scholarly journals Adult Intestinal Intussusception Caused by the Gastrojejunostomy Tube: An Endoscopically Treatable Phenomenon

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Kermit S. Zhang ◽  
Jash Bansal ◽  
Anmol Bansal ◽  
Vikas Chitnavis
Keyword(s):  
Bowel Wall ◽  
Adult Population ◽  
Rapid Diagnosis ◽  
Adult Intussusception ◽  
Intestinal Intussusception ◽  
Clinically Significant

Adult duodenoduodenal intussusception is extremely rare due to the retroperitoneal fixation of the second, third, and fourth parts of the duodenum. A majority of clinically significant intussusception with identifiable etiologies is typically neoplastic with more rare causes including retained food and indwelling enteral tubes, specifically with gastrojejunostomy (GJ) tubes. Herein, we discuss the case of a 23-year-old male who developed duodenoduodenal intussusception upon a PEGJ placement with associated gastroduodenal dilation and telescope phenomenon. To the best of our knowledge, there are no reports of intussusception found to be caused by GJ tubes in the adult population. The reported patient was found to have a 4-cm enteroenteric intussusception without obstruction or ischemia with bowel thickening proximal to the pathology. Although adult intussusception cases are typically managed surgically, we were able to reduce the intussusception via endoscopy due to rapid diagnosis upon presentation and intervention before the bowel wall could be compromised.

scholarly journals Biological variation and reference change value data for serum copper, zinc and selenium in Turkish adult population

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ceylan Bal ◽  
Serpil Erdogan ◽  
Gamze Gök ◽  
Cemil Nural ◽  
Betül Özbek ◽  
...  
Keyword(s):  
Adult Population ◽  
Reference Intervals ◽  
Serum Copper ◽  
Biological Variation ◽  
Serum Samples ◽  
Reference Change Value ◽  
Index Of Individuality ◽  
Copper Zinc ◽  
Clinically Significant ◽  
Analytical Variation

Abstract Objectives Calculation of biological variation (BV) components is very important in evaluating whether a test result is clinically significant. The aim of this study is to analyze BV components for copper, zinc and selenium in a cohort of healthy Turkish participants. Methods A total of 10 serum samples were collected from each of the 15 healthy individuals (nine female, six male), once a week, during 10 weeks. Copper, zinc and selenium levels were analyzed by atomic absorption spectrometer. BV parameters were calculated with the approach suggested by Fraser. Results Analytical variation (CVA), within-subject BV (CVI), between-subject BV (CVG) values were 8.4, 7.1 and 4.3 for copper; 4.2, 9.1 and 13.7 for zinc; 7.6, 2.5 and 6.9 for selenium, respectively. Reference change values (RCV) were 30.46, 27.56 and 22.16% for copper, zinc and selenium, respectively. The index of individuality (II) values were 1.65, 0.66 and 0.36 for copper, zinc and selenium, respectively. Conclusions According to the results of this study, traditional reference intervals can be used for copper but we do not recommend using it for zinc and selenium. We think that it would be more accurate to use RCV value for zinc and selenium in terms of following significant changes in recurrent results of a patient.

scholarly journals The Basics of Penicillin Allergy: What A Clinician Should Know

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 94 ◽  
Author(s):  
Louis Lteif ◽  
Lea S. Eiland
Keyword(s):  
Antimicrobial Agents ◽  
Adult Population ◽  
The United States ◽  
Cross Reactivity ◽  
Penicillin Allergy ◽  
Patient Specific ◽  
Beta Lactam ◽  
Clinically Significant ◽  
Medication Allergy ◽  
Specific Reactions

Antimicrobials in the penicillin class are first line treatments for several infectious diseases in the pediatric and adult population today. In the United States, patients commonly report having a penicillin allergy, with penicillin being the most frequent beta-lactam allergy. However, very few patients experience a clinically significant immune-mediated allergic reaction to penicillin. If a true penicillin allergy exists, cross-reactivity to other beta-lactam antimicrobials may occur. Mislabeling patients with penicillin allergy can lead to a higher utilization of second line antimicrobial agents, potentially increasing costs and resistance due to a larger spectrum of activity. Pharmacists play an essential role in inquiring about patient specific reactions to presumed medication allergies and developing a further assessment plan, if needed, to determine if the medication allergy is real.

