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https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#1
Sana Ahmad Din, Iman Naimi, Mirza Beg
Sphincter of Oddi dysfunction is caused by stenosis or dyskinesia of the sphincter of Oddi, leading to blockage of bile drainage from the common bile duct. We present the case of a 16-year-old female with chronic abdominal pain who underwent laparoscopic cholecystectomy for cholelithiasis but continued to experience abdominal pain, nausea, and vomiting along with persistently elevated ALT and AST levels. Postoperative abdominal ultrasound was nondiagnostic. Esophagogastroduodenoscopy showed mild reflux esophagitis and mild chronic Helicobacter pylori-negative gastritis...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#2
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28098054/long-term-esophageal-motility-changes-after-thyroidectomy-associations-with-aerodigestive-disorders
#3
G Scerrino, A Inviati, S Di Giovanni, N C Paladino, S Di Giovanni, N C Paladino, V Di Paola, C Raspanti, G I Melfa, F Cupido, S Mazzola, C Porrello, S Bonventre, G Gullotta
BACKGROUND: Patients undergoing thyroidectomy often complain aerodigestive disorders. In a previous study we showed the associations between voice impairment and proximal acid reflux, swallowing impairment and Upper Esophageal Sphyncter (UES) incoordination and the decrease in UES pressure in thirty-six patients observed before and soon afterwards uncomplicated thyroidectomy. This study investigated the state of post-thyroidectomy esophageal motility changes and its associations with these disorders after 18-24 months...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28079668/noninvasive-assessment-of-portal-hypertension-and-detection-of-esophageal-varices-in-cirrhosis-state-of-the-art
#4
Ana C de Oliveira
Portal hypertension (PHT) is a major consequence of any chronic liver disease and it is the main cause of complications in patients with cirrhosis. Measurement of hepatic vein pressure gradient is considered the gold standard for PHT assessment, together with its diagnosis and prognosis relevance. Even though hepatic vein pressure gradient measurement is a safe procedure, it is still considered an invasive technique and not widely available. There is thus a need for noninvasive methods that can predict the progression of PHT as well as the presence and the risk of complications related to esophageal varices...
January 10, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28079588/the-cricoid-force-necessary-to-occlude-the-esophageal-entrance-is-there-a-gender-difference
#5
Ahed M Zeidan, M Ramez Salem, Munir Bamadhaj, Jean-Xavier Mazoit, Hussein Sadek, Hassan Houjairy, Kamal Abdulkhaleq, Nabil Bamadhaj
BACKGROUND: We tested the hypothesis whether gender differences exist in the applied cricoid force necessary to prevent regurgitation. Real-time visual and dynamic means were used to assess the effectiveness of different applied cricoid forces in occluding the esophageal entrance in men (group 1) and in women (group 2). METHODS: In anesthetized and paralyzed patients, the glottis and esophageal entrance were visualized with a Glidescope video laryngoscope. Trained operators performed cricoid pressure (CP) and gastric tube insertion trials...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28078818/objectively-diagnosing-rumination-syndrome-in-children-using-esophageal-ph-impedance-and-manometry
#6
M M J Singendonk, J M Oors, A J Bredenoord, T I Omari, R J van der Pol, M J Smits, M A Benninga, M P van Wijk
BACKGROUND: Rumination syndrome is characterized by recurrent regurgitation of recently ingested food into the mouth. Differentiation with other diagnoses and gastroesophageal reflux disease (GERD) in particular, is difficult. Recently, objective pH-impedance (pH-MII) and manometry criteria were proposed for adults. The aim of this study was to determine diagnostic ambulatory pH-MII and manometry criteria for rumination syndrome in children. METHODS: Clinical data and 24-hour pH-MII and manometry recordings of children with a clinical suspicion of rumination syndrome were reviewed...
January 12, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28078463/endoscopic-vacuum-therapy-for-various-defects-of-the-upper-gastrointestinal-tract
#7
Florian Kuehn, Gunnar Loske, Leif Schiffmann, Michael Gock, Ernst Klar
BACKGROUND: Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28066619/clinical-management-of-chronic-obstructive-pulmonary-disease-patients-with-muscle-dysfunction
#8
REVIEW
Joaquim Gea, Carme Casadevall, Sergi Pascual, Mauricio Orozco-Levi, Esther Barreiro
Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28058473/brain-oxygenation-during-thoracoscopic-repair-of-long-gap-esophageal-atresia
#9
Lisanne J Stolwijk, David C van der Zee, Stefaan Tytgat, Desiree van der Werff, Manon J N L Benders, Maud Y A van Herwaarden, Petra M A Lemmers
BACKGROUND: Elongation and repair of long gap esophageal atresia (LGEA) can be performed thoracoscopically, even directly after birth. The effect of thoracoscopic CO2-insufflation on cerebral oxygenation (rScO2) during the consecutive thoracoscopic procedures in repair of LGEA was evaluated. METHODS: Prospective case series of five infants, with in total 16 repetitive thoracoscopic procedures. A CO2-pneumothorax was installed with a pressure of maximum 5 mmHg and flow of 1 L/min...
