scholarly journals Efficacy and Safety of Endoscopic Esophageal Dilatation in Pediatric Patients with Esophageal Strictures

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Hasan M. A. Isa ◽  
Khadija A. Hasan ◽  
Husain Y. Ahmed ◽  
Afaf M. Mohamed
Keyword(s):  
Success Rate ◽  
Anastomotic Stricture ◽  
Demographic Data ◽  
Complete Response ◽  
Inadequate Response ◽  
Efficacy And Safety ◽  
Esophageal Dilatation ◽  
Cross Sectional ◽  
Anastomotic Strictures ◽  
Esophageal Strictures

Background and Objectives. Benign strictures are the main cause of esophageal strictures in children. They can be managed by different modalities but endoscopic dilatation is the standard therapy. This study is aimed at reviewing the efficacy and safety of endoscopic dilatations in children with esophageal strictures. Materials and Methods. In this retrospective cross-sectional single center study, records of patients with esophageal strictures presented to the pediatric department, Salmaniya Medical Complex, Bahrain, in the period between 1995 and 2019 were reviewed. Demographic data, indications of endoscopic dilatations, the procedure success rate, and possible complications were assessed. Results. Forty-six children were found to have esophageal strictures. Twenty-five (54.3%) patients were males. Most patients presented during infancy (86.5%, 32/37 patients). Twenty-six (56.5%) patients required 88 dilatation sessions, while the remaining 20 (43.5%) patients did not require dilatations. The median number of dilatation sessions per patient was three (interquartile range = 2 –5). Savary-Gilliard bougienages were the main dilators used (80.8%, 21/26 patients). Anastomotic stricture (post esophageal atresia/tracheoesophageal fistula repair) was the main cause of esophageal strictures and was found in 35 (76.1%) patients. Patients with nonanastomotic strictures had more frequent dilatations compared to those with anastomotic strictures ( P = 0.007 ). The procedure success rate was 98.8%. Yet, it was operator dependent ( P = 0.047 ). Complete response to dilatation was found in 18 (69.2%) patients, satisfactory in seven (26.9%), and an inadequate response in one (3.9%). Those with satisfactory responses still require ongoing dilatations based on their symptoms and radiological and endoscopic findings. No perforation or mortality was reported. Patients with dilatations had more recurrent hospitalization ( P < 0.0001 ), more dysphagia ( P = 0.001 ), but shorter hospital stay ( P = 0.046 ) compared to those without dilatations. Surgical intervention was required in one patient with caustic strictures. The median follow-up period was six years (interquartile range = 2.25 –9.0). Conclusions. Endoscopic esophageal dilatation in children with esophageal strictures is effective and safe. Yet, it was operator dependent. Nonanastomotic strictures require more dilatations compared to anastomotic strictures. Findings of this study are comparable to those reported worldwide.

scholarly journals Interventional radiology methods of treating ureteral strictures developed on anastomoses after the radical cystectomy in Mainz Pouch II and ileal conduit derivation

2007 ◽  
Vol 54 (4) ◽  
pp. 83-87 ◽  
Author(s):  
H.M. Maksimovic ◽  
B.B. Markovic ◽  
T. Pejcic ◽  
J. Hadzi-Djokic ◽  
Z. Markovic ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Stent Implantation ◽  
Anastomotic Stricture ◽  
Balloon Catheter ◽  
Intravenous Urography ◽  
Percutaneous Nephrostomy ◽  
Stent Insertion ◽  
Anastomotic Strictures ◽  
Significant Difference

Objective of this work is to evaluate interventional radiology modalities such as balloon catheter dilation (BCD) and stent insertion, as minimally invasive methods in treatment uretero-enteral anastomotic strictures. Material and method: Retrospective study enrolled 26 patients (pts) in whom percutaneous BCD (17 pts) and metal stent implantation (9 pts) were done. Study was conducted from June 2005 till August 2007 and included total amount of 470 pts operated during 4 year period from 2003 till 2007. In 26 pts 35 ureteral units were treated, all of them in ambulatory conditions under oral analgosedation, monitored by fluoroscopy. Percutaneous BCD or stent implantation was performed in 24 pts and in 2 pts combined antegrade- retrograde approach for stent delivery, was applied. In all cases percutaneous nephrostomy (PCN) was left for 7 days period after procedure but in 6 units (5 pts) it remained permanent solution. First check up was done 7 days after by contrast media injection through nephrostomy tube prior to its extraction. Second control was done 30 days after by ultrasound exam and the last control (3 months after) by intravenous urography (IVU). Results: In our specimen 17pts had strictures unilaterally (65.4%) and in 9 pts (34.6%) it occurred bilaterally. First check up revealed 82.7% success of BCD, in 17.3% BCD was repeated with the final success rate of 73.5% (19/26). In four pts (26.5%) after BCD reobliteration happened and PCN was left. Patent ureteral lumen was observed in 6 pts (85.7%) with stent inserted while one pt underwent surgical reintervention. No significant difference between BCD and stent insertion success rate was noticed, based upon morphological parameters (ureteral lumen diameter, pelvicaliceal system dilatation) and serum creatinin level. Conclusion: BCD and stent insertion showed satisfactory results (following 3 months) in ureteroenteral anastomotic stricture recanalization. They include ambulatory conditions, ability to repeat procedure, without complications -excluding restenosis which finally can be surgically treated.

