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Surgical treatment of Candida albicans spondylodiscitis.

IntroductionSpinal infection poses a demanding diagnostic and treatment problem for which a multidisciplinary approach with spine surgeons, … herapy. Ten years later, a tracheostomy was performed for laryngeal edema, and again, an endoscopic gastrostomy was performed due to feeding difficulties. He then developed fever and cervical pain along with pain in the bilateral upper extremities. An infectious etiology was suspected for which multiple antibiotics were started with no positive response. An M …

Neutrophils-to-Lymphocyte Ratio Is Associated with Progression and Overall Survival in Amyotrophic Lateral Sclerosis.

BACKGROUND: Amyotrophic lateral sclerosis (ALS) is a devastating and untreatable motor neuron disease, with a 3-5-year survival from diagnos … ts with tracheostomy or receiving mechanical ventilation; (2) patients with percutaneous endoscopic gastrostomy; and (3) patients who did not sign the informed consent. The rate of disease progression (ΔFS score) represents the monthly decline of the ALSFRS-R score, and was computed as (48 - total ALSFRS-R at recruitment)/symptom duration in months. Patients …

Association of Time Elapsed Since Ischemic Stroke With Risk of Recurrent Stroke in Older Patients Undergoing Elective Nonneurologic, Noncardiac Surgery.

IMPORTANCE: Perioperative strokes are a major cause of death and disability. There is limited information on which to base decisions for how long to delay elective nonneurologic, noncardiac surgery in patients with a history of stroke. OBJECTIVE: To examine whether an association exists between the time elapsed since an ischemic stroke and the risk of recurrent stroke in older patients undergoing elective nonneurologic, noncardiac surgery. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from the 100% Medicare Provider Analysis and Review files, including the Master Beneficiary

Faecal microbiota transplantation in the treatment of recurrent intestinal Clostridioides difficile infection - a ten-year single-center experience.

Clostridioides difficile (Clostridium difficile in older taxonomy) is a gram-positive anaerobic and bacteria enabled by endospores. Clostrid … e given a nasoenteral tube and one patient (0.9 %) was administered FMT per percutaneous endoscopic gastrostomy (PEG). We applied a frozen universal donor FMT in 81 patients (69.8 %), and a freshly prepared FMT from a person living in the same household was used in 35 patients (30.1 %). The secondary endpoint (the absence of clinical manifestations of CDI wit …

Perioperative complications with multilevel anterior and posterior cervical decompression and fusion.

OBJECTIVE: Cervical spondylotic myelopathy (CSM) is a progressive degenerative pathology that frequently affects older individuals and cause … sogastric parenteral nutrition and 9 (12.5%) patients ultimately undergoing percutaneous endoscopic gastrostomy (PEG) placement. Nine of the 72 patients required a tracheostomy. The incidence of pneumonia was 6.9% (5 patients) overall, and 2 of these patients were in the tracheostomy group. Superficial wound infections occurred in 4 patients (5.6%). Periopera …

Conferencia magistral oropharyngeal disorders: diagnosis and treatment.

In summary, the management of oropharyngeal dysphagia often involves a polydisciplinary evaluation, the aims of which are to identify and ch … ther treatment strategies, the clinician must first establish whether institution of non-oral (e.g. gastrostomy) feeding is indicated. This will depend on establishing the likelihood that the patient will be able to sustain adequate nutrition safely via the oral route and on the unproven, but reasonable, premise that non-oral feeding is likely to reduce the r …

[Application of free tissue flaps using the facial artery and vein/retromandibular vein as recipient vessels in the repair of postoperative nasopharyngeal skull base necrosis].

Objective: To evaluate the clinical efficacy of free tissue flap transplantation for repairing skull base defects following osteoradionecros … d in 24 patients, with a median indwelling time of 21 (12, 32) d; one patient underwent concomitant gastrostomy. Postoperative pathology confirmed 20 cases of simple nasopharyngeal necrotizing inflammation, 4 cases of necrotizing inflammation combined with squamous cell carcinoma (recurrence of nasopharyngeal carcinoma), and 1 case of necrotizing inflammation …

[Clinical effect of minimally invasive duodenum preserving pancreatic head resection for benign and pre-malignant lesions of pancreatic head].

