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https://www.readbyqxmd.com/read/29140124/apprenticeship-based-training-in-neurogastroenterology-and-motility
#1
Dipesh H Vasant, Amol Sharma, Jigar Bhagatwala, Lavanya Viswanathan, Satish S C Rao
Although neurogastroenterology and motility (NGM) disorders affect 50% of patients seen in clinics, many gastroenterologists receive limited NGM training. One-month apprenticeship-based NGM training has been provided at ten centers in the USA for a decade, however, outcomes of this training are unclear. Our goal was to describe the effectiveness of this program from a trainees perspective. Areas Covered: We describe the training model, learning experiences, and outcomes of one-month apprenticeship-based training in NGM at a center of excellence, using a detailed individual observer account and data from 12 consecutive trainees that completed the program...
November 15, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29134969/the-prevalence-and-impact-of-overlapping-rome-iv-diagnosed-functional-gastrointestinal-disorders-on-somatization-quality-of-life-and-healthcare-utilization-a-cross-sectional-general-population-study-in-three-countries
#2
Imran Aziz, Olafur S Palsson, Hans Törnblom, Ami D Sperber, William E Whitehead, Magnus Simrén
OBJECTIVES: The population prevalence of Rome IV-diagnosed functional gastrointestinal disorders (FGIDs) and their cumulative effect on health impairment is unknown. METHODS: An internet-based cross-sectional health survey was completed by 5,931 of 6,300 general population adults from three English-speaking countries (2100 each from USA, Canada, and UK). Quota-based sampling was used to generate demographically balanced and population representative samples with regards to age, sex, and education level...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29132530/diagnosis-and-management-of-anorectal-disorders-in-the-primary-care-setting
#3
REVIEW
Danielle Davies, Justin Bailey
Anorectal disorders are very common among a wide population of patients. Because patients may be embarrassed about the anatomic location of their symptoms, they may present to care late in the course of their illness. Care should be taken to validate patient concerns and normalize fears. This article discusses the diagnoses and management of common anorectal disorders among patients presenting to a primary care physician.
December 2017: Primary Care
https://www.readbyqxmd.com/read/29102367/-the-psychiatric-comorbidity-of-anorexia-nervosa-a-comparative-study-in-a-population-of-french-and-greek-anorexic-patients
#4
M Kountza, G Garyfallos, D Ploumpidis, E Varsou, I Gkiouzepas
OBJECTIVE: The current study had two objectives: (1) to access the psychiatric comorbidity in axis I and axis II (according to DSM-IV) of anorexia nervosa in a sample of 60 anorexic patients; (2) to compare the features of the psychiatric comorbidity between the two groups of French and Greek anorexic patients who participated in the study, as well as to compare some psychological and behavioral aspects of their anorectic psychopathology. METHOD: Sixty anorexic patients, thirty French and thirty Greek, aged between 18 and 60 years, referred for evaluation and therapy at the unit of eating disorders at the "Institut national Marcel-Rivière of the MGEN" (hôpital de La Verrière, France) and at the unit of eating disorders of the First Department of Psychiatry of EGINITIO University Psychiatric Hospital in Athens (Greece), were accessed with the Eating Attitudes Test-26 (EAT26), Eating Disorder Inventory (EDI), Symptom Checklist-90-Revised (SCL90R), Mini International Neuropsychiatric Interview, Version 5...
November 1, 2017: L'Encéphale
https://www.readbyqxmd.com/read/29068554/internal-anal-sphincter-nerves-a-macroanatomical-and-microscopic-description-of-the-extrinsic-autonomic-nerve-supply-of-the-internal-anal-sphincter
#5
S Stelzner, M Böttner, J Kupsch, W Kneist, P Quirke, N P West, H Witzigmann, T Wedel
BACKGROUND: The internal anal sphincter (IAS) contributes substantially to anorectal functions. While its autonomic nerve supply has been studied at the microscopic level, little information is available concerning the macroscopic topography of extrinsic nerve fibres. This study was designed to identify neural connections between the pelvic plexus and the IAS, provide a detailed topographical description, and give histological proof of autonomic nerve tissue. METHODS: Macroscopic dissection of pelvic autonomic nerves was performed under magnification in seven (5 males, 2 females) hemipelvises obtained from body donors (67-92 years)...
October 25, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29050194/update-on-the-pathophysiology-and-management-of-anorectal-disorders
#6
REVIEW
Tanisa Patcharatrakul, Satish S C Rao
Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions...
October 23, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29022390/randomised-double-blind-placebo-controlled-trial-on-lactobacillus-reuteri-dsm-17938-improvement-in-symptoms-and-bowel-habit-in-functional-constipation
#7
G Riezzo, A Orlando, B D'Attoma, M Linsalata, M Martulli, F Russo
Dysbiosis may contribute to constipation and its symptoms, therefore probiotic administration could improve significantly gut health and functions. The aim of the study was to investigate the effects of a long-lasting administration of Lactobacillus reuteri DSM 17938 (LR DSM 17938) on symptoms and quality of life (QoL) score in patients with functional constipation (FC). 56 FC patients with normal colonic transit time and without anorectal disorders and pelvic floor dysfunctions completed the study. LR DSM 17938 was administered for 105 days in a randomised double-blind clinical trial (28 patients per arm)...
