Dysphagia

Dysphagia
The fluoroscopy and the upper gastrointestinal endoscopy are different, but remarkable diagnostic methods used for the people suffering from
dysphagia. Dysphagia is a medical term that means difficulty swallowing due to abnormal contractions of the esophageal muscles. It is important to
find a quick evaluation that will lead to a better diagnosis and recovery with lesser complications. This research paper will discuss the appropriate
diagnostic method by comparing between the fluoroscopic unit, and the UGI endoscopy. Data will be collected from King Abdul Aziz University
hospital, the sample will be a large diverse patients with dysphagia as the main complaint.
Dysphagia is a common indication that needs functional and anatomical assessment. ... Show more content on Helpwriting.net ...
Images were obtained for the oropharynx, the whole length of the esophagus including the proximal and distal ends, and the gastroesophageal
junction ( GEJ ) for any present pathology, with single and double contrast studies for mucosal relief. The images were taken while the patients
were in the supine position. For upper GI endoscopy, a complete preparation was done for the patients including nothing per oral ( NPO ) for at
least four hours before the start of the examination, under local anesthesia. The complications and risks of the procedure were also explained to
the patients prior the exam. The patients were positioned on their left side, and to prevent them from biting on the endoscope, a mouth guard was
placed between the teeth. The endoscope was moved over the tongue into the oropharynx under vision, the endoscope was guided into the
esophagus with fast and gentle manipulation, noting any pathology while the endoscope was gradually advanced down the esophagus. If
necessary, a biopsy was taken immediately. The result of the study was ten of the patients ( 83.34% ) were diagnosed with videofluoroscopy, and
five patients ( 41% ) were diagnosed with upper GI endoscopy, however; eight of the examined patients, no problems were found on both
videofluoroscopy, or upper GI endoscopy. The results showed That in comparison with the upper GI endoscopy, videofluoroscopy can accurately
diagnose a large number of positive causes of dysphagia. Also, videofluoroscopy was readily done, and it did not require a previous work up of the
... Get more on HelpWriting.net ...

Brunner's Gland Hamartoma
Brunner's gland hamartoma is an uncommon benign lesion which is most commonly found in the bulb of the duodenum. It is often a small lesion
which is asymptomatic. Most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. Symptoms are often
hemorrhage or duodenal obstructive symptoms which are mainly due to ulceration of the lesions. Histologically, Brunner's gland hamartoma consists
of components of Brunner's gland cells, containing glandular, adipose and muscle cells. In this study we report a case of a 30–year–old man
presenting with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The
hamartoma was removed successfully by endoscopic resection without significant complications. Microscopically, the lesion was found to be entirely
composed of variable Brunner's glands and adipocytes. Key Words: Brunner's gland, Hamartoma, Gastrointestinal Bleeding Case report... Show more
content on Helpwriting.net ...
His background was hypertension, diabetes mellitus and hypercholesterolaemia. He was initially seen in a primary clinic and underwent
esophagogastroduodenoscopy where a duodenal subepithelial lesion was found. He was diagnosed with lipoma by endoscopic ultrasonography. He was
treated conservatively and subsequent abdominal ultrasound and colonoscopy findings were normal. The patient received 8 units of blood transfusion
twice for iron deficiency anemia. However, the patient did not improve over three months, and had ongoing dizziness and nausea. He was then referred
to this hospital for further investigation of gastrointestinal bleeding and known duodenal lesion. The patient denied weight loss or use of non steroidal
anti–inflammatory drugs (NSAIDs). His height and weight were 180.9 cm and 145.8 kg, with a body mass index (BMI) of 44.5

Esophagogastroduodenoscopy Research Paper
Esophagogastroduodenoscopy Esophagogastroduodenoscopy (EGD) is a procedure to examine the lining of the esophagus, stomach, and first part of
the small intestine (duodenum). A long, flexible, lighted tube with a camera attached (endoscope) is inserted down the throat to view these organs.
This procedure is done to detect problems or abnormalities, such as inflammation, bleeding, ulcers, or growths, in order to treat them. The procedure
lasts about 5–20 minutes. It is usually an outpatient procedure, but it may need to be performed in emergency cases in the hospital. LET YOUR
CAREGIVER KNOW ABOUT: Allergies to food or medicine. All medicines you are taking, including vitamins, herbs, eyedrops, and over
–the–counter
medicines and creams. Use... Show more content on Helpwriting.net ...
However, as with any procedure, complications can occur. Possible complications include: Infection. Bleeding. Tearing (perforation) of the esophagus,
stomach, or duodenum. Difficulty breathing or not being able to breath. Excessive sweating. Spasms of the larynx. Slowed heartbeat. Low blood
pressure. BEFORE THE PROCEDURE Do not eat or drink anything for 6–8 hours before the procedure or as directed by your caregiver. Ask your
caregiver about changing or stopping your regular medicines. If you wear dentures, be prepared to remove them before the procedure. Arrange for
someone to drive you home after the procedure. PROCEDURE A vein will be accessed to give medicines and fluids. A medicine to relax you
(sedative) and a pain reliever will be given through that access into the vein. A numbing medicine (local anesthetic) may be sprayed on your throat
for comfort and to stop you from gagging or coughing. A mouth guard may be placed in your mouth to protect your teeth and to keep you from biting
on the endoscope. You will be asked to lie on your left side. The endoscope is inserted down your throat and into the esophagus, stomach, and
duodenum. Air is put through the endoscope to allow your caregiver to view the lining of your esophagus

GI Endoscopy Biopsy (EGD)
43239 Upper GI endoscopy biopsy (Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple). The beneficiary underwent an
esophagogastroduodenoscopy (EGD) and was diagnosed with "unspecified disorder of the stomach and duodenum" (537.9), which is not covered by
the Local Coverage Determination Policy L29167. The documentation did not include prior physician progress notes to support the medical necessity
for the EGD procedure. There was no indication of symptoms of physical findings that would support the medical necessity of the procedure in
accordance with Medicare guidelines. The beneficiary was a 65 year old woman who had been diagnosed with mild gastritis. She complained of
abdominal pain for approximately 5... Show more content on Helpwriting.net ...
The provider submitted a copy of the claim and medical records. The provider also indicated that a corrected claim had been submitted with the
diagnosis code 537.89. On March 09, 2014, the QIC sent a letter to the provider stating that the payment was "denied due to the lack of medical
necessity/invalid diagnosis." The claim was billed with the diagnosis 537.9 (the incorrect code) not covered within the LCD. However, the provider
had already submitted the appeal with the correct diagnosis twice. Was that information taken into account at the time of the QIC's determination?
The QIC also indicated that the documentation submitted did "not include any prior physician progress notes from the billing physician/PCP to
substantiate medical necessity for the procedure billed." How would the progress notes have changed the determination? The claimant was
evaluated in the ER; the ER doctor discussed the case with the billing provider while the claimant was still in the ER. Per the ER documentation
"6:46 PM Discussed case with Dr. Selub (GI) states for the PT to call his office at 9 AM and he will be able to F/U with the Pt in 1