scholarly journals Atypical Presentation of Intestinal Intussusception Caused by Insidious Inflammatory Myofibroblastic Tumor of the Bowel Wall

2017 ◽  
Vol 102 (7-8) ◽  
pp. 345-350
Author(s):  
Shuo Dong ◽  
Xiaoying Xie ◽  
Linsheng Zhao ◽  
Guanghua Pei
Keyword(s):  
Physical Examination ◽  
Inflammatory Myofibroblastic Tumor ◽  
Bowel Wall ◽  
Early Recognition ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Case Presentation ◽  
Intestinal Intussusception ◽  
Chinese Girl ◽  
Operative Findings

Introduction: Inflammatory myofibroblastic tumor (IMT) is a rare but real tumor, which is histologically characterized by myofibroblastic spindle cells proliferation with inflammatory infiltrate. The lung is the most common affected organ, and extrapulmonary IMTs are less common. However, IMT seldom presents in the gastrointestinal tract, and intussusception is a rare complication of this tumor. Case presentation: We documented this rare case of a 12-year-old Chinese girl presenting with abdominal pain. The clinical and radiologic impression was bowel intussusception and bowel obstruction. No sign of abdominal mass was found before surgery, neither physical examination nor radiologic images. Operative findings revealed intestinal intussusception secondary to a little mass. Histopathlogic evaluation of this mass revealed IMT. Conclusion: In conclusion, IMT may present with bowel intussusception. However, at the intestinal location, the tumor may be found as an abdominal mass or may be insidious; hence, detailed history, physical examination, and imaging studies are necessary for early recognition and diagnosis.

Feasibility and safety of transradial access for pediatric neurointerventions

2020 ◽  
Vol 12 (9) ◽  
pp. 893-896 ◽  
Author(s):  
Visish M Srinivasan ◽  
Caroline C Hadley ◽  
Marc Prablek ◽  
Melissa LoPresti ◽  
Stephanie H Chen ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Adult Population ◽  
Safety Data ◽  
Related Complication ◽  
Femoral Access ◽  
Transradial Access ◽  
Potential Benefits ◽  
Clinically Significant ◽  
Procedural Outcomes

BackgroundDiagnostic cerebral angiograms are increasingly being performed by transradial access (TRA) in adults, following data from the coronary literature supporting fewer access-site complications. Despite this ongoing trend in neuroangiography, there has been no discussion of its use in the pediatric population. Pediatric TRA has scarcely been described even for coronary or other applications. This is the first dedicated large study of transradial access for neuroangiography in pediatric patients.MethodsA multi-institutional series of consecutively performed pediatric transradial angiograms and interventions was collected. This included demographic, procedural, outcomes, and safety data. Data was prospectively recorded and retrospectively analyzed.ResultsThirty-seven diagnostic angiograms and 24 interventions were performed in 47 pediatric patients. Mean age, height, and weight was 14.1 years, 158.6 cm, and 57.1 kg, respectively. The radial artery measured 2.09+/-0.54 mm distally, and 2.09+/-0.44 mm proximally. Proximal and distal angiography were performed for both diagnostic and interventional application (17 distal angiograms, two distal interventions). Clinically significant vasospasm occurred in eight patients (13.1%). Re-access was successfully performed 11 times in seven patients. Conversion to femoral access occurred in five cases (8.2%). The only access-related complication was a small asymptomatic wrist hematoma after TR band removal.ConclusionsTransradial access in pediatric patients is safe and feasible. It can be performed successfully in many cases but carries some unique challenges compared with the adult population. Despite the challenge of higher rates of vasospasm and conversion to femoral access, it is worth exploring further, given the potential benefits.

scholarly journals Níveis de ideação suicida associados ao uso de álcool

2021 ◽  
Vol 20 (3) ◽  
pp. 127-161
Author(s):  
Clara Santos ◽  
Claudete Monteiro
Keyword(s):  
Suicidal Ideation ◽  
Alcohol Use ◽  
Suicide Ideation ◽  
Adult Population ◽  
Family Health ◽  
Cross Sectional Study ◽  
Stressful Event ◽  
Source Population ◽  
Cross Sectional ◽  
Clinically Significant

