scholarly journals Zenker Diverticulum: Does Size Correlate With Preoperative Symptoms?

2021 ◽  
Author(s):  
Jhon F. Martinez-Paredes ◽  
Razan Alfakir ◽  
Jan L. Kasperbauer ◽  
Amy Rutt
Keyword(s):  
Quality Of Life ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Gastrointestinal Symptoms ◽  
Zenker Diverticulum ◽  
Chief Complaints ◽  
Upper Gastrointestinal Symptoms ◽  
Retrospective Study Design ◽  
Upper Gastrointestinal

Abstract Introduction Zenker diverticulum (ZD) usually affects adults after the 7th decade of life. Treatment for ZD is indicated for all symptomatic patients, but some patients prefer to defer surgical treatment until symptoms get worse and decrease their quality of life. Objective To evaluate the association of the preoperative symptoms in ZD patients with the size of the ZD. Methods A retrospective study design. Electronic medical records were used to identify patients diagnosed with ZD and treated over 11 years. Data collection included the chief complaints and symptoms, medical history, and findings on radiologic swallow evaluations of the patients. The diverticulum size was stratified into 3 groups: small (< 1 cm), moderate (1–3 cm), and large (> 3 cm). Results A total of 165 patients were enrolled and stratified by diverticulum size (48 small, 67 medium, and 50 large). Dysphagia, cough, and regurgitation were the most prevalent symptoms. Dysphonia was more frequent among patients with a small pouch. Logistic regression analysis showed that dysphagia and choking were associated with large and medium diverticulum size (p < 0.05). Additionally, dysphonia was significantly associated with the presence of a small-sized ZD (p < 0.04). Conclusion Upper gastrointestinal symptoms such as dysphagia and choking may be associated with a ZD > 1 cm and should always be evaluated. Additionally, the presence of dysphonia was found to be correlated with a ZD < 1 cm, suggesting that a prompt and appropriate fluoroscopic evaluation must be considered in those patients in whom no other clear cause of dysphonia is evident.

Rikkunshito for Upper Gastrointestinal Syndrome in Patients With Cancer: A Systematic Review and Meta-analysis Protocol

2021 ◽  
Author(s):  
Hong Liu ◽  
Yifeng Ren ◽  
Yuting Wang ◽  
Yu Yang ◽  
Chuan Zheng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Gastrointestinal Symptoms ◽  
Cochrane Library ◽  
Complete Control ◽  
Patients With Cancer ◽  
Treatment Interruptions ◽  
Phase 0 ◽  
Upper Gastrointestinal

Abstract BackgroundUpper gastrointestinal syndrome including nausea, vomiting, and anorexia is a common side effect of chemotherapy, which are associated with treatment interruptions, reduced food intake, decreased functionality and a worse quality of life. Rikkunshito is a traditional herbal medicine that has gained increasing attention in recent years for its effect on relieving gastrointestinal disorders in various digestive diseases, while its efficacy for upper gastrointestinal syndrome induced by chemotherapy remains uncertain. MethodsDatabases including PubMed, EMBASE, MEDLINE, Cochrane Library, Chinese databases, and Japanese database will be systematically searched from their inception onwards. Randomized controlled trials will be assessed. The primary outcome parameters are the complete control (CC) rate, complete response (CR) rate, and complete protection (CP) rate in the overall phase (0–120 hours). The secondary outcomes include: (I) the CC rate, CR rate and CP rate during the acute phase (0–24 hours) and delayed phase (24–120 hours); (II) the score and frequency of vomiting, nausea, and anorexia occurring; (III) the daily dietary intake and body weight; (IV) plasma ghrelin level; (V) quality of life; (VI) incidence of adverse events. The overall quality of the data will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Risk of bias will be evaluated by the Cochrane tool. Reporting bias will be estimated using Begg and Egger tests. Heterogeneity will be evaluated by the I2 statistic and Q test. If I2 > 50%, sensitivity analysis and subgroup analysis of different items will be performed. DiscussionFrom the study, we will ascertain the efficacy and safety of rikkunshito in chemotherapy-induced upper gastrointestinal syndrome. This review may provide evidence for rikkunshito as an adjuvant to treat upper gastrointestinal symptoms in patients with cancer. Systematic review registrationCRD42020214299 in PROSPERO.

Using Electronic Medical Records of Nursing Care to Characterize Constipation in Patients with Intracerebral Hemorrhage

2021 ◽  
pp. 1-8
Author(s):  
Wei Chen ◽  
Jieyi Zhao ◽  
Xiangkui Li ◽  
Xiaoyu Wang ◽  
Jing Chen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Intracerebral Hemorrhage ◽  
Hospital Mortality ◽  
Electronic Medical Records ◽  
Nursing Care ◽  
Medical Records ◽  
Care Center ◽  
Tertiary Care

<b><i>Introduction:</i></b> Constipation is one of the common poststroke complications that directly affect the patients’ quality of life in patients with intracerebral hemorrhage (ICH), which has not been paid enough attention. <b><i>Objective:</i></b> This study investigates constipation’s clinical characteristics and its risk factors in ICH patients driven by the electronic medical records of nursing care. <b><i>Methods:</i></b> This retrospective chart review investigated patients with acute spontaneous ICH admitted at a tertiary care center from October 2010 to December 2018. Poststroke constipation was defined as a first stool passage occurring after 3 days postadmission and the use of enemas or laxatives after ICH. The associations between constipation present and potential factors were evaluated. <b><i>Results:</i></b> Of 1,748 patients, 408 (70.3% men, mean age 58 ± 14 years) patients with poststroke constipation were identified. After adjusting for potential confounding variables, the risk factors independently associated with poststroke constipation are admission Glasgow Coma Scale score (odds ratio [OR] 0.62, 95% confidence interval [CI] 0.44–0.88; <i>p</i> = 0.007), use of mechanical ventilation (OR 3.74, 95% CI 2.37–5.89, <i>p</i> &#x3c; 0.001), enteral nutrition (OR 2.82, 95% CI 1.85–4.30, <i>p</i> &#x3c; 0.001), hematoma evacuation (OR 2.10, 95% CI 1.40–3.16; <i>p</i> &#x3c; 0.001), opioid analgesics (OR 1.86, 95% CI 1.32–2.62; <i>p</i> &#x3c; 0.001), sedation (OR 1.83, 95% CI 1.20–2.77; <i>p</i> = 0.005), and vasopressors (OR 1.81, 95% CI 1.26–2.61; <i>p</i> = 0.001) in order. Similar associations were observed in the prespecified length of the stay subgroup. Patients with constipation were associated with a longer hospital stay length (2.24 days, 95% CI 1.43–3.05, <i>p</i> &#x3c; 0.001) but not with in-hospital mortality (OR 1.05, 95% CI 0.58–1.90, <i>p</i> = 0.871). <b><i>Conclusions:</i></b> Our findings suggested that risk factors influence the absence of constipation after ICH with the synergy of different weights. The occurrence of constipation likely affects a longer length of stay, but not in-hospital mortality. Future prospective investigations are warranted to validate our findings and identify the optimal management of constipation that may improve the quality of life in patients with ICH.

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