Endoscopic closure of refractory esophageal fistula after esophagectomy using polyglycolic acid sheets: a pilot study

Abstract Background and study aims Esophageal fistulas after esophagectomy are associated with high mortality and poor quality of life. They are sometimes intractable to conservative management and surgery that increases mortality. Few studies have assessed use of polyglycolic acid (PGA) sheets with fibrin glue for esophageal fistulas. We investigated the safety of using PGA sheets with fibrin glue for esophageal fistulas after esophagectomy. Patients and methods This was a single-center prospective pilot study. Patients who had refractory esophageal fistulas after esophagectomy were included. PGA sheets were filled in the fistula using biopsy forceps. Fibrin glue was applied to the PGA sheets. We repeated the procedure 1 week later. The outcome measures were the incidence of adverse events (AEs) and closure of the fistula. Results Five patients were assessed. No adverse events were observed. The esophageal fistula was closed with the application of PGA sheets four times in 40 % (2/5) of the cases. Conclusions PGA sheets with fibrin glue were safe for esophageal fistula closure after esophagectomy and do not involve the risk of AEs.

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A Multicenter, Prospective Pilot Study of Gamma Knife Radiosurgery for Mesial Temporal Lobe Epilepsy: Seizure Response, Adverse Events, and Verbal Memory

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(10)79267-x ◽

2010 ◽

Vol 2010 ◽

pp. 223-224

Author(s):

P.A. House

Keyword(s):

Pilot Study ◽

Adverse Events ◽

Temporal Lobe Epilepsy ◽

Gamma Knife ◽

Temporal Lobe ◽

Verbal Memory ◽

Gamma Knife Radiosurgery ◽

Mesial Temporal Lobe Epilepsy ◽

Prospective Pilot Study ◽

Mesial Temporal Lobe

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Assessing the Severity and Impact of Oral Mucositis after Autologous Transplantation for Myeloma: A Prospective Pilot Study Comparing the Patient-Reported Quality of Life and Objective Evaluation by a Healthcare Professional

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2017.12.203 ◽

2018 ◽

Vol 24 (3) ◽

pp. S266-S267

Author(s):

Brynn FitzGerald ◽

Najla El Jurdi ◽

Nina Dambrosio ◽

Ali Filali-Mouhim ◽

Iman Salem ◽

...

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Healthcare Professional ◽

Oral Mucositis ◽

Autologous Transplantation ◽

Objective Evaluation ◽

Prospective Pilot Study ◽

Patient Reported

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Endoscopic closure of an anastomo-cutaneous fistula: Filling and shielding using polyglycolic acid sheets and fibrin glue with easily deliverable technique

Endoscopy International Open ◽

10.1055/a-0584-6669 ◽

2018 ◽

Vol 06 (08) ◽

pp. E994-E997 ◽

Cited By ~ 3

Author(s):

Hideaki Kawabata ◽

Yuji Okazaki ◽

Naonori Inoue ◽

Yukino Kawakatsu ◽

Misuzu Hitomi ◽

...

Keyword(s):

Pancreatic Cancer ◽

Fibrin Glue ◽

Polyglycolic Acid ◽

Invasive Treatment ◽

Cutaneous Fistula ◽

Endoscopic Closure

Abstract Background and study aims Recently, endoscopic closure of gastrointestinal fistulas using polyglycolic acid (PGA) sheets with fibrin glue (FG) has been attempted. A 70-year-old woman who had undergone pancreaticoduodenectomy for pancreatic cancer suffered from a refractory anastomo-cutaneous fistula at the site of gastro-jejunostomy. We attempted endoscopic closure with filling and shielding using PGA sheets and FG. After introducing a guidewire into the fistula, a small piece of PGA sheet was skewered onto the guidewire and then pushed using a tapered catheter over the guidewire and delivered into the fistula. A total of 10 sheets were delivered via the same procedure. Next, the mucosa around the fistula was ablated, and the orifice of the fistula along with the surrounding mucosa was shielded with a piece of PGA sheet fixed with hemoclips and FG. After this procedure, the leakage disappeared and the fistula was undetectable on contrast radiograms. Endoscopic closure of anastomo-cutaneous fistula with filling and shielding using PGA sheets and FG is an effective, safe, low-invasive treatment, and the filling technique using a guidewire ensures a safe, smooth procedure.

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Neuromuscular electrical stimulation for treatment of dysphagia in infants and young children with neurological impairment: a prospective pilot study

BMJ Paediatrics Open ◽

10.1136/bmjpo-2018-000382 ◽

2019 ◽

Vol 3 (1) ◽

pp. e000382

Author(s):

Sherna Marcus ◽

Jeremy N Friedman ◽

Ashley Lacombe-Duncan ◽

Sanjay Mahant

Keyword(s):

