Biodegradable Stents for Caustic Esophageal Strictures: Do They Work?

AbstractBiodegradable (BD) stents have been used for the management of various esophageal strictures (ES) but the experience of its use in caustic strictures is limited. The present study, aimed at evaluating efficacy of BD stents for the treatment of refractory caustic-induced ES, was a retrospective multi-center study conducted at three tertiary care centers in India wherein adult patients with refractory caustic induced strictures underwent placement of a BD stent. Patients were followed up for immediate complications and long term outcome. All 13 patients (39.3  ± 15.1 years) underwent successful BD stent placement. Retrosternal chest pain occurred in 2 patients and stent migration in 1 (7.6%) patient. At 3 months, restenosis with recurrence of dysphagia was seen in nine (69.2%) patients, at 6 months, 10 (77%) patients had dysphagia of whom three und erwent surgery and the remaining seven patients required dilatations. At 1 year, one patient remained asymptomatic while nine had dysphagia. The requirement for dilatation was once in 3 months in seven patients&once in a month in two patients. At 2  years, the requirement of dilatations was further reduced to once in 4–6 months in all patients. Over a 3 year follow up three (23%) patients had undergone surgery, one was free of symptoms while nine patients continued to be on periodic dilatation although the requirement had reduced to once in 4–6 mont...
Source: Dysphagia - Category: Speech Therapy Source Type: research

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Publication date: Available online 22 February 2019Source: Best Practice &Research Clinical RheumatologyAuthor(s): Kay M. Crossley, Marienke van Middelkoop, Christian J. Barton, Adam G. CulvenorAbstractPatellofemoral pain is one of the most common knee complaints, particularly among physically active young individuals. Although once thought to be self-limiting, prospective studies have demonstrated the propensity towards the chronicity of patellofemoral pain (PFP). The pathogenesis of PFP is complex, with multiple interactive pathways suggested to contribute to its onset and persistence. Quadriceps weakness is one of t...
Source: Best Practice and Research Clinical Rheumatology - Category: Rheumatology Source Type: research
Publication date: Available online 10 February 2019Source: Best Practice &Research Clinical Obstetrics &GynaecologyAuthor(s): Vasilios Tanos, Zara Abigail ToneyAbstractThe increasing rate of elective and indicated caesarean sections worldwide has led to new pathologies and management challenges. The number of patients undergoing trial of labor after caesarean section (TOLAC) is also increasing. Three professional societies provide detailed guidelines based on scientific evidence for the management of patients attempting vaginal birth after caesarean section (VBAC). However, they do not provide any recommendations f...
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research
ConclusionPatients with PIFP are frequently misdiagnosed leading to prescription of ineffective medications and unnecessary investigations and surgical interventions. Educational efforts should emphasize on improving knowledge and awareness of this condition.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research
Publication date: Available online 22 February 2019Source: Practical Radiation OncologyAuthor(s): Shutao Wang, Lucas Resende Salgado, Ava Adler, Sanders Chang, Meng Ru, Erin Moshier, Kavita Dharmarajan, Hearn Jay Cho, Richard L. BakstAbstractIntroductionThe management of multiple myeloma (MM) has evolved in the past twenty years secondary to novel biological therapeutics. Radiotherapy remains an important intervention in the management of painful lytic bone lesions. However, the currently used radiotherapy regimens were developed in the pre-biological therapy era. The goal of this study is to assess the effects of dose and...
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
To evaluate the current distribution of “evaluation and management” (E&M) services rendered by interventional radiologists (IR), interventional cardiologists (IC) and pain management specialists (PM) for Medicare beneficiaries in 2016 and to compare the current status with the historical data.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 15: Fantastic Spreadsheets (Practice Management) Source Type: research
There are no reported descriptions of motor nerve cryoablation in humans. As a result, physicians faced with inadvertent motor nerve cryoablation during palliative or therapeutic procedures for established indications are forced to rely on preclinical studies to manage patient expectations. (1, 2) In addition, potential applications of motor nerve cryoablation, such as for management of spasticity and pain, have been avoided because of the unknown prognosis following cryoneurolysis of mixed or motor nerves.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 41: Other Nonvascular Interventions Source Type: research
To analyze the safety and efficacy of image-guided genicular nerve radiofrequency ablation (RFA) for the treatment of pain in non-surgical candidates with moderate to severe knee osteoarthritis (OA).
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific Session 31: You ’re So Hip (MSK) Source Type: research
The objective of this study was to assess outcomes and safety of celiac plexus block cryoablation procedure in regards to refractory visceral abdominal pain management. No large retrospective study of the CT-guided cryoablation has been performed.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Scientific e-Posters Source Type: research
ConclusionDespite the extraordinary preoperative morbidity of massive abdominal wall defects, with an experienced General Surgery and Plastic Surgery multidisciplinary team, these highly complex patients are able to achieve a significant improvement in their pain and quality of life following repair and reconstruction with complex mesh hernia repair and microsurgical free tissue transfer.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionImplementation of a HEART pathway in the ED evaluation of patients with chest pain resulted in less inpatient care and noninvasive cardiac testing and was safe. Using HEART to risk stratify chest pain patients can improve the efficiency and quality of care.
Source: Annals of Emergency Medicine - Category: Emergency Medicine Source Type: research
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