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At least 937 records · Page 52Linked to original sources
PubMed2006

Decompressive percutaneous gastrostomy tube use in gynecologic malignancies.

Percutaneous gastrostomy tube placement is a technically feasible and safe procedure for palliation in patients with small bowel obstruction (SBO) caused by advanced gynecologic malignancies. It is used commonly in patients who are poor surgical candidates, those who elect to not undergo surgery, and in patients with a limited lifespan because of end-stage cancer. Percutaneous gastrostomy tube placement is even technically possible in patients with tumor encasing the stomach, diffuse carcinomatosis, and ascites. Percutaneous endoscopic gastrostomy (PEG) tubes provide symptomatic relief of nausea and vomiting in most patients with advanced gynecologic cancer and SBO. PEG tube placement allows most patients to have end- of-life care at home or in an inpatient hospice. It is a cost effective procedure and is associated with low morbidity and mortality. Placement of PEG tubes should be highly considered in patients who present with recurrent bowel obstruction and who have undergone a prior operation for SBO in the setting of advanced gynecologic malignancy.

Endoscopy, Gastrointestinal↗
PubMed1999

Effect of preoperative paracetamol on gastric volumes and pH in children.

The effect preoperative paracetamol elixir has on gastric contents is unknown. Children presenting for elective adenotonsillectomy were randomized to receive either paracetamol elixir (40 mg x kg(-1)) 90 min before surgery or paracetamol suppositories (40 mg x kg(-1)) intraoperatively. Following induction of anaesthesia a 16 Fr multiple-oriface orogastric tube was passed into the stomach and measure taken of the residual gastric volume and pH. The children had a mean age of 8.5 years (SD 3.2) with a weight of 35 kg (SD 16.5). Children given elixir (n=41) had a mean residual gastric volume of 0.083 ml x kg(-1) (95% CI; 0.006, 1.24) and a pH of 1.83 (95% CI; 0.75, 4.49), while those given suppositories (n=40) had a mean residual gastric volume of 0.083 ml x kg(-1)(95% CI; 0.008, 0.9) and a pH of 2.07 (95% CI; 0.84, 5.12). There was no significant difference between these two groups. Paracetamol elixir is rapidly absorbed in the gastrointestinal system of children and preoperative administration has no effect on gastric contents. Given paracetamol's slow equilibration rate constant from the central to the effect compartment, children may be given this medication preoperatively for routine surgical procedures.

Absorption↗
PubMed2004

Gastric emptying and small intestinal transit time in preterm infants: a scintigraphic method.

OBJECTIVES: Practical methods to determine gastric emptying (GE) and small intestinal transit time in preterm infants are required. The aim of this study was to develop a scintigraphic method to determine GE and small intestinal transit time in preterm infants which produce minimal radiation exposure and physical disturbance in these infants. METHODS: Ten premature infants were studied. Median (and range) for gestational age was 28.9 (26-33) weeks, postnatal age was 19 (6-37) days, birth weight was 1194 (687-2300) grams and feeding volume was 173 (6-205) mL/kg/day. Nine of the patients were on nasal continuous positive airway pressure; one patient was on mechanical ventilation. A dose (0.2-0.4 MBq) of 99mTc-DTPA (0.5 mL) was given at the end of a meal administered by naso-gastric tube. Static images were obtained with a mobile gamma camera during the next 9 to 12 hours. The radiation dose was at most 0.30 mSv. Regions of interest (ROIs) were drawn around the stomach and the cecum. Time-activity curves were generated. Gastric emptying half-time (T(1/2)GE) was calculated. Residual gastric activity after 1 hour (R(1h)) and after 2 hours (R(2h)) was determined. Orocecal transit time was defined as the time until significant increase in activity was detected in the cecal ROI. RESULTS: Images showed gastric emptying in all cases. Median (range) half time was 1.0 (0.5-3.0) h. R(1h) was 37.5% (19% to 100%), R(2h) was 23% (6% to 61%). In one patient the tracer did not reach the cecum within 12 hours. In the remaining nine patients orocecal transit time was 3.1 (1.3-6.1) h. CONCLUSIONS: We present a new scintigraphic method to determine GE and orocecal transit time. It appears safe and practicable as a research tool in preterm infants.

Female↗
PubMed2004

Dwell time and functional failure in percutaneous endoscopic gastrostomy tubes: a prospective randomized-controlled comparison between silicon polymer and polyurethane percutaneous endoscopic gastrostomy tubes.

BACKGROUND: Silicone percutaneous endoscopic gastros-tomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications. AIM: To compare dwell time and patterns of failure ofsilicone polymer and polyurethane PEG tubes. METHODS: Participants randomized to receive a siliconepolymer (n = 76) or polyurethane (n = 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded. RESULTS: Tube failure occurred in 25% of silicone PEGs and 12.9% of polyurethane PEGs. Mean tube survival for silicone PEGs was 377.2 days (CI: 326-428) and for polyurethane 436.8 days (CI: 383-490; P = 0.13). A greater proportion of silicone PEGs developed intralumenal colonization and altered tube integrity than polyurethane (P < 0.001). Silicone PEGs blocked more frequently (P < 0.005) and were removed because of irreversible blockage more often than polyurethane PEGs (P < 0.05). Silicone PEGs with reversible blockage and tube integrity changes had a significantly greater probability of failure than silicone tubes without these changes (P < 0.005 and P < 0.05, respectively). CONCLUSIONS: Observations over time indicate that sili-cone PEGs are more susceptible than polyurethane PEGs to tube deterioration, resulting in substantially increased management demands to sustain patients' feeding and medication schedules.