Esophagogastroduodenoscopy (EGD) is the most widely used...
Esophagogastroduodenoscopy (EGD) is the most widely used method to investigate esophageal diseases with excellent accuracy. Till date it has been
considered the gold standard for the diagnosis and surveillance of esophageal diseases including interventional procedures. It has mainly been used for
diagnosing barret's esophagus, reflux esophagitis, esophageal varices and esophageal cancers. However the EGD is expansive and uncomfortable to
the patient along with a small potential risk for complications. It involves the risk of conscious sedation along with loss of productivity. It has more
complication rate in cases of cirrhosis. Next step was the development of a safer and more comfortable method to view the mucosa of esophagus thus
came ... Show more content on Helpwriting.net ...
First the study was done on healthy volunteers which are themselves capsule endoscopists. Subsequently study was done of patients with suspected
esophageal disease to compare the feasibility, efficacy, quality and patient discomfort between the two methods. Feasibility and the quality of the test
has been compares in al the four main diagnostic indications of EGD and this has been shown the table format as well as compared with the pictures.
This article is on a very commonly performed procedure EGD, all over the world which has changed its role from mainly diagnostic procedure in the
early years to a therapeutic procedure. Authors have presented the feasibility data compares to EGD. More than feasibility they have emphasized that
SSCE is more comfortable to the patient. It has less complication rate as compared to EGD. It has equal quality of the images of the esophagus and
rather better image quality than EGD in certain diseases. Capsule endoscopy has shown moderate efficacy in lower end esophageal images because of
no control over the movement of the capsule. SSCE has overcome the difficulty by attaching a string to the capsule with which up and down
movement of the capsule can be controlled ad lib to improve the focus on the area of interest. It has many other advantages:
It is a controlled method for esophagoscopy
No sleeve or string Was broken in the study
More comfortable to the patient

Wireless Capsule Endoscopy : Past And Present
ELEC5031M Industry Dissertation
Wireless Capsule Endoscopy
Etinosa Ekomwenrenren
Student ID: 200990550
The University of Leeds
School of Electronic and Electrical Engineering
April 2017
Table of Contents
Abstractiii
List of Abbreviationsiv
List of Figuresv
List of Tablesvi
Chapter 1 Introduction1
Chapter 2 Wireless capsule endoscopy: past and present2
2.1 History of wireless capsule endoscopy2
2.2 Current wireless capsule endoscope systems4
2.3 Clinical utility of wireless capsule endoscopy7
2.3.1 Small bowel diseases7
2.3.1.1 Obscure gastrointestinal bleeding7
2.3.1.2 Crohn's disease7
2.3.1.3 Celiac disease7
2.3.1.4 Polyposis syndrome and other small bowel disorders8

2.3.2 Oesophageal diseases8
2.3.2.1 ... Show more content on Helpwriting.net ...
It involves swallowing a capsule that's able to wirelessly transmit images of the gastrointestinal tract – the pathway from the mouth through the
oesophagus, stomach, small, and large intestines [2].
The capsule is the size of a large pill that leaves the body naturally through defecation [2]. Typically, It has a CMOS chip video camera that captures
video images (at two frames per second) that are transmitted by video telemetry to aerials secured to the patient's body [3]. These images are stored in
a digital recorder worn around the patient's waist [3].
Although presently an effective method of assessing small bowel diseases, such as obscure gastrointestinal bleeding and Celiac disease [3], this
technology provides an opportunity to develop low–cost screening techniques that can save lives of people at risk of gastric and oesophageal cancers,
which are prevalent in low–income

Medical Terminology: A Case Study
CYANOTIC: A patient who has cyanosis, or a slight bluish discoloration of the skin due to the presence of abnormal amounts of reduced
hemoglobin in the blood JAUNDICE: A yellow discoloration of the skin GASTROSCOPY: A scope for inspecting the stomach COLONOSCOPY:
An endoscope to inspect the colon (large intestines) ANGIOSCOPE: Views the heart and major vessels VASCULAR ENDOSCOPE: Views that
interior or small vessels BRONCHOSCOPY: An endoscope to inspect the bronchial tree LARYNGOSCOPY: An endoscope to inspect the larynx
LAPAROSCOPY:Views the abdominal organs THORACOSCOPY: Views the organs of the thoracic cavity VENTRICULOSCOPY: Views the
ventricles of the brain CYSTOSCOPE: Passed through the urethra and into the bladder to examine the interior... Show more content on Helpwriting.net
...
When the veins around the anus swell, we call them hemorrhoids. Colon cancer is a condition in which polyps form in the lining of the colon (large
intestine). Crohn's disease is a chronic inflammatory granulomatous lesion involving the terminal ileum. Irritable bowel syndrome (IBS) is sometimes
called a functional disorder because there is no sign of disease in the colon. Case Study: Robert Johnson noticed blood in his stool. For several months
, he had experienced pain in his abdomen and diarrhea. What endoscopic procedure will his physician order? –Robert Johnson's physician would order
a Pillcam Endoscopic procedure. Mr. Johnson has the precise reasons for the order of the Pillcam, The Pillcam evaluates unexplained rectal bleeding,
intermittent abdominal pain, and diarrhea. A Pillcam is different from the various other endoscopic procedures, it is a vitamin sized vitamin that a
patient swallows. The pill then travels throughout the body providing the physician with images of Mr. Johnson's internal organs. This procedure will
most likely be all that is needed to find the source of the bleeding and the reason for the abdominal pain and

Clinical Rotation At Florida Hospital
This is one of the biggest hospitals in Florida and I feel really fortunate to work here as an observer in the Department of Nephrology. The morning
rounds with the attending physician are very informative as they are enabling me to learn many new concepts like indications of renal biopsy and
management of post–transplant patients. Observing management of patients before, during and after the dialysis is a routine over here. Since there
was a training course regarding the EPIC software of electronic medical records before the start of the rotation, the advantage of having access to
patient records will go a long way in consolidating my grip on patient notes and charting.
During my clinical rotation at Florida Hospital, Tampa, I got the opportunity of doing retrospective analysis on EKOS Catheter and Angiovac Cannula
Systems. Study of EKOS Catheter is mainly focused on the effect of ultrasound–guided localized release of tPA within the pulmonary artery on
pulmonary artery pressures while Angiovac study deals with catheter assisted decrease in systemic thrombus load and its benefits and complications.
While working on data collection, I have gained a considerable command on CERNER software of EMRs. The foresight, precision and patience I am
learning as a researcher will help me better understand a disease from its origin and enable me to become a better clinician.
Three week rotation in Internal Medicine at Florida Hospital, Tampa was thrilling as it is one of the biggest

S. R.: A Nursing Case Study
S.R. is a 63–year–old Caucasian female currently working as an operating room nurse. She has a significant past medical history consisting of Breast
Cancer, Depression, Fall, Diverticulitis of the Colon, Follicular Lymphoma (stage 3), Irritable Bowel Syndrome, Osteoarthritis and Sciatica. Currently
S.R. is going through chemo with Rituximab for recurring lymphoma, gastritis and atrial fibrillation. S.R came to the emergency department presenting
with shortness of breath and dizzy from having intractable nausea and coffee ground emesis overnight. Her chief complaint was of feeling dizzy and
weak at home after vomiting with chills and sweating. The client knows her history and the fact that she needs to be on proton pump inhibitors twice a
day,... Show more content on Helpwriting.net ...
773). This is the first step in problem solving and promotes creative problem solving. The client was able to open up with nurse about her current
stress. Once that was completed, teaching the client how to evaluate methods of coping that worked or just partially successful. According to Cox,
Hinz, & Newfield (2007), "it strengthens the effective coping methods and elimination of ineffective ones" (pg.

