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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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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 48-year-old man is evaluated for a 2-day history of right anterior knee pain and swelling. The pain began suddenly and has increased in intensity. He currently rates his pain as an 8 on a 10-point scale. He has no knee instability and reports no fever or chills. He has no history of trauma and has never had this problem before. Other than his right knee pain and swelling, he feels well. He is employed as a carpet layer. His only medication is ibuprofen, which provides minimal relief. On physical examin...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Orthopedics Rheumatology Source Type: blogs
CONCLUSION: Time to diagnosis of CN was shorter than previously reported, though the high rate of deformities still suggests a significant delay in diagnosis. Increased education of healthcare professionals and people with diabetes-related neuropathy is important to ensure early diagnosis and appropriate management to reduce deformities and complications. PMID: 29240741 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
CONCLUSION: Use of MRI can aid in the early diagnosis and facilitate faster rehabilitation for patients. It can also potentially reduce patient stay in hospital and result in significant cost savings for the healthcare system. Imaging guidelines should be developed in the assessment of patients with low back pain in an acute hospital setting. PMID: 29240738 [PubMed - in process]
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
This article reviews the clinical presentation of aberrant scars and illustrates how they can be differentiated. It outlines their pathophysiology and emphasizes the unique molecular mechanisms underlying each disorder. It also examines how altered expression levels and the distribution of several factors may contribute to their unique clinical characteristics and presentation. Further research is needed to elucidate optimal treatments and preventive measures for these types of aberrant scarring.
Source: Advances in Skin and Wound Care - Category: Dermatology Tags: Features: Clinical Management Extra Source Type: research
Publication date: Available online 15 December 2017 Source:Anaesthesia Critical Care & Pain Medicine Author(s): Ali Ahiskalioglu, Haci Ahmet Alici, Bahadir Ciftci, Mine Celik, Omer Karaca
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
Conclusion In conclusion, when supervised by an anaesthetist, resident anaesthesia management is no more likely to result in complaints about intraoperative recall than anaesthetist managements.
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research
We describe here a case of trigeminal neuralgia caused by both DVA and a small enhancing neoplasm. According to our knowledge and literature review, this is the first case of TN caused by such a dual compressive pathology.
Source: Interdisciplinary Neurosurgery - Category: Neurosurgery Source Type: research
This study aimed to identify the efficacy of early mobilization in patients undergoing VATS-E.MethodsWe retrospectively reviewed the patients who underwent VATS-E between November 2008 and October 2016. All the patients underwent preoperative physiotherapy and postoperative early mobilization for standard perioperative management. We examined the relation between early mobilization and the factors affecting postoperative pulmonary complications and the duration of physiotherapy with regard to the surgical outcome of VATS-E.ResultsA total of 118 patients who underwent VATS-E were assessed. The incidence of postoperative pul...
Source: Esophagus - Category: Gastroenterology Source Type: research
DiscussionGiven the lack of standard terms used to define co-occurring musculoskeletal pain, the search strategy will include the broader term “back pain,” different terms for the “other co-occurring pain,” and specific study designs combined with several exclusion terms. The results of this proposed review will identify the prevalence and patterns of co-occurring musculoskeletal pain among those with persistent low back pain, whic h is likely to inform clinical management, research, and policy in management of musculoskeletal disorders.Systematic review registrationPROSPEROCRD42017068807
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research
Publication date: January 2018 Source:Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA), Volume 128 Author(s): John Douglas Mann, Keturah R. Faurot, Beth MacIntosh, Olafur S. Palsson, Chirayath M. Suchindran, Susan Ann Gaylord, Chanee Lynch, Angela Johnston, Kristen Maiden, David A. Barrow, Joseph R. Hibbeln, Christopher E. Ramsden Migraine is a prevalent neurological disorder, affecting over 16% of adult women and 7% of adult men in the U.S., causing significant pain, disability, and medical expense, with incomplete benefits from conventional medical management. Migraine, as a chronic pain syndrome, provides...
Source: Prostaglandins, Leukotrienes and Essential Fatty Acids (PLEFA) - Category: Lipidology Source Type: research
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