Traumatic Brain Injury Treatment Internationally

Surveying Speech Language Pathologist Around the Worl

Valor del diámetro ecográfico de vena porta en la predicción de varices esofágicas en adultos con cirrosis del hospital Belén de Trujillo

Demostrar que el diámetro ecográfico de vena porta tiene valor en la predicción de varices esofágicas en adultos con cirrosis del Hospital Belén de Trujillo. Material y métodos: Estudio de pruebas diagnósticas, retrospectivo, observacional, en 74 pacientes cirróticos. Se calculó la sensibilidad, especificidad, valor predictivo positivo y negativo. Se aplicó el test de chi cuadrado y área bajo la curva. Resultados: El mejor punto de corte del diámetro ecográfico de vena porta fue 11 milímetros correspondiéndole una sensibilidad, especificidad, valor predictivo positivo y negativo de 83%, 73%, 88%, 65%; respectivamente. El área bajo la curva fue de 0.84. Conclusiones: El punto de corte de 11 milímetros del diámetro ecográfico de vena porta ofrece el mejor perfil predictivo con gran significancia estadística para varices esofágicas en cirróticos. El área bajo la curva calculada le confiere exactitud intermedia.Determine the ability of portal vein diameter to predict esophageal varixs in cirrhotic patients at Trujillo Belen Hospital. Material and methods: Retrospective, observational, diagnosis test study to plicate in 74 cirrhotic patients. We calculated the sensitivity, specificity, positive and negative predictive value to mortality in acute coronary syndrome. We calculated the chi square test and the area under the curve. Results: The best cut off value to portal vein diameter was 11 millimeters and sensibility, specificity, positive and negative predictive value was 83%, 73%, 88%, 65% respectively . The under the curve area were 0.84. Conclusions: The best cut off value of portal vein diameter was 11 millimeters and this offers the better predictive value with a great statistical significance to esophageal varixs in cirrhotic patients. The under the curve area offer an intermedium degree of exactitude.Tesi

Recurring pleural effusion secondary to walled-off pancreatic necrosis

Recurring, exudative, lymphocytic-predominant pleural effusions have not been previously reported in association with walled-off pancreatic necrosis. We present a case of chronic pancreatitis complicated by a large pancreatic fluid collection and recurrent pleural effusion. Endoscopic drainage of the walled-off pancreatic necrosis was the definitive treatment for both fluid collections

Transpapillary drainage has no added benefit on treatment outcomes in patients undergoing EUS-guided transmural drainage of pancreatic pseudocysts: a large multicenter study

Background and Aims The need for transpapillary drainage (TPD) in patients undergoing transmural drainage (TMD) of pancreatic fluid collections (PFCs) remains unclear. The aims of this study were to compare treatment outcomes between patients with pancreatic pseudocysts undergoing TMD versus combined (TMD and TPD) drainage (CD) and to identify predictors of symptomatic and radiologic resolution. Methods This is a retrospective review of 375 consecutive patients with PFCs who underwent EUS-guided TMD from 2008 to 2014 at 15 academic centers in the United States. Main outcome measures included TMD and CD technical success, treatment outcomes (symptomatic and radiologic resolution) at follow-up, and predictors of treatment outcomes on logistic regression. Results A total of 375 patients underwent EUS-guided TMD of PFCs, of which 174 were pseudocysts. TMD alone was performed in 95 (55%) and CD in 79 (45%) pseudocysts. Technical success was as follows: TMD, 92 (97%) versus CD, 35 (44%) (P = .0001). There was no difference in adverse events between the TMD (15%) and CD (14%) cohorts (P = .23). Median long-term (LT) follow-up after transmural stent removal was 324 days (interquartile range, 72-493 days) for TMD and 201 days (interquartile range, 150-493 days) (P = .37). There was no difference in LT symptomatic resolution (TMD, 69% vs CD, 62%; P = .61) or LT radiologic resolution (TMD, 71% vs CD, 67%; P = .79). TPD attempt was negatively associated with LT radiologic resolution of pseudocyst (odds ratio, 0.11; 95% confidence interval, 0.02-0.8; P = .03). Conclusions TPD has no benefit on treatment outcomes in patients undergoing EUS-guided TMD of pancreatic pseudocysts and negatively affects LT resolution of PFCs