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https://www.readbyqxmd.com/read/28212205/spontaneous-breathing-during-extracorporeal-membrane-oxygenation-in-acute-respiratory-failure
#1
Stefania Crotti, Nicola Bottino, Giulia Maria Ruggeri, Elena Spinelli, Daniela Tubiolo, Alfredo Lissoni, Alessandro Protti, Luciano Gattinoni
BACKGROUND: We evaluate the clinical feasibility of spontaneous breathing on extracorporeal membrane oxygenation and the interactions between artificial and native lungs in patients bridged to lung transplant or with acute exacerbation of chronic obstructive pulmonary disease (COPD) or acute respiratory distress syndrome. METHODS: The clinical course of a total of 48 patients was analyzed. Twenty-three of 48 patients were enrolled in the prospective study (nine bridged to lung transplant, six COPD, and eight acute respiratory distress syndrome)...
February 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28212050/volume-controlled-ventilation-does-not-prevent-injurious-inflation-during-spontaneous-effort
#2
Takeshi Yoshida, Susumu Nakahashi, Maria Aparecida Miyuki Nakamura, Yukiko Koyama, Rollin Roldan, Vinicius Torsani, Roberta R De Santis, Susimeire Gomes, Akinori Uchiyama, Marcelo B P Amato, Brian P Kavanagh, Yuji Fujino
RATIONALE: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort. OBJECTIVES: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation...
February 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28178125/comprehensive-swallowing-exercises-to-treat-complicated-dysphagia-caused-by-esophageal-replacement-with-colon-a-case-report
#4
Li Jiang, Yujue Wang, Na Li, Weihong Qiu, Huixiang Wu, Jianshan Huo, Meng Dai, Yong Yu, Guifang Wan, Zulin Dou, Weiping Guo
INTRODUCTION: Surgical procedures for colonic replacement of the esophagus are most commonly associated with anastomotic stricture which cause dysphagia. In this report, we describe a rare case of a patient who demonstrated dysphagia resulting from an anastomotic stricture following esophageal replacement with the colon. All the treatments to dilate the anastomotic stricture were ineffective. To investigate the new treatment strategy for a case with complicated dysphagia, clinical dysphagia evaluations, functional oral intake scale (FOIS), videofluoroscopic swallowing study as well as high-resolution manometry were used to evaluate the swallowing function of the patient before and after treatments...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28163259/effects-of-age-on-esophageal-motility-use-of-high-resolution-esophageal-impedance-manometry
#5
Young Kwang Shim, Nayoung Kim, Yo Han Park, Jong-Chan Lee, Jihee Sung, Yoon Jin Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee
Background/Aims: Disturbances of esophageal motility have been reported to be more frequent in aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on the esophageal motility using high-resolution esophageal impedance manometry (HRIM). Methods: Esophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (n = 32), 40-65 years (n = 185), and > 65 years (n = 62)...
February 5, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28147382/-effect-of-bolus-volume-on-pharyngeal-swallowing-dynamics-evaluated-with-small-high-resolution-manometry-catheters
#6
Michael Jungheim, Johanna Kallusky, Martin Ptok
The bolus volume has a modulating effect on the swallowing dynamics, but previously reported adaptations of the pharyngeal function have been inconsistent. Therefore, the aim of this study was to comprehensively evaluate changes of pressure and time parameters in the pharynx and upper esophageal sphincter (UES) in relation to the swallowed bolus volume with high-resolution manometry (HRM). To examine the normal swallowing physiology, particularly thin HRM probes were used, which were expected to influence the investigated structures only minimally...
February 1, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28145965/laparoscopic-anterior-partial-fundoplication-is-comparable-with-nissen-fundoplication-for-gastroesophageal-reflux-disease
#7
Pawanindra Lal, Swati H Shah, Nitin Leekha, Amarender Singh Puri
BACKGROUND: Laparoscopic Nissen fundoplication (LNF) has been the gold standard for gastroesophageal reflux disease (GERD), but the side effects of dysphagia and bloating have lead to interest in partial fundoplication as an alternative. AIM: To compare the symptomatic and objective parameters after LNF and laparoscopic anterior partial fundoplication (LAPF) in patients with GERD. PATIENTS AND METHODS: The study was conducted in the Division of Minimal Access Surgery, Maulana Azad Medical College from June 2008 to October 2016...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28133879/normal-values-of-esophageal-pressure-responses-to-a-rapid-drink-challenge-test-in-healthy-subjects-results-of-a-multicenter-study
#8
I Marin, D Cisternas, L Abrao, E Lemme, C Bilder, A Ditaranto, R Coello, A Hani, A M Leguizamo, A Meixueiro, J Remes-Troche, M A Zavala, A Ruiz de León, J Perez de la Serna, M A Valdovinos, J Serra
BACKGROUND: Multiple water swallow is increasingly used as a complementary challenge test in patients undergoing high-resolution manometry (HRM). Our aim was to establish the range of normal pressure responses during the rapid drink challenge test in a large population of healthy subjects. METHODS: Pressure responses to a rapid drink challenge test (100 or 200 mL of water) were prospectively analyzed in 105 healthy subjects studied in nine different hospitals from different countries...
