Temporary percutaneous radiologic gastrojejunostomy with single gastropexy

2020 ◽  
pp. 028418512092970
Author(s):  
Jung-Hoon Park ◽  
Young Chul Cho ◽  
Ji Hoon Shin ◽  
Yasir Nouri ◽  
Jong Woo Kim ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Esophageal Perforation ◽  
Clinical Success ◽  
Oral Intake ◽  
Clinical Effectiveness ◽  
Technical Feasibility ◽  
Needle Technique ◽  
The One ◽  
Age Range

Background Although the effectiveness of percutaneous radiologic gastrojejunostomy (PRGJ) has been reported, a detailed description of the indications and clinical effectiveness of temporary PRGJ is still limited. Purpose To evaluate the clinical effectiveness and technical feasibility of temporary PRGJ using the modified Chiba-needle technique with single gastropexy. Material and Methods Temporary PRGJ using the modified Chiba-needle technique with single gastropexy was performed in 27 consecutive patients (19 men, 8 women; mean age = 61 years; age range = 32–77 years) for esophageal perforation (n = 18) or postoperative gastroparesis (n = 9). Outcomes analyzed included the technical and clinical success, procedure-related complications, and the tube indwelling period. Results Technical and clinical success was achieved in all 27 patients. All the tubes were electively removed 19–364 days (mean indwelling period = 104 days) after confirmation of the possibility of oral intake. Asymptomatic pneumoperitoneum occurred in 2/27 (7.4%) patients as minor complications and was resolved spontaneously by the time of the one-week follow-up. There were no major complications. During the follow-up period, a total of 11 tube changes were performed in seven patients for an elective tube change within a six-month interval (n = 5) or because of tube occlusion (n = 6). Conclusion Temporary PRGJ using the modified Chiba-needle technique with a single gastropexy was clinically effective and technically feasible in patients with esophageal perforation or gastroparesis. It can provide adequate enteral nutrition during its temporary placement.

scholarly journals Percutaneous cryoablation of chondroblastoma and osteoblastoma in pediatric patients

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Elena Serrano ◽  
Federico Zarco ◽  
Anne E. Gill ◽  
C. Matthew Hawkins ◽  
Napoleón Macías ◽  
...  
Keyword(s):  
Clinical Success ◽  
Lumbar Vertebra ◽  
Late Complications ◽  
Primary Objective ◽  
Percutaneous Cryoablation ◽  
Pediatric Hospitals ◽  
Age Range ◽  
Femur Condyle ◽  
Imaging Response

Abstract Background To review the safety and efficacy of percutaneous cryoablation for the treatment of chondroblastoma and osteoblastoma in the pediatric and adolescent population. Materials and methods A retrospective review from 2016 to 2020 was performed to evaluate clinical and imaging response to percutaneous cryoablation in 11 symptomatic patients with diagnosis of chondroblastoma and osteoblastoma treated from two pediatric hospitals with at least 12-month follow-up. Technical success (correct needle placement and potential full coverage of the tumor with the planned ablation zone) and clinical success (relief of the symptoms) were evaluated. The primary objective was to alleviate pain related to the lesion(s). Immediate and late complications were recorded. Patients were followed in clinic and with imaging studies such as MRI or CT for a minimum of 6 months. Results A total of 11 patients were included (mean 14 years, age range 9–17; male n = 8). Diagnoses were osteoblastoma (n = 4) and chondroblastoma (n = 7). Locations were proximal humerus (n = 1), femur condyle (n = 1), and proximal femur (n = 1) tibia (n = 3), acetabulum (n = 3), thoracic vertebra (n = 1) and lumbar vertebra (n = 1). Cryoablation was technically successful in all patients. Clinical success (cessation of pain) was achieved in all patients. No signs of recurrence were observed on imaging follow-up in any of the patients. One of the patients developed periprocedural right L2–L3 transient radiculopathy as major immediate complication. Conclusions Percutaneous image-guided cryoablation can be considered potentially safe and effective treatment for chondroblastoma and osteoblastoma in children and adolescents.

scholarly journals Clinical effectiveness of the sequential 4-channel NMES compared with that of the conventional 2-channel NMES for the treatment of dysphagia in a prospective double-blind randomized controlled study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Kyoung-Ho Seo ◽  
Joonyoung Jang ◽  
Eun Gyeong Jang ◽  
Yulhyun Park ◽  
So Young Lee ◽  
...  
Keyword(s):  
Neuromuscular Electrical Stimulation ◽  
Oral Intake ◽  
Clinical Effectiveness ◽  
Controlled Study ◽  
Double Blind ◽  
Registration Number ◽  
Md Anderson ◽  
Functional Oral Intake Scale ◽  
Anderson Dysphagia Inventory

