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Role of macroscopic on-site evaluation of endoscopic ultrasoundguided fine-needle aspiration/biopsy:Results of a multicentric prospective study

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World Journal of Gastrointestinal Endoscopy 2024年第11期16卷 595-606页

作者： Hussein H Okasha Hiwa A Hussein Khaled m Ragab Omar Abdallah Fedoua Rouibaa Borahma mohamed Fahd Ghalim mahmoud farouk mohamed Lasheen mohamed A Elbasiony Ahmed E Alzamzamy Ahmed El Deeb Hassan Atalla mahmoud El-Ansary Sahar mohamed moaz Elshair Wafaa Khannoussi mohamed Z Abu-Amer Amine Elmekkaoui mohammed S Naguib Adil Ait Errami Ahmed El-meligui Ahmed H El-Habashi mahmoud G Ameen Dalia Abdelfatah mona Kaddah Hanane Delsa Division of Gastroenterology and Hepatology Department of Internal MedicineKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Sulaimani Center for Advanced Gastrointestinal Endoscopy Sulaimani College of MedicineSulaymaniyah 46001Iraq Department of Hepatology and Gastroenterology Theodor Bilharz Research InstituteCairo 11211Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineMansoura UniversityFaculty of MedicineMansoura 35516Egypt Gastrointestinal Endoscopy Center Military Hospital Mohamed VFaculty of Medicine of RabatRabat 10100Rabat-Salé-KénitraMorocco Department of Gastroenterology“C” Ibn Sina HospitalMohammed V University in RabatRabat 10000Rabat-Salé-KénitraMorocco Digestive Endoscopy Unit Mekka ClinicCasablanca 20000Casablanca-SettatMorocco Department of Tropical medicine and Gastroenterology Luxor UniversityLuxor 85951Egypt Hepatology and Gastroenterology Unit Department of Internal MedicineFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Gastroenterology and Hepatology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11841Egypt Department of Gastroenterology National Hepatology and Tropical Medicine Research InstituteCairo 12556Egypt Department of Hepatology Gastroenterology and Infectious DiseasesFaculty of MedicineAl-Azhar UniversityCairo 11651Egypt Department of Gastroenterology and Endoscopy Center Cheikh Khalifa International University HospitalMohammed VI University of Sciences and HealthCasablanca 82403Casablanca-SettatMorocco Research Unit Mohammed VI Center for Research and InnovationRabat 10100Rabat-Salé-KénitraMorocco Department of Hepato-Gastroenterology Hassan II University Hospital of FezFaculty of MedicinePharmacy and Dentistry of FezSidi Mohamed Ben Abdellah UniversityFes 30003Fès-MeknèsMorocco Department of Gastroenterology Ahmed Maher Teaching HospitalCairo 11451Egypt Department of Gastroenterology Cadi Ayyad UniversityMohammed VIth University HospitalMarrakech

BACKGROUND The concept of macroscopic on-site evaluation(mOSE)was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on mOSE was superior to 4 *** studies suggest that mOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation,and some classi-fications have been *** studies have assessed the adequacy of histologic cores in mOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy(EUS-FNA/FNB).AIm To evaluate the performance of mOSE during EUS-FNA/*** This multicentric prospective study was conducted in 16 centers in 3 countries(Egypt,Iraq,and morocco)and included 1108 patients with pancreatic,biliary,or gastrointestinal pathology who were referred for EUS *** prospectively analyzed the mOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core *** management and analysis were performed using a Statistical Package for Social Sciences(SPSS)version *** A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological *** age was 59 years,and 509 patients(50.5%)were *** mean lesion size was 38 *** most frequently utilized needles were FNB-Franseen(74.5%)and 22 G(93.4%),with a median of 2 *** to 2 classifications,618 non-bloody cores(61.3%)and 964 good samples(95.6%)were adequate for histological *** overall diagnostic yield of cytopathology was 95.5%.The cytological examination confirmed the diagnosis of malignancy in 861 patients(85.4%),while 45 samples(4.5%)were ***-procedural adverse events occurred in 33 patients(3.3%).Statistical analysis showed a difference between needle types(P=0.035)with a high sensitivity of FNB(97%).The analysis of the relationship between the mOSE-score and the final diagnosis showed a significant difference between the different

