ORCID Profile
0000-0002-7419-9361
Current Organisations
Monash Health
,
I-Med Network
,
Alfred Health
,
Royal Australian and New Zealand College of Radiologists
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Publisher: Discover STM Publishing Ltd.
Date: 2020
Publisher: Georg Thieme Verlag KG
Date: 09-02-2021
Abstract: Introduction Long-term percutaneous enteral nutrition forms an important part of treatment for patients with an inability to meet nutrient requirements orally. Radiologically inserted gastrostomy (RIG) is an alternative to the traditionally performed percutaneous endoscopic gastrostomy technique. However, there is marked heterogeneity in the way that RIG is performed. In addition, the role for antibiotic prophylaxis during RIG insertion is not clearly established. This study aimed to assess the safety of RIG insertion using our technique including the role of antibiotics in RIG insertion. Method Retrospective study over 5 years at a tertiary teaching hospital. Periprocedural or early complications within the first 2 weeks of the procedure were collected and correlated with the use of prophylactic antibiotics. Results A total of 116 patients met the inclusion criteria. 18-French tube was used in 96.6%. Note that 58.6% of procedures were done with intravenous sedation. Prophylactic 1 g cefazolin was used in 70 patients with 1 case of infection. Procedures were performed without antibiotics in 46 patients with 3 infections, p = 0.20. There were two major complications (1.7%) consisting of right gastric artery injury requiring embolization and gastric wall injury requiring laparotomy. There were 12 minor complications (10.3%) including 4 cases of infection, 3 of severe pain, 1 of minor bleeding, 2 of early dislodgement, and 2 of leak/bypass of gastric contents around the tube. Conclusion The technique used for RIG insertion at our institution results in a low complication rate. In addition, this study shows no significant difference in early peristomal infection rate with the use of antibiotic prophylaxis.
Publisher: Wiley
Date: 09-07-2014
DOI: 10.1111/ANS.12771
Publisher: Georg Thieme Verlag KG
Date: 15-02-2021
Publisher: Georg Thieme Verlag KG
Date: 18-05-2021
Abstract: Paradoxical cerebral embolism, although rare, can be secondary to acquired causes such as superior vena cava (SVC) occlusion and development of a mediastinal right-to-left shunt. Such shunts allow undisturbed passage of thromboemboli to bypass the pulmonary circulation and enter the systemic circulation. This report presents a case of paradoxical cerebral embolism due to a right-to-left shunt originating from occlusion of the SVC. The etiology of the SVC occlusion stems from a prior central venous access line used for treatment of lymphoma. The patient underwent endovascular treatment with successful coil embolization of the mediastinal shunt.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2016
Publisher: Wiley
Date: 02-09-2021
Abstract: Cardiac pacemakers are one of the most frequently encountered cardiac devices seen on chest imaging. They may include single or dual chamber pacemakers, automated implantable cardioverter defibrillators (AICD), biventricular pacemakers used for cardiac resynchronisation therapy (CRT), wireless CRT, leadless pacemakers, and subcutaneous implantable cardioverter defibrillators (SICD). This review aims to provide an up‐to‐date review on current implantable pacemaker and defibrillator devices.
Publisher: Wiley
Date: 15-06-2021
Abstract: This study aimed to risk‐stratify chest pain as a presenting symptom in patients with a diagnosis of pulmonary thromboembolism (PE) to assess for any association. In addition, this study aimed to assess traditionally acknowledged PE risk factors in an Australian population. This was a retrospective single‐centre cohort study assessing patients who presented to our emergency department during the period of 1 January 2019 to 1 January 2020. 730 consecutive patients who went on to computed tomography pulmonary angiography (CTPA) examination after presentation were included. The rate of CTPA being positive in this study was 11.6% (85/730). Chest pain was associated with a non‐significant reduction in the odds of PE (OR 0.774, P = 0.327). Univariate analysis showed significantly increased odds of a diagnosis of PE with presentation for leg pain/swelling (OR 6.670, P 0.001). Multivariate analysis showed increasing age (OR 1.018, 95% CI 1.002–1.034, P = 0.024), clinical signs of a DVT (OR 3.194, 95% CI 1.803–5.657, P 0.001) and positive D‐dimer (OR 1.762, 95% CI 1.011–3.071, P = 0.046) were associated with increased odds of PE. In this study, Emergency Department presentation with chest pain, whilst the most common reason to perform a CTPA, resulted in reduced odds with regard to the diagnosis of pulmonary thromboembolism. The use of CTPA in this setting may be rationalised according to other factors such as localised leg pain as a symptom, signs of DVT, increasing age or positive D‐dimer.
Location: Australia
No related grants have been discovered for Ronny Kuang.