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https://www.readbyqxmd.com/read/29144018/navigated-retrograde-endoscopic-myotomy-rem-for-the-treatment-of-therapy-resistant-achalasia
#1
K D Pham, R F Havre, T Langø, E F Hofstad, G A Tangen, R Mårvik, T Pham, O H Gilja, J G Hatlebakk, A Viste
BACKGROUND: In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29134329/esophageal-motility-disorders-new-perspectives-from-high-resolution-manometry-and-histopathology
#2
REVIEW
Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Go Hasegawa, Shuji Terai
High-resolution manometry (HRM) and peroral endoscopic myotomy (POEM) have contributed significantly to the field of esophageal motility disorders in recent years. The development of HRM has categorized various esophageal motility disorders with a focus on a diverse range of manometric anomalies. Additionally, the Chicago classification criteria is widely used for manometric diagnosis. Moreover, POEM was introduced as a minimally invasive radical therapy for achalasia and shows promise for other spastic esophageal motility disorders as well...
November 13, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/29122601/per-oral-endoscopic-myotomy-in-patients-with-or-without-prior-heller-myotomy-comparing-long-term-outcomes-in-a-large-u-s-single-center-cohort-with-videos
#3
Xiaocen Zhang, Rani J Modayil, David Friedel, Krishna C Gurram, Collin E Brathwaite, Sharon I Taylor, Maria M Kollarus, Sony Modayil, Bhawna Halwan, James H Grendell, Stavros N Stavropoulos
BACKGROUND AND AIMS: Heller myotomy (HM) is one of the most effective treatments for esophageal achalasia. However, failures do exist and the success rate tends to decrease with time. The efficacy of rescue treatments for patients with failed Heller is limited. A few small-scale studies have reported outcomes of per-oral endoscopic myotomy (POEM) in these patients. We conducted this study to systematically assess feasibility, safety, and efficacy of POEM on post-Heller patients. METHODS: Patients at least 3 months out from their POEM were selected from our prospective database: 318 consecutive POEMs performed from October 2009 to October 2016...
November 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29113155/poems-syndrome-presentation-with-progressive-weakness-in-upper-and-lower-limbs-a-case-report
#4
Chuang-Jie Cao, Cheng-Yun Dou, Ke-Hua Zhou, Jin-Bo Liu, Hong Lai
Polyneuropathy, organomegaly, endocrinopathy, M proteins, and skin changes (POEMS) syndrome is a rare variant of plasma cell disorders with multiple systemic manifestations. A 50-year-old female patient presented with progressive weakness in her upper and lower limbs; tingling, numbness and burning in her feet; polyneuropathy (demyelinating in the majority of cases of POEMS syndrome); monoclonal plasma cell disorder (typicallyλ-restricted in cases of POEMS syndrome); sclerotic lesions on the spine and pelvis; organomegaly, including hepatomegaly, splenomegaly and lymphadenopathy; edema; pleural effusion; adrenal, thyroidal, pituitary, gonadal and pancreatic endocrinopathy; skin changes, including hyperpigmentation, dry skin and hypertrichosis; thrombocytosis; pulmonary hypertension; low vitamin B12 and weight loss...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29113005/is-integrated-relaxation-pressure-a-promising-predictor-of%C3%A2-effectiveness-of-peroral-endoscopic-myotomy-for-achalasia
#5
Hong Jin, Wei Zhao, Lili Zhang, Zhongqing Zheng, Tao Wang, Lanlan Wu, Bangmao Wang
Background Peroral endoscopic myotomy (POEM), first introduced in 2010, appears to be an effective therapy with few complications. This study aimed to find an optimal predictor of POEM outcome in achalasia. Methods We retrospectively assessed 89 patients diagnosed with achalasia who underwent POEM in General Hospital of Tianjin Medical University, from September 2012 to March 2015. Associations of Eckardt score with symptom duration, lower esophageal resting pressure, 4-second integrated relaxation pressure (4s-IRP), and maximum esophageal diameter were assessed before POEM...
November 7, 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29108981/outcomes-of-per-oral-endoscopic-myotomy-for-treatment-of-esophageal-achalasia-with-a-median-follow-up-of-49-months
#6
Quan-Lin Li, Qiu-Ning Wu, Xiao-Cen Zhang, Mei-Dong Xu, Wei Zhang, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Wen-Zheng Qin, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Ping-Hong Zhou
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) has received wide acceptance as a highly effective and safe treatment for esophageal achalasia. Short-term and small-scale studies are ample but long-term large-scale studies are few. The aim of the study was to systematically analyze our long-term results of POEM, with particular emphasis on POEM failures and associated risk factors. METHODS: This is a single-center study. Consecutive POEM patients between August 2010 and December 2012 were included...
