ABSTRACT
Percutaneous endoscopic gastrostomy (PEG) is an enteral nutritional assistance technique using a simple device compatible with conventional feeding and thus enabling the patient to be integrated into his or her social and familial surroundings. This inexpensive device is quickly and easily inserted under local anaesthesia. It causes little morbidity and virtually no mortality and has many advantages for patients with amyotrophic lateral sclerosis (ALS). We report the results of PEG in 28 ALS patients with bulbar involvement. Three of these patients developed minor complications during 6 consecutive months of PEG-assisted nutrition (2 had periostomial infection, 1 had mild haematemesis). There were no major complications, and mortality directly ascribable to PEG was nil. All patients put on weight or had their weight stabilized, and GEP was well accepted in all cases.
Subject(s)
Amyotrophic Lateral Sclerosis/complications , Deglutition Disorders/therapy , Gastrostomy/methods , Adult , Aged , Amyotrophic Lateral Sclerosis/therapy , Enteral Nutrition/methods , Female , Gastroscopy/adverse effects , Gastroscopy/methods , Gastrostomy/adverse effects , Humans , Male , Middle Aged , Time FactorsABSTRACT
The protein C system is essential in limiting the activation of coagulation in vivo. We report the case of a 45 year old man with portal vein thrombosis complicated by ruptured oesophageal varices. Low concentration of plasma protein C was found in the patient and subsequently in one brother with a history of venous thromboembolism, and also in one son and one nephew who were asymptomatic. Hereditary protein C deficiency should be considered in patients with portal hypertension due to portal vein thrombosis.
Subject(s)
Esophageal and Gastric Varices/etiology , Portal Vein , Protein C Deficiency , Thrombosis/etiology , Humans , Male , Middle Aged , Pedigree , Rupture, SpontaneousABSTRACT
Cerebral aspergilloma of initial sinus origin developed in a patient with mixed cell leukemia. Computed tomography imaging showed signs of a cystic multitumoral syndrome with a crown-shaped filling image without peritumoral edema. Follow up of cerebral lesions during medical treatment was by repeated CT scans, with progressive regression of images over a period of 8 months. The patient died after recurrence. Aspergilloma is seen mainly in patients with alternating immunity defenses.
