LCIIG. Measurements included the Unified Parkinson Disease Rating Scale (UPDRS)-III and the UPDRS axial compound. RESULTS: There were 19 patients in the DBS-LCIIG therapy group and 21 in the control group. The DBS-LCIIG patients were younger and had disease duration longer than controls. The median time from DBS to gastrostomy was 7.8 years (range, 2-12 years). In both study groups, the mean scores of the UPDRS-III and UPDRS axial subscales improved significantly after LCIIG treatment (DBS-LCIIG group: UPDRS-III, 62.0 [15.7] vs 30.9 [12.1]; UPDRS axial, 24.7 [4.9] vs 10.2 [2.7]; P < 0.0005 for all comparisons). There were no differences in adverse events between the groups. In the follow-up of the DBS-LCIIG group. 5 patients discontinued DBS-LCIIG therapy and returned to DBS, 5 discontinued DBS and were maintained with LCIIG, and the remaining 9 continued with DBS-LCIIG therapy. Mean time until discontinuation in the double DBS-LCIIG group was 891 days. The main risk factors for discontinuation were age at the beginning of LCIIG and severity of the UPDRS axial subscale. CONCLUSIONS: Levodopa/carbidopa intestinal infusion gel therapy may be a valuable option in selected patients with advanced PD who develop refractory symptoms after long-term subthalamic nucleus-DBS.
[Mh] Termos MeSH primário: Antiparkinsonianos/administração & dosagem
Carbidopa/administração & dosagem
Estimulação Encefálica Profunda
Gastrostomia
Levodopa/administração & dosagem
Doença de Parkinson/tratamento farmacológico
Doença de Parkinson/terapia
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Fatores Etários
Idoso
Antiparkinsonianos/efeitos adversos
Antiparkinsonianos/uso terapêutico
Carbidopa/efeitos adversos
Carbidopa/uso terapêutico
Terapia Combinada/efeitos adversos
Estimulação Encefálica Profunda/efeitos adversos
Combinação de Medicamentos
Duodeno
Feminino
Seguimentos
Gastrostomia/efeitos adversos
Géis
Seres Humanos
Intubação Gastrointestinal
Levodopa/efeitos adversos
Levodopa/uso terapêutico
Masculino
Meia-Idade
Doença de Parkinson/fisiopatologia
Pacientes Desistentes do Tratamento
Estudos Prospectivos
Índice de Gravidade de Doença
Espanha
Núcleo Subtalâmico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiparkinson Agents); 0 (Drug Combinations); 0 (Gels); 0 (carbidopa, levodopa drug combination); 46627O600J (Levodopa); MNX7R8C5VO (Carbidopa)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000216


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[PMID]:29351343
[Au] Autor:Faigle R; Carrese JA; Cooper LA; Urrutia VC; Gottesman RF
[Ad] Endereço:Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
[Ti] Título:Minority race and male sex as risk factors for non-beneficial gastrostomy tube placements after stroke.
[So] Source:PLoS One;13(1):e0191293, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tubes are widely used for enteral feeding after stroke; however, PEG tubes placed in patients in whom death is imminent are considered non-beneficial. AIM: We sought to determine whether placement of non-beneficial PEG tubes differs by race and sex. DESIGN AND SETTING/PARTICIPANTS: In this retrospective cohort study, inpatient admissions for stroke patients who underwent palliative/withdrawal of care, were discharged to hospice, or died during the hospitalization, were identified from the Nationwide Inpatient Sample between 2007 and 2011. Logistic regression was used to evaluate the association between race and sex with PEG placement. RESULTS: Of 36,109 stroke admissions who underwent palliative/withdrawal of care, were discharge to hospice, or experienced in-hospital death, a PEG was placed in 2,258 (6.3%). Among PEG recipients 41.1% were of a race other than white, while only 22.0% of patients without PEG were of a minority race (p<0.001). The proportion of men was higher among those with compared to without a PEG tube (50.0% vs. 39.2%, p<0.001). Minority race was associated with PEG placement compared to whites (OR 1.75, 95% CI 1.57-1.96), and men had 1.27 times higher odds of PEG compared to women (95% CI 1.16-1.40). Racial differences were most pronounced among women: ethnic/racial minority women had over 2-fold higher odds of a PEG compared to their white counterparts (OR 2.09, 95% CI 1.81-2.41), while male ethnic/racial minority patients had 1.44 increased odds of a PEG when compared to white men (95% CI 1.24-1.67, p-value for interaction <0.001). CONCLUSION: Minority race and male sex are risk factors for non-beneficial PEG tube placements after stroke.