scholarly journals Evaluation the success rate of extra corporal shock wave lithotripsy (ESWL) in patients with urinary stones

2018 ◽  
Vol 5 (5) ◽  
pp. 1192
Author(s):  
Ali Hoseinkhani ◽  
Firouz Amani ◽  
Hadi Hadi seddigh-namini
Keyword(s):  
Shock Wave ◽  
Partial Response ◽  
Success Rate ◽  
Shock Wave Lithotripsy ◽  
Renal Stones ◽  
Complete Response ◽  
Urinary Stones ◽  
Cross Sectional ◽  
Extracorporeal Shock Wave ◽  
Before And After

Background: Urinary stones are one of the most common and earliest known human diseases. Extracorporeal shock wave lithotripsy (ESWL) is known as the most common method for treating urinary stones less than 20-25 mm. The aim of this study was to evaluation the success rate of ESWL in patients with urinary stones.Methods: In this cross-sectional descriptive study 200 patients with urinary stones between 7-25 mm which were candidates for lithotripsy, enrolled in the study. Patients with coagulation disorders, urinary or other organ transplantation, pregnant women, uncontrolled blood pressure patients, and those who are contraindicated for drug use have been excluded from the study. The process was carried out by an operator and by the Dornier Compact Delta II lithotriptor. Two weeks later, the patients were re-visited, and ultrasound was performed, and the success rate of stones was measured and recorded and classified in three groups complete response, partial response and failure in treatment. Collected data analysed by statistical methods in SPSS version 19.Results: Efficacy of Arian 101 lithotriptor in removing of renal stones, were found to be 74% complete response, 25.5% partial response while 0.5% of subjects had no response. There was significant positive correlation between the size of stones before and after lithotripsy (r=0.49, p=0.001). In stones upper than 10 mm, the upper calices stones had 100% complete response. Also, in stones lower than 10 mm, the upper calices stones had 100% complete response.Conclusions: The results showed that Dornier Compact Delta II lithotriptor has more efficacy in treatment of stones. In stones below 10 mm, the success rate of treatment was generally higher, especially in the upper calices stones and pelvic. In stones larger than 10 mm, the success rate was slightly lower, but in the case of upper calices stones, the complete response was 100%.

scholarly journals Bipolar Plasma Kinetic Vaporization Resection in the Management of Benign Anastomotic Stricture after Rectal Cancer Surgery: A Report of 12 Cases

2021 ◽  
Author(s):  
Shaopeng Zhang ◽  
Mingming Xiao ◽  
Song Wu ◽  
guoqiang pan ◽  
yuan kong ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Stricture ◽  
Rectal Surgery ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Efficacy And Safety ◽  
Common Complication ◽  
Endoscopic Dilation ◽  
Plasma Kinetic ◽  
Anastomotic Strictures

Abstract Background: Postoperative anastomotic stricture is a common complication after kinds of rectal cancer surgery, especially in low anterior resection and anal retention patients. Currently, various of treatments including anal expansion, endoscopic dilation and also surgery are applied with different efficacy and safety. Besides, bipolar plasma kinetic vaporization resection is a technique used to be applied for benign prostatic hyperplasia with minimally invasion and high safety. To the best of my knowledge, it had not been reported to be applied for narrow scars after rectal surgery.Methods: To analysis retrospectively the clinical data of 12 patients who suffered anastomotic strictures after rectal cancer surgery in the First Hospital of Jilin University from Feb 2015 to December 2017. Result：All of them were successfully treated by the technique of once bipolar plasma kinetic vaporization resection in 8 cases, twice in 3 cases, and more times in 1 cases without occurrence of additional complications. Conclusions: Demonstrated by these limited cases, bipolar plasma kinetic vaporization resection would be applied as an alternative method in the treatment of postoperative anastomotic strictures due to its advantages as well as its effectiveness and safety.

