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Sixteen patients receiving percutaneous endoscopic gastrostomy (PEG) feeding following a period of nasogastric (NG) feeding were investigated to assess acceptance and identify problems by means of a questionnaire. PEG was considered to be superior to NG feeding in terms of tolerance and cosmetic acceptance by 81% and 88% of participants respectively ( P < 0.001). Pain was an infrequent problem. Interruptions to feeding were consideed to be more common with NG feeding by 50% of participants; 38% considered interruptions equally common with both PEG and NG, and 12% considered interruptions more common with PEG feeding ( P = NS). The time for care was equivalent for both methods. Seventy-five percent considered PEG to have made a valuable contribution to enteral feeding. Leakage was however considered to be more frequent in PEG feeding by 81% of participants (compared to 12% who considered leakage to be more common with NG feeding; P < 0.001) and leakage was more frequent at die junctions in the catheter rather than from the stoma. Thirty-one percent of patients with PEG had needed systemic antibiotics for stomal infections. All patients with both PEG and NG feeding needed professional help. Sixty-two percent needed professional help more frequently with PEG than with NG feeding (compared to 19% who considered that the NG tube needed professional help more frequently; P <0.05). We conclude that leakage and infections are major problems in PEG enteral feeding. 相似文献
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The magnetic resonance (MR) images of six patients with thrombosis of a dural sinus were reviewed. The diagnosis had been verified by computed tomographic scans in three patients and arteriograms in two; in the sixth patient, only MR imaging was used to confirm the clinical syndrome. In all patients, high-intensity signal was seen from the thrombus within the affected dural sinus on all echoes. This persistent signal intensity allowed intravascular clot to be distinguished from normal causes of increased signal such as flow-related enhancement (entry phenomenon) and even-echo rephasing. MR imaging demonstrated the cause of the thrombosis in three patients: two were secondary to adjacent tumors, and one was secondary to unsuspected mastoiditis. Complications such as infarction were also demonstrated. Using MR imaging, one can easily and safely diagnose thrombosis of a dural sinus. MR should be the imaging method of choice in patients suspected of having thrombosis of a dural sinus. 相似文献
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Bhabatosh Biswas Dipayan Ghosh Rupak Bhattacharjee Ashis Patra Subir Basuthakur Rajarshi Basu 《Indian Journal of Thoracic and Cardiovascular Surgery》2004,20(2):88-90
Introduction Hydatid cysts of the lung are quite frequent in our country. Some patients have additional cysts in the liver. Though most
of the liver cysts remain asymptomatic for long time, but may be symptomatic with increasing size. Surgical removal is the
treatment of choice for both lung & liver cysts. Aim of the study was to establish suitability of one stage surgery for pulmonary
& hepatic hydatid cysts.
Methods From 1996 through 2003 we operated on 216 pulmonary hydatid cysts, out of which 42 patients had hydatid cysts in the right
lung as well as in the right lobe of liver. Right thoracotomy was done to remove the lung hydatids followed by phrenotomy
to remove the liver cysts.
Results Right thoracotomy was done in 42 patients having hydatid cysts of lung & liver. In 36 patients, cysts were removed, bronchial
leaks were sutured & residual cavities were obliterated. Out of rest 6 patients, having dense adhesions or destruction of
pulmonary parenchyma, 4 had segmentectomy & 2 had lobectomy. Right phrenotomy was then done with radial incision above the
palpated liver cysts. Hydatid cyst was removed from liver. Cavity and remaining pericystic liver tissue was inverted with
sutures. Water seal chest drain & subdiaphragmatic drain were placed. Post operative albendazole was continued for 3 months
in the dose of 10–20 mg/kg with a gap of 2 weeks after each month. Post operative recovery was uneventful in most of the cases.
However, air leak continued for almost 3 weeks in 4 patients & 3 months in one patient. There was no death.
Conclusion Surgical management of pulmonary and hepatic hydatids with one stage right thoracotomy & phrenotomy is a suitable option.
It avoids additional laparotomy and thereby additional cost & hospital stay. Results are quite satisfactory. 相似文献