October 12, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28991086/bowel-dysfunction-related-to-spina-bifida-keep-it-simple
#8
Charlène Brochard, Benoît Peyronnet, Anne Dariel, Hélène Ménard, Andréa Manunta, Alain Ropert, Michel Neunlist, Guillaume Bouguen, Laurent Siproudhis
BACKGROUND: Although care of urological disorders in spina bifida is well established, there is yet no agreement on a standardized approach to bowel dysfunction in this population. OBJECTIVE: The purpose of this study was to assess bowel dysfunction using validated instruments and the risk factors in adults with spina bifida. DESIGN: A multidisciplinary team prospectively collected patient data, focusing on anorectal and urological symptoms...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28922706/functional-outcome-of-low-rectal-resection-evaluated-by-anorectal-manometry
#9
Peter Ihnát, Petr Vávra, Jiří Prokop, Anton Pelikán, Lucia Ihnát Rudinská, Igor Penka
BACKGROUND: Low anterior resection syndrome (LARS) covers disordered bowel function after rectal resection, leading to deterioration in patients' quality of life. The aim of this study was to evaluate anorectal function after laparoscopic low anterior resection (LAR) by means of standardized instruments. METHODS: This was a prospective clinical cohort study conducted in a single institution to assess functional outcome of patients 1 year after laparoscopic LAR by means of LARS score and high-resolution anorectal manometry...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28893560/endoscopic-mucosal-resection-is-superior-to-rectal-suction-biopsy-for-analysis-of-enteric-ganglia-in-constipation-and-dysmotility
#10
Kenneth Barshop, Field F Willingham, William R Brugge, Lawrence R Zukerberg, Braden Kuo
BACKGROUND AND AIMS: Patients with chronic constipation or motility disorders may be referred for rectal suction biopsy (RSB) to rule out Hirschsprung's disease (HD). RSB may not be successful beyond infancy due to the increased thickness of rectal mucosa. Endoscopic mucosal resection (EMR) could improve the diagnostic yield for HD when compared with traditional RSB because of the larger and deeper samples acquired for analysis. METHODS: In this prospective, single-center study, patients referred for RSB were offered enrollment for concurrent EMR...
September 8, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28873483/a-rare-case-of-amelanotic-anorectal-melanoma
#11
Nicole A Negbenebor, Edward Feller
We report an exceedingly rare case of amelanotic anorectal melanoma misdiagnosed as hemorrhoids. A 74-year-old man presented with a week's history of "blood on toilet tissue" without bowel complaints or history of cutaneous melanoma. Skin evaluation was normal. Rectal exam was negative for blood, but revealed an anal nodule, interpreted as a hemorrhoid. Hemoglobin was normal; bleeding persisted. After one month, colonoscopy detected a non-pigmented anal lesion. Biopsy showed melanoma. Noncutaneous mucosal melanoma represents 0...
September 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28871380/mri-of-anal-canal-common-anal-and-perianal-disorders-beyond-fistulas-part-2
#12
REVIEW
Ayşe Erden
A broad spectrum of disease, from benign processes to life-threatening pathologies, can cause anal pain. MR imaging (MRI) has become increasingly widely used method over the past two decades for the evaluation of individuals with anorectal symptoms. Although imaging is rarely necessary to determine the etiology of the majority of cases, MRI is particularly useful as a noninvasive method of excluding severe neoplastic conditions. In this article, MRI findings of a number of pathologies such as anal and perianal neoplasms, hemorrhoidal disease, arteriovenous malformation of the perianal region, and anal sphincter lesions (defects, scarring, atrophy) which may lead to fecal incontinence are presented...
September 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28818558/current-and-emerging-pharmacotherapies-for-obesity-in-australia
#13
REVIEW
Samantha Hocking, Anthony Dear, Michael A Cowley
BACKGROUND: Obesity is a major issue in Australia and globally. Many individuals struggle to maintain weight loss with lifestyle modification, and adjunctive pharmacotherapy may help. Historically, there have been limited pharmacotherapies for managing obesity. In addition, previous treatments such as phentermine-fenfluramine, rimonabant and sibutramine were withdrawn due to safety issues, resulting in lingering safety concerns. METHODS: This is a narrative review of published data examining four new pharmacotherapy options for weight management in Australia...