关键词： macroscopic on-site evaluation Fine-needle aspiration Fine-needle biopsy Endoscopic ultrasound Specimen

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The Effects of Vestibular rehabilitation after Bilateral Superior Semicircular Canal Dehiscence: A Case Report

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International Journal of Clinical medicine 2017年第6期8卷 439-461页

作者： Connor L. Naccarato Kristen m. Johnson University of St. Augustine for Health Sciences San Marcos CA USA Physio Strength LLC Tacoma WA USA Bench mark rehab Partners Ooltewah TN USA

Background and Purpose: Despite the strong body of evidence for vestibular rehabilitation, research is lacking for effective clinical management of patients with superior semicircular canal dehiscence (SSCD) and endolymphatic hydrops (EH). The purpose of this case report is to describe the effects of physical therapy in the treatment of a patient diagnosed with bilateral SSCD. Case Description: The patient was a 56-year-old woman with a long-standing otologic history involving bilateral SSCD and EH. The patient’s body structure and function impairments include constant headaches, dizziness with head rotation and eye movements, sensitivity to sounds and lights, and instability during gait. Her activity limitations include lower extremity dressing, driving, and playing her flute. Her participation restrictions include taking part in social gatherings, going to church, driving longer than 30 minutes, playing with her dogs, and teaching flute lessons. Interventions: Specific interventions included vestibular habituation and adaptation exercises, balance and gait training, and patient education. Physical therapy services were provided for approximately 11 weeks with a frequency of two times per week. Outcomes: After eleven weeks of physical therapy, the patient made improvements on the Lower Extremity Functional Scale (43/80 to 52/80), the Dynamic Gait Index (19/24 to 24/24), the Dizziness Handicap Inventory (86/100 to 68/100), and the Sharpened Romberg (2 seconds to >30 seconds). The patient improved in all her activity limitations and participation restrictions. She was able to play her flute for 20-minute intervals, play with her dogs, partake in social gatherings, and drive for 5 hours without symptoms. The patient had plans to pursue surgical intervention within the next year. Discussion: For a patient with a complex otologic history and a current diagnosis of bilateral SSCD, vestibular rehabilitation was an effective management option. The information from this cas

关键词： Physical Therapy Superior Semicircular Canal Dehiscence Vestibular rehabilitation Gaze Stabilization

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The effects of a patient-centred rehabilitation model of care targeting older adults with cognitive impairment on healthcare practitioners

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Advances in Aging Research 2014年第1期3卷 48-58页

作者： Paula m. van Wyk Steven Stewart Katherine S. mcGilton Department of Kinesiology and Health Studies Queen’s University Kingston Canada Department of Kinesiology University of Windsor Windsor Canada Department of Research Toronto Rehabilitation Institute University Health Network Toronto Canada Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Canada

Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adults with a CI may negatively influence the attitudes and job satisfaction of healthcare practitioners working with this population. The current study is a part of a larger intervention study allowing patients with CI following a hip fracture access to rehabilitation care and implementing a patient-centred model to facilitate caring for this new population. This new model required a substantial change in the skillset and knowledge of healthcare practitioners. The focus of this study was to explore the impact on the healthcare practitioners of adopting this new model for providing care to older adults with a CI following a hip fracture. The attitudes, dementia knowledge, job satisfaction, and work stress of healthcare practitioners were the focus of evaluation. Key study findings showed that stress due to relationships with coworkers, workloads and scheduling, and the physical design and conditions at work were moderated post-intervention. Staff responses also improved for job satisfaction, biomedical knowledge of dementia, and degree of hopefulness about dementia. Although we cannot state conclusively that the our model was solely responsible for all the staff improvements observed post-intervention, our findings provide further support to the argument that patients with CI should be allowed access to rehabilitation care. rehabilitation units need to provide education that utilizes a person-centred approach accepting of patients with CI, and focuses on areas that can bolster staff’s positive, dementia-sensitive attitudes. Ultimately, the aim is to create a culture that provides the highest standard of care for all patients, reduces work-related stress, increases job satisfaction, and leads to the highest quality of life for patients during and after rehab

