Electrically Stimulated Gracilis Neosphincter for End-stage Fecal Incontinence

2014 ◽  
Vol 57 (2) ◽  
pp. 215-222 ◽  
Author(s):  
Derek J. Boyle ◽  
Jamie Murphy ◽  
Alexander Hotouras ◽  
Marion E. Allison ◽  
Norman S. Williams ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
End Stage

scholarly journals Dynamic versus Adynamic Graciloplasty in Treatment of End-Stage Fecal Incontinence: Is the Implantation of the Pacemaker Really Necessary? 12-Month Follow-Up in a Clinical, Physiological, and Functional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Piotr Walega ◽  
Michal Romaniszyn ◽  
Benita Siarkiewicz ◽  
Dorota Zelazny
Keyword(s):  
Quality Of Life ◽  
Fecal Incontinence ◽  
Functional Results ◽  
Severity Index ◽  
Functional Study ◽  
Dynamic Graciloplasty ◽  
Related Complication ◽  
Complication Risk ◽  
End Stage

Purpose. The aim of the study is to compare functional results of end-stage fecal incontinence treatment with dynamic graciloplasty and adynamic graciloplasty augmented with transanal conditioning of the transposed muscle.Methods. A total of 20 patients were qualified for graciloplasty procedure due to end-stage fecal incontinence. 7 patients underwent dynamic graciloplasty (DGP), whereas 13 patients were treated with adynamic graciloplasty, with transanal stimulation in the postoperative period (AGP). Clinical, functional, and quality of life assessments were performed 3, 6, and 12 months after the procedures.Results. There were no intraoperative or early postoperative complications. The detachment of gracilis muscle tendon was observed in one patient in DGP group and two in AGP group. There was a significant improvement of Fecal Incontinence Quality of Life (FIQL) and Fecal Incontinence Severity Index (FISI) scores in both groups 12 months after procedure. Anorectal manometry showed improvement regarding basal and squeeze pressures in both groups, with significantly better squeeze pressures in AGP group.Conclusions. The functional effects in the DGP and AGP groups were similar. Significantly lower price of the procedure and avoidance of implant-related complication risk suggest the attractiveness of the AGP method augmented by transanal stimulation.

scholarly journals Suffering and Symptoms At the End of Life in ICU Patients Undergoing Renal Replacement Therapy

2021 ◽  
pp. 104990912110057
Author(s):  
Sarah J. Ramer ◽  
Martin Viola ◽  
Paul K. Maciejewski ◽  
M. Carrington Reid ◽  
Holly G. Prigerson
Keyword(s):  
Renal Replacement Therapy ◽  
Fecal Incontinence ◽  
Replacement Therapy ◽  
End Of Life ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Multivariable Model ◽  
Cross Sectional ◽  
Icu Patients ◽  
End Stage

Background: We know little about the end-of-life suffering and symptoms of intensive care unit (ICU) decedents in general and those who undergo renal replacement therapy (RRT) in particular. Objectives: To examine differences in end-of-life suffering and various symptoms’ contribution to suffering between ICU decedents who did not undergo RRT, those who underwent RRT for end-stage kidney disease (ESKD), and those who underwent RRT for acute kidney injury (AKI). Methods: This is a cross-sectional study conducted at a quaternary-level referral hospital September 2015-March 2017. Nurses completed interviews about ICU patients’ suffering and symptoms in their final week. We dichotomized overall suffering into elevated and non-elevated and each symptom as contributing or not to a patient’s suffering. Results: Sixty-four nurses completed interviews on 165 patients. Median patient age was 67 years (interquartile range 57, 78); 41% were female. In a multivariable model, undergoing RRT for AKI (odds ratio [OR] 2.95, 95% confidence interval [CI] 1.34-6.49) was significantly associated with elevated suffering compared to no RRT; undergoing RRT for ESKD was not. Adjusting for length of stay, AKI-RRT patients were more likely than non-RRT patients to have fecal incontinence (OR 2.21, 95% CI 1.00-4.93), painful broken skin (OR 2.41, 95% CI 1.14-5.12), and rashes (OR 3.61, 95% CI 1.35-9.67) contributing to their suffering. Conclusions: Undergoing RRT for AKI was associated with elevated suffering in the last week of life in ICU decedents. Painful broken skin, rashes, and fecal incontinence were more likely to contribute to suffering in AKI-RRT patients than in non-RRT patients. How to reduce suffering associated with AKI-RRT in ICU patients merits further study.

