Beyond Magnamosis: A Method to Test Sutureless Esophageal Anastomotic Devices in Living Swine by Creating an Esophageal Bypass Loop for Natural Oral Nutrition

2019 ◽  
Vol 29 (6) ◽  
pp. 852-855 ◽  
Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Andreas Lindner ◽  
Axel Heimann ◽  
Alexandru Balus ◽  
Veeshal H. Patel ◽  
...  
Keyword(s):  
Oral Nutrition ◽  
Anastomotic Devices

„Clampless“ proximal anastomotic devices for CABG surgery

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
G Dohmen ◽  
JW Spillner ◽  
N Hatam ◽  
G Mühlenbruch ◽  
M Schmid ◽  
...  
Keyword(s):  
Cabg Surgery ◽  
Anastomotic Devices

scholarly journals A New Classification System to Predict Functional Outcome after Laryngectomy and Laryngopharyngectomy

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1474
Author(s):  
Stefan Grasl ◽  
Elisabeth Schmid ◽  
Gregor Heiduschka ◽  
Markus Brunner ◽  
Blažen Marijić ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Classification System ◽  
Salvage Surgery ◽  
Tumor Resection ◽  
Previous Treatment ◽  
Extent Of Resection ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Oral Nutrition

(1) Objective: To evaluate long-term functional outcome in patients who underwent primary or salvage total laryngectomy (TL), TL with partial (TLPP), or total pharyngectomy (TLTP), and to establish a new scoring system to predict complication rate and long-term functional outcome; (2) Material and Methods: Between 1993 and 2019, 258 patients underwent TL (n = 85), TLPP (n = 101), or TLTP (n = 72). Based on the extent of tumor resection, all patients were stratified to (i) localization I: TL; II: TLPP; III: TLTP and (ii) surgical treatment (A: primary resection; B: salvage surgery). Type and rate of complication and functional outcome, including oral nutrition, G-tube dependence, pharyngeal stenosis, and voice rehabilitation were evaluated in 163 patients with a follow-up ≥ 12 months and absence of recurrent disease; (3) Results: We found 61 IA, 24 IB, 63 IIA, 38 IIB, 37 IIIA, and 35 IIIA patients. Complications and subsequently revision surgeries occurred most frequently in IIIB cases but rarely in IA patients (57.1% vs. 18%; p = 0.001 and 51.4% vs. 14.8%; p = 0.002), respectively. Pharyngocutaneous fistula (PCF) was the most common complication (33%), although it did not significantly differ among cohorts (p = 0.345). Pharyngeal stenosis was found in 27% of cases, with the highest incidence in IIIA (45.5%) and IIIB (72.7%) patients (p < 0.001). Most (91.1%) IA patients achieved complete oral nutrition compared to only 41.7% in class IIIB patients (p < 0.001). Absence of PCF (odds ratio (OR) 3.29; p = 0.003), presence of complications (OR 3.47; p = 0.004), and no need for pharyngeal reconstruction (OR 4.44; p = 0.042) represented independent favorable factors for oral nutrition. Verbal communication was achieved in 69.3% of patients and was accomplished by the insertion of voice prosthesis in 37.4%. Acquisition of esophageal speech was reached in 31.9% of cases. Based on these data, we stratified patients regarding the extent of surgery and previous treatment into subgroups reflecting risk profiles and expectable functional outcome; (4) Conclusions: The extent of resection accompanied by the need for reconstruction and salvage surgery both carry a higher risk of complications and subsequently worse functional outcome. Both factors are reflected in our classification system that can be helpful to better predict patients’ functional outcome.

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

2021 ◽  
pp. 194338752110264
Author(s):  
Sean A. Knudson ◽  
Kristopher M. Day ◽  
Patrick Kelley ◽  
Pablo Padilla ◽  
Ian X. Collier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Planning ◽  
Average Length ◽  
Case Series ◽  
Retrospective Case ◽  
Oral Nutrition ◽  
Microsurgical Reconstruction ◽  
Virtual Surgical Planning ◽  
And Function ◽  
Ballistic Trauma

Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

scholarly journals Calculating the True Costs of Food Service in Long-Term Care: Development of a Costing Methodology

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 88-88
Author(s):  
Mikaela Wheeler ◽  
Karen Abbey ◽  
Sandra Capra
Keyword(s):  
Long Term Care ◽  
Systems Approach ◽  
Food Service ◽  
Term Care ◽  
Oral Nutrition ◽  
Total Cost ◽  
Real Cost ◽  
Future System ◽  
Care Development