scholarly journals Uncovered self-expandable metal stents for the treatment of refractory benign colorectal anastomotic stricture

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ji Taek Hong ◽  
Tae Jun Kim ◽  
Sung Noh Hong ◽  
Young-Ho Kim ◽  
Dong Kyung Chang ◽  
...  
Keyword(s):  
Clinical Success ◽  
Anastomotic Stricture ◽  
Symptom Relief ◽  
Therapeutic Modality ◽  
Metal Stents ◽  
Pneumatic Dilation ◽  
Covered Stents ◽  
Efficacy And Safety ◽  
Anastomotic Strictures ◽  
Stricture Recurrence

AbstractSelf-expandable metal stent (SEMS) placement has been suggested as a therapeutic modality for treating benign colorectal strictures. Covered stents are generally used, given the concerns regarding the efficacy and safety of uncovered stents. Hence, few studies have evaluated the efficacy and safety of uncovered SEMSs (UCSEMSs) in patients with refractory benign colorectal anastomotic strictures. In this study, 12 patients with postoperative benign symptomatic anastomotic strictures refractory to pneumatic dilation (range, 2–9) and transient indwelling-covered SEMSs were treated using UCSEMS. All enrolled patients were men (mean age, 61 years). Stent placement was successful in all 12 patients, and early clinical success was achieved in 11 (92%) patients. Four patients (25%) showed successful clinical outcomes without further intervention, but eight patients (75%) were clinically unsuccessful, and showed stricture recurrence or functional obstructive symptoms. Three patients underwent surgery, and the remaining five patients required repeat stent procedures. Despite the high reobstruction rate, the median follow-up period after UCSEMS placement was 16.7 months, demonstrating that UCSEMS may be able to achieve medium-term symptom relief without any complications. Therefore, UCSEMS may be an alternative option in exceptional circumstances in carefully selected patients, where invasive surgical treatments, such as stoma diversion, are not an option, thereby improving patients’ quality of life.

Breakfast Skipping Is an Independent Predictor of Obesity but not Overweight Among Children in a Southeastern European Population

2016 ◽  
Vol 86 (5-6) ◽  
pp. 242-248 ◽  
Author(s):  
Genc Burazeri ◽  
Jolanda Hyska ◽  
Iris Mone ◽  
Enver Roshi
Keyword(s):  
Task Force ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
European Population ◽  
Overweight And Obesity ◽  
World Health ◽  
Communist Country ◽  
Western Balkans ◽  
Cross Sectional ◽  
Breakfast Skipping

Abstract.Aim: To assess the association of breakfast skipping with overweight and obesity among children in Albania, a post-communist country in the Western Balkans, which is undergoing a long and difficult political and socioeconomic transition towards a market-oriented economy. Methods: A nationwide cross-sectional study was carried out in Albania in 2013 including a representative sample of 5810 children aged 7.0 – 9.9 years (49.5% girls aged 8.4 ± 0.6 years and 51.5% boys aged 8.5 ± 0.6 years; overall response rate: 97%). Children were measured for height and weight, and body mass index (BMI) calculated. Cut-off BMI values of the World Health Organization (WHO) and the International Obesity Task Force (IOTF) were used to define overweight and obesity in children. Demographic data were also collected. Results: Upon adjustment for age, sex, and place of residence, breakfast skipping was positively related to obesity (WHO criteria: OR = 1.5, 95% CI = 1.3–1.9; IOTF criteria: OR = 1.9, 95% CI = 1.4–2.5), but not overweight (OR = 1.1, 95% CI = 0.9–1.3 and OR = 1.1, 95% CI = 0.9–1.4, respectively). Furthermore, breakfast skipping was associated with a higher BMI (multivariable-adjusted OR = 1.05, 95% CI = 1.02–1.07). Conclusions: Our findings point to a strong and consistent positive relationship between breakfast skipping and obesity, but not overweight, among children in this transitional southeastern European population. Future studies in Albania and other transitional settings should prospectively examine the causal role of breakfast skipping in the development of overweight and obesity.

