Publications by authors named "Michael Chieng"
Article Synopsis
- Malignant gastric outlet obstruction (GOO) can be debilitating, and self-expanding metal stents (SEMS) are commonly used as a palliative treatment option for patients unable to undergo surgery.
- A study involving 190 patients showed that SEMS had a high technical success rate (97.9%) and a notable clinical success rate (83.9%), although many patients experienced adverse events, with stent occlusion being the most frequent issue.
- The findings indicated that using uncovered SEMS resulted in the least likelihood of stent dysfunction, and specific patient factors like performance status, extrinsic obstruction, and ascites may help identify better candidates for this treatment.
Aims: Per-oral endoscopic myotomy (POEM) is a recognised treatment for achalasia, with the accepted approach involving admission for imaging and dietary progression. However, recent publications suggest same-day discharge (SDD) may be possible, which could be time and cost-saving. We sought to investigate the safety of SDD following POEM.
View Article and Find Full Text PDFThe modern treatment of inflammatory bowel disease (IBD) has evolved significantly in recent years. This includes development of new pharmacologic therapies and their implementation in clinical practice. Moderate-to-severe IBD represents a group of patients at risk of poorer outcomes, and mounting evidence suggests biologic and small molecule medications, collectively termed advanced therapies, are the most effective tools clinicians possess.
View Article and Find Full Text PDFBackground: Artificial intelligence-assisted colonoscopy (AIAC) has gained attention as a tool to assist with polyp detection during colonoscopy. Uncertainty remains as to the clinical benefit, given limited publications using different modules.
Method: A single-centre retrospective study was performed at Waitematā Endoscopy, a private endoscopy centre in Auckland, New Zealand.
Article Synopsis
- The study compares the clinical outcomes of two intravenous corticosteroids, methylprednisolone (IVMP) and hydrocortisone (IVHC), for treating acute flares of inflammatory bowel disease (IBD).
- Patients receiving IVMP needed more rescue therapy but experienced lower rates of hypokalemia compared to those on IVHC.
- Overall, both treatment regimens showed similar hospitalization duration and rates of bowel resection within 30 days.
Background: Patients attending general medicine outpatient clinics (GM OPC) at hospital face multiple healthcare demands in an environment that has evolved with the clinician at its centre. The ideas, knowledge and understanding that patients bring to their clinic appointments are not well studied in the New Zealand setting.
Aims: To assess how hospitals prepare patients for their outpatient appointments and encourage people to participate actively in their own care.
Case report of a 23-year-old male presenting with a severe flare of Crohn's disease, exacerbated by community-acquired infection with Clostridium difficile. This case outlines the association between C. difficile infection and inflammatory bowel disease, as both a mimic and a precipitant of flares.
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