Abstract As population’s age and the need for long term care (LTC) increases, so too does the focus on the costs to provide that care. Providing food, oral nutrition supplements and meals, can be a considerable expense to a home. The objective of this research was to develop a valid foodservice costing tool (FCT), to calculate the real cost of providing foods and meals in LTC. Current costing methodologies are not specific to LTC and do not account for all costs of a foodservice, including staff, procurement and nutrition supplements. An initial tool was developed using the systems approach in conjunction with literature and professional knowledge. This was piloted in real world contexts, using volunteer LTC homes. Four iterations of the tool were completed to assess its feasibility in calculating costs and useability. Managers were interviewed after completing the tool to gather an understanding of how the tool was interpreted and to refine completion. Following feedback, the resulting tool consists of nine sections, measuring both costs incurred in meal production and service as well as analysis of staff workloads. Preliminary results show consistency between homes within Australia, indicating that the true cost is much higher than that reported in the literature to date. The development of a comprehensive, usable tool which captures the total cost of foodservice allows homes to accurately report and understand costs from a systems level. This information can be used to demonstrate cost effectiveness of a foodservice and the potential to justify and plan future system changes.

scholarly journals The Contribution of Registered Dietitians in the Management of Hyperemesis Gravidarum in the United Kingdom

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1964
Author(s):  
Kate Maslin ◽  
Hazel A. Billson ◽  
Caitlin R. Dean ◽  
Julie Abayomi
Keyword(s):  
United Kingdom ◽  
Clinical Guidelines ◽  
Hyperemesis Gravidarum ◽  
Oral Intake ◽  
Registered Dietitians ◽  
Oral Nutrition ◽  
The United Kingdom ◽  
Referral Criteria ◽  
Patient Resources

Hyperemesis Gravidarum (HG) is a condition at the extreme end of the pregnancy sickness spectrum, which can cause poor oral intake, malnutrition, dehydration and weight loss. The aim of this study is to explore the role of Registered Dietitians (RD) in the management of HG in the United Kingdom (UK). A survey was designed and distributed electronically to members of the British Dietetic Association. There were 45 respondents, 76% (n = 34) worked in secondary care hospitals, 11% (n = 5) were in maternal health specialist roles. The most commonly used referral criteria was the Malnutrition Universal Screening Tool (40%, n = 18), followed by second admission (36%, n = 16). However 36% (n = 16) reported no specific referral criteria. About 87% (n = 37) of respondents did not have specific clinical guidelines to follow. Oral nutrition supplements were used by 73% (n = 33) either ‘sometimes’ or ‘most of the time’. Enteral and parenteral nutrition were less commonly used. There was an inconsistent use of referral criteria to dietetic services and a lack of specific clinical guidelines and patient resources. Further training for all clinicians and earlier recognition of malnutrition, alongside investment in the role of dietitians were recommended to improve the nutritional care of those with HG.

Oral nutrition and gastroenterology

1988 ◽  
Vol 4 (2) ◽  
pp. 289-298
Author(s):  
S. M. Fowlie ◽  
M. A. Eastwood
Keyword(s):  
Oral Nutrition

PP060-MON IMPACT OF A STANDARDIZED ORAL NUTRITION PROTOCOL AFTER UNCOMPLICATED CYSTECTOMY

2011 ◽  
Vol 6 (1) ◽  
pp. 137-138
Author(s):  
P. Declercq ◽  
G. De Win ◽  
E. Beels ◽  
I. Spriet ◽  
H. Van Poppel ◽  
...  
Keyword(s):  
Oral Nutrition

Assessment of patented coronary end-to-side anastomotic devices using micromechanical bonding

2000 ◽  
Vol 70 (1) ◽  
pp. 218-221 ◽  
Author(s):  
Jules S Scheltes ◽  
Martijn Heikens ◽  
Peter V Pistecky ◽  
Carolien J van Andel ◽  
Cornelius Borst
Keyword(s):  
Anastomotic Devices

Essential Fatty Acid Deficiency in Patients Receiving Simultaneous Parenteral and Oral Nutrition

1980 ◽  
Vol 4 (4) ◽  
pp. 343-345 ◽  
Author(s):  
T. Peter Stein ◽  
Gordon P. Buzby ◽  
W. Clark Hargrove ◽  
Maria J. Leskiw ◽  
James L. Mullen
Keyword(s):  
Fatty Acid ◽  
Essential Fatty Acid ◽  
Essential Fatty Acid Deficiency ◽  
Oral Nutrition ◽  
Acid Deficiency ◽  
Fatty Acid Deficiency
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