SPA Reflective Essay
Goals
I went to SPA with two goals, including: To know the criteria for type of anesthesia for each procedure, and to know the most commonly performed
procedure and whether any research had been conducted to uncover the disease condition that warrants this procedure. According Dr. Chopra, Kathryn,
RN, and Katie, Charge nurse, severity of patient's problem and whether the procedure will involve major tissues are some of the criteria used to decide
on the type anesthesia for each procedure. In addition, the charge nurse in person of Katie reported that esophagogastroduodenoscopy (EGD) ranks
highest among many procedures performed at SPA. I was told that EGD is both diagnostic and therapeutic procedure, which makes it to be commonly
performed, ... Show more content on Helpwriting.net ...
My professor took walked me to SPA around 8 am, and I was introduced to the charge nurse of the unit, who received me warmly. After this, I was
assigned initially to Vaishali, RN who took me to the first patient. With this patient, we did initial assessment before the procedure where plethora of
questions were asked to ensure patient's safety. Immediately after this, I was asked to follow one patient to a procedure room for observation. I had
the opportunity to see how the patient was prepared for the procedure, the type of anesthesia, type of health professionals who make up the SPA team
for each procedure, and the patient is monitored throughout the process. After the procedure, I was told to stay with the patient for 30 minutes in the
recovery room, where the vital signs are monitored every five minutes until patient fully comes around or better still, becomes fully aware the
environment. Furthermore, discharge teachings are given at recovery room, and what took my interest was the language used in this area. One of the
staff nurses said to patient that "You are legally intoxicated for the next 24 hours, therefore, no driving, signing of legal documents, and no operation
of microwave." I like this statement because, it underscores patient safety. Thereafter, I followed other patient, and the whole processes stated above
were repeated. I learned how division of labor brings efficiency. I will remember to utilize this in the nearest

A Case of a 62 Year Old with Epigastric Pain
Mr. A.M, a 62 year old man presented at the outpatient clinic with a two month history of epigastric pain. He also reported that the pain was
strongly correlated to meals. He also felt that his appetite has decreased, however he did not lose any weight. He has a history of gastroesophageal
reflux disease (GERD), which dates back 5 years ago, which he took proton pump inhibitors for one month. He is smoking for the last 40 years
around one package a day, and does not consume any alcohol. He had an appendectomy when he was 12 years old. Mr. A.M is married and just
retired six months ago from his former job as an accountant. He is currently on an ACE inhibitor for the control of his hypertension. On
examination, he appears comfortable and well. He has an abdominal distention. Chest is clear on auscultation, his blood pressure is 125/75mmHg
and pulse rate is 85/min. He is tender 2cm below the sternum when deep palpation is performed, no lumps are felt, and the pain does not radiate.
Liver is palpable 2cm below costal margins. There is no shifting dullness or fluid thrill. 3. INVESTIGATIONS A referral to the cardiologist was
made to exclude any cardiac causes since the pain Mr. A.M felt was epigastric. Physical examination along with ECG as the preferred test by the
cardiologist did not reveille any abnormalities. CBC count and LFT's were ordered. Mr. A.M was later on referred to a gastroenterologist for focused
examination on the gastrointestinal system.

Diagnosis And Treatment Of Cancer Essay
Cancer is very large throughout the U.S. and Canada, it is said that one and a half million people will receive a new diagnosis of cancer each year
(Ignatavicius & Workman, 2013).Many years back a diagnosis of cancer had a very poor outcome and you were basically considered dead.
Technology and research have been focusing on cancer, and how to prevent it. This paper will review the diagnosis of cancer as well as the staging of
cancer, as well as possible treatment options and side effects related and how to deal with the psychological burden that cancer patients deal with.
Diagnosis and Staging of Cancer The body consists of millions of tissues and cells that are grown from conception to adulthood. Cancer cells are
cells that are not normal and have the capability of infinite replication, they are harmful to the normal cells and serve no benefit to the body
(Ignatavicius & Workman, 2013).Cancer cells are also defined as malignant cells; they tend to start in one spot which is called the primary location.
They may break from the primary location and spread to other locations to establish more colonies. When the cancer spreads it is known as
metastasis. There are several tests that are needed to be done prior to confirming a cancer diagnosis. Depending on the cancer suspected, different
tests may be done. It is very common to take a biopsy of the infected area and wait for pathologists to evaluate the specimen. Blood work is also very
important for

Renal Failure: A Case Study
On February 4th and 5th of 2015, I provided care in the Cardiovascular Intensive Care Unit (CVICU) at Jefferson Regional Medical Center to a 77
year old white female, M. H. She came to the Emergency Room (ER) on January 26, 2015 with a chief complaint of shortness of breath and hypoxia.
She has a history of chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), hypertension (HTN), congestive heart failure (CHF), and
coronary artery disease (CAD). She was admitted the Medical–Surgical floor on the same day. After her initial lab workups, she was given medical
diagnosis of renal failure. Renal failure is a condition in which the kidneys fail to adequately filter waste products form the blood. The two main forms
are acute kidney injury and chronic kidney... Show more content on Helpwriting.net ...
Some causes include impaired blood flow to the kidneys, damage to the kidneys, and urine blockage in the kidneys. Signs and symptoms include
vomiting, diarrhea, dehydration, muscle cramps, hyperkalemia, weakness, dizziness, swelling in the hands and feet, difficulty sleeping, and abnormal
heart rhythms. Diagnostic tests and procedures include glomerular filtration rate (GFR), blood urea nitrogen (BUN), creatinine, and computed
tomography (CT) scans to observe kidneys, kidney tissue sampling, and urine output measurements. Treatment includes treating the underlying cause of
kidney failure, balancing fluids in your blood, controlling your potassium, restoring calcium levels, and dialysis to remove toxins from the blood. On
January 28, 2015, M.H. participated in an esophagogastroduodenoscopy (EGD). Upon examination, there was gastrointestinal bleeding from noted
ulcerations as well as gastroesophageal reflux disease (GERD), gastritis,

Childhood Obesity : An Epidemic
Introduction Childhood obesity is rising worldwide in an alarming rate. New Zealand Health Survey results in 2012/2013 showed that one out of nine
children (2–14 years) was obese and it was 11 per cent of the total children population1. Obese children are more prone to have cardiovascular disease,
psychological morbidity, asthma, Type 1 diabetes, and early mortality2 sooner or later in their life. Adverse effects of childhood obesity not only affect
the current or later health status of children but also the country's productivity and economy. Therefore it is very important to break the obesity viscous
cycle in order to have a healthy nation. Various factors involve in the development of this multifaceted condition– "Obesity" such as individual's
genetics, environment and behaviour2. The major causes for childhood obesity in New Zealand include less physical activity, inadequate sleep3,
unhealthy dietary patterns such as skipping breakfast4 and consumption of unhealthy snack food5. There are various preventive strategies for
childhood obesity. The conventional treatments include promoting healthy dietary and behaviour practises and physical activities; however, these seem
to be not having positive impacts in some situations. Moreover, some studies also have shown that different diet and physical activity intervention
studies had failed to have a positive effect on BMI and obesity of children2. Likewise, some existing evidence reflects that traditional obesity prevention

What Are The Advantages And Disadvantages Of Endoscopy
Abstract
Purpose Endoscopy is very important method to obtain exact information such as name of disease, cause of disease and how to cure diseases. Also,
surgery with endoscopy, called endoscopic surgery is really useful tool for elaborate treatment. So, this paper accounts for a variety of endoscopy in
detail for people to know easily what endoscopy is.
Methods This review article explains the fundamental concept of endoscopy, difference between optical & electronic endoscope, comparison rigid
endoscope to flexible endoscope. Also, this paper introduces past & present types of endoscopy and present & future types of endoscopy.
Conclusions
KeywordsEndoscope, Endoscopy, Capsule endoscopy, NIR endoscopy, 3D endoscopy, Virtual endoscopy
INTRODUCTION
Nowadays, Endoscopy has been very widely used. Endoscopy is a medical procedure done with an instrument called an endoscope. The ... Show more
content on Helpwriting.net ...
Doctors can even use the images to create a black and white image that looks like an actual endoscopy.[29]
Virtual endoscopy has some advantages over standard endoscopy; nothing is put into the body and no drugs are needed for the test and the doctor can
change the angle or magnify the image, which can help with diagnosis. However, there are some disadvantages, too. Virtual endoscopy shows good
detail, but it's not quite as good at showing fine surface detail as standard endoscopy such that it can't show color differences. It also exposes the
patient to about the same amount of radiation as a standard CT. And because nothing is put into the body, the doctor can't take biopsy samples or
remove growths. If something abnormal is found, the patient may still need a standard endoscopy.
According to Pauriol–Lacaze, S. et al. [30] virtual endoscopy is a considerably new procedure, and doctors aren't yet sure how best to use it. It will
likely be used more in the future as the technology