关键词： Hip Fracture Cognitive Impairment rehabilitation Patient-Centred Attitudes Job Satisfaction Work Stress

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Timing of percutaneous endoscopic gastrostomy tube placement in post-stroke patients does not impact mortality, complications, or outcomes

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第5期13卷 77-87页

作者： Kavya m Reddy Preston Lee Parul J Gor Antonio Cheesman Noor Al-Hammadi David John Westrich Jason Taylor Vatche and Tamar manoukian Division of Digestive Diseases David Geffen School of Medicine at University of California Los AngelesLos AngelesCA 90095United States Department of Internal medicine Santa Clara Valley Medical CenterSan JoseCA 95128United States Division of Gastroenterology and Hepatology Mercy HospitalSaint LouisMO 63141United States David John Westrich Jason TaylorDivision of Gastroenterology and HepatologySaint Louis University School of MedicineSaint LouisMO 63104United States Saint Louis University Center for Health Outcomes Research Saint Louis UniversitySaint LouisMO 63104United States

BACKGROUND Percutaneous Endoscopic Gastrostomy(PEG)tubes are often placed for dysphagia following a stroke in order to maintain sufficient caloric *** 2011 ASGE guidelines recommend delaying PEG tube placement for two weeks,as half of patients with dysphagia improve within 2 *** are few studies comparing outcomes based on timing of PEG tube placement,and there is increasing demand for early PEG tube placement to meet requirements for timely discharge to rehab and skilled nursing *** To assess the safety of early(≤7 d post stroke)vs late(>7 d post stroke)PEG tube placement and evaluate whether pre-procedural risk factors could predict mortality or *** We performed a retrospective study of patients undergoing PEG tube placement for dysphagia following a stroke at two hospitals in Saint Louis,mO between January 2011 and December *** were identified by keyword search of endoscopy ***,peri-procedural complication rates,and post-procedural complication rates were compared in both *** of morbidity and mortality such as protein-calorie malnutrition,presence of an independent cardiovascular risk equivalent,and presence of Systemic inflammatory response syndrome(SIRS)criteria or documented infection were evaluated by multivariate logistic *** 154 patients had a PEG tube placed for dysphagia following a stroke,92 in the late group and 62 in the early *** were 32 observed deaths,with 8 occurring within 30 d of the *** was an increase in peri-procedural and post-procedural complications with delayed PEG placement which was not statistically *** length of stay was significantly less in patients with early PEG tube placement(12.9 vs 22.34 d,Pmalnutrition,presence of SIRS criteria and/or documented infection prior to procedure or having a cardiovascular disease risk equivalent did not significantly predict mortality or complicati

关键词： Percutaneous endoscopic gastrostomy tube Dysphagia Stroke Enteral nutrition Gastrostomy/adverse effect

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慢性腰背痛患者的P50潜伏中期听觉诱发电位

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世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 16-17页

作者： Fann A.V. Preston m.A. Bray P. 江山 Dept.of Phys. med. and rehab . Ctrl. Arkansas Vet. Hlthcare.System 2200 Fort Roots Dr North Little Rock A R72114 United States

