[Video-endoscopy. An electronic image-transmitting system in endoscopy of the gastrointestinal system].
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Upper endoscopy
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Emergency endoscopy was done in 306 patients with acute upper gastrointestinal bleeding. Most of the patients were in the age group 20—39 years. Male to female ratio was 2.3:1. The main causes of bleeding were peptic ulcer (40.1 8%), oesophageal varices (32.4%) and superficial mucosal lesions (13.9%). Causes of bleeding remained obscure in 7.2% cases; dual lesions were seen in 2.94%. Complete follow up was available in 83.8% cases of portal hypertension and 69.10% peptic ulcers. Overall mortality in portal hypertension and peptic ulcer was 42.4% and 13.2%, respectively. Poor correlation was found between clinical and endoscopic diagnosis (JPMA 38 : 30, 1988).
Upper Gastrointestinal Bleeding
Peptic
Gastric varices
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When endoscopy is performed for acute GI bleeding, therapeutic endoscopic procedures are infrequently required (only 6% of cases). We sought to determine the natural history of GI hemorrhage in patients who have undergone therapeutic endoscopy. We queried our hospital database for inpatients with acute GI bleeding who underwent therapeutic endoscopy between 2015 and 2017. The primary endpoints were recurrence of bleeding and the subsequent need for repeated endoscopic interventions, angioembolization, or surgery. Demographic information was collected. We reviewed 205 hospitalized patients: mean age was 70 years, 58 per cent were male, and mean hemoglobin was 9 g/dL. Patients had medical conditions predisposing them to bleeding in 59 per cent and history of previous GI bleeding in 37 per cent of cases. Sixty per cent were on antiplatelet/ anticoagulation medications, and 10 per cent were receiving nonsteroidal anti-inflammatory medications. Blood transfusions were given to 78 per cent of patients, with an average of 2.3 units of packed red blood cells transfused per patient before intervention. Recurrence of hemorrhage after therapeutic endoscopy was seen in 9 per cent of patients. Only 2 per cent underwent a second therapeutic endoscopic procedure, and 5 per cent had surgery or angioembolization (half of these patients then had a further recurrence of bleeding). In total, seven patients died (3%). Recurrence of GI bleeding after therapeutic endoscopies is uncommon (9%). Surgery and angioembolization are not commonly necessary, but when used are only successful in 50 per cent of cases.
Therapeutic Endoscopy
Gastrointestinal bleeding
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Background: In patients who find difficulty in eating or who have lost the ability to swallow food, percutaneous endoscopic gastrostomy (PEG) is the preferred method of long-term tube feeding.Although PEG is a usually safe technique, several complications sometimes arise.Objective: To study the advantage and disadvantage of PEG to improve the maneuver and increase the success rate by identification of outcome complications of PEG and their management and evaluation of the efficacy of PEG in improving patient's lifestyles.Patients and methods: This retrospective, single-center study was done on 60 patients who needed PEG tube in the endoscopy unit of internal medicine department, Zagazig University Hospital during the period from December 2020 to May 2021.All patients were subjected to complete relevant evaluation before the study in the form of complete history taking, clinical examination, lab investigation, pelvi-abdominal ultrasound, multislice CT or MRI to assess advanced cancer or peritoneal metastasis and endoscopic examination for outlet patency.Results: A total of 16 patients (26.67 %) had PEG-related complications.Fourteen (23.3 %) patients had minor complications.The most common minor complication recorded was insertion site infection that found in 5 (8.3 %) patients.Two (3.3%) patients in our study reported major PEG-related complications.One (1.7%) patient had massive hematemesis and melena and one (1.7%)patient reported buried bumper syndrome. Conclusion:We concluded that PEG had received global acceptability as a safe approach for administering enteral feeding in patients with inadequate oral intake for more than 28 days and a functioning GI system.
Percutaneous endoscopic gastrostomy
Gastrostomy tube
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Background: We developed a technique for endoscopy-assisted percutaneous repair of acute Achilles tendon tears. Methods: Nineteen patients with acute Achilles tendon tears were prospectively recruited into the study. All patients (18 male, 1 female) had sports-related injuries. Preoperative diagnosis was made from patient history, physical examination, and sonography. The average patient age was 38.7 years, and follow-up averaged 24 months. All patients received endoscopy-assisted percutaneous Achilles tendon repair with modified Bunnell sutures passed by bird beak and No. 5 Ethibond under direct visualization using 4.0-mm arthroscopy. Results were evaluated by physical examination, sonography, and magnetic resonance imaging (MRI). Results: All 19 patients achieved tendon healing. All patients were evaluated by sonography, and the tendons of 16 patients were imaged using MRI to evaluate the extent of healing. Final dorsiflexion was 16 degrees and plantar flexion 26 degrees, and 95% of the patients (18/19) returned to their previous level of sporting activity. One patient developed a superficial infection, and 2 patients had postoperative sural nerve injury with numbness for 1 month. There were no other major complications. Conclusion: Endoscopy-assisted percutaneous repair of the Achilles tendon allowed good tendon healing and return to sports at 6 months. Sural nerve injury during surgery was a potential complication of this procedure. Level of Evidence: Level IV, retrospective case series.
Sural nerve
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Objective To determine the outcome of therapeutic endoscopy for upper gastrointestinal(UGI) bleeding. Methods There were 84 patients with UGI bleeding diagnosed with endoscopy, 54 receiving durg injection through a vein, and 30 receiving endoscopic injection of thrombin and adrenaline diluted in iced saline. The endoscopic cases with obvious hemorrhagic spots were treated with electric coagulation. Then all the patients underwent routine therapy according to each one's indications and their prognosis was analyzed. Results Hemostasia was obtained in 83.3%(25/30) of the patients with therapeutic endoscopy, which was significantly higher than 61.1%(33/54) in the cases with conservative treatment(P0.05). In contrast, the rate of transferring to surgical operation in endoscopic group was 6.7%(2/30),which was lower than 25.9%(14/54) in conservative group(P0.05). In 1 week of hemostasia, there were no differences in recurrence rate between 2 groups. Conclusions Therapeutic endoscopy is efficient for UGI bleeding, and better than conservative treatment. It can decrease the operation rate and shorten the term of recovery.
Therapeutic Endoscopy
Therapeutic effect
Conservative Treatment
Endoscopic treatment
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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The nationally-recognized Susquehanna
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performances have been described
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music making, successful in their
aim to make the audience feel,
to be moved, to be part of the
performance - and all this while
working at an extremely high
musical level.AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA¢AÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂAÂA Experience choral
singing that will take you to new
heights!
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