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- 저자 : ( Daphne Ang ) (검색결과 2 건)
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Helicobacter pylori Treatment Strategies in Singapore
( Tiing Leong Ang ),( Daphne Ang ) 대한간학회 2021 Gut and Liver Vol.15 No.1
The management of Helicobacter pylori infection in Singapore remains a clinical challenge. Similar to other regions, there has been an increase in antibiotic resistance rates through the years. Nonetheless, over the past two decades, clarithromycin-based triple therapy has continued to be used as the first line treatment option, with an eradication rate exceeding 90%, although the accepted treatment duration must now be lengthened from 1 to 2 weeks to maintain efficacy. Concomitant and sequential therapies did not demonstrate superiority over standard triple therapy. Current empiric second line treatment utilizes either bismuth-based quadruple therapy or levofloxacin-based triple therapy, but outcomes remain less than ideal. Identifying options to further improve treatment success rates is challenging. Strategies being considered include the use of potent acid suppressants, such as vonoprazan, and H. pylori culture and antibiotic susceptibility testing-guided therapy. (Gut Liver 2021;15:13-18)
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Clement C H Wu,James W Li,Keng Sin Ng,Daphne S Ang 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.1
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding diffculties, in patients suffering from complicationsof nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges inhemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically,followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidentaldislodgement. Her previous nasopharyngectomy, wide field radiation therapy, and radical neck dissection precluded nasogastric tubefeeding, and the presence of a large hiatus hernia made reinsertion of a new PEG technically challenging. This case highlights themethods used to overcome the above challenges.
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