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Microbiota Transplantation, Health Implications, and the Way Forward
Published in Nwadiuto (Diuto) Esiobu, James Chukwuma Ogbonna, Charles Oluwaseun Adetunji, Olawole O. Obembe, Ifeoma Maureen Ezeonu, Abdulrazak B. Ibrahim, Benjamin Ewa Ubi, Microbiomes and Emerging Applications, 2022
Olugbenga Samuel Michael, Olufemi Idowu Oluranti, Ayomide Michael Oshinjo, Charles Oluwaseun Adetunji, Juliana Bunmi Adetunji, Nwadiuto (Diuto) Esiobu
Meighani et al. (2016) reported that the safety and effective delivery of FMT was done through percutaneous endoscopic gastrostomy tube in upper GI. The group also observed that FMT administration in the upper GI may be specific to some group of patient that have contraindications, complication in tolerating lower GI endoscopy, and retention of enemas may not be possible (Meighani et al., 2016). In their study, a smaller proportion of the suspension of fecal was administered to the lower and upper GI tract with volume from 25 to 150/250–500 mL for comparison in the level effectiveness and safety. The authors also described that serious aspiration pneumonitis is likely disorders that could results from high volume of 500 mL FMT administered through nasoduodenal tube.
Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Percutaneous refers to any medical procedure by which access to inner organs or other tissue is obtained via needle puncture of the skin. Laparoscopic surgery is generally performed with the aid of a trocar, a sleeve or tube resembling a large needle which holds the incision open and protects the surrounding tissue from damage due to instrument exchanges and motion. There is some overlap between the use of the terms percutaneous and laparoscopic, and between needles and trocars (for example, the term percutaneous endoscopic gastrostomy, PEG [66]). In recent practice, percutaneous usually refers to access to blood vessels and the spinal column, and laparoscopic refers to access to larger body compartments.
Imaging in oncology
Published in David A Lisle, Imaging for Students, 2012
Interventional radiology is used in oncology in a wide variety of roles including:Biopsy guidance for primary diagnosisDrainage of malignant ascites and pleural effusionDrainage and stent deployment for malignant obstruction of various structures, for examplePercutaneous nephrostomy and antegrade ureteric stent for malignant obstruction of the urinary tractPercutaneous transhepatic cholangiogram and biliary stent for malignant biliary stricture (Fig. 14.6)Superior vena cava stent for obstruction due to mediastinal tumourTracheobronchial stent for malignant airway obstructionInsertion of gastrostomy or gastrojejunostomy for nutritional supportCentral venous access for delivery of chemotherapy or parenteral nutrition, and repeated aspiration of blood samplesPeripherally inserted central catheter (‘PICC line’)Central venous portTunnelled central venous catheterArterial embolizationBronchial artery embolization for massive haemoptysis due to bronchogenic carcinomaRenal artery embolization for palliation of pain or haemoptysis due to inoperable renal cell carcinomaReduce bleeding risk of hypervascular tumours prior to surgical removal, e.g. renal cell carcinoma, melanomaNon-surgical treatments that use interventional radiology, examples of which are summarized below.
Comprehensive, technology-based, team approach for a patient with locked-in syndrome: A case report of improved function & quality of life
Published in Assistive Technology, 2019
Keara McNair, Madeline Lutjen, Kara Langhamer, Jeremiah Nieves, Kimberly Hreha
Upon admission to rehabilitation, A.R.’s total FIM score was a 17 (Figure 1). His case mix index number was calculated as 2.6928. The case mix number is generated based on the complexity of the patient’s diagnosis and their comorbidities, with higher numbers indicating higher complexity. For example, the facility average is 2.2203, the national average is 2.2220, and the region average is 2.2335. A.R. had low arousal and inconsistent eye opening on command. He was able to answer yes/no questions via vertical eye gaze inconsistently, when alert. He had no active movement in all four limbs, facial musculature, and cervical spine, and presented with generalized hypotonicity. He presented with mild edema in bilateral lower extremities as well as clonus in left ankle. He was unable to swallow and required percutaneous endoscopy gastrostomy (PEG) for all nutrition, medication, and hydration.
