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https://www.readbyqxmd.com/read/29343623/identifying-dna-methylation-biomarkers-for-non-endoscopic-detection-of-barrett-s-esophagus
#1
Helen R Moinova, Thomas LaFramboise, James D Lutterbaugh, Apoorva Krishna Chandar, John Dumot, Ashley Faulx, Wendy Brock, Omar De la Cruz Cabrera, Kishore Guda, Jill S Barnholtz-Sloan, Prasad G Iyer, Marcia I Canto, Jean S Wang, Nicholas J Shaheen, Prashanti N Thota, Joseph E Willis, Amitabh Chak, Sanford D Markowitz
We report a biomarker-based non-endoscopic method for detecting Barrett's esophagus (BE) based on detecting methylated DNAs retrieved via a swallowable balloon-based esophageal sampling device. BE is the precursor of, and a major recognized risk factor for, developing esophageal adenocarcinoma. Endoscopy, the current standard for BE detection, is not cost-effective for population screening. We performed genome-wide screening to ascertain regions targeted for recurrent aberrant cytosine methylation in BE, identifying high-frequency methylation within the CCNA1 locus...
January 17, 2018: Science Translational Medicine
https://www.readbyqxmd.com/read/29340828/hiatal-hernia-recurrence-following-magnetic-sphincter-augmentation-and-posterior-cruroplasty-intermediate-term-outcomes
#2
Kais A Rona, James M Tatum, Joerg Zehetner, Katrin Schwameis, Carol Chow, Kamran Samakar, Adrian Dobrowolsky, Caitlin C Houghton, Nikolai Bildzukewicz, John C Lipham
BACKGROUND: We have previously reported short-term outcomes after hiatal hernia repair (HHR) at the time of magnetic sphincter augmentation (MSA) for gastroesophageal reflux disease (GERD). Here we report intermediate-term outcomes and hernia recurrence rate after concomitant MSA and HHR. METHODS: This is a retrospective cohort study of patients who underwent repair of a hiatal hernia 3 cm or larger at the time of MSA implantation between May 2009 and December 2015...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29333834/-congenital-esophageal-stenosis-diagnosis-and-treatment-cases-review
#3
Enrique J Romero Manteola, Pablo Ravetta, Celeste C Patiño González, Víctor H Defago
Congenital esophageal stenosis is a very rare condition and there is no standard treatment. We report the diagnosis, treatment and outcome of 11 patients with this condition managed at our institution. The most common symptom was dysphagia. The age at diagnosis was between 1 day and 14 years (mean age: 4.7 years). The esophagogram confirmed the diagnosis. Five patients presented associated anomalies. Four patients received surgical treatment and 7 only balloon dilatations. Pathologic examinations showed 3 fibromuscular stenosis and one with tracheobronchial remnants...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29323931/esophageal-manometry-and-regional-transpulmonary-pressure-in-lung-injury
#4
Takeshi Yoshida, Marcelo B P Amato, Domenico Luca Grieco, Lu Chen, Cristhiano A S Lima, Rollin Roldan, Caio C A Morais, Susimeire Gomes, Eduardo L V Costa, Paulo F G Cardoso, Emmanuel Charbonney, Jean-Christophe M Richard, Laurent Brochard, Brian P Kavanagh
RATIONALE: Esophageal manometry is the clinically available method to estimate pleural pressure, thus enabling calculation of the transpulmonary pressure (PL). However, many concerns make uncertain in which lung region esophageal manometry reflects local PL. OBJECTIVES: To determine the accuracy of esophageal pressure (Pes) and in which regions esophageal manometry reflects Ppl and PL; to assess whether lung stress in non-dependent regions can be estimated at end-inspiration from PL...
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29323536/high-positive-end-expiratory-pressure-renders-spontaneous-effort-non-injurious
#5
Caio C A Morais, Yukiko Koyama, Takeshi Yoshida, Glauco M Plens, Susimeire Gomes, Cristhiano L A S Lima, Ozyres P Ramos, Sérgio M Pereira, Naomasa Kawaguchi, Hirofumi Yamamoto, Akinori Uchiyama, João B Borges, Marcos F Vidal Melo, Mauro R Tucci, Marcelo B P Amato, Brian P Kavanagh, Eduardo L V Costa, Yuji Fujino
RATIONALE: In ARDS, atelectatic 'solid-like' lung tissue impairs transmission of negative 'swings' in pleural pressure (Ppl) resulting from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions, e.g., non-dependent lung (Pendelluft) or from the ventilator. Lowering of the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort non-injurious...
