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Biomedical subjects

L Iliás

Publications and source records attributed to L Iliás.

11 recordsLinked to original sources
PubMed2001

Technical modifications for improving the success rate of PEG tube placement in patients with head and neck cancer.

BACKGROUND: Patients with head and neck cancer (HNC) benefit from nutritional support by means of PEG tubes, but endoscopy may be impossible when there is partial or complete trismus and/or stenosis or occlusion of the upper aerodigestive tract. METHODS: PEG tubes were placed in 277 patients with HNC. Oral insertion of an endoscope into the esophagus was impossible in 27 patients. Transnasal endoscopy was performed (n = 4). In the cases of high-grade tumor obstruction, the endoscope was introduced into the esophagus through a straight laryngoscope (n = 9). When upper aerodigestive tract occlusion was present, endoscopy with PEG placement was successfully performed during surgery by means of the opened pharynx after tumor resection (n = 12). RESULTS: In 25 of the 27 cases PEG tubes could be placed by using the above alternative techniques. There were no immediate complications, and no complications occurred within 30 days of PEG placement. CONCLUSIONS: Transnasal, straight laryngoscopic, or intraoperative open endoscopy can improve the success rate for PEG tube placement in patients with HNC.

Adult↗
PubMed1999

[Percutaneous endoscopic gastrostomy: experience of three years].

UNLABELLED: Patients who are not able to eat do need tube feeding. The most preferred way of artificial enteral nutritional support is feeding via percutaneous endoscopic gastrostomy (PEG) tubes. Head and neck cancer patients do represent a special group of patients needing a PEG. On the one hand at the time of admission to the hospital they are mainly undernourished. On the other hand the failure rate of placing a PEG is the highest among them. Furthermore in the perioperative period nasogastric tubes do cause a lot of complications in these settings. 188 PEG placements were carried out from July 1995 till November 1998. INDICATIONS: head and neck cancer (n = 171), neurologic disorders (n = 17). PEG tubes were placed 76 times during intratracheal narcosis and 112 times following local anaesthesia. 39 times there was a prior abdominal surgery in our patients medical history. The pull-through, the push-wire and the introducer techniques were used. Beside the usual oro-gastric way of endoscopying (n = 163), 25 times the following alternative ways of entering the upper gastrointestinal tract were used: transnasal route (n = 4), through a Kleinsasser type direct laryngoscope (n = 7) and via the opened pharynx (n = 14). No immediate or late onset procedure related complications occurred. During a follow-up of 22,480 tubedays 26 minor (dermatitis n = 24, ulcer n = 2) and 8 major (abscess n = 4, perforation/peritonitis n = 3, stomach and bowel wall necrosis n = 1) complications occurred. The success rate of placing a PEG was 98.9%. In head and neck cancer patients placing a PEG is suggested when there is a need for at least a 7 days time tube-feeding. Using the described alternative ways, a PEG tube can be placed almost always. Because of the uncertain outcome, nutritional support via PEG tubes is suggested also in cachectic patients and in vegetative state as well.

Enteral Nutrition↗
PubMed1996

[Massive haemothorax caused by intralobar pulmonary sequestration].

The authors present the case of a young male with massive haemothorax caused by intralobar bronchopulmonary sequestration. Angiography is necessary for the exact diagnosis of bronchopulmonary sequestration. The most common site of intrapulmonary type sequestration is the left lower lobe of the lung. In this case the aberrant artery was originated from the abdominal aorta. During thoracotomy after ligature of the aberrant vessels S5,S10 segmentectomy was performed. The authors emphasize that the rare cause of rapid anaemia in consequence of haemothorax could be intralobar bronchopulmonary sequestration.

Adult↗
PubMed1995

[Repeated serious water intoxication in an aged patient. (Data on the relationship between the inappropriate antidiuretic hormone syndrome and the atrial natriuretic factor)].

An old women was in an 8-year-period 9 times admitted to the hospital because of severe mental disturbances. The average serum sodium concentration was 126.25 +/- 2.43 mmol/l at the admissions; it increased to 139.44 +/- 1.40 mmol/l after intravenous infusion of hypertonic solutions accompanied with the disappearance of the mental disturbances. The patient was usually chronically hyponatremic due to the increased water intake and the insufficient water excretion. The latter was induced by the augmented vasopressin levels. The remarkable feature of the syndrome of inappropriate antidiuretic hormone secretion was its association with lowered blood level of atrial natriuretic factor accompanied by sodium, and volume depletion. Discontinuation of the exaggerated water intake resulted in the elimination of the permanent hyponatremia; no episode of water intoxication occurred during the last 3 and 1/2 years.

Aged↗
PubMed1994

[Eosinophilic gastroenteritis].

A case of a young man with eosinophilic gastroenteritis with mucosal involvement in the antrum and duodenum is presented. The diagnosis was based on endoscopic biopsy with histological examination, peripheral blood eosinophilia and gastrointestinal symptoms, like abdominal cramping, nausea, vomiting and diarrhoea. Parasitic and extraintestinal diseases were ruled out. Steroid therapy was effective. It is emphasised that in the cases of abdominal complaints accompanied by eosinophilia, this rare disease should be considered.

Adult↗
PubMed1991

[Experience with cytostatic therapy of stomach cancer].

The authors have been working on the cytostatic treatment of gastric cancer since 1982. The patients were divided into two groups. Group 1.: Patients who had been operated radically on gastric cancer. Group 2.: Patients who had advanced gastric cancer. The following cytostatic drugs were administrated: Cyclophosphamide, Vincristine, Ftorafur. The patients who had been operated on radically were given adjuvant cytostatic treatment for 3 months according to their own protocol. The patients advanced gastric cancer got life long systemic cytostatic treatment. Between 1982 and 1989, 36 histologically proven gastric carcinoma patients were treated. The effectiveness of the therapy was measured by the survival time from the beginning of the cytostatic treatment. The control group 67 patients consisted of radically or palliative operated patients of the surgical department of those who had not got chemotherapeutic treatment. According to the experiences of the authors, the survival time was prolonged considerably by cytostatic treatment in the group of palliative operated or inoperable patients.

Antineoplastic Combined Chemotherapy Protocols↗