November 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29102729/gastroesophageal-reflux-disease-after-per-oral-endoscopic-myotomy-as-compared-with-heller-s-myotomy-with-fundoplication-a-systematic-review-with-meta-analysis
#7
REVIEW
Alessandro Repici, Lorenzo Fuccio, Roberta Maselli, Fabrizio Mazza, Loredana Correale, Daniele Mandolesi, Cristina Bellisario, Amrita Sethi, Mouen Kashab, Thomas Rösch, Cesare Hassan
BACKGROUND AND AIMS: Per-oral endoscopic myotomy (POEM) represents a less invasive alternative, as compared with conventional laparoscopic Heller's myotomy (LHM), for achalasia patients. It cannot be excluded, however, that the lack of fundoplication after POEM may result in a higher incidence of reflux disease, as compared with LHM. The aim was to conduct a systematic review of prospective studies reporting the incidence of reflux disease developed after POEM and LHM. METHODS: Literature search with electronic databases was performed (up to February 2017) to identify full articles on the incidence of gastro-esophageal reflux symptoms, endoscopic- and pH-monitoring-findings after POEM and LHM (with fundoplication)...
November 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29100675/skull-base-plasmacytoma-a-unique-case-of-poems-syndrome-with-a-plasmacytoma-causing-craniocervical-instability
#8
Hannah Gilder, Meghan E Murphy, Mohammed Ali Alvi, Panagiotis Kerezoudis, Daniel Shepherd, Patrick R Maloney, Michael J Yaszemski, Jonathan M Morris, Angela Dispenzieri, Jane M Matsumoto, Mohamad Bydon
INTRODUCTION: Plasmacytomas, considered to be the solitary counterparts of multiple myeloma, are neoplastic monoclonal plasma cell proliferations within soft tissue or bone. Plasmacytomas often present as a collection of findings known as POEMS-syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, M-Protein spike, and Skin changes). CASE DESCRIPTION: We present a report of a 47 yo male diagnosed with POEMS-syndrome secondary to a skull base plasmacytoma. The mass resulted in marked instability of the cranio-cervical junction due to bony erosion...
October 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29092839/the-clearing-poems-by-doctors
#9
Daniel Racey
No abstract text is available yet for this article.
November 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/29089698/laparoscopic-heller-s-myotomy-for-achalasia-cardia-one-time-treatment-in-developing-countries
#10
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/29078682/the-current-state-of-per-oral-endoscopic-myotomy-for-achalasia
#11
REVIEW
Shane P Smith, Brian E Louie
Achalasia is an acquired neuromuscular disorder that has been treated using a variety of modalities throughout medical history. Recently, the technique of per oral endoscopic myotomy (POEM) was introduced to treat the disease using a truly minimally invasive, natural orifice technique that is rapidly being adopted across the world. This review outlines the development of POEM, the technique itself, and gives a comparison to other procedures, specifically laparoscopic Heller myotomy (LHM).
2017: J Vis Surg
https://www.readbyqxmd.com/read/29072527/william-osler-and-the-fixed-period-of-creativity
#12
Charles T Ambrose
In 1905, William Osler was the pre-eminent physician in American medical circles but was unknown to the general public. The latter suddenly learned of him through damning newspaper accounts of his address announcing his retirement from the Johns Hopkins Medical School. In it Osler mentioned two "fixed ideas" he held-(1) that most major advances in civilization have been made by men under age 40 (the "fixed period") and (2) that those over 60 should retire because they create little of significance and sometimes stifled the initiatives of younger colleagues...
January 1, 2017: Journal of Medical Biography
https://www.readbyqxmd.com/read/29056130/an-adult-with-polyneuropathy-and-hypogonadism-due-to-poems-syndrome
#13
Saba Zaidi, Sidra Sattar, Khealani Bhojo Asumal
POEMS (acronym for polyneuropathy, organomegaly, endocrinopathy, M protein myeloma and skin changes), is a rare disease which occurs in the setting of plasma cell dyscrasias. We describe a case of an adult lady who presented with gradual onset weakness of all four limbs and multisystem involvement characterized by pedal edema, ascites, hyperpigmentation and hypogonadism. Nerve conduction study showed severe sensorimotor polyneuropathy. Serum immunofixation showed lambda light chain restricted monoclonal gammopathy...