Gastric Ulcer Research Paper
Gastric ulcers are a large problem now a days in the medical community. It has the attention of all the core measure directors of every hospital in the
country. That is because a gastric ulcer is preventable in the hospital setting. Since the gastric ulcer is considered preventable, new diagnosed ulcers,
once being an inpatient, would not be permitted to seek reimbursement for any care provided. You could see why it has their attention.
In the past it was believed that gastric ulcers were caused by life style modifiable risk factors. The biggest culprit now is Helicobacter pylori (H.
pylori). H. Pyloris is a bacterium commonly found in the gut. The bacteria breaks down the lining of the stomach. Then the stomach acid further breaks
down the lining which causes the ulcer. This is the reason, unless contraindicated, most patient receives either a Histamine–2 Receptor Antagonist or a
proton pump inhibitor in the hospital. The GI symptoms that are present with gastric ulcers would decrease the appetite of the patient. Therefore the
patient would encounter a digestion problem. ... Show more content on Helpwriting.net ...
The vessels inside the lining also break down causing the patient to bleed. Depending where the ulcer is will the patient present with Hematemesis or
Hematochezia. Another complication could be perforation of the stomach. This allows gastric contents to release into the sterile portion of the
abdominal cavity. This could cause a severe infection and often requires surgical repair. The third major complication could be obstruction. Often if a
ulcer presents in the narrow part of the distal stomach, an obstruction can occur. That is because scar tissue grows back often occluding the path of
gastric contents. Surgical repair would also be necessary in this

Helicobacter Peptic Ulcer Disease
As there are many causes of peptic ulcer disease, the number one causative agent is a Helicobacter pylori infection. This spiral shaped bacterium was
known as far back as 1875. It was discovered that this bacteria inhabited the lining of the human stomach by German scientists. Unfortunately it was
impossible to culture at the time so it fell by the wayside and was forgotten ( Hardy, J ). It wasn't until 1979 that an Australian pathologist Robin Warren
noticed that many of his patients who were suffering from gastric ulcers had mysterious bacteria clinging to the tissues of his biopsy specimens. He
alongside with his associate physician Barry Marshall, worked endlessly to culture what they saw under the microscope. It was by accident in 1982
that they left their cultures incubating over a five day span and what they discovered upon returning was a turning point in the treatment of peptic ulcer
disease. There were growing colonies of what ... Show more content on Helpwriting.net ...
This was an amazing discovery but it was unfortunately met with a lot of skepticism in the medical community as it was believed that no bacteria
could survive the hostile environment of the stomach. Discouraged, Dr. Marshall actually drank a beaker full of the H. pylori in a broth solution. He
became very ill days later and via endoscopy ten days after inoculation he was noted to have gastritis with the presence of H. pylori in his stomach.
This marked the beginning of the belief that peptic ulcer disease is an infectious disease. Doctors Marshall and Warren went on to prove that antibiotics
are an effective treatment in the management of PUD. It wasn't until 2005 that Warren and Marshall were awarded the Noble Prize inMedicine for their
work on H. pylori (Hardy,

The Tuberculosis ( Mtb )
Mycobacterium tuberculosis (MTB) is an infection that about one–third of the population has. MTB, which is an airborne infection, can infect nearly
any organ of the body. Human immunodeficiency virus or HIV also has an impact on the world. In 2011, it was estimated that around 34 million
people were living with HIV. This virus is contracted by the exchange of blood or bodily fluids whether it be from sexual contact or sharing needles or
syringes used for drugs. In addition, HIV is a retrovirus specifically attacking the CD4 T lymphocytes. Acquired immunodeficiency syndrome (AIDS) is
the disease caused by already having the HIV infection. The possibility of having both diseases has gradually diminished due to the improvements
made in ... Show more content on Helpwriting.net ...
The rest of her examinations deemed normal. He white blood cell count was 7500/ВµL (normal range being 4,800–10,800/ВµL with seventy–five
percent neutrophils. Her hematocrit test (the volume of red blood cells to the total volume of blood) was thirty–four point three percent. Along with her
urinalysis, serum electrolytes, and liver function tests, the patient was ruled completely normal.
Treatments that were provided during her stay were empiric intravenous vancomycin and piperacillin/tazobactam, along with oral fluconazole, which
was added due to oral candidiasis. Azithromycin 1200mg weekly was added for MAC prophylaxis and since she was at a lower risk for the
nosocomial pathogens, the antibiotics given were reduced to amoxicillin instead.
The patient had tests ran such as an esophagogastroduodenoscopy (EGD) which stated the esophagus was estimated average. No granuloma or
acid–fast bacilli(AFB) were seen, her duodenum was normal, but atrophic gastric mucosa was seen and enlarged folds with friable mucosa with lacy
reticular pattern was found in gastric fundus. Therefore, an upper endoscopic ultrasound (EUS) was conducted. This showed that the patient had a
3.1cm x 1.8 cm heterogeneous mass lesion coming from the submucosa in the fundus with small anechoic spaces. Viscous serosanguinous liquid was
obtained by fine needle aspiration. A gram stain confirmed negative of aspirate yet the AFB showed an excess

Crohn's Disease Analysis
Crohn's Disease is an Inflammatory Bowel Disease (IBD). It is a disease that causes inflammation in the gastrointestinal tract. The gastrointestinal
tract includes the oral cavity, esophagus, liver, stomach, small intestine, terminal ileum, large intestine/colon, rectum, and anus. Crohn's Disease
affects thousands of people in America. Crohn's disease was first discovered in 1932 by three doctors named Burrill Crohn, Leon Ginzberg, and
Gordon D. Oppenheimer. The Crohn's & Colitis Foundation of America (2014) declared "these doctors collected data from 14 patients with
symptoms of abdominal cramps, diarrhea, fever, and weight loss, which showed that the symptoms were not the result of tuberculosis or any other
known disease. They described a new disease entity, which was first called regional ileitis, and later, Crohn's disease" (p. 7). Even though Crohn's
Disease was discovered over 80 years ago, there is no cure, but there is constantly more new information being found out about this disease. There is
no known cause of Crohn's Disease. Some key factors in the development of Crohn's Disease are genes, the immune system, and environmental... Show
more content on Helpwriting.net ...
This disease can be overwhelming physically, emotionally, and financially. Crohn's Disease is very unpredictable so those who live with it have to
be careful from day to day and make sure to listen closely to their bodies. According to the Crohn's & Colitis Foundation of America (2014) "living
with this disease can also be very expensive. Direct medical costs include expenses for hospitalizations, physician services, prescription drugs,
over–the–counter drugs, skilled nursing care, diagnostic procedures, and other healthcare services. Indirect costs are the value of lost earnings or
productivity. Indirect costs also include the value of leisure time lost" (p.19). However, the good thing is that patients can still lead a happy and
productive

