Publications by authors named "Shane Selvanderan"
Endohepatology: Arrival at the frontier of interventional endosonography.
World J Gastroenterol
May 2024
Article Synopsis
- Endohepatology is a new field combining endoscopic ultrasound (EUS) techniques for diagnosing and treating liver diseases.
- Recent studies show that EUS-guided procedures, such as biopsies and abscess drainage, are effective and safe for liver management.
- More randomized trials and collaboration between endoscopy and hepatology are needed to broaden EUS's use beyond specialized medical centers.
Background: Small bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE) have an established role in the investigation and management of small bowel pathology. Previous studies have reported on the yield of SBCE (60%) and DAE (57%), but none have been in an Australian setting.
Aims: To determine the yield of SBCE and any DAE performed as a direct consequence of SBCE in an Australian referral centre.
Dysphagia is a common problem affecting all ages. It is increasing in frequency particularly among the younger population due to the rising incidence of eosinophilic oesophagitis, a condition which often leads to acute presentation to hospital for the first time with food bolus obstruction requiring endoscopic removal. Careful history taking remains the first and most important step in evaluating dysphagia, and it is especially important to distinguish an oropharyngeal versus oesophageal origin, which helps to guide further investigation and therapy.
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- - The study investigates how therapeutic drug monitoring (TDM) of biologic drugs, specifically anti-TNF agents, impacts management decisions in patients with Crohn's disease (CD) by comparing clinician decisions based on drug levels to a panel consensus.
- - An analysis of 187 trough levels from 108 patients showed that TDM influenced management decisions in 46.9% of cases, with a higher impact in reactive TDM situations (63%) compared to proactive TDM (36%).
- - The findings suggest that incorporating TDM into regular clinical practice improves the management of adult CD patients undergoing anti-TNF therapy, affecting treatment choices significantly in both proactive and reactive contexts.
Objectives: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration.
View Article and Find Full Text PDFNutritional care in hospitalized patients with chronic liver disease.
World J Gastroenterol
December 2015
Aim: To evaluate the practice of nutritional assessment and management of hospitalised patients with cirrhosis and the impact of malnutrition on their clinical outcome.
Methods: This was a retrospective cohort study on patients with liver cirrhosis consecutively admitted to the Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital over 24 mo. Details were gathered related to the patients' demographics, disease severity, nutritional status and assessment, biochemistry and clinical outcomes.