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29302501/management-of-benign-esophageal-strictures-in-children
#6
REVIEW
Yvan Vandenplas
Esophageal strictures are seldom in children. In many countries, accidental ingestion of corrosives is a major cause of risk for stricture formation. Therefore, their management is a challenge. Safety and long-term efficacy of esophageal dilation for benign esophageal strictures has been confirmed in children. Because most children with structures are toddlers or younger, balloon dilatation is often preferred over bouginage. There is increasing evidence that short duration administration of high doses steroids may be of benefit in some specific situation (IIb esophagitis according to Zargar classification)...
December 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/29247269/late-esophageal-wall-injury-after-mesh-repair-for-large-esophageal-hiatal-hernia-a-case-report
#7
Kentaro Yatabe, Soji Ozawa, Eisuke Ito, Junya Oguma, Akihito Kazuno, Miho Nitta, Yamato Ninomiya
BACKGROUND: Plication of an esophageal hiatus during surgery for esophageal hiatal hernia is a common practice; however, a mesh may be used if the hiatus is markedly enlarged. Recently, various late complications occurring as a result of mesh-induced esophageal and/or gastric wall injuries have been reported. CASE PRESENTATION: A 71-year-old woman presented at a neighborhood clinic in November 2010 with chief complaints of respiratory distress on exertion and heartburn...
December 15, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29234193/results-of-portosystemic-shunt-embolization-in-selected-patients-with-cirrhosis-and-recurrent-hepatic-encephalopathy
#8
Narendra S Choudhary, Sanjay Saran Baijal, Sanjiv Saigal, Amit Agarwal, Neeraj Saraf, Rohit Khandelwal, Vaibhav Jain, Anubhav Harish Khandelwal, Abhay Kapoor, Deepak Jain, Smurti R Misra, Rajesh Puri, Randhir Sud, Arvinder S Soin
Background: Large portosystemic shunts (PSSs) may lead to recurrent encephalopathy in patients with cirrhosis and embolization of these shunts may improve encephalopathy. Material and methods: Five patients underwent balloon-occluded retrograde transvenous obliteration (BRTO) or plug-assisted retrograde transvenous obliteration (PARTO) of a large PSS at our center in last 2 years for recurrent hepatic encephalopathy (HE) at a tertiary care center at north India...
December 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/29234120/oral-epithelial-cell-sheets-engraftment-for-esophageal-strictures-after-endoscopic-submucosal-dissection-of-squamous-cell-carcinoma-and-airplane-transportation
#9
Naoyuki Yamaguchi, Hajime Isomoto, Shinichiro Kobayashi, Nobuo Kanai, Kengo Kanetaka, Yusuke Sakai, Yoshiyuki Kasai, Ryo Takagi, Takeshi Ohki, Hiroko Fukuda, Tsutomu Kanda, Kazuhiro Nagai, Izumi Asahina, Kazuhiko Nakao, Masayuki Yamato, Teruo Okano, Susumu Eguchi
Endoscopic submucosal dissection (ESD) permits en bloc removal of superficial oesophageal squamous cell carcinoma (ESCC). However, post-procedure stricture is common after ESD for widespread tumours, and multiple endoscopic balloon dilation (EBD) procedures are required. We aimed to evaluate the safety and effectiveness of endoscopic transplantation of tissue-engineered autologous oral mucosal epithelial cell sheets that had been transported by air over a distance of 1200 km in controlling postprocedural oesophageal stricture...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29232174/analysis-of-reported-balloon-malfunctions-and-proposed-rescue-strategy-for-malfunction-during-airway-dilation
#10
E Brandon Strong, Derrick R Randall, Daniel J Cates, Peter C Belafsky
Objective The rate of balloon dilator failure is unknown, and a rescue strategy for device malfunction has not been established. The purposes of this investigation were to determine the approximate number of balloon failures in the gastrointestinal tract and airway, evaluate the parameters required to rupture balloon dilators, and develop a rescue strategy to efficiently reestablish airway patency. Study Design Retrospective cohort and basic medical research. Setting Academic tertiary care medical center. Subjects and Methods The Manufacturer and User Facility Device Experience database was queried for adverse events associated with tracheal and esophageal dilators between January 1, 2014, and January 1, 2017...