August 14, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/28774507/clinical-factors-associated-with-in-hospital-death-in-pediatric-surgical-patients-admitted-to-the-neonatal-intensive-care-unit-a-15-year-single-tertiary-center-experience
#14
Kohei Otake, Keiichi Uchida, Michiko Kubo, Akira Yamamoto, Yuka Nagano, Ryo Uratani, Kiyoshi Hashimoto, Kohei Matsushita, Mikihiro Inoue, Hirofumi Sawada, Masato Kusunoki
BACKGROUND/PURPOSE: The purpose of this study was to explore clinical characteristics and primary surgical diagnoses associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. METHODS: This retrospective study includes all patients admitted to our NICU for pediatric surgical diseases between January 2001 and December 2015. Univariate and multivariate binary logistic regression were performed to assess independent factors associated with in-hospital death...
July 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28770126/anorectal-malformations-histomorphological-and-immunohistochemical-evaluation-of-neuronal-dysfunction
#15
Yashika Bhatia, Sunita Singh, Kamal Nain Rattan, Padam Parmar, Divya Sahni, Rajeev Sen
OBJECTIVE: The patients with anorectal malformations (ARM) have been identified with specific and non-specific pathological changes. The present study was conducted with the aim to study histomorphological changes and various immunohistochemical (IHC) markers (calretinin, S-100, CD117) in intestinal wall specimens to assess neuronal dysfunction in ARM patients. MATERIAL AND METHODS: Thirty children having ARM were included in our study. In all the cases, a representative biopsy was received...
April 2017: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/28699318/high-resolution-anorectal-manometry-an-expensive-hobby-or-worth-every-penny
#16
REVIEW
G Basilisco, A E Bharucha
Introduced approximately 10 years ago, high-resolution manometry catheters have fostered interest in anorectal manometry. This review, which accompanies two articles in this issue of Neurogastroenterology and Motility, reviews the methods, clinical indications, utility, and pitfalls of anorectal manometry and revisits the American Gastroenterological Association (AGA) Medical Position Statement on Anorectal Testing Techniques, which was last published in 1999. High-resolution manometry provides a refined assessment of the anorectal pressure profile, obviates the need for station pull-through maneuvers, and minimizes movement artifacts...
August 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28674948/transitional-health-care-for-patients-with-hirschsprung-disease-and-anorectal-malformations
#17
M J Witvliet, N Petersen, E Ekkerman, C Sleeboom, E van Heurn, A F W van der Steeg
BACKGROUND: Hirschsprung disease (HD) and anorectal malformations (ARM) are congenital disorders with potentially lifelong consequences. Although follow-up is performed in most pediatric patients, transfer to adult health care is often problematic. This study assesses transitional care with the help of questionnaires in consultation with adult patients. METHODS: This study was conducted in an outpatient clinic of a pediatric surgical center in the Netherlands. All patients born and treated for ARM or HD before 1992 were invited to visit our clinic...
July 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28655980/psychometry-and-pescatori-projective-test-in-coloproctological-patients
#18
Ana Célia Caetano, Dinis Oliveira, Zaida Gomes, Edgar Mesquita, Carla Rolanda
BACKGROUND: Psychological assessment is not commonly performed nor easily accepted by coloproctological patients. Our aim was to evaluate the psychological component of coloproctological disorders using uncommon tools. METHODS: The 21-Item Depression Anxiety and Stress Scale and the Pescatori projective test were applied to coloproctological outpatients of the Gastroenterology Department of our hospital as well as to healthy volunteers. RESULTS: Seventy patients (median age 47 years, 22 male) divided in 4 groups (functional constipation, constipated irritable bowel syndrome, benign anorectal disease and perianal Crohn's disease) and 52 healthy volunteers (age 45 years, 18 male) completed the tests...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28649615/imaging-parkinson-s-disease-below-the-neck
#19
Per Borghammer, Karoline Knudsen, Tatyana D Fedorova, David J Brooks
Parkinson's disease is a systemic disorder with widespread and early α-synuclein pathology in the autonomic and enteric nervous systems, which is present throughout the gastrointestinal canal prior to diagnosis. Gastrointestinal and genitourinary autonomic symptoms often predate clinical diagnosis by several years. It has been hypothesized that progressive α-synuclein aggregation is initiated in hyperbranched, non-myelinated neuron terminals, and may subsequently spread via retrograde axonal transport. This would explain why autonomic nerves are so prone to formation of α-synuclein pathology...
2017: NPJ Parkinson's Disease
https://www.readbyqxmd.com/read/28639056/relevance-of-the-clinical-and-psychophysiological-variables-in-the-dyssynergic-defecation-a-comparative-study-in-elderly-subjects
#20
Miguel A Simón, Ana M Bueno
The relevance of several clinical and psychophysiological variables in the dyssynergic defecation in elderly subjects was investigated in this study. To accomplish this, 30 elderly subjects (10 without anorectal disorders, 10 with chronic constipation and 10 with dyssynergic defecation) were repeatedly assessed once per week for 4 weeks, with the following measures being collected at each session: EMG-activity (µV) of the external anal sphincter (at rest, during squeezing, and during straining to defecate), stool frequency, difficulty defecation level, pain grade during defecation, and satisfaction level after evacuation...
June 21, 2017: Applied Psychophysiology and Biofeedback
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