Patency of endoscopic ultrasound-guided gastroenterostomy in the treatment of malignant gastric outlet obstruction

Background and study aims Endoscopic ultrasoundguided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent (LAMS) is a novel, minimally invasive technique in the palliative treatment of malignant gastric outlet obstruction (GOO). Several studies have demonstrated feasibility and safety of EUS-GE, but evidence on long-term durability is limited. The aim of this study was to evaluate patency of EUS-GE in treatment of malignant GOO. Patients and Methods An international multicenter study was performed in seven centers in four European countries. Patients who underwent EUS-GE with a LAMS between March 2015 and March 2019 for palliative treatment of symptomatic malignant GOO were included retrospectively. Our main outcome was recurrent obstruction due to LAMS dysfunction; other outcomes of interest were technical success, clinical success, adverse events (AEs), and survival. Results A total of 45 patients (mean age 69.9 ± 12.3 years and 48.9% male) were included. Median duration of followup was 59 days (interquartile range [IQR] 41–128). Recurrent obstruction occurred in two patients (6.1 %), after 33 and 283 days of follow-up. Technical success was achieved in 39 patients (86.7 %). Clinical success was achieved in 33 patients (73.3 %). AEs occurred in 12 patients (26.7 %), of which five were fatal. Median overall survival was 57 days (IQR 32–114). Conclusions EUS-GE showed a low rate of recurrent obstruction. The relatively high number of fatal AEs underscores the importance of careful implementation of EUSGE in clinical practice

THU0116 European multicentre pilot survey to assess vitamin d and clinical status in rheumatoid arthritis patients

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Bibliography: p. 188-189.Mode of access: Internet

Comparação entre o desempenho funcional de crianças com síndrome de down e crianças com desenvolvimento típico dos 2 aos 7 anos de idade

Introdução: A síndrome de Down (SD) é a alteração cromossômica mais comum entre os humanos. O desenvolvimento funcional da criança com a síndrome é prejudicado pelas alterações neuromotoras, musculoesqueléticas, cardiológicas entre outras que a caracterizam. Objetivos: Comparar o desempenho funcional de crianças com SD com o de crianças com desenvolvimento típico (DT) dos dois aos sete anos de idade, provenientes da cidade de Porto Alegre e região metropolitana. Verificar a influência de características familiares e de patologias no desenvolvimento funcional das crianças e seus maiores déficits. Métodos: Estudo observacional com delineamento transversal, com amostragem por conveniência. Utilizou-se o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) para comparar o desenvolvimento funcional dos dois grupos de crianças. Os grupos também foram comparados por faixas etárias de um ano e seis meses. Foi utilizado um questionário para verificar as características familiares e patologias associadas às crianças. Resultados: Participaram 95 crianças, sendo 49 com SD e 46 com DT. Os dois grupos apresentaram diferença estatística em todas as áreas do PEDI analisadas quando comparados em conjunto ou por faixas etárias. As crianças com SD tiveram os escores abaixo do esperado em todas as áreas do PEDI, exceto quanto à assistência do cuidador nas áreas de mobilidade e função social. As características familiares que influenciaram no desenvolvimento funcional foram: profissão da mãe fora do lar, grau de instrução do pai e a frequência na escola. A presença de patologias associadas à síndrome não influenciou o desempenho funcional na SD. Discussão/conclusão: Tanto as crianças com SD como as com DT tiveram dificuldades funcionais, porém nas com SD elas apresentaram-se em atividades menos complexas. As limitações cognitivas nas crianças com SD pode ter influenciado no desenvolvimento funcional. A profissão da mãe fora do lar e frequência na escola podem ter sido favoráveis devido à convivência com outras pessoas e crianças. Provavelmente, com o avanço das cirurgias cardíacas e demais tratamentos, as patologias associadas não influenciaram o desenvolvimento das crianças com SD. Foi verificado nesse estudo que as crianças com SD apresentaram desenvolvimento funcional abaixo do esperado em todas as áreas do PEDI. Quando comparados os dois grupos e subgrupos por faixa etária, crianças com SD e com DT, observou-se que as diferenças mantiveram-se mesmo nas faixas etárias superiores. Não temos como prever o desenvolvimento de uma criança com SD, porém podemos investir na sua independência e qualidade de vida.Introduction: Down syndrome (DS) is the most common chromosome abnormalities among humans. The functional development of the child with the syndrome is impaired by neuromotor, musculoskeletal, cardiac abnormalities that characterize among others. Objectives: To compare the functional performance of Down syndrome (DS) children with that of children with typical development (TD) from two to seven years of age, from the city of Porto Alegre and its metropolitan area. To investigate the influence of family characteristics and pathologies in the functional development of children and their larger deficits. Methods: Observational study with cross-sectional design with convenience sampling. We used the Pediatric Evaluation of Disability Inventory (PEDI) to compare the functional development of the two groups of children. The groups were also compared by age, using age ranges of one year and six months. A questionnaire was used to assess family characteristics and pathologies associated with children. Results: Participants were 95 children, 49 with DS and 46 with TD. The two groups displayed statistical differences in all areas of the PEDI analyzed, when compared together and also in comparisons involving age groups. Children with DS had scores lower than controls in all areas of the PEDI, except for caregiver assistance in the areas of mobility and social function. Family characteristics that influence the functional development were: mother's profession outside the home, level of parent education and school attendance. The presence of pathologies associated with the syndrome did not influence the functional performance in SD. Discussion/conclusion: Both the children with DS and those with TD had functional difficulties; however, for those with DS, the difficulties appeared in less complex activities. Cognitive limitations in the children with DS may have had an influence on the functional development. The profession of the mother outside the home and school attendance may have been favorable due to interaction with other people and children. Probably, with the advancement of cardiac surgery and other treatments associated pathologies did not influence children's development. It was found in this study that children with DS showed lower than expected functional development in all areas of the PEDI. When comparing the two groups and subgroups by age, children with DS and DT, it was observed that the differences remained even in old age. We cannot predict the development of children with DS; however, we can invest in their independence and quality of life