December 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29201795/pneumatic-balloon-dilatation-for-achalasia-cardia-outcome-complications-success-and-long-term-follow-up
#11
Sudhir J Gupta, Nitin R Gaikwad, Amol R Samarth, Sonal R Gattewar
Background: Achalasia is a chronic disease that can be managed with effective endoscopic modalities. Aim: To evaluate the effectiveness of single setting of pneumatic balloon dilatation for achalasia and assess the long-term success and outcomes. Materials and methods: This is a retrospective study of all achalasia patients who underwent pneumatic balloon dilatation at our institute. Patients who could be contacted were inquired regarding their symptoms and dysphagia-free interval after dilatation...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29166377/the-effect-of-body-position-on-esophageal-reflexes-in-cats-a-possible-mechanism-of-sids
#12
Ivan M Lang, Bidyut K Medda, Reza Shaker, Sudarshan Jadcherla
BACKGROUND: It has been hypothesized that life threatening events are caused by supra-esophageal reflux (SER) of gastric contents which activates laryngeal chemoreflex-stimulated apnea. Placing infants supine decreases the risk of sudden infant death syndrome (SIDS). The aim of this study was to determine whether body position affects esophageal reflexes that control SER. METHODS: We instrumented the pharyngeal and esophageal muscles of decerebrate cats (N=14) to record EMG or manometry, and investigated the effects of body position on the esophago-upper esophageal sphincter (UES) contractile reflex (EUCR), esophago-UES relaxation reflex (EURR), esophagus-stimulated pharyngeal swallow response (EPSR), secondary peristalsis (SP), and pharyngeal swallow (PS)...
November 22, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29151413/-effects-of-mechanical-ventilation-on-diaphragmatic-contractile-function-in-patients-with-aecopd
#13
Feifei Wang, Xiaoping Zhu, Changjing Zhang, Hui Zhu, Yu Feng, Yang Liu, Shaolin Ma
OBJECTIVE: To study diaphragmatic strength in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) during mechanical ventilation (MV), and to explore the predictive value of maximal transdiaphragm pressure (Pdi max) for successful extubation. METHODS: A prospective study was conducted. Twenty-one patients with AECOPD receiving MV admitted to intensive care unit (ICU) of Shanghai East Hospital of Tongji University of School Medicine from February 2015 to May 2017 were enrolled...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29142537/pneumatic-balloon-dilatation-for-achalasia-cardia-early-late-results-a-single-center-study
#14
S Waqar H Shah, Arshad K Butt, K Malik, Altaf Alam, Anwaar A Khan
Objective: Achalasia Cardia is treated by Pneumatic balloon dilatation, Heller's Myotomy and recently, by Peroral Esophagaeal Myotomy. This study reports the efficacy of pneumatic balloon dilatation as a non-surgical motility in achieving relief of dysphagia, clinical improvement and recurrence. Long-term complications were reported. Methods: Eight hundred ninety two adult achalasia patients of both genders were treated from January 1988 till December 2011, with pneumatic balloon (Rigiflex Microvasive(®)) dilatation, under fluoroscopy Barium swallow was obtained prior to and five minutes after dilatation to evaluate for efficacy of dilatation as well as for complications...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29140849/endoscopic-submucosal-dissection-for-superficial-proximal-esophageal-neoplasia-is-highly-successful
#15
Yi-Qun Zhang, Tao Chen, Chen Zhang, Quan-Lin Li, Wei-Feng Chen, Li-Qing Yao, Ping-Hong Zhou, Mei-Dong Xu
OBJECTIVE: The aim of this study was to evaluate the outcomes of endoscopic submucosal dissection (ESD) for superficial proximal esophageal neoplasia. SUMMARY OF BACKGROUND DATA: The surgery for a tumor located in proximal esophagus is relatively difficult and leads to a high morbidity and mortality. ESD is a minimally invasive endoscopic treatment of superficial neoplasia of the gastrointestinal tract allowing en block resection with low recurrence rates; however, ESD for superficial proximal esophageal neoplasia is little known...