[Mh] Termos MeSH primário: Grupos de Populações Continentais/estatística & dados numéricos
Nutrição Enteral/instrumentação
Gastrostomia/instrumentação
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Fatores de Risco
Distribuição por Sexo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191293


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[PMID]:29211227
[Au] Autor:Pomerantzeff PMA; Veronese ET; Dinato FJ; Jatene FB
[Ad] Endereço:Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor-HCFMUSP), São Paulo, SP, Brazil.
[Ti] Título:Resection of Left Atrial Myxoma in a Patient with Retrosternal Gastric Tube: a Case Report.
[So] Source:Braz J Cardiovasc Surg;32(5):438-441, 2017 Sep-Oct.
[Is] ISSN:1678-9741
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The median sternotomy remains the standard approach in cardiovascular surgery but, in some conditions, it can be considered difficult to perform, especially in patients with history of esophagectomy. This case report describes a successful resection of a left atrial myxoma through a right anterolateral thoracotomy approach in a patient with a previous retrosternal gastric tube reconstruction. The decision for the best surgical approach was made after a heart surgery team discussion. Through this surgical access, a safe and excellent exposure of the left atrium was possible, and a complete resection of the myxoma was performed without any injury to the gastric tube.
[Mh] Termos MeSH primário: Neoplasias Cardíacas/cirurgia
Mixoma/cirurgia
[Mh] Termos MeSH secundário: Idoso
Gastrostomia
Átrios do Coração/patologia
Átrios do Coração/cirurgia
Seres Humanos
Masculino
Toracotomia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:27778255
[Au] Autor:Wagle P; Yadav KS; Sali PA; Garg R; Varty P
[Ad] Endereço:Department of Gastrointestinal Services, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India. drprasadwagle@gmail.com.
[Ti] Título:Is Revision Surgery Justified for Symptomatic Pancreatico-enteric Anastomotic Stenosis in Long-term Survivors Following Pancreaticoduodenectomy for Malignancy?
[So] Source:J Gastrointest Surg;21(2):339-343, 2017 02.
[Is] ISSN:1873-4626
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pancreatico-enteric anastomotic (PEA) stenosis is one of the late complications following pancreaticoduodenectomy (PD) and reported for benign diseases. Literature for PEA stenosis following PD for malignancy is very limited due to low survival. MATERIAL AND METHODS: Patients undergoing surgery for symptomatic, recurrent, obstructive pancreatitis due to PEA stenosis following PD for malignancy were retrospectively identified from the authors' prospective database between January 1997 and December 2014. RESULTS: Six patients with median age 56.5 years underwent revision surgery for PEA stenosis during this time period. At primary PD, all were node negative with T1/T2 disease. The primary PEA were pancreatico-jejunostomy (PJ) (n = 5) and pancreatico-gastrostomy (n = 1). Median time to develop symptoms was 62 months. At revision surgery, a Roux-en-Y longitudinal PJ (n = 5) and an end-to-side PJ (n = 1) were done. With a median follow-up of 36 months, pain relief was excellent (n = 5) to average (n = 1). CONCLUSION: With improving long-term survival in patients undergoing PD for malignancy more such patients will be identified in future. Patients with symptomatic PEA stenosis following PD for malignancy can be managed surgically, with excellent outcomes in centers of expertise in pancreatic surgery.
[Mh] Termos MeSH primário: Pancreaticoduodenectomia/efeitos adversos
Pancreatite Crônica/etiologia
Pancreatite Crônica/cirurgia
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anastomose Cirúrgica/efeitos adversos
Constrição Patológica/etiologia
Constrição Patológica/cirurgia
Feminino
Gastrostomia
Seres Humanos
Jejunostomia
Masculino
Meia-Idade
Reoperação
Estudos Retrospectivos
Sobreviventes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s11605-016-3309-6


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[PMID]:29186164
[Au] Autor:Mitchell S; Williams JP; Bhatti H; Kachaamy T; Weber J; Weiss GJ
[Ad] Endereço:Arizona State University, Tempe, Arizona, United States of America.