An Autosomal Dominant Disorder
Recurrent epistaxis is one of the diagnostic criteria for Hereditary Hemorrhagic Telangiectasia (HHT). HHT is an autosomal–dominant disorder that is
also depicted by skin and mucosal telangiectasias. Feared complications of HHT include rupture of pulmonary or cerebral arteriovenous malformations
(AVM). The etiology of HHT is most often due to genetic mutations that impair normal angiogenesis. We report a case of suspected HHT in a
49–year–old female, with a first–degree relative with HHT, and a history of recurrent epistaxis status post coiling of left and right internal maxillary
arteries. Of special note, her initial hemoglobin level was 1.7, but she was alert and walking at triage. Her presentation was consistent with multiple prior
admissions in the past three years. Patients with suspected hereditary telangiectasia should receive a comprehensive work up, including serum studies,
imaging, and possibly genetic testing. Treatment should focus on both acute management of the bleed and prevention of future complications.
Introduction:
Hereditary Hemorrhagic Telangiectasia, or Osler–Weber–Rendu syndrome, is an autosomal dominant disorder characterized by recurrent epistaxis and
small arteriovenous malformations known as telangiectasias . Telangiectasias can rupture with minimal or no trauma, and resultant bleeds can be
difficult to manage. The epistaxis can lead to chronic anemia in a small set of afflicted patients. The estimated prevalence of HTT is estimated to be one

Gastritis Case Study Hypertension
This patient is a 62–year–old male who required inpatient hospitalization due to: Mr. C had a spiculated nodule in his right middle lobe identified on
screening lung computerized tomography scan. It was hypermetabolic on positron emission tomography and suspicious for carcinoma and deep for
wedge biopsy. Additionally, he had a hypermetabolic findings in his stomach without complaints of gastritis or heartburn. He was brought to Mary San
Juan Operating room for elective surgery for right middle lobe mass. His medical history was significant for hypertension, lung mass and a smoker.
Upon presentation, he was NPO for more than six hours with outpatient laboratory finding of platelets 139 and PT of 10.4.
Mr. C was admitted to the hospital for ... Show more content on Helpwriting.net ...
Two right chest tubes at the right lung base were inserted and secured with surgical sutures. He was transferred to ICU after he was discharge from
anesthesia care. Post–operatively despite chest tubes, he continued to have a worsening crepitus. Chest x–ray was done revealing right pneumothorax
with subcutaneous emphysema, right middle lobe spiculated lesion and positive lesion in stomach. He was transferred to the floor for some time, but
was returned back to ICU after he developed an increased in subcutaneous air in face and neck for which a 3rd chest tube was placed through a prior
surgical incision. During his hospitalization, his vital signs worsened with blood pressure of 104/56 mmHg, oxygen saturation of 80% on room air,
respiratory rate of 38 breaths per minutes and a temperature of 35.6 В°Celsius. After two of the three right chest tubes have been removed, he was
advised of needing to go home with chest tube or heimlich valve. Then, he was given specific discharge instructions including chest tube and
pleurevac care, wound care, activity, diet, and meds. He verbalized understanding and agrees with plan after he was advised to follow up in the office
this week with the probability of removing the chest and to return to Emergency Department if his symptoms

Bariatric Procedure Yields
6/12/2016 www.generalsurgerynews.com/Article/PrintArticle?articleID=34020 http://www.generalsurgerynews.com/Article
/PrintArticle?articleID=34020 1/6 In the News
OCTOBER 22, 2015
New Bariatric Procedure Yields Exciting Results
Preliminary Data Strong For ModiдђЈбЊЂed Duodenal Switch
By Christina Frangou
A pair of U.S. surgeons has developed a new bariatric procedure, a modiдђЈбЊЂed version of a duodenal switch, which may be technically easier to
perform and results in weight loss on par with the most effective bariatric operations.
"The weight loss is impressive and, based on historical comparison, greater than vertical sleeve gastrectomy," reported study author Mitchell Roslin,
MD, chief of bariatric surgery at Lenox Hill Hospital, in New York City.... Show more content on Helpwriting.net ...
"I don't think anybody has enough experience with this yet to say anything for sure regarding the long–term need for revision, or the best way to revise
it if there is a problem."
He added that surgeons who start performing new procedures must study them carefully, follow their patients, and publish and report their data so that
surgeons can make informed decisions about whether to continue with the procedure.
"The biggest challenge is selecting the right patient for the operation, and maintaining good, really close follow–up on the patients because that's
critical if this procedure is to become mainstream."
Richard M. Peterson, MD, MPH, director of UT Medicine Center for Bariatric and Metabolic Surgery at UT San Antonio, said
SIPS could be ideally suited for super–obese patients who need something more than a sleeve or a gastric bypass. "But I need to know long term that
the results carry more weight loss than a bypass and are as durable, or close to it, and I need to know6/12/2016 www.generalsurgerynews.com/Article
/PrintArticle?articleID=34020
http://www.generalsurgerynews.com/Article/PrintArticle?articleID=34020

Dr Peter Chweyah Case Summary
An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated 06/16/2016, indicated that the claimant presented with
complaints of lower extremity weakness, neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed an
extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic kidney disease, and hypertension. It was noted that the
claimant was totally disabled from 05/30/2017 through 06/15/2017 and 05/23/2017 – 05/26/2017 secondary to gout.
A progress note from Dr. Chweyah, dated 06/26/2017, indicated that the claimant presented for follow–up of gout, muscle weakness, and weight loss.
He had ongoing weakness of the legs with knee pain. He stated that her weight drop had stopped. His current weight was 210 pounds. Objective
findings showed a pulse rate of 105 with a blood pressure of 92/60. His BMI was 28.56. He was diagnosed with an acute pain in both knees, muscle
weakness in the legs, chronic gout, and weight loss. A referral to neurology and medications were recommended.... Show more content on
Helpwriting.net ...
Chweyah, dated 08/11/2017, indicated that the claimant presented for a follow–up visit after his discharge from the hospital on 08/08/2017. He was
admitted on 08/04/2017 due to normocytic anemia, pain in both knees, starvation ketoacidosis, hypertension, gout with tophus, and duodenitis. The
esophagogastroduodenoscopy revealed erythematous duodenopathy, erythematous mucosa in the antrum, and small hiatal hernia. He had a
colonoscopy which revealed internal hemorrhoids. Objective findings showed blood pressure of 112/86 with a pulse of 105. He was diagnosed with
quadriceps weakness, pain in both knees, normocytic anemia, type 2 diabetes mellitus, hypertension, stable chronic kidney disease stage III, and
bilateral impacted cerumen. It was noted that he can return to work on 08/16/2017 with limitations of not standing for more than 10 minutes at a time
for 1

The Visualization Of The Small Bowel
Abstract The visualization of the small bowel has posed a challenge to gastroenterologists due to the difficulty of physically reaching more distal
regions of the small bowel anatomically. As the small bowel can often be a source of pathology, endoscopy of the small bowel can be a useful
diagnostic and therapeutic technique. Over the last few years' enteroscopies has been introduced and being used widely. Various types of enteroscopies
are being used; among them the most commonly used are double balloon, single balloon and spiral enteroscopies. In this dissertation, I am focusing
and comparing among the three to find which one is having highest diagnostic and therapeutic benefits. Objective: To assess the invasive enteroscopic
technique with maximum diagnostic and therapeutic yield, for common small bowel diseases like OGIB, small bowel crohn 's and polyps. Methods:
Online electronic search of databases– Medline, CIHNAL, EMBASE, citation searching, the relevant literatures, carefully selected keywords
(enteroscopy, Single balloon enteroscopy, double balloon enteroscopy, spiral enteroscopy) and its appropriate combinations were used. Further the
citation searching was done to identify more relevant literatures. Results: From the 1035 articles, selected from 2001 to 2015, six articles were
selected after excluding the relevant criteria's and those were critically apprised and compared to get comprehensive results. Conclusion: The various
enteroscopic procedures have

