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E-Book

E-Book, Englisch, 392 Seiten, ePub

Reihe: Thieme

Tytgat Grading and Staging in Gastroenterology


1. Auflage 2008
ISBN: 978-3-13-257951-4
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 392 Seiten, ePub

Reihe: Thieme

ISBN: 978-3-13-257951-4
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark



Staging and grading are indispensable in reaching an adequate diagnosis, to determine disease severity, to choose an appropriate therapy, and to assure the best patient care and quality of life, but up to now no one source in gastroenterology has existed. Gastroenterologists, gastrointestinal surgeons, and fellows-in-training in gastroenterology will therefore immediately recognize the practical value of Grading and Staging in Gastroenterology - a comprehensive and systematic overview of all the current and most relevant information regarding grading and staging in gastroenterology - now selected and compiled for the first time in a single volume.

Organized into three sections - Instruments for Overall Patient and Disease Assessment; Organ and Disease-related Staging and Grading Systems, and Quality of Life Patient Assessments - readers have the option of using as an overall reference, to refer to a specific organ or disease, or by virtue of the extensive subject index, to research according to specific instrument or other relevant topics.

The following timesaving and didactic features further enhance the usefulness, and whether you are a clinician or surgeon, responsible for training, involved in research including setting up research trials, or require deeper understanding of evidence-based studies you will find making this compendium a part of your gastroenterology library a smart investment.

Uniform presentation -- each of the grading and staging systems is anchored in a strict text structure which includes aims, comments, and exact reference

Precise and unobtrusive explanatory notes (comments) -- especially useful for nurse practitioners

Numerous supplementary, high-quality line drawings, and endoscopic, radiologic and histological images -- clarify and elucidate where appropriate

Complete and accurate reference of all original sources respective to each instrument -- saves valuable research time
Grading and Staging in Gastroenterology is for all gastrointestinal professionals looking for an ideal guide into the myriad of staging and grading systems in gastroenterology.

Tytgat Grading and Staging in Gastroenterology jetzt bestellen!

Weitere Infos & Material


Chapter 1 Instruments for Overall Patient and Disease Assessment
Chapter 2 Organ-Related Staging and Grading
Chapter 3 Assessment of Quality of Life (QoL)



Chapter 2 Organ-Related Staging and Grading


Oropharynx

Esophagus

Stomach

Small Intestine

Colon

Liver

Biliary System

Pancreas

Spleen

Peritoneal Cavity

Oropharynx


Anatomical Variants


Laryngotracheal-Esophageal Cleft: Grading the Laryngotracheal-Esophageal Cleft According to Pettersson

Aims

The original classification of laryngotracheal-esophageal clefts is divided into three types depending on the extent of tracheal involvement (for Type IV see Comments below).

Type I

Cleft involves the larynx, inter-arytenoid muscles, and the cricoid laminae

Type II

Extends beyond the cricoid lamina up to the cervical trachea (sixth tracheal ring)

Type III

Involves the trachea including the carina

Type IV

Cleft extending beyond the carina into either one or both main stem bronchi

From Ryan DP, Muehrcke DD, Doody DP. Laryngotracheoesophageal cleft (type IV): Management and repair of lesions beyond the carina. . 1991;26:962–970. With permission of Elsevier.

Comments

Ryan et al. added type IV in 1991. They described three cases of laryngotracheal-esophageal clefts extending into the bronchi.

References

Pettersson G. Laryngotracheal esophageal cleft. . 1969;7:43–49.

Ryan DP, Muehrcke DD, Doody DP. Laryngotracheoesophageal cleft (type IV): Management and repair of lesions beyond the carina. . 1991;26:962–970.

Laryngotracheal-Esophageal Cleft: Grading of Laryngotracheal Cleft According to Evans

Aims

To modify Pettersson's classification of laryngotracheal-esophageal clefts to allow a more precise definition of the milder cases in which surgery carries a reasonable prognosis.

Type 1

Limited to cricoid cartilage: 1A Inter-arytenoid cleft, extending to, but not into the superior aspect of the cricoid cartilage; 1B Cleft extends partially through the cricoid; 1C Cleft extends completely through the cricoid

Type 2

Cleft includes the proximal 3 cm of the tracheoesophageal septum

Type 3

Involves the trachea including the carina

Type 4

Cleft involves the entire tracheoesophageal septum

From Pettersson G. Inhibited separation of larynx and the upper part of trachea from oesophagus in a newborn; report of a case successfully operated upon. . 1955;110:250–254. By permission of Taylor & Francis AS.