Objective: To examine the clinical effect of minimally invasive duodenum preserving pancreatic head resection(DPPHR) for benign and pre-mali … scence imaging was used in 19 patients to guide operation. Five patients were performed pancreatico-gastrostomy and the rest 28 patients underwent pancreaticojejunostomy. Pathological outcomes confirmed 9 solid pseudo-papillary neoplasms, 9 intraductal papillary mucinous neoplasms, 7 serous cystic neoplasms, 6 pancreatic neuroendocrine tumors, 1 mucous cystic …

Diffuse Angiogram-Negative Subarachnoid Hemorrhage is Associated with an Intermediate Clinical Course.

BACKGROUND: The cerebral angiography result is negative for an underlying vascular lesion in 15-20% of patients with nontraumatic subarachno … ectively; p < 0.01). Similar trends were noted with long-term supportive care with tracheostomy and gastrostomy tubes and length of stay. Cerebrospinal fluid diversion was increasingly required across bleed types (9.3% vs. 54.6% vs. 76.3% for perimesencephalic SAH vs. diffuse SAH vs. aneurysmal SAH, respectively, p < 0.001). Vasospasm and delayed cerebral isc …

[Multidisciplinary management with neuromuscular electrical stimulation therapy in a Goldenhar syndrome patient who presented swallowing disorder and failure to thrive.].

INTRODUCCIÓN: El síndrome de Goldenhar es un trastorno heterogéneo, esporádico en su mayoría o por patrón de herencia autosómico dominante o … t of 10 sessions with 10 mA intensity. At 4 months, thickening of formula with cereal; at 7 months, gastrostomy tube; at 20 months, palate surgery and macrostomy. Improvement in drooling intensity was observed during the first 10 sessions, and improvement in swallowing after 30 sessions. At 3 years of age, the patient consumes 100% of food orally. CONCLUSION …

In-Hospital Utilization and Outcomes of Palliative Care Consultation in Patients With Advanced Heart Failure Complicated by Cardiogenic Shock Requiring Mechanical Circulatory Support.

Prior studies have shown that the early inclusion of palliative care (PC) specialist is associated with better end-of-life experiences. The National Inpatient Sample Database was queried from 2012 to 2017 for relevant of ICD)-9 and -10 procedural and diagnostic codes to identify patients above 18 years with advanced heart failure (HF) admitted with cardiogenic shock (CS) requiring mechanical circulatory support (MCS). Baseline characteristics, utilization trends and invasive procedures and complications were compared among patients evaluated by PC and those who were not. There were 65,230 pati

Palliative radiotherapy indications during the COVID-19 pandemic and in future complex logistic settings: the NORMALITY model.

IntroductionThe COVID-19 pandemic has challenged healthcare systems worldwide over the last few months, and it continues to do so. Although some restrictions are being removed, it is not certain when the pandemic is going to be definitively over. Pandemics can be seen as a highly complex logistic scenario. From this perspective, some of the indications provided for palliative radiotherapy (PRT) during the COVID-19 pandemic could be maintained in the future in settings that limit the possibility of patients achieving symptom relief by radiotherapy. This paper has two aims: (1) to provide a summ

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… = Disagree; 4 = Strongly Disagree MESCC Metastatic Epidural Spinal Cord Compression; fx fraction; OS overall Survival; RT Radiotherapy; pt patient; BID bis in die; Q schedule repetition interval; QoL quality of life; SBRT stereotactic body RT mets: metastases; wks weeks; PEG percutaneous endoscopic gastrostomy … Disagree; 4 = Strongly Disagree MESCC Metastatic Epidural Spinal Cord Compression; fx fraction; OS: overall Survival; RT Radiotherapy; pt patient; BID bis in die; Q schedule repetition interval; QoL quality of life; SBRT stereotactic body RT; mets metastases; wks weeks; PEG percutaneous endoscopic gastrostomy …

Combined surgery and postoperative radiotherapy for carcinoma of the base of radiotherapy for carcinoma of the base of tongue: analysis of treatment outcome and prognostic value of margin status.

BACKGROUND: Choice of treatment for base of tongue carcinoma is controversial, with options including surgery alone, radiotherapy alone, or multimodality treatment. Given the highly aggressive nature of these tumors, it has been our institutional policy to manage this disease with combined partial glossectomy (with attempt to avoid laryngectomy if possible) with planned postoperative radiotherapy (RT). We reported on our institutional experience with this approach. METHODS: A retrospective review of the charts of 17 patients with primary base of tongue squamous cell carcinoma treated with sur

Immune Tolerance Strategies in Siblings with Infantile Pompe Disease-Advantages for a Preemptive Approach to High-Sustained Antibody Titers.