Abstract Background To date, conventional swallowing therapies and 2-channel neuromuscular electrical stimulation (NMES) are standard treatments for dysphagia. The precise mechanism of 2-channel NMES treatment has not been determined, and there are controversies regarding the efficacy of this therapy. The sequential 4-channel NMES was recently developed and its action is based on the normal contractile sequence of swallowing-related muscles. Objective To evaluate and compare the rehabilitative effectiveness of the sequential 4-channel NMES with that of conventional 2-channel NMES. Methods In this prospective randomized case–control study, 26 subjects with dysphagia were enrolled. All participants received 2- or 4-channel NMES for 2–3 weeks (minimal session: 7 times, treatment duration: 300–800 min). Twelve subjects in the 4-channel NMES group and eleven subjects in the 2-channel NMES group completed the intervention. Initial and follow-up evaluations were performed using the videofluoroscopic dysphagia scale (VDS), the penetration-aspiration scale (PAS), the MD Anderson dysphagia inventory (MDADI), the functional oral intake scale (FOIS), and the Likert scale. Results The sequential 4-channel NMES group experienced significant improvement in their VDS (oral, pharyngeal, and total), PAS, FOIS, and MDADI (emotional, functional, and physical subsets) scores, based on their pretreatment data. VDS (oral, pharyngeal, and total) and MDADI (emotional and physical subsets) scores, but not PAS and FOIS scores, significantly improved in the 2-channel NMES group posttreatment. When the two groups were directly compared, the 4-channel NMES group showed significant improvement in oral and total VDS scores. Conclusions The sequential 4-channel NMES, through its activation of the suprahyoid and thyrohyoid muscles, and other infrahyoid muscles mimicking physiological activation, may be a new effective treatment for dysphagia. Trial registration: clinicaltrial.gov, registration number: NCT03670498, registered 13 September 2018, https://clinicaltrials.gov/ct2/show/NCT03670498?term=NCT03670498&draw=2&rank=1.

Gastric per-oral endoscopic myotomy (G-POEM) for the treatment of gastric sleeve stenosis: a feasibility and safety study

Endoscopy ◽  
2021 ◽  
Author(s):  
Linda Y Zhang ◽  
Marcia Irene Canto ◽  
Michael Schweitzer ◽  
Mouen A Khashab ◽  
Vivek Kumbhari
Keyword(s):  
Clinical Success ◽  
Oral Intake ◽  
Surgical Revision ◽  
Symptom Improvement ◽  
Gastric Sleeve ◽  
Safe Technique ◽  
Endoscopic Myotomy ◽  
Per Oral ◽  
Sleeve Stenosis

Background/aims: Traditional endoscopic treatments have limited success for treatment of gastric sleeve stenosis (GSS). Gastric peroral endoscopic myotomy (G-POEM) could conceivably obliterate the twist/angulation that causes GSS through a tunneled stricturotomy (instead of pyloromyotomy). We report early outcomes of G-POEM for GSS treatment. Methods: We retrospectively reviewed all patients with GSS treated with G-POEM at a single center. The primary endpoint was clinical success, defined as symptom improvement with resumption of adequate oral intake, without requiring further intervention. Results: 13 patients (12 female, mean age 43±10.9 years) underwent G-POEM for predominantly helical (n=11, 85%) GSS. Three (23%) had concurrent sleeve leak and ten (77%) had prior GSS treatment. There were two intraoperative AEs resulting in no deviation to the procedure. No major AEs occurred. At a median 175 (IQR119-260) days follow up, clinical success was achieved in 10 patients (77%). Median GCSI score in responders decreased post-G-POEM from 2.06 (IQR1.5-2.8) to 0.39 (IQR0.2-0.5). Three patients (23%) required surgical revision. Conclusions: G-POEM is a feasible and safe technique which may provide an alternative option for those averse to undergoing surgical revision for treatment of GSS.

scholarly journals Transarterial Coil-Augmented Onyx Embolization for Brain Arteriovenous Malformation Technique and Experience in 22 Consecutive Patients

2014 ◽  
Vol 20 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Xu Gao ◽  
Guobiao Liang ◽  
Zhiqing Li ◽  
Xiaogang Wang ◽  
Chunyong Yu ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Injection Technique ◽  
Initial Experience ◽  
Brain Arteriovenous Malformation ◽  
Technical Feasibility ◽  
Valuable Adjunct ◽  
Procedural Complication ◽  
Brain Avms ◽  
Age Range