Adult↗
PubMed2002

High-fat diet effects on gut motility, hormone, and appetite responses to duodenal lipid in healthy men.

There is evidence that gastrointestinal function adapts in response to a high-fat (HF) diet. This study investigated the hypothesis that an HF diet modifies the acute effects of duodenal lipid on appetite, antropyloroduodenal pressures, plasma CCK and plasma glucagon-like peptide-1 (GLP-1) levels in humans. Twelve healthy men were studied twice in randomized, crossover fashion. The effects of a 90-min duodenal lipid infusion (6.3 kJ/min) on the above parameters were assessed immediately following 14-day periods on either an HF or a low-fat (LF) diet. After the HF diet, pyloric tonic and phasic pressures were attenuated, and the number of antropyloroduodenal pressure-wave sequences was increased when compared with the LF diet. Plasma CCK and GLP-1 levels did not differ between the two diets. Hunger was greater during the lipid infusion following the HF diet, but there was no difference in food intake. Therefore, exposure to an HF diet for 14 days attenuates the effects of duodenal lipid on antropyloroduodenal pressures and hunger without affecting food intake or plasma hormone levels.

Adult↗
PubMed2000

Effects of intraduodenal glucose and fructose on antropyloric motility and appetite in healthy humans.

Oral fructose empties from the stomach more rapidly and may suppress food intake more than oral glucose. The purpose of the study was to evaluate the effects of intraduodenal infusions of fructose and glucose on antropyloric motility and appetite. Ten healthy volunteers were given intraduodenal infusions of 25% fructose, 25% glucose, or 0.9% saline (2 ml/min for 90 min). Antropyloric pressures, blood glucose, and plasma insulin, gastric inhibitory peptide (GIP), and glucagon-like peptide-1 (GLP-1) were measured concurrently; a buffet meal was offered at the end of the infusion. Intraduodenal fructose and glucose suppressed antral waves (P < 0. 0005 for both), stimulated isolated pyloric pressure waves (P < 0.05 for both), and increased basal pyloric pressure (P = 0.10 and P < 0. 05, respectively) compared with saline, without any significant difference between them. Intraduodenal glucose increased blood glucose (P < 0.0005), as well as plasma insulin (P < 0.0005) and GIP (P < 0.005) more than intraduodenal fructose, whereas there was no difference in the GLP-1 response. Intraduodenal fructose suppressed food intake compared with saline (P < 0.05) and glucose (P = 0.07). We conclude that, when infused intraduodenally at 2 kcal/min for 90 min 1) fructose and glucose have comparable effects on antropyloric pressures, 2) fructose tends to suppress food intake more than glucose, despite similar GLP-1 and less GIP release, and 3) GIP, rather than GLP-1, probably accounts for the greater insulin response to glucose than fructose.

Adult↗
PubMed2006

Site-specific accumulation of the cancer preventive dietary polyphenol ellagic acid in epithelial cells of the aerodigestive tract.

Ellagic acid (EA), a polyphenol present in berries, has been demonstrated to prevent oesophageal and colon cancer in animals. To better understand the site-specificity of these effects, we studied the accumulation and transport of [14C]EA in rat aerodigestive epithelial cells in-vivo and in cultured human cells. When [14C]EA was administered to rats by gavage, a high content of EA was found in the oesophagus and small intestine at 0.5 h after oral administration and in the colon at 12 h, with very low amounts in plasma and peripheral tissues. Studies in human intestinal Caco-2 and human oesophageal HET-1A cells found very limited transcellular transport (Caco-2) of EA but high accumulation (Caco-2 and HET-1A) in the cells. In more detailed studies in the Caco-2 cells, accumulation of EA displayed ATP- and Na+-dependency. Multiple interventions permitted the exclusion of a number of transporters as mediators of this uptake. A dramatically reduced transport of EA at low pH (5.5) compared with high pH (7.4) suggested an important role for the negative charge of EA. This was supported by the organic anion transport inhibitors 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid and bromosulfophthalein. The latter produced as much as 78% inhibition at the 100 microM concentration. Finally, Caco-2 cells were shown to express organic anion transporter 4 (OAT4) mRNA, as was the human large intestine. EA appears to be accumulated along the aerodigestive tract using OAT-like transporters, one of which might be OAT4.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗
PubMed1978

Tubes.

Explore the source record for details and available documents.

England↗
PubMed1984

[Indication and risk of internal intestinal splinting. Comments and supplement to the published article of W. Kapral: Splinting of the small intestine with the Miller-Abbot tube. Chirurg (1984) 55:394].

The usefulness of splinting of the bowel to prevent recurrent bowel obstruction caused by adhesions is analysed. For that is differentiated between three possible indication groups: 1. late bowel obstruction, 2. early postoperative bowel obstruction, 3. mixed peritonitic and mechanical ileus. The risk of splinting of the bowel can only be seen in relation to the number of recurrences, complications and mortality rates as seen in the three indication groups, treated without splinting. From that it shows that in case of peritonitis splinting can only be an adjuvant measure of therapy, and that in case of both recurrent late bowel obstruction and early postoperative bowel obstruction splinting of the bowel has a real preventive effect. This differentiation in indication is of no importance in childhood.

Adult↗