A review of chyme reinfusion: new tech solutions for age old problems
Published in Journal of the Royal Society of New Zealand, 2022
Chen Liu, Sameer Bhat, Ian Bissett, Gregory O’Grady
This technology was further trialled and improved in a subsequent clinical study. The second study involved 19 adult ileostomy patients recruited between April 2019 and May 2020 (Liu et al. 2021). Patients were divided into three groups in chronological order. The first group used off-the-shelf gastrostomy tubes that were utilised in the Active-LinkTM device (Group One; n = 7 patients), the second group were involved in the iterative development phase where new tube designs were trialled (Development Group; n = 7) and the third group used a late iteration of the tube design (Group Two; n = 5). A total of 549 patient-days of device-use was captured. The gastrostomy feeding tubes used by patients from Group One exhibited multiple issues such as dislodgement (n = 4), localised abdominal pain (n = 3), inadequate fit of the tube/pump complex within the stoma appliance (n = 1) and bending of the tube leading to partial obstruction (n = 1). These problems led to the development of a custom enteral feeding tube specifically designed for use in a stoma, as depicted in Figure 2. Patients from Group Two experienced few tube-related issues, with no complaints relating to poor device fit. This is the first known instance of a built-for-purpose feeding tube for use in CR. The tube carries the following key features: (a) A plastic introducer that allows easy insertion of the device into the distal DES limb, (b) A long segment of the tube that can be cut at any length to allow customisation of tube size relative to a patient’s stoma appliance, (c) A 90° retention sleeve to allow the tube to sit flat and parallel to the patient’s abdominal wall and reduce device protrusion, and (d) A biconcave half-balloon tip that allows adequate tube retention within the abdomen without placing excessive pressure on the bowel wall. This tube design was incorporated into the Active-LinkTM system, and following these modifications, the device was more recently renamed The Insides SystemTM (The Insides Company, Auckland, NZ), as depicted in Figure 3.
Collision versus loss-of-control motorcycle accidents: Comparing injuries and outcomes
Published in Traffic Injury Prevention, 2022
Russell Seth Martins, Sabah Uddin Saqib, Mohummad Hassan Raza Raja, Mishal Gillani, Hasnain Zafar
Although lower limb injuries were the most common type of injury in both categories, CA victims were more likely to have head and neck injuries, abdominal injuries, and pelvic fractures. Motorcycle CA victims were also more likely to have polytrauma and arrive at the emergency department. Additionally, a greater percentage of CA victims required neurosurgery, limb amputation, and other surgeries (laparotomy, percutaneous endoscopic gastrostomy, cesarean section, nerve grafting, and bone grafting). However, LOCA victims were more likely to require skin grafting. Nevertheless, these results indicate that injuries due to CAs were generally more serious than those due to LOCAs. Though lower limb injuries are classically the most common motorcycle accident injuries sustained overall (Lateef 2002), head and neck injuries are especially common in CAs when passengers are not wearing helmets (Obimakinde et al. 2018). This may be due to direct impact of the passenger’s head with an object or due to sudden neck–body relative deceleration or whiplash injuries. The higher frequency of head and neck trauma in CAs is also why CA victims were more likely to require neurosurgery. Abdominal injuries, which were also more common in motorcycle CAs, include lacerations or contusions to the liver, kidney, and spleen, as well as bowel injuries. Moreover, pelvic injuries are more commonly associated with the high-velocity impact of direct motorcycle CAs, leading to pelvic fracture (“crotch rocket” fracture; Hurson et al. 2004), testicular rupture, and urethral or bladder injuries (Ankarath et al. 2002). Victims of CAs also had a significantly higher incidence of limb amputations, which may be due to crush injury or partial traumatic amputations during CAs. These amputations confer lifelong disability upon motorcycle victims and cause significant psychosocial impairment. Finally, the characteristic primary, secondary, and tertiary impacts seen in motorcycle collision injuries explain the higher prevalence of polytraumatic injuries in CA victims (Toney-Butler and Varacallo 2019). On the other hand, the higher percentage of skin graft operations performed in the group of LOCA victims can be explained by the biomechanics of LOCAs, which frequently involve high-friction drag injuries across a roadway (Lloyd 2016). In Pakistan, the traditional shalwar kameez (a combination of garments consisting of a long shirt and loose trousers made of very lightweight fabrics) offers very little protection from drag injuries against hard, concrete roads. Other injuries commonly seen in LOCAs include lacerations, contusions, and fractures (Lloyd 2016).