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28054418/could-the-peristaltic-transition-zone-be-caused-by-non-uniform-esophageal-muscle-fiber-architecture-a-simulation-study
#10
W Kou, J E Pandolfino, P J Kahrilas, N A Patankar
BACKGROUND: Based on a fully coupled computational model of esophageal transport, we analyzed how varied esophageal muscle fiber architecture and/or dual contraction waves (CWs) affect bolus transport. Specifically, we studied the luminal pressure profile in those cases to better understand possible origins of the peristaltic transition zone. METHODS: Two groups of studies were conducted using a computational model. The first studied esophageal transport with circumferential-longitudinal fiber architecture, helical fiber architecture and various combinations of the two...
January 5, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28050744/simulation-studies-of-the-role-of-esophageal-mucosa-in-bolus-transport
#11
Wenjun Kou, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
Based on a fully coupled computational model for esophageal transport, we analyzed the role of the mucosa (including the submucosa) in esophageal bolus transport and how bolus transport is affected by mucosal stiffness. Two groups of studies were conducted using a computational model. In the first group, a base case that represents normal esophageal transport and two hypothetical cases were simulated: (1) esophageal mucosa replaced by muscle and (2) esophagus without mucosa. For the base case, the geometric configuration of the esophageal wall was examined and the mechanical role of mucosa was analyzed...
January 3, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28049863/the-effect-of-acute-stress-on-esophageal-motility-and-gastroesophageal-reflux-in-healthy-humans
#12
Hong Sub Lee, Chung Kyun Noh, Kwang Jae Lee
Background/Aims: Little research has been done to evaluate the effect of stress in exacerbating the symptoms associated with gastroesophageal reflux (GER). We aimed to investigate the effect of acute stress on esophageal motility and GER parameters in healthy volunteers. Methods: A total of 10 (M:F = 8:2, median age 34 years-old) healthy volunteers without any recurrent gastrointestinal symptoms participated in this study. They underwent esophageal high-resolution manometry with 10 wet swallows (Experiment I) and esophageal impedance-pH monitoring (Experiment II) in the basal period and in the stress period...
January 30, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28045709/cricoid-pressure-controversies-narrative-review
#13
M Ramez Salem, Arjang Khorasani, Ahed Zeidan, George J Crystal
Since cricoid pressure was introduced into clinical practice, controversial issues have arisen, including necessity, effectiveness in preventing aspiration, quantifying the cricoid force, and its reliability in certain clinical entities and in the presence of gastric tubes. Cricoid pressure-associated complications have also been alleged, such as airway obstruction leading to interference with manual ventilation, laryngeal visualization, tracheal intubation, placement of supraglottic devices, and relaxation of the lower esophageal sphincter...
January 3, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28025477/duodenal-loop-obstruction-as-an-unusual-cause-of-acute-pancreatitis-a-case-series
#14
Hyeonmin Lee, Yonghyeok Choi, Hyewon Jeong, Jae Kyu Lim, Taeyoung Jung, Joung Ho Han, Seon Mee Park
Duodenal loop obstruction is an unusual cause of acute pancreatitis. Increased intraluminal pressure hinders pancreatic flow, causing dilatation of the pancreatic duct and inducing acute pancreatitis. We experienced three cases of acute pancreatitis that resulted from duodenal loop obstruction after (1) an esophagectomy with gastric pull-up procedure for esophageal cancer, (2) a gastrectomy with Billroth I reconstruction for gastric cancer, and (3) a gastrojejunostomy for abdominal trauma. An abdominal CT scan revealed a distended duodenal loop, dilated pancreatic duct, and inflamed pancreas with fluid collection...
December 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28004166/anti-angiotensin-ii-type-1-receptor-autoantibodies-at1r-aas-in-patients-with-systemic-sclerosis-lack-of-association-with-disease-manifestations
#15
Ufuk İlgen, Müçteba Enes Yayla, Nurşen Düzgün
Angiotensin II type 1 receptor autoantibodies (AT1R-AAs) are known to be associated with malignant hypertension, preeclampsia, and vascular rejection in kidney transplantation. They were also suspected to have pathogenetic role in vasculopathic changes in systemic sclerosis (SSc). Clinical data regarding AT1R-AAs in SSc are scarce. In this work, we will examine the relationship between serum levels of AT1R-AAs and disease manifestations. Serum samples from SSc patients and healthy controls were analyzed for AT1R-AAs by using a commercial ELISA kit...