Perineal Antropylorus Transposition for End-Stage Fecal Incontinence in Humans

2013 ◽  
Vol 56 (3) ◽  
pp. 360-366 ◽  
Author(s):  
Abhijit Chandra ◽  
Ashok Kumar ◽  
M. Noushif ◽  
Vishal Gupta ◽  
Devendra Singh ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
End Stage

Free Antropyloric Valve Flap for End-Stage Fecal Incontinence as a Substitute to Permanent Colostomy

2015 ◽  
Vol 32 (03) ◽  
pp. 215-221
Author(s):  
Abhijeet Chandra ◽  
Somashekar Gejje ◽  
M. Noushif ◽  
Divya Upadhyay ◽  
Nalini Mishra ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Permanent Colostomy ◽  
End Stage

Gluteus maximus neosphincter is a viable option for patients with end-stage fecal incontinence

2000 ◽  
Vol 43 (11) ◽  
pp. 1635 ◽  
Author(s):  
Ahmed A. Abou-Zeid ◽  
Deya M. Marzouk
Keyword(s):  
Fecal Incontinence ◽  
Gluteus Maximus ◽  
Viable Option ◽  
End Stage

scholarly journals Complex Obstetric Perineal Injury Reconstruction Using Antropyloric Valve Transposition

2020 ◽  
Vol 36 (1) ◽  
pp. 58-61
Author(s):  
Saket Kumar ◽  
Noushif Medappil ◽  
Sunil Kumar Singh ◽  
Abhijit Chandra
Keyword(s):  
Fecal Incontinence ◽  
Surgical Techniques ◽  
Tissue Loss ◽  
Long Term Results ◽  
Incontinence Score ◽  
Perineal Injury ◽  
Anorectal Reconstruction ◽  
End Stage ◽  
Perineal Injuries

Despite significant advancements in the field of medicine, management of complex obstetric perineal injuries remains a challenge. Although several surgical techniques have been described, no techniques have provided satisfactory long-term results. Recently, a perineal transposed antropyloric valve has been used for anorectal reconstruction in patients with damaged or excised anal sphincters. We describe this technique in the case of complex obstetric perineal trauma with extensive tissue loss, presenting with end stage fecal incontinence. The functional outcome after this procedure was evaluated. The patient tolerated the surgery well, and there were no procedure-related upper gastrointestinal disturbances. Short-term functional outcomes were encouraging. At the 36-month follow-up, the patient’s neoanal resting and squeeze pressures were 50 and 70 mmHg, respectively. The postoperative St. Mark’s incontinence score was 7. Perineal antropyloric valve transposition is feasible and can be successfully applied in the management of end-stage fecal incontinence associated with complex obstetric perineal injury.

Localization of endothelial nitric oxide synthase in the normal and failing human atrial myocardium

1996 ◽  
Vol 54 ◽  
pp. 786-787
Author(s):  
Chi-Ming Wei ◽  
Margarita Bracamonte ◽  
Shi-Wen Jiang ◽  
Richard C. Daly ◽  
Christopher G.A. McGregor ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Heart Failure ◽  
Nitric Oxide Synthase ◽  
Endothelial Nitric Oxide Synthase ◽  
Cardiac Tissues ◽  
Mammalian Tissues ◽  
End Stage Heart Failure ◽  
End Stage ◽  
Oxide Synthase ◽  
Endothelial Nitric Oxide

Nitric oxide (NO) is a potent endothelium-derived relaxing factor which also may modulate cardiomyocyte inotropism and growth via increasing cGMP. While endothelial nitric oxide synthase (eNOS) isoforms have been detected in non-human mammalian tissues, expression and localization of eNOS in the normal and failing human myocardium are poorly defined. Therefore, the present study was designed to investigate eNOS in human cardiac tissues in the presence and absence of congestive heart failure (CHF).Normal and failing atrial tissue were obtained from six cardiac donors and six end-stage heart failure patients undergoing primary cardiac transplantation. ENOS protein expression and localization was investigated utilizing Western blot analysis and immunohistochemical staining with the polyclonal rabbit antibody to eNOS (Transduction Laboratories, Lexington, Kentucky).

DYSPEPSIA SYNDROME AND HELICOBACTER PYLORI INFECTION IN END STAGE RENAL FAILURE

2000 ◽  
Vol 15 (12) ◽  
pp. H2-H2
Author(s):  
IS Mertasudira ◽  
JR Saketi ◽  
A. Djumhana ◽  
J. Widjojo ◽  
SA Abdurachman
Keyword(s):  
Renal Failure ◽  
Helicobacter Pylori ◽  
Helicobacter Pylori Infection ◽  
End Stage Renal Failure ◽  
End Stage
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