[Ti] Título:A retrospective matched cohort study evaluating the effects of percutaneous endoscopic gastrostomy feeding tubes on nutritional status and survival in patients with advanced gastroesophageal malignancies undergoing systemic anti-cancer therapy.
[So] Source:PLoS One;12(11):e0188628, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many patients with cancer or other systemic illnesses can experience malnutrition. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy. METHODS: GE cancer patients who were treated and evaluated by a nutritionist and had at least 2 nutritionist follow-up visits were identified. Patients with PEG tube were matched to patients that did not undergo PEG placement (non-PEG). Clinical characteristics, GE symptoms reported at nutrition follow-up visits, and OS were recorded. RESULTS: 20 PEG and 18 non-PEG cases met criteria for further analyses. After correction for multiple testing, there were no OS differences between PEG and non-PEG, treatment naive and previously treated. However, PEG esophageal carcinoma has statistically significant inferior OS compared with non-PEG esophageal carcinoma. PEG placement did not significantly reduce the proportion of patients with weight loss between the initial nutrition assessment and 12-week follow-up. CONCLUSIONS: In this small study, PEG placement had inferior OS outcome for GE esophageal carcinoma, no improvement in OS for other evaluated groups, and did not reduce weight loss between baseline and 12-week follow-up. Unless there is prospective randomized trial that can show superiority of PEG placement in this population, PEG placement in this group cannot be endorsed.
[Mh] Termos MeSH primário: Nutrição Enteral
Neoplasias Esofágicas/cirurgia
Neoplasias Gastrointestinais/cirurgia
Gastrostomia/métodos
Estado Nutricional
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias Esofágicas/fisiopatologia
Feminino
Neoplasias Gastrointestinais/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188628


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[PMID]:29187921
[Au] Autor:Hamid M; Chaoui Y; Mountasser M; Sabbah F; Raiss M; Hrora A; Alaoui M; Ahallat M; Chaouch S; Ouazzani H
[Ad] Endereço:Department of Surgery C, Hôpital Ibn-Sina, Rabat, Faculté de Médecine et de Pharmacie Rabat, Mohammed V University Souissi, Rabat, Morocco.
[Ti] Título:Giant gastric trichobezoar in a young female with Rapunzel syndrome: case report.
[So] Source:Pan Afr Med J;27:252, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:Rapunzel syndrome is an extremely rare complication of a gastric trichobezoar in. We report here the unusual case of a case of a 16 years old girl presented with severe abdominal pain and vomiting. Clinical examination revealed a malnourished girl, with presence of a mobile and sensitive abdominal mass of 20x15 cm witch filled the upper quadrant. An abdominal computed tomography scan showed a heterogeneous mass occupying the whole stomach cavity with extension into the third portion of the duodenum. A diagnostic of giant trichobezoar is suspected after further questioning reveling a trichotillomania, trichophagia and onychophagia. The removal of the trichobezoar endoscopically failed and it was possible to pull only few fibers of hair to comfort the diagnostic. She was subjected to an exploratory laparotomy. An antral gastrostomy were performed and a 25x10x7 cm trichobezoar was extracted. The patient had an uneventful postoperative outcome and was derived to psychiatry. Rapunzel syndrome is an uncommon trichobezoar, it's commonly found in young females usually with an underlying psychiatric disorder. Management requires gastrotomy. A psychiatric assessment and a long-term follow-up are advocated as a regular part of treatment to prevent recurrence.
[Mh] Termos MeSH primário: Dor Abdominal/etiologia
Bezoares/diagnóstico
Tricotilomania/complicações
Vômito/etiologia
[Mh] Termos MeSH secundário: Adolescente
Bezoares/patologia
Bezoares/cirurgia
Endoscopia/métodos
Feminino
Gastrostomia/métodos
Cabelo
Seres Humanos
Laparotomia/métodos
Desnutrição
Estômago
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.252.9110


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[PMID]:29180216
[Au] Autor:Sutherland C; Carr B; Biddle KZ; Jarboe M; Gadepalli SK
[Ad] Endereço:Division of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
[Ti] Título:Pediatric gastrostomy tubes and techniques: making safer and cleaner choices.