References

Armitage EN. Laryngotracheo-esophageal cleft. A report of three cases. . 1984;39:706–713.

Pettersson G. Inhibited separation of larynx and the upper part of trachea from oesophagus in a newborn; report of a case successfully operated upon. . 1955;110: 250–254.

Laryngotracheal-Esophageal Cleft: Grading of Laryngotracheal-Esophageal Cleft According to Armitage

Aims

To review the clinical features, associated congenital abnormalities, management, and morbidity of infants presenting with posterior laryngeal and laryngotracheal clefts.

Type I

31%

Clefts are limited to the inter-arytenoid region above the vocal folds. This type does not involve the cricoid cartilage

Type II

47%

This type includes the cricoid and extends into the cervical trachea

Type III

22%

This type involves the thoracic trachea

From Evans JNG. Management of the cleft larynx and tracheoesophageal clefts. . 1985;94:627–630. With permission of Annals Publishing Co.

Comments

Treatment is conservative, via primary endoscopic surgical repair or primary repair via an anterior laryngofissure. Gastroesophageal reflux is controlled by fundoplication.

References

Evans JNG. Management of the cleft larynx and tracheoesophageal clefts. . 1985;94: 627–630.

Laryngotracheal-Esophageal Cleft: Grading of Laryngotracheal-Esophageal Cleft According to Benjamin and Inglis and According to Dubois

Aims

Benjamin and Inglis and Dubois proposed a classification of laryngeal clefts with four main types.

Grading according to Benjamin and Inglis

Type I

Cleft is limited to the supraglottic lumen above the vocal folds

Type II

A partial cleft of the cricoid extending below the level of the vocal folds

Type III

Involves the whole cricoid cartilage and may extend to the cervical TE septum

Type IV

Involves a major part of the TE wall in the thorax

From Benjamin B, Inglis A. Minor congenital laryngeal clefts: diagnosis and classification. . 1989;98:417–420. With permission of Annals Publishing Co.

Grading according to Dubois

Type I

Cleft extends down to, but does not involve, the superior portion of the posterior cricoid plane

Type II

Cleft extends into and at times as far down as the inferior aspect of the posterior cricoid plane

Type III

Cleft extends into the cervical trachea to a variable distance

Type IV

Cleft extends into the thoracic trachea and may reach the carina or even beyond to involve one or both main-stem bronchi

From DuBois JJ, Pokorny WJ, Harberg FJ, Smith RJ. Current management of laryngeal and laryngotracheoesophageal clefts. . 1990;25:855–860. With permission of Elsevier Inc.

Inflammation


Oral Problems in the Elderly: The Dental Screening Tool

Aims

To propose a screening instrument for oral problems in the elderly for referral and further evaluation.

The dental screening tool

Score

D

Dry mouth

2

E

Eating difficulty

1

N

No dental care within past two years

1

T

Tooth loss

2

A

Alternative food selection because of masticatory problems

1

L

Lesions, scores, or lumps in mouth

1

From Bush LA, Horenkamp N, Morley JE, Spiro A 3rd. D-E-N-T-A-L: A rapid self-administered screening instrument to promote referrals for further evaluation in older adults. . 1996;44:979–481. With permission of Blackwell Publishing.

Fig. 2.1 Laryngotracheal-esophageal clefts: grading according to Benjamin and Inglis and according to Dubois.

Comments

The cleft larynx is a rare congenital anomaly. Type II–IV require urgent airway management. Dubois classified laryngotrachealesophageal clefts on an embryological basis.

References

Benjamin B, Inglis A. Minor congenital laryngeal clefts: diagnosis and classification. . 1989; 98:417–420.

DuBois JJ, Pokorny WJ, Harberg FJ, Smith RJ. Current management of laryngeal and laryngotracheoesophageal clefts. . 1990;25:855–860.

Comments

This score can be used to identify potential oral problems.

References

Bush LA, Horenkamp N, Morley JE, Spiro A 3rd. D-E-N-T-A-L: A rapid self-administered screening instrument to promote referrals for further evaluation in older adults. . 1996;44:979–481.

Thompson WM, Brown RH, Williams SM. Dentures, prosthetic treatment needs, and mucosal health in an institutionalized elderly population. . 1992;88:51.

Gastroesophageal Reflux: The Eccles and Jenkins Index of Dental Lesions

Aims

Dental and periodontal lesions in patients with gastroesophageal reflux disease are graded.

Rating

Erosion severity

Grade 0

No superficial enamel...



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