Crohn'S Disease . .. .. .. .. .. .. .. .. . By: Elizabeth
Crohn 's Disease
By: Elizabeth Nazginov 8G1
Due: April 5th 2017
Crohn 's disease is one of two conditions referred to by the term "Inflammatory Bowel Disease" (IBD). The other condition that is referred to as an
IBD is called Ulcerative Colitis. Both Crohn's and Ulcerative Colitis are conditions that cause recurring or persistent inflammation in one or more
sections of the intestine. The literal definition of "inflammation" is "being set on fire". It is a protective reaction that happens when tissue is injured or
destroyed. There are two types of inflammations. The first is acute inflammation, which is defined by heat, redness, pain and swelling. The ... Show
more content on Helpwriting.net ...
There is approximately a fifteen to twenty five percent chance of Inflammatory Bowel Disease in the extended family of someone who has Crohn 's.
However in this situation, ulcerative colitis would be less likely than Crohn 's. The risk of Inflammatory Bowel Disease occurring if both of a
child 's parents having an IBD begins at least around fifty percent. According to Mayoclinic.org, open quote "As many as 1 in 5 people with Crohn
's disease has a family member with the disease" closed quote. Crohn 's Disease is most commonly found in advanced areas like in Scandinavia,
North America, the United Kingdom and Western Europe. Crohn 's Disease affects Ashkenazi Jews and Caucasians more than any other racial
groups. Another reason that supports the theory of genetics being a cause of Crohn 's can also be found on page eleven in the same book as the
book in the first reason. On page eleven it is written: open quote "While little has been accomplished so far in ulcerative colitis, mutations in a gene
known as NOD2, located on chromosome 16, have been shown to predispose some people to Crohn 's in the Ileum, especially the form of the disease
that causes a lot of scarring and narrowing" closed quote. In other words, there has been mutations in a gene found on chromosome sixteen that have
been proved to cause some people to get Crohn 's in the Ileum (which

Essay On Ulcerative Colitis
T–CELL RESPONSE:
This disease have a TH2 profile, but the concentrations of IL–4 and IL–5, which are normally increased in TH2 responses, have been variable in
ulcerative colitis tissues.
From studies of the oxazalone colitis model, one of the few models to exhibit a TH2 profile, ulcerative colitis has an atypical TH2 response, mediated
by natural killer T cells that secrete IL–13. These natural killer T cells are activated by APCs that express the nonclassical major histocompatibility
MHC molecule, CD1d, which presents lipid instead of protein antigens to T cells. will require blockade of IL–13 could provide an exciting new
approach to ulcerative colitis treatment.
T–cell subsets are stimulated by APCs, most notably dendritic ... Show more content on Helpwriting.net ...
Inflammation occurs in rectum and sigmoid colon. Symptoms include bloody diarrhea, abdominal cramps and pain.
Left–sided colitis. Inflammation spread from the rectum up through the sigmoid and descending colon. Symptoms include bloody diarrhea, abdominal
cramping left side pain, and weight loss.
Pancolitis. Affects the entire colon and causes severe bloody diarrhea, abdominal cramps and pain, fatigue, and significant weight loss.
Acute severe ulcerative colitis. Rare form of colitis affects the entire colon and causes severe pain, diarrhea, bleeding, fever and inability to eat.and
increase risk of colon cancer 70–80%. And usually doctor suggest to remove the part of colon or whole colon.
SYMPTOMS: According to inflammation and site, symptoms can be different depend on the type of colitis. Diarrhea or internal bleeding, risk of
causing anemia followed by bloody stool, fever, weight loss due to low appetites, fatigue, stomach pain and cramping some other complication occur
like pore in the colon, loss of water and blood from the body, loss of calcium and damage the bone osteoporosis, high risk of colon cancer,sorness and
abscess in mouth, stiffness, lung embolism ,blood coagulation in deep vein

DIAGNOSIS:
Diagnosis occurs on the basis of medical history of the patient related to gastrointestinal symptoms and physical examination for the GI tract,
dermatologic, optical system. Looking for any condition among crohn's, ischemic, infections and

Signet-Ring Cell Adenocarcinoma Case Summary
A Case of Signet Ring Cell Adenocarcinoma–Unique presentation with Concurrent Non–gastrointestinal Malignancy.
Authors: Sandar Linn1, Hernan A. Lopez–Morra1, Sofia Nigar1, Juan Tejada1, Nami S Haeri1,Shah Giashuddin2,Jonathan Chow2, Mahesh K.
Krishniah1, Sury Anand1.
1 Division of Gastroenterology, Department of Internal Medicine, the Brooklyn Hospital Center, Brooklyn, NY.
2 Department of Pathology, the Brooklyn Hospital Center, Brooklyn, NY.
Abstract:
Background: Signet–ring cell adenocarcinoma (SRCC), the histological variant of ampullary carcinoma, is an extremely uncommon malignancy. To our
knowledge, this report is the first case of SRCC with concurrent non–gastrointestinal malignancies.
Case Report: A 66 year old male with history ofprostate cancer, anglioblastoma multiforme presented with jaundice and abdominal pain. Endoscopic
retrograde cholangiopancreatography (ERCP) and Endoscopic Ultrasound (EUS) suggested a duodenal tumor at ... Show more content on
Helpwriting.net ...
90% of SRCC take place in the stomach [1]. SRCC is extremely uncommon in the ampulla of Vater, and only 32 previous cases have been described in
the literature [3].
Because of its uncommon entity, the histological genesis of SRCC is still mysterious. While previous authors suggested that the tumor came from the
ectopic gastric mucosa located at the ampullary region since most of SRCC are found in stomach [9, 10], others declared that SRCC occurs from the
gastric–type metaplastic epithelium [1] which appeared possibly due to the elevated acidity since the metaplastic changes were are usually observed
at the duodenal bulb in peptic ulcer patients [10]. However, Our case did not support both theories like the other case because it did not show any
gastric mucosa around the tumor nor peptic ulcer found in EGD

Gluten, Wheat And Grain Products
Gluten is made up of many different proteins and is often found in wheat and grain products. It is used in foods to hold together ingredients. Some
food sources that contain gluten are flour, wheat, barley and rye. Some alternatives for people who cannot tolerate gluten are soy, chickpeas,
flaxseed, millet, potato, corn and buckwheat. Some common symptoms of celiac disease include gas, bloating, fatigue, diarrhea and skin rashes.
One way that celiac disease can be diagnosed is through a blood test that tests for antibodies specialized to celiac disease. Another test that can be
done to diagnose celiac disease is a small intestinal biopsy which uses an EGD (esophagogastroduodenoscopy) to collect samples of the small
intestine. Doctors then use this to look for signs of celiac disease. Lactose intolerance is caused by the large intestine's inability to digest lactose, a
type of sugar. When lactose is ingested, an enzyme called lactase in the large intestine works to break down lactose, for people who are lactose
intolerant have low levels of this enzyme. People who are lactose intolerant may experience abdominal bloating, abdominal pain, diarrhea, gas and
nausea after ingesting lactose. Some non–dairy alternatives to lactose–containing foods are almond milk, coconut milk, rice milk, lactose–free products
and soya products. There are many things that can trigger asthma, some of these things include dust mites, animals, cold air, smoke, viral infections,
certain air