December 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29129303/endoscopic-treatment-of-eosinophilic-esophagitis
#16
REVIEW
Joel E Richter
In eosinophilic esophagitis, the main cause of solid-food dysphagia is tissue remodeling resulting in strictures and narrowed esophagus. Endoscopy and biopsies help to identify the degree of inflammation but often miss the fibrosis. Although initially considered dangerous, esophageal dilation has evolved into an extremely effective and safe treatment in fibrostenotic disease. The key is starting low with small-diameter bougies or balloons, and gradually dilating the esophagus and strictures to 16 to 18 mm. Results in more than 1000 adults and children have shown low rates of complications, especially perforations, and no deaths, but postprocedure chest pain is common...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29128036/an-inexpensive-esophageal-balloon-tamponade-trainer
#17
Timothy P Young, Heather M Kuntz, Bradley Alice, Jon Roper, Mike Kiemeney
BACKGROUND: Emergency medicine practitioners must be able to perform rare, life-saving procedures. One such example is esophageal balloon tamponade, which is complex, fraught with complications, and difficult to demonstrate and practice. DISCUSSION: We constructed a simple, inexpensive model esophagus and stomach that we attached to a mannequin, allowing emergency medicine residents to visualize and practice esophageal balloon tamponade device placement. CONCLUSION: Our esophageal balloon tamponade model was easy to construct and allowed demonstration, conceptual visualization, and simulated performance of the procedure...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110056/efficacy-and-safety-of-balloon-occluded-retrograde-transvenous-obliteration-of-gastric-varices-with-lauromacrogol-foam-sclerotherapy-initial-experience
#18
Xuefeng Luo, Huaiyuan Ma, Jiaze Yu, Ying Zhao, Xiaoze Wang, Li Yang
PURPOSE: Balloon-occluded retrograde transvenous obliteration (BRTO) is a widely-accepted treatment for gastric varices (GVs). The purpose of this study was to evaluate the efficacy and safety of BRTO with lauromacrogol foam sclerotherapy. MATERIALS AND METHODS: Between May 2014 and June 2015, 32 patients were treated with lauromacrogol foam. Lauromacrogol foam was made using a combination of agents, with a 2:1:1 ratio of room air: lauromacrogol: contrast media...
November 6, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29089698/laparoscopic-heller-s-myotomy-for-achalasia-cardia-one-time-treatment-in-developing-countries
#19
Vishal Gupta, Hunaid Hatimi, Saket Kumar, Abhijit Chandra
Laparoscopic Heller's myotomy (LHM) and endoscopic balloon dilation are two main treatment modalities for achalasia cardia. The best treatment modality in Indian setting, however, is still unknown. Here, we present the early results of LHM in achalasia. Hospital data from January 2009 to October 2013 was analyzed. Preoperative assessment included Eckardt's scoring, esophagogastroduodenoscopy, barium swallow examination, and esophageal manometry. Thirty-five patients (19 males and 16 females, median age 31 years, range 12-65) underwent LHM with partial fundoplication (with intraoperative endoscopy)...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29089460/measurements-obtained-from-esophageal-balloon-catheters-are-affected-by-the-esophageal-balloon-filling-volume-in-children-with-ards
#20
Justin C Hotz, Cary T Sodetani, Jeffrey Van Steenbergen, Robinder G Khemani, Timothy W Deakers, Christopher J Newth
INTRODUCTION: Esophageal balloon inflation volume may affect the accuracy of transpulmonary pressure estimates in adults, but the effect is unknown in pediatrics. Using a combination bench and human study, we sought to determine a range of optimal filling volumes for esophageal balloon catheters and to derive a technique to inflate catheters to yield the most accurate estimates of pleural pressure. METHODS: In the laboratory study, we evaluated 4 pediatric and adult esophageal balloon catheters, a liquid-filled catheter, and a micro-tip catheter, both with and without a model esophagus...
October 31, 2017: Respiratory Care
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