Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this...Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.展开更多
Polyps are precursors to colorectal cancer,the third most common cancer in the United States.Large polyps,i.e.,,those with a size≥20 mm,are more likely to harbor cancer.Colonic polyps can be removed through various t...Polyps are precursors to colorectal cancer,the third most common cancer in the United States.Large polyps,i.e.,,those with a size≥20 mm,are more likely to harbor cancer.Colonic polyps can be removed through various techniques,with the goal to completely resect and prevent colorectal cancer;however,the management of large polyps can be relatively complex and challenging.Such polyps are generally more difficult to remove en bloc with conventional methods,and depending on level of expertise,may consequently be resected piecemeal,leading to an increased rate of incomplete removal and thus polyp recurrence.To effectively manage large polyps,endoscopists should be able to:(1)Evaluate the polyp for characteristics which predict high difficulty of resection or incomplete removal;(2)Determine the optimal resection technique(e.g.,snare polypectomy,endoscopic mucosal resection,endoscopic submucosal dissection,etc.);and(3)Recognize when to refer to colleagues with greater expertise.This review covers important considerations in this regard for referring and receiving endoscopists and methods to best manage large colonic polyps.展开更多
Hospital inquired post-operative infections are a leading cause of morbidity and mortality in patients receiving left ventricular assist devices. We present the case of a patient who acquired Candida albicans and Stap...Hospital inquired post-operative infections are a leading cause of morbidity and mortality in patients receiving left ventricular assist devices. We present the case of a patient who acquired Candida albicans and Staphylococci infections following left ventricular assist device implantation. Use of standard antibiotics caused the infection to worsen, thus an amniotic membrane patch was used as a last-resort treatment. Within 6 weeks of the amniotic membrane patch treatment, the infection resolved, the wound appeared exceptionally clean upon inspection, and granulation tissue was present. After the infection resolved, a successful latissimusdorsi tissue flap procedure was completed and the patient made a full recovery.展开更多
文摘Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.
文摘Polyps are precursors to colorectal cancer,the third most common cancer in the United States.Large polyps,i.e.,,those with a size≥20 mm,are more likely to harbor cancer.Colonic polyps can be removed through various techniques,with the goal to completely resect and prevent colorectal cancer;however,the management of large polyps can be relatively complex and challenging.Such polyps are generally more difficult to remove en bloc with conventional methods,and depending on level of expertise,may consequently be resected piecemeal,leading to an increased rate of incomplete removal and thus polyp recurrence.To effectively manage large polyps,endoscopists should be able to:(1)Evaluate the polyp for characteristics which predict high difficulty of resection or incomplete removal;(2)Determine the optimal resection technique(e.g.,snare polypectomy,endoscopic mucosal resection,endoscopic submucosal dissection,etc.);and(3)Recognize when to refer to colleagues with greater expertise.This review covers important considerations in this regard for referring and receiving endoscopists and methods to best manage large colonic polyps.
文摘Hospital inquired post-operative infections are a leading cause of morbidity and mortality in patients receiving left ventricular assist devices. We present the case of a patient who acquired Candida albicans and Staphylococci infections following left ventricular assist device implantation. Use of standard antibiotics caused the infection to worsen, thus an amniotic membrane patch was used as a last-resort treatment. Within 6 weeks of the amniotic membrane patch treatment, the infection resolved, the wound appeared exceptionally clean upon inspection, and granulation tissue was present. After the infection resolved, a successful latissimusdorsi tissue flap procedure was completed and the patient made a full recovery.