Mallory-Weiss Syndrome Research Paper
Mallory–Weiss syndrome
Overview:
Mallory–Weiss disorder or gastro–esophageal cut disorder alludes to seeping from tears (a Mallory–Weiss tear) in the mucosa at the intersection of the
stomach and throat, normally brought about by severe alcoholism, coughing, vomiting, and retching.
Causes:
The most widely known causes for MWS is prolonged or severe vomiting. While this sort of vomiting is connected with disease, it additionally much of
the time happens because of unending liquor abuse or bulimia.
Albeit incessant heaving commonly causes MWS, different conditions can bring about a gash of the throat, including:
1. Trauma to the midsection or guts
2. Severe or delayed hiccups
3. Intense hacking
4. Intense wheezing
5. Heavy lifting ... Show more content on Helpwriting.net ...
Abdominal agony 2. Severe regurgitating 3. Vomitingblood (a condition called "hematemesis") 4. Bloody stool 5. Involuntary regurgitating
Diagnosis:

Diagnosis of Mallory–Weiss syndrome is made by your specialist amid a complete physical exam. Your specialist will get some information about any
therapeutic issues, including day by day liquor admission and late sicknesses, to distinguish the fundamental reason for your side effects.
In the event that your side effects show dynamic seeping in the throat, your specialist may do an esophagogastroduodenoscopy (EGD). Prior to this
methodology, you will be given a narcotic and a painkiller to keep any inconvenience. An endoscope (little, adaptable tube with a camera joined to it)
will be embedded through the throat and into the stomach. This can help your specialist see the throat and recognize the area of the tear.
A complete blood check (CBC) might likewise be requested to affirm low hematocrit (number of red platelets). Your red platelet check may be low in
the event that you have seeping in the throat. Taking into account the discoveries from these tests, your specialist will have the capacity to figure out
whether you have MWS.
Treatment:

Personal Writing : A Personaltive Of Personal Narrative
Personal Narrative
"I don't want to do this! Please don't make me! I'm scared!" I stammered and cried at the same time.
"OH MY!" I gasped. Then everything went as black as the dead of night. ...
One day earlier The warm, windy August night before my critical day, my Mom took me out to SpirosPizza. When I walked through the enormous,
fancy glass doors to Spiros, the aroma of Italian pizza dough filled the air. When my hot, melty, sizzling pizza arrived, I began gobbling it like a
turkey. The pizza was a greasy mess that lathered my face from chin to forehead; I'm surprised I didn't break out all over my face. Unfortunately for
me, I didn't know it was the last time I would ever be able to eat there.
"I'm scared for tomorrow," I murmured as I was stuffing pizza in my mouth. "Don't worry, you'll be fine. It's just going to be like short nap. Probably
20 minutes," my mom said. My mom is a kind hearted woman who thinks about other people before herself.
"I know but it's like...You know...um."
"Fear of the unexpected?" My mom questioned.
"Yea," I replied. Unlike my mom, I am an outgoing daredevil that loves adventures.
"It's normal to be nervous," she explained.
"Ok," I resigned. The next morning
The next morning I woke up to a mouth as dry as

Deadly Disease : Kaposi Sarcoma
The deadly disease, known as Kaposi Sarcoma, was first discovered by Moritz Kaposi and later named after the discoverer himself. Moritz Kaposi
was a Hungarian physician and dermatologist and he first discovered the disease in 1872 describing it as an idiopathic multiple pigmented sarcoma of
the skin. He studied the affliction on five elderly male patients. Moritz continued to describe the various characteristics of the disease including nodules
developing on the skin, mainly on the hands and feet, tinted in either blue–red or brown–red forms. Moritz continued to describe the behavior of the
nodules by describing two scenarios. One in which the nodules remain isolate and begin to protrude growing in a spherical shape. Another scenario
involves the nodules multiplying in number but remaining flat in the skin. Generally the nodules begin to form on the instep of the foot and soon
after develop on the hands. As the disease progresses, the formations tend to group around several areas including the arms, legs, face, and trunk
except they cluster in irregular patterns and in smaller numbers as well. Moritz Kaposi continues describe the affliction throughout its stages as some
of the nodules have been observed in a state or atrophy or regression seeming to only ulcerate at a later point, gangrene (refers to the death of body
tissue due to a lack of blood flow or a bacterial infection) usually taking the place of the degenerating nodules. Further into kaposi sarcoma, the patient

ED Summary
A study by McGuire (2012) explored the statistical occurrence of ED in the veteran population and it relation to mental illness, specifically PTSD. The
study consisted of 135 male participants with ages ranging from 18 to 35. Although military branch specificity was not a criterion, majority of the study
group make–up contained Marines, which was 98 percent of the participants. The U.S. Navy made up 8 percent of the group. Researchers used four
assessment tools; State–trait inventory, PTSD Checklist–Military, Patient Health questionnaire and the Pediatric Anesthesia Emergence Delirium to
assess anxiety, symptomatology, depression and behavior observed during periods of ED, respectively. Results of the study indicated ED had a 20
percent occurrence... Show more content on Helpwriting.net ...
In a study by Wilson (2013) the perception of ED by anesthesia providers was evaluated. The survey group, consisting of 254 practitioners, was
administered a questionnaire regarding their experience with ED and perceived dangerous behavior, such as violence toward staff, vandalism and
agitation. Of those having been surveyed, 78 percent reported a personal experience with ED. In regards to violent emergence, 68 percent reported
witnessing various types of aggressive behavior and feeling there was imminent or actual danger (See Table 1). Thirty–three percent of those surveyed
felt that ED was a significant problem. An addendum made after publication noted that ED was seen in higher rates among patients with PTSD
(Wilson, 2013). Again, practitioners must understand the possibly dangers that can occur with ED. Furthermore, even if ED is non–violent it can be
very disconcerting for the

Endoscopy Essay
ENDOSCOPY EGD stands for an esophagogastroduodenoscopy. This procedure is used to visualize the esophagus, stomach, and the duodenum. This
is done via a lighted tube or endoscope to detect abnormalities. Possible abnormalities are tumors, ulcerations, or an obstruction. The patient should be
NPO for 8 hours before the test. When the patient arrives medical history, consent forms, explanation of test, and insertion of an IV are all completed.
The patient is given preoperative sedation and an IV sedation may also be given for the test. The throat is anesthetize with a local spray or gargle.
Each facility has different ways the patient is positioned for the test. The book states that the patient lies on a table with head extended. GVMH has the
patient sit and the endoscope is introduced... Show more content on Helpwriting.net ...
Polyps can be removed or biopsies taken during the procedure. Clear liquid diet should be 1–3 days before the test. The patient should be NPO for 8
hours before the test. Laxatives are given for 1–3 days before the test and enemas the night before. GVMH has a different prep than the book. Their
prep consists of clear liquid diet, five Dulcolax in the am, and then at 3pm a 64oz of Gatorade with Miralax the day before the test. When the patient
arrives medical history, consent forms, explanation of test, and insertion of an IV are all completed. The patient is given preoperative sedation and is
moderately sedated via IV for the test. The patient is positioned on their left side in bed. The length of the procedure depends on the reason for the test.
Most colonoscopies take 30 minutes to an hour but some can take 1.5–2 hours if abnormalities are found. After the procedure is complete vital signs
should be monitored every 15–30 minutes or as ordered. Watch for increased temperature, abdominal distention, or pain. This could be a possible
complication known as perforation or rectal bleeding