[So] Source:J Surg Res;220:88-93, 2017 Dec.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Gastrostomy tube placement is a common procedure that can be accomplished with a variety of techniques, each with its attendant complications. In an effort to standardize practice at our institution, we retrospectively evaluated complications including early dislodgement requiring operative repair, leaks, and granulation tissue to determine the optimal technique. MATERIALS AND METHODS: A retrospective cohort study (June 2008-July 2014) evaluating children (<18) receiving gastrostomy tubes was completed. We recorded demographic data, placement technique, and postoperative complications within 120 days. The seven techniques in use at our institution were categorized into three groups: standard pull-type techniques for percutaneous endoscopic gastrostomies (PEGs), "push" techniques using transabdominal sutures or T-fasteners for securement of the stomach, and "fascial" techniques using sutures directly from the stomach to the abdominal fascia at the stoma site. Descriptive statistics were analyzed using t test and Kruskal-Wallis tests as appropriate, and outcomes with P < 0.05 were considered significant. RESULTS: Of the 450 patients, 255 (56.7%) were male. Median age and weight at the time of operation were 19.3 months (interquartile range, 6.5-89.6 months) and 9.0 kg (interquartile range, 5.7-17.1 kg) respectively. By technique, 245 patients underwent fascial placement (54.4%), 112 underwent push (24.9 %), and 93 underwent PEG (20.7%). Push and fascial techniques were less likely become dislodged than PEG, with odds ratios (ORs) of 0.14 (confidence interval CI 0.02-0.66) and 0.31 (CI 0.11-0.83), respectively. Fascial techniques had more granulation tissue than either push or PEG pull methods, OR 2.39 (CI 1.20-3.36), and more leakage, OR 2.22 (CI 1.19-4.15). CONCLUSIONS: Dislodgement is most likely with PEG techniques. Granulation and leakage are most likely with fascial suture techniques. Push techniques are associated with the lowest complication rate.
[Mh] Termos MeSH primário: Nutrição Enteral/efeitos adversos
Falha de Equipamento/estatística & dados numéricos
Gastroscopia/efeitos adversos
Gastrostomia/efeitos adversos
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Nutrição Enteral/instrumentação
Nutrição Enteral/métodos
Feminino
Gastroscopia/instrumentação
Gastroscopia/métodos
Gastrostomia/instrumentação
Gastrostomia/métodos
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Dispositivos de Fixação Cirúrgica
Técnicas de Sutura/efeitos adversos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29085204
[Au] Autor:Wolpert LE; Summers DM; Tsang A
[Ad] Endereço:Department of General Surgery, Peterborough City Hospital, Edith Cavell Campus, Bretton Gate, Peterborough PE3 9GZ, United Kingdom. laura@wolperts.com.
[Ti] Título:Novel endoscopic management of buried bumper syndrome in percutaneous endoscopic gastrostomy: The Olympus HookKnife.
[So] Source:World J Gastroenterol;23(35):6546-6548, 2017 Sep 21.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Buried bumper syndrome (BBS) is an uncommon but serious complication of percutaneous endoscopic ga-strostomy. It involves the internal fixation device, or "bumper", migrating into the gastric wall and subsequent mucosal overgrowth. We described a case series of four patients with BBS treated with a novel endoscopic technique using a HookKnife between June 2016 and February 2017. The HookKnife is a rotating L-shaped cutting wire designed for hooking tissue and pulling it away from the gastric wall towards the lumen. The technique was successful in all four cases with no complications. Each patient was discharged on the day of treatment. The HookKnife is a manoeuvrable, safe and effective device for endoscopic removal of buried bumpers and could avoid surgery in a high risk group of patients. To our knowledge this technique has not been described previously. We suggest that this technique should be added to the treatment algorithms for managing BBS.
[Mh] Termos MeSH primário: Remoção de Dispositivo
Gastrostomia
[Mh] Termos MeSH secundário: Endoscopia
Nutrição Enteral
Seres Humanos
Intubação Gastrointestinal
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171101
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i35.6546


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[PMID]:28964285
[Au] Autor:Kay-Rivest E; Khendek L; Bernard G; Daniel SJ
[Ad] Endereço:Department of Pediatric Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
[Ti] Título:Pediatric leukodystrophies: The role of the otolaryngologist.