Objetivo: Analizar la asociación entre ideación suicida y consumo de alcohol en una población adulta atendida en atención primaria de salud en Teresina / Piauí / Brasil, de junio a septiembre de 2019.Material y método: Estudio observacional, analítico y transversal realizado con 380 adultos en 11 Unidades Básicas de Salud. La población de origen estuvo constituida por 14.062 adultos de 20 a 59 años, registrados en el sistema de información e-SUS de los Equipos de Salud de la Familia. La recolección de datos se realizó entre junio y septiembre de 2019, con aplicación de un cuestionario sociodemográfico, Escala de Ideación Suicida de Beck y Prueba de Identificación de Desórdenes por Uso de Alcohol.Resultados: La prevalencia de ideación suicida en la muestra fue del 17,9%. Entre estos, el 39,7% tiene ideación suicida clínicamente significativa. El consumo de alcohol por personas con ideación suicida fue del 42,6% y con ideación suicida clínicamente significativa del 44,4%. En individuos con probable dependencia, hubo un aumento en la prevalencia de ideación suicida e ideación suicida clínicamente significativa, 33,3% y 16,7%, respectivamente. No tener pareja tenía 1,4 veces más posibilidades de tener ideación suicida y un historial de discriminación 1,9 posibilidades más. Haber tenido un evento estresante aumenta las posibilidades de tener ideas suicidas clínicamente significativas en 3,1 veces y de problemas con el sueño en 2,9 veces.Conclusión: El estudio mostró que el consumo de alcohol influyó en la presencia de ideación suicida e ideación suicida clínicamente significativa en la muestra. Objective: To analyze the association between suicidal ideation and alcohol use in an adult population assisted in primary health care in Teresina, Piauí, Brazil, from June to September 2019.Material and Method: This is an observational, analytical and cross-sectional study conducted with 380 adults in 11 Basic Health Units. The source population consisted of 14,062 adults aged 20 to 59 years, registered in the e-SUS information system of the Family Health Teams. Data collection took place between June and September 2019, using a sociodemographic questionnaire, the Beck Scale for Suicide Ideation, and the Alcohol Use Disorders Identification Test.Results: The prevalence of suicidal ideation in the sample was 17.9%. Among these, 39.7% had clinically significant suicidal ideation. The prevalence of alcohol use by people with suicidal ideation was 42.6%, and 44.4% used alcohol among those with clinically significant suicidal ideation. There was an increase in the prevalence of suicidal ideation (33.3%) and clinically significant suicidal ideation (16.7%) in individuals with possible dependence. Those who did not have a partner were 1.4 times more likely to have suicidal ideation. Those with a history of discrimination were 1.9 times more likely to have suicidal ideation. Having a stressful event increased the chances of clinically significant suicidal ideation by 3.1 times and problems with sleep by 2.9 times.Conclusion: The study showed that alcohol use influenced suicidal ideation and clinically significant suicidal ideation in the sample. Objetivo: Analisar a associação entre ideação suicida e uso de álcool em população adulta atendida na atenção primária à saúde de Teresina/Piauí/Brasil, no período de junho a setembro de 2019. Material e Método: Estudo observacional, analítico e transversal realizado com 380 adultos em 11 Unidades Básicas de Saúde. A população fonte constou de 14.062 adultos de 20 a 59 anos, cadastrados no sistema de informação e-SUS das Equipes de Saúde da Família. A coleta de dados ocorreu entre junho e setembro de 2019, com aplicação de questionário sociodemográfico, Escala de Ideação Suicida de Beck e Alcohol Use Desorders Identification Test. Resultados: A prevalência de ideação suicida na amostra foi 17,9%. Dentre estes 39,7% apresentam ideação suicida clinicamente significante. O uso de álcool por pessoas com ideação suicida foi de 42,6% e com ideação suicida clinicamente significante de 44,4%. Em indivíduos com provável dependência observou-se um aumento na prevalência de ideação suicida e ideação suicida clinicamente significante, 33,3% e 16,7%, respectivamente. Não ter companheiro apresentou 1,4 vezes mais chances de presença de ideação suicida e histórico de discriminação 1,9 mais chances. Ter tido evento estressor aumenta as chances de ideação suicida clinicamente significante em 3,1 vezes e problemas com sono em 2,9 vezes. Conclusão: O estudo mostrou que o uso de álcool exerceu influência para presença de ideação suicida e ideação suicida clinicamente significante na amostra.