Enzyme replacement therapy (ERT) has led to a significant improvement in the clinical course of patients with infantile Pompe disease (IPD), an autosomal recessive glycogen storage disorder characterized by the deficiency in lysosomal acid α-glucosidase. A subset of IPD patients mount a substantial immune response to ERT developing high sustained anti-rhGAA IgG antibody titers (HSAT) leading to the ineffectiveness of this treatment. HSAT have been challenging to treat, although preemptive approaches have shown success in high-risk patients (those who are cross-reactive immunological material [

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… Gastrostomy tube was placed around 19 months of age and ultimately converted to a gastrojejunal tube due to concerns of recurrent aspiration. Both a tracheostomy and a gastrostomy tube were recommended during previous admissions, but the family was unwilling to proceed until the third admission. … Tracheostomy was discussed during each admission and gastrostomy tube during the latter two admissions, but the family preferred to continue to monitor him closely without these procedures. …

Image-guided palliative care procedures.

The image-guided procedures discussed in this article are used to alleviate pain and suffering of patients with malignancies and/or multiple comorbidities. It is not possible to discuss the entire breadth of image-guided palliative procedures; only a few commonly requested procedures are reviewed: cholecystostomy, biliary decompression, enteral feeding and decompression tubes, chemical neurolysis (for pain control), cementoplasty, tunneled drainage catheters, transjugular intrahepatic portasystemic shunt pleurodesis, tube thoracostomy, thermal and chemical tumor ablation, transcatheter arteria

Routes of administration, reasons for use, and approved indications of medical cannabis in oncology: a scoping review.

INTRODUCTION: Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients' reasons, and prescribed indications must be better understood. METHODS: Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evidence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A searc

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… Percutaneous endoscopic gastrostomy Administration of a concentrated hash oil, hemp oil or cannabis oil inserted in a percutaneous endoscopic gastrostomy •Not applicable •What were the reasons for your administration of cannabis derivatives through your gastrostomy? … Percutaneous endoscopic gastrostomy | Administration of a concentrated hash oil, hemp oil or cannabis oil inserted in a percutaneous endoscopic gastrostomy | •Not applicable | •What were the reasons for your administration of cannabis derivatives through your gastrostomy? …

Evaluation of an Extended-Release, Abuse-Deterrent, Microsphere-in-Capsule Analgesic for the Management of Patients with Chronic Pain With Dysphagia (CPD).

BACKGROUND: Patients who have chronic pain with dysphagia (difficulty swallowing) (CPD) often have difficulty taking oral medication and, as … rospheres were administered through varying sizes of nasogastric (10 and 12 Fr.) tubes and a 16 Fr. gastrostomy tube using 5 different delivery vehicles (ie, water, liquid nutritional feeds [Jevity®, Ensure®], and milk [whole milk and 2% milk]). Drug release rate was characterized using a standard in vitro dissolution methodology; dissolution of intact Oxycod …

[Results of emergency management of esophageal lesions related to caustic ingestion in children in the emergency department of the General Reference Hospital of Niamey (Niger)].

INTRODUCTION: Caustic ingestion in children is a public health problem; it is mainly due to domestic accidents due to improper packaging and storage of caustic products. It is a medical and surgical emergency whose management is multidisciplinary. The lesions caused by the accidental ingestion of caustics can affect the functional and vital prognosis in 10% of cases. METHODOLOGY: A retrospective, descriptive study from January 2020 to December 2022 (2 years), carried out in the emergency department of the General Reference Hospital of Niamey (Niger). The study included patients less than 15 y

[A 49-year-old man with progressive bulbar palsy and respiratory failure].

We report a 49-year-old man with progressive bulbar palsy and respiratory failure. He was well until his 48 years of the age (December 1994) … out patient follow-up, however, in October of 1995, he noted difficulty in swallowing solid foods. Gastrostomy was placed and he was discharged to his home. In February 11th of 1996, he was found unresponsive and brought into the ER of our hospital. On admission, he was comatose without spontaneous respiration. BP could not be obtained. He was immediately in …

Gastroesophageal reflux in childhood.

Gastroesophageal reflux (GER) is one of the most frequent symptomatic clinical disorders affecting the gastrointestinal tract of infants and … cally impaired children are at high risk for having symptomatic GER, particularly if nasogastric or gastrostomy feedings are necessary. Delayed gastric emptying (DGE) has been documented with increasing frequency in infants and children who have symptoms of GER, particularly those with neurologic disorders. DGE may also be a cause of gas bloat, gagging, and b …