Onyx has been widely adopted for the treatment of arteriovenous malformations (AVMs). However, its control demands operators accumulate a considerable learning curve. We describe our initial experience using a novel injection method for the embolization of AVMs. We retrospectively reviewed the data of all 22 patients with brain AVMs (12 men, 10 women; age range, 12–68 years; mean age, 43.2 years) treated by the transarterial coil-augmented Onyx injection technique. The size of the AVMs ranged from 25 mm to 70 mm (average 35.6 mm). The technical feasibility of the procedure, procedure-related complications, angiographic results, and clinical outcome were evaluated. In every case, endovascular treatment (EVT) was completed. A total of 31 sessions were performed, with a mean injection volume of 6.1 mL (range, 1.5–16.0 mL). An average of 96.7% (range 85%-100%) estimated size reduction was achieved, and 18 AVMs could be completely excluded by EVT alone. The results remained stable on follow-up angiograms. A procedural complication occurred in one patient, with permanent mild neurologic deficit. Our preliminary series demonstrated that the coil-augmented Onyx injection technique is a valuable adjunct achieving excellent nidal penetration and improving the safety of the procedure.

Nonspecific bowel activity in imaging inflammation with Tc-99m labelled monoclonal anti-NCA-90 Fab’ fragment MN3

2001 ◽  
Vol 40 (03) ◽  
pp. 71-74 ◽  
Author(s):  
A. Wolter ◽  
D. L. Munz ◽  
V. Ivančević
Keyword(s):  
Fab Fragment ◽  
Musculoskeletal Infection ◽  
Planar Images ◽  
Early Imaging ◽  
Inflammatory Bowel ◽  
The Mean ◽  
The One ◽  
Bowel Segments ◽  
Age Range

Summary Aim: Since the Tc-99m labelled monoclonal anti-NCA 90 granulocyte antibody Fab’ fragment MN3 (MN3 Fab’) might be of interest for imaging abdominal inflammation which could be hampered by nonspecific bowel activity, we prospectively investigated the appearance of bowel activity in MN3 Fab’ imaging. Methods: Eighty consecutive patients (age range 12-85 years) referred for suspected nonabdominal, mostly musculoskeletal infection, were included. Abdominal inflammation was excluded clinically and there were no signs of inflammatory bowel disease in the patients’ histories. One, 5, and 24 hours after intravenous injection of up to 1.1 GBq of MN3 Fab’ planar images of the abdomen were performed. Bowel activity was graded visually using a 5-point scale. Results: The one (N = 80), 5 (N = 79), and 24 (N = 52) hour images revealed 46 (10%), 162 (34%), and 173 (55%) accumulating bowel segments, respectively, in 37 (46%), 69 (87%), and 52 (100%) patients. The mean intensity score per accumulating segment was 1.1,1.8 and 2.7 (p = 0), respectively. Relative frequencies of appearance of the small intestine were 38%, 57%, and 21%, ileocaecal region 6%, 53%, and 48%, ascending colon 5%, 67%, and 89%, transverse colon 1%, 9%, and 69%, descending colon 8%,15 %, and 67%, and rectosigmoid 0%, 4%, and 38%, respectively. Follow-up investigations in 13 patients revealed diverging uptake patterns. Conclusion: Nonspecific bowel activity is often present in the early and almost always and more intense, in the delayed images. Early imaging at one hour after administration seems feasible, but a loss in sensitivity has to be considered. Thus, nonspecific bowel activity can be anticipated to be a pitfall in imaging abdominal inflammation with MN3 Fab’.

Endoscopic ultrasound-guided gastroenterostomy using an oroenteric catheter-assisted technique: a retrospective analysis

Endoscopy ◽  
2021 ◽  
Author(s):  
Nam Q. Nguyen ◽  
Christopher M. Hamerski ◽  
Andrew Nett ◽  
Rabindra R. Watson ◽  
Morgan Rigopoulos ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Symptom Relief ◽  
Outlet Obstruction ◽  
Oral Intake ◽  
Metal Stent ◽  
Technical Success ◽  
Ultrasound Guided

Abstract Background This study evaluated an oroenteric catheter (OEC)-assisted technique to distend the enteric loop for endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in patients with gastric outlet obstruction (GOO). Methods Patient outcomes were reviewed. Proximal enteric loops were filled with water via an OEC (7 Fr or 8 Fr), providing a target for EUS-GE using a lumen-apposing metal stent (15-mm caliber). Clinical success was defined as toleration of a non-liquid diet by Day 3. Results 42 patients (mean age 73.1 [SEM 2.8] years; 23 male) underwent EUS-GE for malignant (n = 37) and benign (n = 5) duodenal strictures. EUS-GE creation was successful in 41/42 (98 %), with mean procedure time of 36 (SEM 3) minutes and no serious complications. Clinical success was achieved in 39/42 (93 %) at 5.7 (SEM 2.6) months’ follow-up. Of 14 patients who died, 13 (93 %) maintained oral intake until death. EUS-GE provided good symptom relief in all 28 surviving patients until follow-up. Conclusions OEC-assisted EUS-GE provided satisfactory relief of GOO symptoms, with high technical success (98 %) and no serious complications.