December 21, 2016: Rheumatology International
https://www.readbyqxmd.com/read/28002887/pediatric-rumination-subtypes-a-study-using-high-resolution-esophageal-manometry-with-impedance
#16
R Rosen, L Rodriguez, S Nurko
BACKGROUND: The differential diagnosis of intractable reflux in children includes rumination syndrome, but confirming the diagnosis using antroduodenal manometry is invasive, is costly, and requires anesthesia. High-resolution esophageal manometry with impedance (HRM-MII) overcomes these limitations, and the goal of this study is to validate the use of HRM-MII as a diagnostic tool for rumination and to describe the subtypes of pediatric rumination. METHODS: We reviewed the HRM-MII tracings of 21 children presenting with symptoms of intractable reflux in whom rumination was being considered...
December 21, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28002118/hemodynamic-response-to-primary-prophylactic-therapy-with-nonselective-%C3%AE-blockers-is-related-to-a-reduction-of-first-variceal-bleeding-risk-in-liver-cirrhosis-a-meta-analysis
#17
Annarein J C Kerbert, Fang W T Chiang, Mark van der Werf, Theo Stijnen, Hilde Slingerland, Hein W Verspaget, Bart van Hoek, Minneke J Coenraad
The current primary prophylaxis for esophageal variceal bleeding in cirrhotic patients consists of nonselective β-blocker (NSBB) therapy. However, only approximately half of the patients achieve a sufficient hemodynamic response to NSBB therapy. Clinical application of hemodynamic response monitoring is still under debate. The aim of this meta-analysis is to assess the potential clinical value of monitoring the hemodynamic response to NSBB therapy using hepatic venous pressure gradient (HVPG) measurements in the primary prophylaxis for variceal bleeding...
December 20, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27997805/physiologic-effects-of-high-flow-nasal-cannula-in-acute-hypoxemic-respiratory-failure
#18
Tommaso Mauri, Cecilia Turrini, Nilde Eronia, Giacomo Grasselli, Carlo Alberto Volta, Giacomo Bellani, Antonio Pesenti
RATIONALE: High-flow nasal cannula (HFNC) improves the clinical outcomes of non-intubated acute hypoxemic respiratory failure (AHRF) patients. OBJECTIVES: To assess the effects of HFNC on gas exchange, inspiratory effort, minute ventilation, end-expiratory lung volume, dynamic compliance and ventilation homogeneity in AHRF patients. METHODS: This was a prospective randomized cross-over study in non-intubated AHRF patients with PaO2/setFiO2 ≤300 mmHg admitted to the Intensive Care Unit...
December 20, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27984319/optimization-of-positive-end-expiratory-pressure-targeting-the-best-arterial-oxygen-transport-in-the-acute-respiratory-distress-syndrome-the-optipep-study
#19
Loïc Chimot, Yannick Fedun, Arnaud Gacouin, Boris Campillo, Sophie Marqué, Antoine Gros, Pierre Delour, Sandrine Bedon-Carte, Yves Le Tulzo
: The optimal setting for positive end-expiratory pressure (PEEP) in mechanical ventilation remains controversial in the treatment of acute respiratory distress syndrome (ARDS). The aim of this study was to determine the optimum PEEP level in ARDS, which we defined as the level that allowed the best arterial oxygen delivery (DO2).We conducted a physiological multicenter prospective study on patients who suffering from ARDS according to standard definition and persistent after 6 hours of ventilation...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27980234/effects-of-postural-change-on-transesophageal-echocardiography-views-and-parameters-in-healthy-dogs
#20
Seijirow Goya, Tomoki Wada, Kazumi Shimada, Daiki Hirao, Ryuji Fukushima, Norio Yamagishi, Miki Shimizu, Ryou Tanaka
The purpose of the present study is to investigate the effect of postural change on transesophageal echocardiography (TEE) views and parameters of interest anesthesia monitoring in healthy dogs. Twelve Beagle dogs were anesthetized and randomly positioned in one of four postures: right lateral-recumbency, left lateral-recumbency, supine position and prone position. After examinations in one posture, the same examination was demonstrated in another posture and repeated in all postures. In each posture, several standard TEE views were demonstrated: longitudinal cranial-esophageal aorta long-axis-view, transverse middle-esophageal mitral valve long-axis-view and transgastric middle short-axis-view...
December 16, 2016: Journal of Veterinary Medical Science
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