Parent’s Experiences from the Treatment of their Children at the Physic Children’s Surgery Clinic in Skopje.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
M. Trajchevska ◽  
A. Lleshi ◽  
S. Gjoshev ◽  
A. Trajchevski
Keyword(s):  
Health Care ◽  
Health Status ◽  
Independent Predictor ◽  
Demographic Data ◽  
Parental Satisfaction ◽  
Pediatric Care ◽  
Simple Random Sample ◽  
Significant Independent Predictor ◽  
Cross Sectional ◽  
Significant Difference

Background: The respect of the needs and wishes of the patients is in the focus of the human health system. The experience of the parents in terms of child’s health care may be used as an indicator of quality of the health care. Material and methods: The research is a quantitative analytical cross-sectional study. In accordance with the inclusion and exclusion criteria, simple random sample of 207 parents / guardians is covered, whose children in the period of three months, had been hospitalized in the hospital department JZUU Pediatric Surgery Clinic in Skopje.It was used a two parted questionnaire. The first part is a standardized questionnaire (Parent Experience of Pediatric Care - PECP), and the second part concerns the general socio-demographic data of the parent/guardian. Statistical evaluation was performed using appropriate statistical programs (Statistics for Windows 7,0 and SPSS 17.0). Results: In accordance with the age of the parents, the survey respondents were divided into two groups: a) age ≤ 33 years - 107 (51.69%) and b) age> 33 years - 100 (48.31%).Significant independent predictor of parental satisfaction from the receipt of their child to the clinic research confirms the age of the parent under / over 33 years due to 4.1% of the change in satisfaction (R2 = 0,041). Parents generally believe that their children's room of the clinic is "good", without significant difference between parental satisfaction from both age groups (Mann-Whitney U Test Z = -0,9613 p = 0,3364). Significant independent predictor of parental satisfaction from the room of their child improves the health status after treatment due to 6% of the change in satisfaction (R2 = 0,060). Parents generally believe that testing and treatment of their children in the clinic was "very good" and an independent significant predictor is to improve the health status after the treatment - 7,8% (R2 = 0,078). Conclusions: Regardless of the generally good parental satisfaction about health care for their children, it is necessary to continuously monitor the status of the clinic in order to consider the possible deficiencies and needs of intervention.

Socio Demographic and Clinical Profile of Indoor Female Patients of RINPAS

2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Mental Health Problems ◽  
Demographic Data ◽  
Relevant Information ◽  
Health Problems ◽  
High Rate ◽  
Physical And Mental Health ◽  
Cross Sectional

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient

Social media engagement, service complexity, and experiential quality in US hospitals

2020 ◽  
Vol 34 (6) ◽  
pp. 833-845 ◽  
Author(s):  
Youngsu Lee ◽  
Joonhwan In ◽  
Seung Jun Lee
Keyword(s):  
Social Media ◽  
Demographic Data ◽  
Positive Association ◽  
Customer Engagement ◽  
Service Firms ◽  
Multiple Sources ◽  
Cross Sectional ◽  
Content Type ◽  
Social Media Engagement ◽  
Experiential Quality

Purpose As social media platforms become increasingly popular among service firms, many US hospitals have been using social media as a means to improve their patients’ experiences. However, little research has explored the implications of social media use within a hospital context. The purpose of this paper is to investigate a hospital’s customer engagement through social media and its association with customers’ experiential quality. Also, this study examines the role of a hospital’s service characteristics, which could shape the nature of the interactions between patients and the hospital. Design/methodology/approach Data from 669 hospitals with complete experiential quality and demographic data were collected from multiple sources of secondary data, including the rankings of social media friendly hospitals, the Hospital Compare database, the Center for Medicare and Medicaid (CMS) cost report, the CMS impact file, the Healthcare Information and Management Systems Society Analytics database and the Dartmouth Atlas of Health Care. Specifically, the authors designed the instrumental variable estimate to address the endogeneity issue. Findings The empirical results suggest a positive association between a hospital’s social media engagement and experiential quality. For hospitals with a high level of service sophistication, the association between online engagement and experiential quality becomes more salient. For hospitals offering various services, offline engagement is a critical predictor of experiential quality. Research limitations/implications A hospital with more complex services should make efforts to engage customers through social media for better patient experiences. The sample is selected from databases in the US, and the databases are cross-sectional in nature. Practical implications Not all hospitals may be better off improving the patient experience by engaging customers through social media. Therefore, practitioners should exercise caution in applying the study’s results to other contexts and in making causal inferences. Originality/value The current study delineates customer engagement through social media into online and offline customer engagement. This study is based on the theory of customer engagement and reflects the development of mobile technology. Moreover, this research may be considered as pioneering in that it considers the key characteristics of a hospital’s service operations (i.e., service complexity) when discovering the link between customers’ engagement through a hospital’s social media and experiential quality.

Sign in / Sign up

Export Citation Format

Share Document