scholarly journals INTERVENSI PENURUNAN TINGKAT DEPRESI MELALUI EMPATHIC LOVE THERAPY

2020 ◽  
Vol 17 (1) ◽  
pp. 129-144
Author(s):  
Eka Widiasari
Keyword(s):  
Narrative Analysis ◽  
Middle Age ◽  
Early Adulthood ◽  
Prevalence Of Depression ◽  
Before And After ◽  
Therapy Clients ◽  
The One ◽  
Age Range ◽  
Effective Contribution

Depression is the one global significant problem in the world. The prevalence of depression in Indonesia is higher than the prevalence in other countries. The risk of first developing depression increase in late adolescence and early adulthood, eventualy peaking in the middle age range (age 45-55). Empathic love therapy emphasizes on how individuals accept and love all aspects of him/herself.  This research  aimed to test the effectivity of empathic love in decreasing depression. This therapy was applied to 3 clients, who pass the inclusive criteria for selected participant, in 8 sessions of individual setting therapy. Clients was selected using Beck Depression Inventory-II (BDI-II). BDI-II was given before and after therapy, and one in the follow up session after therapy. BDI-II showed significant decrease in 3 clients depression from mild to normal in the end of therapy. Narrative analysis of conversation transcript showed decreases level of depression. The conclusion is empathic love therapy can decreas level of depression. Further research is needed to be held to find out effective contribution of therapy techniques to its succes and therapy’s reliability. 

Clinical Success Using the Audio-Visual Feedback Training for Cluttering

2019 ◽  
Vol 4 (6) ◽  
pp. 1589-1594
Author(s):  
Yvonne van Zaalen ◽  
Isabella Reichel
Keyword(s):  
Visual Feedback ◽  
Clinical Success ◽  
Pause Duration ◽  
Digital Audio ◽  
Male Adolescents ◽  
Feedback Training ◽  
Positive Effects ◽  
Speech Monitoring ◽  
Adolescents And Adults

Purpose Among the best strategies to address inadequate speech monitoring skills and other parameters of communication in people with cluttering (PWC) is the relatively new but very promising auditory–visual feedback (AVF) training ( van Zaalen & Reichel, 2015 ). This study examines the effects of AVF training on articulatory accuracy, pause duration, frequency, and type of disfluencies of PWC, as well as on the emotional and cognitive aspects that may be present in clients with this communication disorder ( Reichel, 2010 ; van Zaalen & Reichel, 2015 ). Methods In this study, 12 male adolescents and adults—6 with phonological and 6 with syntactic cluttering—were provided with weekly AVF training for 12 weeks, with a 3-month follow-up. Data was gathered on baseline (T0), Week 6 (T1), Week 12 (T2), and after follow-up (T3). Spontaneous speech was recorded and analyzed by using digital audio-recording and speech analysis software known as Praat ( Boersma & Weenink, 2017 ). Results The results of this study indicated that PWC demonstrated significant improvements in articulatory rate measurements and in pause duration following the AVF training. In addition, the PWC in the study reported positive effects on their ability to retell a story and to speak in more complete sentences. PWC felt better about formulating their ideas and were more satisfied with their interactions with people around them. Conclusions The AVF training was found to be an effective approach for improving monitoring skills of PWC with both quantitative and qualitative benefits in the behavioral, cognitive, emotional, and social domains of communication.

Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 497-504 ◽  
Author(s):  
Tom De Beule ◽  
Jan Vranckx ◽  
Peter Verhamme ◽  
Veerle Labarque ◽  
Marie-Anne Morren ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Arteriovenous Malformations ◽  
Clinical Success ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Complete Disappearance ◽  
Ethylene Vinyl Alcohol ◽  
Initial Symptoms

Abstract. Background: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs. Patients and methods: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients’ general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms. Results: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients. Conclusions: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.

Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Asciutto ◽  
Lindblad
Keyword(s):  
Saphenous Vein ◽  
Short Term ◽  
Foam Sclerotherapy ◽  
Results Of Treatment ◽  
Ulcer Healing Rate ◽  
Complete Obliteration ◽  
Ceap Classification ◽  
One Year ◽  
The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients’ grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

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