Electrical Stimulation ◽

Pilot Study ◽

Young Children ◽

Adverse Events ◽

Neuromuscular Electrical Stimulation ◽

Neurological Impairment ◽

Oral Feeding ◽

Severe Dysphagia ◽

Prospective Pilot Study ◽

Infants And Young Children

ObjectivesTo describe the acceptability, safety and effectiveness of neuromuscular electrical stimulation (NMES) in infants and young children with neurological impairment (NI) who have severe dysphagia.DesignA prospective pilot study using a before and after study design.SettingThe Hospital for Sick Children, Toronto, Canada.PatientsTen infants and young children (0–24 months) with NI and severe dysphagia on videofluoroscopic swallow study (VFSS) who were referred to an occupational therapist (OT). Those with neurodegenerative conditions were excluded.InterventionNMES treatments lasting 20–45 min twice weekly for the duration of 2–4 months. The NMES was administered during feeding therapy sessions by a trained OT.Main outcome measuresImprovement in swallowing function as measured by VFSS and the need for tube feeding, adverse events and parental acceptability.ResultsSeven of 10 enrolled subjects (median age, 8.9 months) completed biweekly NMES treatments (median number of treatments per subject, 18). All of the seven (100%) subjects who completed treatment showed an improvement in swallow function on VFSS. Of the five patients who were not safe to orally feed on any consistency of liquid or puree at baseline, three established full oral feeding and two established partial oral feeding. At baseline, 5/7 children were completely fed by tube versus 0/7 at the end of treatment. No adverse events occurred other than mild skin irritation at the site of electrode placement. Five of seven caregivers felt that feeding was improved and were satisfied with the intervention.ConclusionsOur prospective pilot study of NMES in seven neurologically impaired infants and young children with severe dysphagia suggests that NMES is safe, acceptable to parents and has potential efficacy. Trials are needed to determine if any treatment benefit exists.Trial registrationClinicalTrials.gov NCT01723358.

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Safety culture in the context of operating room: Nurses' perception regarding notification of errors/adverse events

Journal of Nursing Education and Practice ◽

10.5430/jnep.v9n3p40 ◽

2018 ◽

Vol 9 (3) ◽

pp. 40

Author(s):

Teresa Vinagre ◽

Rita Marques

Keyword(s):

Patient Safety ◽

Pilot Study ◽

Adverse Events ◽

Operating Room ◽

Safety Culture ◽

Continuous Training ◽

Operating Room Nurses ◽

Quantitative Descriptive ◽

Probabilistic Sample

The notification of errors/adverse events is one of the central aspects for the quality of care and patient safety. The purpose of this pilot study is to analyse the safety culture of the operating room in relation to the errors/adverse events and their notification, in the nurses’ perception. It is a quantitative, descriptive-exploratory pilot study. A survey “Nurses’ Perception regarding Notification of Errors/Adverse Events” was applied, consisting of 8 closed questions to an intentional non-probabilistic sample consisting of 43 nurses working in the operating room of a private hospital in Lisbon. The results showed that only 51.2% of the adverse events that caused damage to patients were always notified by the nurses. Of the various adverse events occurred, 60.5% were not reported, justified by “lack of time”. There was also a negative correlation between professional experience and the frequency of error notification (p < .05). The factors referred as those that contributed most to the occurrence of errors were, pressure to work quickly (100.0%), lack of human resources (86.0%), demotivation (86.0%), professional inexperience and hourly overload (83.7%), lack of knowledge (74.4%) and communication failures (65.1%). The perception of Patient Safety was assessed by the majority of participants as “acceptable”. In conclusion, it was evident the reduced notification of adverse events in the operation room so it becomes crucial to focus on the continuous training of health professionals, as well as work on the error, to increase a safety culture with quality.

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Development and Validation of a Questionnaire Evaluating the Impact of Prosthetic Dental Treatments on Patients’ Oral Health Quality of Life: A Prospective Pilot Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145037 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5037 ◽

Cited By ~ 1

Author(s):

Eitan Mijiritsky ◽

Yael Lerman ◽

Ori Mijiritsky ◽

Asaf Shely ◽

Joseph Meyerson ◽

...

Keyword(s):

Quality Of Life ◽

Oral Health ◽

Pilot Study ◽

Post Treatment ◽

Self Report ◽

Measurement Tool ◽

The Novel ◽

Prospective Pilot Study ◽

The Impact

Objectives: the aims of this study were the development of a novel questionnaire to assess the impact of prosthetic treatments on oral health-related quality of life (OHRQoL) and the performance of a prospective pilot study. Background: the currently preferred OHRQoL measurement tool is the oral health impact profile-49 (OHIP-49), a self-report questionnaire which mainly focuses on general effects related to oral health. Materials and methods: A total of 24 adult participants (9 females and 15 males) were recruited and asked to complete the novel questionnaire twice: once before the prosthetic treatment began and 4–6 weeks post-treatment. The assessment of the change in OHRQoL was based on the differences in participants’ answers before and after treatment. Data were analyzed using ANOVA with a repeated-measures method and t-tests. The reliability of the questionnaire was tested using Cronbach’s alpha and intraclass coefficient (ICC). Results: The questionnaire was found to be reliable (α ≥ 0.6), with “social disability” having the highest score (α = 0.868). All domains showed an improvement (α < 0.005) in OHRQoL scores after treatment. Conclusions: the novel questionnaire tested in this study was found to be reliable and convenient to use, and demonstrated that prosthetic treatments have a significant positive effect on OHRQoL post-treatment scores.

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