Barium Swallow : Patient Clinical Details
Barium swallow Patient clinical details The patient was referred to the Radiologist from his GP, because of ongoing pain and difficulty when
swallowing. The patient was 45years old male, consumed alcohol regularly and a heavy smoker. Due to the clinical details the radiologist decided to
perform a barium swallow this allows for the best visualisation of the internal structures, mainly the upper gastrointestinal tract and the stomach.
Barium swallows show any strictures or narrowing 's in this region which would account for the patients clinical details. Esophageal carcinomas are
able to be diagnosed from: Barium swallow Chest MRI or thoracic CT Endoscopic ultrasound Esophagogastroduodenoscopy (EGD) and biopsy PET
scan Because barium swallows are non–invasive and clearly outline the shape of the esophagus, the radiologist decided this form of imaging was best
suited to the patient and his clinical details which strongly suggested cancer to be the cause of the clinical details. Esophageal cancers usually present
with the following symptoms: Difficulty swallowing (dysphagia) Backwards movement of food through the esophagus and possibly mouth
(regurgitation) Chest pain not related to eating Weight loss without trying Worsening indigestion or heartburn Coughing or hoarseness But early
esophageal cancers typically causes no symptoms and have no apparent signs. Barium Swallow A barium swallow is a procedure of the upper
gastrointestinal tract,

Ferritin Case Study
K. Pagana, T. Pagana, and Pike–MacDonald (2013) state "the normal values of ferritin as:
Male: 12–30 mcg/L Female: 10–150 mcg/L
Child/Adolescent:
Newborn: 25–200 mcg/L2–5 months: 50–200 mcg/L
в‰¤1 month: 200–600 mcg/L6 months to 15 years: 7–142 mcg/L
1 mcg/L of serum ferritin corresponds to approximately 8 mg of stored iron" (p. 264).
All ages; both sexes who may be experiencing:
–unexplained fatigue, weakness, dizziness, headaches, pallor, pica (iron deficiency)
–unexplained joints pain, fatigue, weakness, weight loss, energy decrease, pain in abdomen, decreased libido, hair loss, or heart issues such as
congestive heart failure (iron overload)
–blood loss (specifically female teens/women with heavy menses), trauma patients
–blood in stool/rectal bleeding or positive fecal occult blood (FOB)
–malnutrition
Or patients:
–with iron overload disorders or family disposition for hemochromatosis, hemosiderosis; or at risk for iron overload from iron poisoning, or recent
blood transfusions
–with chronic diseases such as cancer, alcoholism, uremia, collagen diseases, chronic liver diseases such as hepatitis, or patients with chronic renal
failure to monitor iron stores
–with already diagnosed anemia – all types (to monitor treatment)
–who are pregnant or post delivery
Information collected from: Dunning III & Fischbach (2011), Pagana et al., (2013), Lab Tests Online (n.d.) and Juravinski Cancer Centre (JCC) personal

What Is Peptic Ulcer Disease?
Peptic Ulcer Disease Rebecca Hang Id number Peptic ulcer disease also known as PUD, is a disease in which hydrochloric acid and pepsin comes
into contact with a tissue in the GI tract causing injury to that area. The area that peptic ulcer occur most is the first portion of the small intestine which
is called the duodenum. It occurs in the duodenum due to the acidic chyme that enters the small intestine. Another area for peptic ulcer is between the
stomach and the esophagus due to reflex of stomach content that contains acids. Other possible area is the stomach and the jejunum if surgery was use
to connect it together. Men that are in their middle age are more likely to have peptic ulcer disease. Peptic ulcer... Show more content on Helpwriting.net
...
The pain can follow 1 to 2 hours after eating and it can interfere with sleep. The pain may be reduce by eating food, because the food thins out the
stomach acids. Some client may present with back pain due to the ulcer affecting the pancreas. The first sign of ulcer, in about 20% of client is
bleeding (hemorrhage, hematemesis or melena). Later, weight loss and vomiting can

Research Paper On Heel Pain
Heel Pain
Definition and Overview
Heel pain is a common medical problem. A number of conditions can produce heel pain, including injuries or disorders of the bones, muscles, tendons
and nerves of the foot, among others. Heel pain is typically felt either underneath the heel or behind the heel. Although the causes of heel pain are not
life–threatening, persistent heel pain can be debilitating, and if not adequately addressed, may interfere with exercise and even activities of daily living.
Over 2 million people in the United States alone experience heel pain every year.
Cause of Condition
A variety of diseases can present with heel pain. Heel pain is usually due to overuse. Majority of an individual's weight is absorbed by the heel.
Running places an even greater pressure on it, and thus, athletes tend to be at risk for this condition. This soreness may be attributed to repetitive stress
and pressure. The pain is typically mild, and gets better with rest.
One of the most common causes of heel pain is plantar fasciitis, both in athletes and in normal individuals. The plantar fascia is a fibrous band located
on the underside of the foot, from the forefoot to the heel. This fascia serves to ... Show more content on Helpwriting.net ...
A gastroenterologist will be able to evaluate you thoroughly, and can request for various examinations to diagnose your condition. If you are suspected
of having stomach cancer, you will have to undergo an esophagogastroduodenoscopy, or EGD. A scope with a camera is inserted into your mouth
down to your stomach to check for any masses. A biopsy can be done in the same sitting, in order to determine the presence of cancer cells. You may
also have to undergo imaging tests, such as a CT scan, to determine the extent of the disease. If you are indeed discovered to have stomach cancer,
your gastroenterologist may refer you to several other specialists, such as a general surgeon, a medical oncologist and a radiation

Peptic Ulcer Research Paper
Peptic ulcer disease – PUD is one of the most common disease, affecting millions of Americans (Jill, 2015). Furthermore, peptic ulcers are a recurrent
problem; unless patient is preventing recurrence.
Many people with peptic ulcer have no symptoms or present pain in the upper abdomen, which can be worsening with food or sometimes makes pain
better. Some other symptoms associated with peptic ulcer are nausea, vomiting, feeling bloated or full. The most serious presentation is bleeding, which
if unnoticed can be life–threatening hemorrhage and individual can become anemic with symptoms such as fatigue, shortness of breath with exercise,
feeling lightheaded, and pale skin (Caufield and Schafer, 2012).
Causes of ulcer can be associated with a

Clinical Overview : Esophageal Varices
CLINICAL OVERVIEW– Esophageal Varices
TERMINOLOGY
CLINICAL CLARIFICATION o Esophageal varices are abnormal, enlarged veins in the lower part of the esophagus. Esophageal varices develop when
normal blood flow to the liver is obstructed by scar tissue in the liver or a clot. Seeking a way around the blockages, blood flows into smaller blood
vessels that are not designed to carry large volumes of blood. The vessels may leak blood or even rupture, causing life–threatening bleeding.
CLASSIFICATION
Small varices and no hemorrhage
Hepatic venous pressure gradient в‰Ґ 10mmHg
Varices development rate 8% per year
Large varices and no hemorrhage
Hyper dynamic circulation
Progression from small to large 8% per year
Variceal hemorrhage
Pressure > Variceal wall tension
Esophageal hemorrhage 5–15% per year
Bleeding in patients with gastric varices is reports in 25% of patients in 2 years
Recurrent hemorrhage
Persistence of portal pressure and variceal status
DIAGNOSIS
CLINICAL PRESENTATION History
Patients are usually asymptomatic unless they bleed
Symptoms of bleeding esophageal varices include:
Vomiting blood
Black, tarry or bloody stools Physical Examination
If varices are related to liver disease, may see any of the following: Shock (in severe cases)
Yellow coloration of your skin and eyes (jaundice)

A cluster of tiny blood vessels on the skin, shaped like a spider (spider nevi)
Reddening of the skin on the palm of hands (palmar

Dysphagia

Recommended

Recommended

More Related Content

Similar to Dysphagia

Similar to Dysphagia (7)

More from Kim Tagtow

More from Kim Tagtow (14)

Recently uploaded

Recently uploaded (20)

Dysphagia