ABSTRACT
OBJECTIVE: To study the attitudes of parents toward percutaneous endoscopic gastrostomy (PEG) tube placement and identify contributing factors to their negative attitudes. METHODS: Thirty consecutive parents were included retrospectively through a single endoscopy unit at the King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia from January to July 2012. A structured 25-item questionnaire was designed to examine their demographics, attitudes, and experience with the PEG procedure. RESULTS: Patients' ages were 3-19 years (mean: 10.2), mostly with severe cerebral palsy (77%). Their PEG tubes were inserted 2-144 months (mean: 39) prior to the encounter. Only 43% of the parents felt informed and most (73%) had negative attitudes toward the procedure, which was associated with significant delays (p=0.016). After the procedure, most parents (67%) reported a better-than-expected experience, which was associated with their information levels (p=0.03). Most parents (80%) regretted not having the PEG tube placed earlier. This depended on their information level, as those who were not informed were more likely to have strong regrets when compared to those informed (82% versus 42%, p=0.008). CONCLUSION: Most parents are not well-informed regarding the PEG procedure, which affects their expectations and experiences. Most parents found the experience better than what they expected and regretted not having carried it out earlier.
Subject(s)
Enteral Nutrition , Intubation, Gastrointestinal , Parents/psychology , Adolescent , Adult , Cerebral Palsy/therapy , Child , Child, Preschool , Female , Gastroscopy , Gastrostomy , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
BACKGROUND AND OBJECTIVES: Antenatally detected urinary tract abnormalities (ADUTA) are increasingly recognized. Our aims were to determine the incidence and outcomes of antenatally diagnosed congenital hydronephrosis in a large cohort. DESIGN AND SETTINGS: We recorded the number of total deliveries over 4 years at King Abdulaziz University Hospital (KAUH) between January 2008 and December 2011 from the number of nursery and neonatal intensive care unit (NICU) admissions. PATIENTS AND METHODS: We reviewed the records of 18 853 deliveries between January 2008 and December 2011 at KAUH, Saudi Arabia. ADUTA were recorded, and their postnatal medical records were reviewed for demographic and radiological data. RESULTS: ADUTA were diagnosed in 327 fetuses (1.7%). The commonest pathology was congenital hydronephrosis (n=313, 95.7%). Cystic renal anomalies were reported in 4 babies (1.2%), and 10 children (3.1%) were reported to have other renal anomalies, including duplex kidneys or a single kidney. A total of 240 babies with congenital hydronephrosis were followed up. Hydronephrosis resolved in 99 children (41.2%) within 2 months of birth. A total of 29 subjects had underlying renal anomalies (12.1%), including vesicoureteral reflux (n=12, 5%), pelvi-ureteric junction obstruction (n=14, 5.8%), and posterior urethral valve (n=3, 1.3%). The best predictor for nonresolving congenital hydronephrosis and underlying anatomical abnormalities was the anteroposterior diameter on the first postnatal scan. A cut-off point of 5 mm was found to be 83% sensitive in predicting nonresolving hydronephrosis, while 7 mm was 88% sensitive and 10 mm was 94% sensitive. CONCLUSIONS: Congenital hydronephrosis is the commonest ADUTA. A large percentage resolved within 2 months of birth, but underlying anatomical abnormalities were found in 12.1%. All babies with antenatally detected hydronephrosis should be examined by ultrasound postnatally but further radiological investigations should only be performed for persistent significant AP dilatation >=10 mm.