[So] Source:Int J Pediatr Otorhinolaryngol;101:141-144, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Leukodystrophies consist of degenerative neurogenetic diseases often associated with comorbidities that extend beyond the neurological system. Despite their impacts on patients' quality of life and risks of complications, head and neck symptomology is poorly reported in the literature. The objective of this study was to identify and quantify the main head and neck complaints among a cohort of patients diagnosed with leukodystrophies and define the role of the otolaryngologist as part of a multidisciplinary team for treating these patients. METHODS: During the First Canadian National Conference on Leukodystrophies held at the Montreal's Children Hospital, a cohort of 12 patients diagnosed with leukodystrophies were recruited and evaluated by a multidisciplinary team. An otolaryngology-focused assessment was done through history and physical examination, and included a screening questionnaire for 23 common otolaryngology issues. If families reported a history of sialorrhea, a validated questionnaire (Drool Quality of Life Assessment Questionnaire (DroolQoL)) was subsequently distributed. Results from the questionnaires were then compiled and analyzed. RESULTS: Of the 12 recruited patients, 83% (10/12) were known to an otolaryngologist. Drooling affected 67% (8/12) of patients although only 37.5% (3/8) of patients had undergone medical or surgical therapies for this issue. Four patients experienced at least one aspiration pneumonia. 58% (7/12) of the patients had dysphagia, of whom 43% (3/12) were fed exclusively via gastrostomy tube and 28% (2/7) required thickening of feeds. Two patients, despite suspicion of dysphagia and aspiration, had never undergone evaluation. As for otologic issues, it was noted that 25% (3/12) of patients had a history of pressure equalizing tubes (PETs) and one patient had a history of hearing loss. CONCLUSION: Head and neck comorbidities affect children with leukodystrophies. Therefore, the otolaryngologist should be part of the multidisciplinary team, specifically for the management of dysphagia and sialorrhea.
[Mh] Termos MeSH primário: Transtornos de Deglutição/etiologia
Doenças Neurodegenerativas/complicações
Doenças Neurodegenerativas/terapia
Sialorreia/etiologia
[Mh] Termos MeSH secundário: Adolescente
Canadá
Criança
Pré-Escolar
Feminino
Gastrostomia
Hospitais Pediátricos
Seres Humanos
Lactente
Masculino
Otorrinolaringologistas
Qualidade de Vida
Estudos Retrospectivos
Sialorreia/complicações
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


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[PMID]:28940403
[Au] Autor:Singh RR; Nah SA; Roebuck DJ; Eaton S; Pierro A; Curry JI; PEG-RIG trial collaborators
[Ad] Endereço:Department of Paediatric Surgery, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children, London, UK.
[Ti] Título:Double-blind randomized clinical trial of percutaneous endoscopic gastrostomy versus radiologically inserted gastrostomy in children.
[So] Source:Br J Surg;104(12):1620-1627, 2017 Nov.
[Is] ISSN:1365-2168
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The aim of this RCT was to determine whether radiologically inserted gastrostomy (RIG) in children is associated with more complications than percutaneous endoscopic gastrostomy (PEG). METHODS: Children at a single tertiary children's hospital requiring a primary gastrostomy were randomized to PEG or RIG. Patients were followed by assessors blinded to the insertion method. Complications were recorded, assigned a severity score, and analysed by zero-inflated Poisson regression analysis on an intention-to-treat basis, adjusting for length of follow-up. RESULTS: Over a 3-year period, 214 children were randomized (PEG, 107; RIG, 107), of whom 100 received PEG and 96 RIG. There was no significant difference in the number of complications between PEG and RIG groups (P = 0·875), or in the complication score: patients undergoing RIG had a 1·04 (95 per cent c.i. 0·89 to 1·21) times higher complication score than those who underwent PEG (P = 0·597). Only age had an independent significant effect on complication score, with older patients having a 0·97 (0·95 to 1·00) times lower complication score per year. CONCLUSION: PEG and RIG are both safe methods of gastrostomy insertion with a low rate of major complications. Registration number: NCT01920438 ( http://www.clinicaltrials.gov).
[Mh] Termos MeSH primário: Gastroscopia/métodos
Gastrostomia/métodos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Método Duplo-Cego
Gastroscopia/efeitos adversos
Gastrostomia/efeitos adversos
Seres Humanos
Lactente
Complicações Pós-Operatórias
Estudos Prospectivos
Radiografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170924
[St] Status:MEDLINE
[do] DOI:10.1002/bjs.10687



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