Objective: Patients with Chronic Low Back Pain (CLBP) show arousal, attentiona l and cognitive disturbances. The sleep state dependent P50 midlatency auditory evoked potential was used to determine if patients with CLBP [with and without c o-morbid depression (DEP)] show quantitative disturbances in the manifestation of the P50 potential. methods: P50 potential latency,amplitude and habituation t o repetitive stimuli at 250,500and 1000 ms interstimulus intervals (ISIs) was re corded, along with the mcGill Pain Questionnaire-Short Form (mPQ-SF).CLBP subj ects (n=42) were compared with Controls (n=43), and with subjects with DEP only (n=6). Of the CLBP subjects, 20/42 had clinical depression (CLBP+DEP); 8/20 wer e taking anti-depressant medication (CLBP+DEP+med), the others were not (CLBP +DEP-med). Results: There were no differences (ANOVA) in age, sex or P50 poten tial latency, although there was a trend towards increased latencies in CLBP gro ups. P50 potential amplitude was lower in CLBP groups, but not in sub-groups, a gain indicating a trend. P50 potential habituation was decreased in the DEP only subjects at the 250 m ISI, and decreased in CLBP+DEPmed subjects at the 500 ms ISI. This difference was not present in CLBP+DEP+med subjects. The mPQ-SF re vealed that patients with CLBP and CLBP+DEP-med showed lower pain scores than CLBP+DEP+med patients. Conclusions: There is decreased habituation of the P50 potential habituation in unmedicated patients with CLBP+DEP compared to C ***: Patients with CLBP+DEP-med may be less able to disregard incoming sensory information, including painful sensations, but anti-depressan t medications help correct this deficit. However, their perception of pain may b e increased by medication.

关键词：慢性腰背痛 P50 听觉诱发电位抗抑郁治疗 auditory sensory 郁症 evoked deficit medication

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产后持续压力性尿失禁物理治疗的随机对照试验

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世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 45-46页

作者： Dumoulin C. Lemieux m.-C. Bourbonnais D. 王伟华 rehabilitat ion Institute of montreal Res. Ctr. Interdisc. Res. Rehab. 6300 Darlington Mo ntreal Que. H3S 2J4 Canada Dr.

OBJECTIVE: The aim of this study was to compare the effectiveness of multimo da l supervised physiotherapy programs with the absence of treatment among women wi th persistent postnatal stress urinary incontinence. mETHODS: This was a single -blind randomized controlled trial. Sixty-four women with stress urinary incon tinence were randomly assigned to 8 weeks of either multimodal pelvic floor reha bilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscl e training (n = 23), or control non-pelvic floor rehabilitation (n = 20). The p rimary outcome measure consisted of a modified 20-minute pad test. The secondar y outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Uro genital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic fl oor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70%of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) w ere continent on pad testing compared with 0%of women in die control group. Sco res on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Inc ontinence Impact Questionnaire improved significantly in both treatment groups ( all P muscle function, however, did not improve significantly in either active grou p. CONCLUSION: multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.

关键词：压力性尿失禁随机对照试验物理治疗骨盆底盆底肌肉单盲视觉模拟锻炼组机能恢复肌肉功能

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疑似阿尔茨海默病患者不自觉认知功能缺陷(认知功能病感失认)的对照研究

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世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 50-50页

作者： Barrett A.m. Eslinger P.J. Ballentine N.H. Heilman K.m. 邓剑平 Kess ler med. rehab. Res./Educ. Corp. 1199 Pleasant Valley Way West Orange NJ 07052 United States Dr.

Objective: To develop a quantitative method of assessing cognitive anosognosia in six cognitive and two noncognitive ***: Control (n =32) and prob able Alzheimer disease(pAD) (n = 14) subjects self-estimated memory, attention, generative behavior, naming, visuospatial skill, limb praxis, mood,and uncorrec ted vision, both before and after these abilities were assessed. Based on this e stimate and their performance the authors calculated an anosognosia ratio (AR) b y dividing the difference between estimated and actual performance by an estimat ed and actual performance sum. With perfect awareness,AR = 0. Overestimating abi lities would yield a positive AR (≤1); underestimation would yield a negative A R (≥-1). Results: Relative to controls, pAD subjects demonstrated anosognosia. Pre-testing (off-line), pAD subjects overestimated their visuospatial skill; p ost-testing (on-line), pAD subjects overestimated their memory. Control subjec ts also made selfrating errors, underestimating their attention pre-testing and overestimating limb praxis and vision post-testing. Conclusions:This anosognos ia assessment method may allow more detailed examination of distorted self-awar eness. These results suggest that screening for anosognosia in probable Alzheime r disease (pAD) should include self-estimates of visuospatial function, and tha t, in pAD, it may be useful to assess anosognosia for amnesia both before and af ter memory testing.

关键词：认知功能阿尔茨海默病失认病感记忆测试视觉空间过高估计矫正视力不自觉自我评价

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