scholarly journals Successful laparoscopic approach for idiopathic adult colo-colonic intussusception: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Kyota Tatsuta ◽  
Mayu Sakata ◽  
Kosuke Sugiyama ◽  
Toshiya Akai ◽  
Katsunori Suzuki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Transverse Colon ◽  
Bowel Wall ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Laparoscopic Approach ◽  
Laparoscopic Procedure ◽  
Adult Intussusception ◽  
Surgical Reduction

Abstract Background Adult intussusception is recognized as an abdominal emergency. More than 90% of adult patients with intussusception have distinct causes that are related to benign or malignant tumors. In contrast, idiopathic intussusceptions, which are observed in children, are rare conditions in adult. Especially, colo-colonic idiopathic intussusceptions are rare among them. Surgery is traditionally considered the primary treatment option. Recently, laparoscopic surgery has been reported to be safe and feasible. However, laparoscopic surgical reduction, which is a common procedure in pediatric surgery, is not common in adult intussusception. Case presentation We report a 34-year-old man who presented with sudden abdominal pain. Computed tomography revealed the target sign in the transverse colon. There was no evidence of bowel obstruction, bowel wall edema, or tumor. We diagnosed idiopathic intussusception and selected laparoscopic procedure because of the strong abdominal pain experienced by the patient. There were no signs of perforation, bowel wall ischemia, or tumor in abdominal cavity. We confirmed idiopathic colo-colonic anterograde intussusception. Laparoscopic surgical reduction was achieved by a combination of delicate direct pressure on the anal side of the transverse colon and gentle pulling on the oral side. The patient’s postoperative course was uneventful. Conclusions We achieved successful surgical reduction laparoscopically because of an accurate preoperative diagnosis based on characteristic computed tomography features and appropriate surgical technique. Laparoscopic procedure and surgical reduction is considered to be an effective treatment strategy for adult idiopathic intussusceptions with severe symptoms.

scholarly journals Prevalence of Noncardiac Findings in Patients Undergoing Cardiac Magnetic Resonance Imaging

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christopher W. May ◽  
William T. Mansfield ◽  
Andrew B. Landes ◽  
Adrian M. Moran
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Cardiac Magnetic Resonance Imaging ◽  
Adult Population ◽  
Adult Patients ◽  
Resonance Imaging ◽  
Cardiac Abnormalities ◽  
Clinically Significant ◽  
The Impact

Purpose. We sought to determine the prevalence of clinically significant non-cardiac abnormalities found in pediatric and adult patients undergoing cardiac magnetic resonance imaging (CMRI), and understand the impact of age on it’s occurrence.Methods. We retrospectively reviewed all patients undergoing CMRI between May 2004 and July 2007. Findings were considered significant if they required radiographic or clinical follow-up.Results. A total of 408 patients underwent CMRI during the study period. Twenty two (16%) pediatric patients (age < 19 years,n=135) were found to have a total of 22 non- cardiac abnormalities, 3 of which were clinically significant. Sixty four (23%) adult patients (age > 19 years,n=273) were found to have a total of 77 non-cardiac abnormalities, 33 of which were clinically significant. The prevalence of clinically significant non-cardiac abnormalities was 2% in the pediatric cohort and 11% in the adult cohort (P=0.05). Within the adult population, the prevalence of significant non-cardiac abnormalities increased with advancing age (P=0.05).Conclusions. In a population of unselected patients undergoing CMRI, unanticipated noncardiac abnormalities were frequently seen. A small number of these were significant, with the prevalence increasing with age.

scholarly journals Adult intussusception secondary to diverticular disease

2018 ◽  
pp. bcr-2018-226678 ◽  
Author(s):  
Habib Syed ◽  
Labib Syed ◽  
Umesh Parampalli ◽  
Mokhtar Uheba
Keyword(s):  
Rare Case ◽  
Bowel Wall ◽  
Distal Segment ◽  
Adult Intussusception ◽  
Malignant Neoplasms ◽  
Age Group ◽  
Common Condition ◽  
Paediatric Age ◽  
Rectal Colon ◽  
Organic Lesions

Intussusception is the invagination of a proximal segment of bowel into the lumen of an adjacent distal segment. It is a common condition in the paediatric age group although it rarely occurs in adults. Organic lesions in the bowel wall are the primary cause of adult intussusceptions with malignant neoplasms being the most common. However, we present a rare case of a 92-year-old man diagnosed with an intussusception of the sigmoid-rectal colon secondary to a diverticular stricture.

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