January 29, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28128890/design-of-a-bioabsorbable-multilayered-patch-for-esophagus-tissue-engineering
#9
Rossella Dorati, Antonella De Trizio, Stefania Marconi, Anna Ferrara, Ferdinando Auricchio, Ida Genta, Tiziana Modena, Marco Benazzo, Alberto Benazzo, Gino Volpato, Bice Conti
A gold standard for esophagus reconstruction is not still available. The present work aims to design a polymer patch combining synthetic polylactide-co-polycaprolacton and chitosan biopolymers, tailoring patch properties to esophageal tissue characteristics by a temperature-induced precipitation method, to get multilayered patches (1L, 2L, and 3L). Characterization shows stable multilayered patches (1L and 2L) by selection of copolymer type, and their M w . In vitro investigation of the functional patch properties in simulated physiologic and pathologic conditions demonstrates that the chitosan layer (patch 3L) decreases patch stability and cell adhesion, while improves cell proliferation...
January 27, 2017: Macromolecular Bioscience
https://www.readbyqxmd.com/read/28117633/treatment-for-early-postoperative-esophageal-fistula-complicated-with-anterior-cervical-surgery
#10
Haifeng Yuan, Huiqiang Ding, Lihong Hu, Zorica Buser, Haoning Zhao, Xusheng Li
OBJECT: To investigate the efficacy of debridement, open drainage, and early feeding to treat early esophageal fistula complicated with anterior cervical surgery. METHODS: Retrospective analysis was conducted on data from 3154 patients who had undergone anterior cervical surgeries for cervical vertebra diseases between January 2006 and January 2013, in which eight patients had esophageal fistula with five males and three females. Four patients had cervical spinal injuries and four patients had cervical spondylosis...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#11
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
January 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28116594/overlap-of-dyspepsia-in-patients-with-gastroesophageal-reflux-disease-impact-of-clinical-metabolic-and-psychosocial-characteristics
#12
Ching-Sheng Hsu, Shu-Hui Wen, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Wei-Yi Lei, Fabio Pace, Chien-Lin Chen
BACKGROUND: Gastroesophageal reflux disease (GERD) and dyspepsia are highly prevalent in the general population with significant symptom overlap, while the interaction between both remains poorly understood. AIM: To examine whether GERD overlapping dyspepsia would have an impact on clinical and psychological features as compared with GERD alone. METHODS: We performed a cross-sectional study in a GERD cohort (n = 868) that was previously recruited from a population-based GERD survey (n = 2752)...
January 23, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28116532/reversible-stress-softening-in-layered-rat-esophagus-in-vitro-after-potassium-chloride-activation
#13
Hongbo Jiang, Donghua Liao, Jingbo Zhao, Guixue Wang, Hans Gregersen
Significant stress softening recovery after potassium chloride (KCl) administration was previously demonstrated in the intact rat esophageal wall. The aim of this study is to investigate the effect of KCl activation on stress softening recovery in the separated mucosa-submucosa layer and muscle layer of rat esophagus. Three series of loading-unloading distensions were carried out on 10 rat esophagi where the two separated layers were distended at luminal pressure levels 0.5, 1.0 and 2.0 kPa. Numerous distension cycles were done in [Formula: see text]-free Krebs solution before and after activation with KCl (110 mmol) for 3 min in calcium-containing media...
January 23, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28114155/capnoperitoneum-during-peroral-endoscopic-myotomy-recognition-and-management-a-case-report
#14
Eric Lee, Jay B Brodsky, Homero Rivas, Karl Zheng, John G Brock-Utne
Peroral endoscopic myotomy (POEM) is a minimally invasive procedure for treating esophageal achalasia. During POEM, carbon dioxide is insufflated under pressure into the esophagus and stomach, which can cause clinically significant capnoperitoneum, capnomediastinum, or capnothorax. We present a case in which gas accumulation in the abdomen during POEM had adverse effects on ventilation. Once the cause was recognized, needle decompression of the abdomen led to immediate improvement in ventilation.
January 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28110513/effect-of-methylnaltrexone-and-naloxone-on-esophageal-motor-function-in-man
#15
E Scarpellini, A Pauwels, R Vos, N Rommel, J Tack
BACKGROUND: Endogenous opioids (EO) acting on μ-opiod receptors in central and enteric nervous system (ENS) control gastrointestinal motility but it is still unclear whether EO in ENS may control esophageal function in man, thus we will study the effects of methylnaltrexone (MNTX), a peripherally selective, and naloxone (NA), a non-selective μ-opiod receptor antagonist, on esophageal motility in healthy subjects. METHODS: Fifteen HV (6 M; 34.1 ± 0.6 years; BMI: 22...
January 22, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28108832/beat-by-beat-assessment-of-cardiac-afterload-using-descending-aortic-velocity-pressure-loop-during-general-anesthesia-a-pilot-study
#16
Fabrice Vallée, Arthur Le Gall, Jona Joachim, Olivier Passouant, Joaquim Matéo, Arnaud Mari, Sandrine Millasseau, Alexandre Mebazaa, Etienne Gayat
Continuous cardiac afterload evaluation could represent a useful tool during general anesthesia (GA) to titrate vasopressor effect. Using beat to beat descending aortic pressure(P)/flow velocity(U) loop obtained from esophageal Doppler and femoral pressure signals might allow to track afterload changes. Methods We defined three angles characterizing the PU loop (alpha, beta and Global After-Load Angle (GALA)). Augmentation index (AIx) and total arterial compliance (Ctot) were measured via radial tonometry. Peripheral Vascular Resistances (PVR) were also calculated...
January 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28100991/sphincter-of-oddi-dysfunction-a-perplexing-presentation
#17
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
#18
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
#19
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
#20
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
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