October 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29048751/severity-strata-for-five-patient-reported-outcomes-in-adults-with-atopic-dermatitis
#14
P P Vakharia, R Chopra, R Sacotte, N Patel, S Immaneni, T White, R Kantor, D Y Hsu, E L Simpson, J I Silverberg
BACKGROUND: Multiple patient-reported outcomes have been used to assess the burden of atopic dermatitis (AD). Some are disease specific, e.g. the Patient Oriented Eczema Measure (POEM). While others pertain to itch, e.g. Numerical Rating Scale (NRS)-itch, ItchyQoL and 5-D itch, or dermatologic disease in general, e.g. Dermatology Life Quality Index (DLQI). Development of severity strata is essential for proper interpretability of these assessments. We sought to confirm previously developed strata for POEM, DLQI and raw ItchyQoL, and develop strata for the NRS-itch, mean ItchyQOL and 5-D itch scale for use in adults with AD...
October 19, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/29048107/lenalidomide-and-dexamethasone-in-patients-with-poems-syndrome-results-of-a-prospective-open-label-trial
#15
Andrea Nozza, Fabrizia Terenghi, Francesca Gallia, Fausto Adami, Chiara Briani, Giampaolo Merlini, Laura Giordano, Armando Santoro, Eduardo Nobile-Orazio
Given its anti-angiogenic activity, lenalidomide may have a role in the treatment of POEMS (Peripheral neuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder and Skin changes) syndrome. This prospective, open-label, pilot study evaluated the combination of lenalidomide + dexamethasone (RD) in 18 POEMS syndrome patients (13 pre-treated, 5 newly-diagnosed but ineligible for high-dose therapy). Treatment consisted of six cycles of lenalidomide (25 mg/day for 21 days followed by 7 days rest) plus dexamethasone (40 mg/once a week)...
October 19, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/29046961/modified-peroral-endoscopic-myotomy-a-push-and-pull-technique
#16
Dan-Feng Zhang, Wei-Feng Chen, Mei-Dong Xu, Yun-Shi Zhong, Yi-Qun Zhang, Quan-Lin Li, Ping-Hong Zhou
BACKGROUND: Peroral endoscopic myotomy (POEM) is a minimally invasive yet challenging procedure for achalasia. Additional technological innovations and improvements are important for simplifying the procedure. METHODS: We report the successful use of a modified POEM procedure, which utilized a "Push and Pull" technique, on a patient with achalasia. RESULTS: Our modifications resulted in a short operation time of only 35 min. No complications arose during or after the procedure, up to a follow-up period of 6 months, and symptoms were significantly and quickly improved...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29034435/advances-in-the-treatment-of-paraproteinemic-neuropathy
#17
REVIEW
Eduardo Nobile-Orazio, Mariangela Bianco, Andrea Nozza
Purpose of review Several advances have been made on the pathogenesis and therapy of neuropathies associated with paraproteinemia (monoclonal gammopathy). It is important for the neurologist to understand the pathogenetic relevance of this association especially when the hematological disease does not require per se any therapy. Recent findings Treatment of the neuropathy in patients with malignant paraproteinemia is mainly addressed by the hematologist while the neurologist is mainly involved in the initial diagnosis and in deciding whether the neuropathy is caused by the disease or by the chemotherapy used for the disease...
October 16, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29030799/gastric-peroral-endoscopic-pyloromyotomy-therapy-for-refractory-gastroparesis
#18
REVIEW
Petros C Benias, Mouen A Khashab
Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery...
December 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29026503/content-analysis-of-the-concept-of-addiction-in-high-school-textbooks-of-iran
#19
Mohammad Hasan Mirzamohammadi, Sayedeh Zainab Mousavi, Omid Massah, Ali Farhoudian
BACKGROUND: This research sought to determine how well the causes of addiction, addiction harms, and prevention of addiction have been noticed in high school textbooks. METHODS: We used descriptive method to select the main related components of the addiction concept and content analysis method for analyzing the content of textbooks. The study population comprised 61 secondary school curriculum textbooks and study sample consisted of 14 secondary school textbooks selected by purposeful sampling method...
January 2017: Addiction & Health
https://www.readbyqxmd.com/read/29019884/utility-of-osteosclerotic-lesion-biopsy-in-diagnosis-of-poems-syndrome-a-case-report
#20
Daisuke Hara, Hisanao Akiyama, Saki Nukui, Takahiro Shimizu, Masahiro Hoshikawa, Yasuhiro Hasegawa
RATIONALE: We report a case of successful diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome based on monoclonality that was confirmed by an osteosclerotic lesion biopsy in a patient without pathognomonic symptoms or monoclonal gammopathy, probably because of comorbidities, which included systemic lupus erythematosus, rheumatoid arthritis, and Sjögren syndrome. PATIENT CONCERNS: A 57-year-old woman presented with an approximately 2-year history of numbness in the toes that had gradually spread, along with muscle weakness in both arms and legs...
October 2017: Medicine (Baltimore)
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