{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T01:52:18Z","timestamp":1772070738909,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2018,10,14]],"date-time":"2018-10-14T00:00:00Z","timestamp":1539475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative condition, whose bulbar involvement compromises language, swallowing, and airway protection. When oral nutrition is no longer adequate, percutaneous endoscopic gastroscopy (PEG) may be indicated. However, as exact timing is still debatable, we tried to find it. (2) Methods: A prospective cohort study was performed using fiber-optic endoscopic evaluation of swallowing (FEES), functional evaluation scales (ALS Functional Rating Scale-Revised (ALSFRS-R) and bulbar sub-score (ALSFRS-R-B)), lung function tests (like Forced Vital Capacity (FVC), Cough Peak Flow (CPF)) and anthropometric data. (3) Results: Twenty-three patients were enrolled (mean 65.4 \u00b1 9.1 years, 60.9% males), 12 with spinal-onset. During the study period, 58 FEES were performed (1\u20134\/patients). Even before formal the PEG indication, suggestions were given to correct the alterations found. PEG was placed in 12 patients, on average 21.8 months after diagnosis (FVC = 69.9% \u00b1 26.7%, ALSFRS-R-B = 7.7 \u00b1 3.7, ALSFRS-R = 28.9 \u00b1 12.3), and being 91.7% under ventilatory support. ALSFRS-R-B, CPF, FVC, and ALSFRS-R showed significant discriminant ability for PEG placement. Sensitivity and specificity were, respectively, ALSFRS-R-B \u2264 8 (100\/90.9), CPF \u2264 205 (83.3), FVC \u2264 74 (83.3\/74.2), and ALSFRS-R &lt; 29 (83.3\/65.1). (4) Conclusions: FEES provide additional information beyond formal PEG indication. ALSFRS-R-B score \u2264 8 was found as a best functional and noninvasive indicator for PEG performance in ALS patients.<\/jats:p>","DOI":"10.3390\/jcm7100352","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T03:43:01Z","timestamp":1539574981000},"page":"352","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Functional and Endoscopic Indicators for Percutaneous Endoscopic Gastrostomy (PEG) in Amyotrophic Lateral Sclerosis Patients"],"prefix":"10.3390","volume":"7","author":[{"given":"Bebiana","family":"Conde","sequence":"first","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar Tra\u0301s-os-Montes e Alto Douro, Avenida da Noruega, Vila Real 5000-508, Portugal"},{"name":"Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, Porto 4200-319, Portugal"},{"name":"Institute for Research and Innovation in Health (i3S), University of Porto, Rua Alfredo Allen, Porto 4200-135, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5934-5201","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Martins","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, Porto 4200-319, Portugal"},{"name":"Institute for Research and Innovation in Health (i3S), University of Porto, Rua Alfredo Allen, Porto 4200-135, Portugal"}]},{"given":"In\u00eas","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar Tra\u0301s-os-Montes e Alto Douro, Avenida da Noruega, Vila Real 5000-508, Portugal"}]},{"given":"Ana","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Centro Hospitalar Tra\u0301s-os-Montes e Alto Douro, Avenida da Noruega, Vila Real 5000-508, Portugal"}]},{"given":"Jo\u00e3o","family":"Winck","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, Alameda Prof. Hern\u00e2ni Monteiro, Porto 4200-319, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2018,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/01616412.2016.1259028","article-title":"Gastrostomy tube placement is safe in advanced amyotrophic lateral sclerosis","volume":"39","author":"Kak","year":"2017","journal-title":"Neurol. 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