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https://www.readbyqxmd.com/read/28717439/achalasia-current-therapeutic-options
#1
REVIEW
Zubin Arora, Prashanthi N Thota, Madhusudhan R Sanaka
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia...
June 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28711287/in-vivo-experience-with-poem-an-essential-activity-for-developing-the-technique-in-humans
#2
A Peñaloza-Ramírez, J Suárez-Correa, J Báez-Blanco, C Sabogal-Gómez, H Kuan-Casas, C Sánchez-Pignalosa, P Aponte-Ordóñez
INTRODUCTION AND OBJECTIVES: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic submucosal myotomy (POEM) has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans...
July 12, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28707343/peroral-endoscopic-myotomy-is-safe-and-effective-in-achalasia-patients-aged-older-than-60%C3%A2-years-compared-with-younger-patients
#3
Xiaowei Tang, Yutang Ren, Qiaoping Gao, Silin Huang, Jieqiong Zhou, Xiaofeng Zhang, Jianfeng Yang, Zhengjie Wei, Zhenyu Chen, Bo Jiang, Wei Gong
AIM: Peroral endoscopic myotomy (POEM) has been proven to be effective for treating achalasia, but there are limited data on POEM in elderly patients. We therefore aimed to assess the role of POEM for achalasia in patients aged ≥60 years. METHODS: All consecutive patients that underwent POEM between December 2011 and November 2015 at a single center were retrospectively reviewed. Patients aged ≥60 years were assigned to group A, whereas patients aged <60 years were assigned to group B...
July 14, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28699668/poems-syndrome-2017-update-on-diagnosis-risk-stratification-and-management
#4
Angela Dispenzieri
DISEASE OVERVIEW: POEMS syndrome is a paraneoplastic syndrome due to an underlying plasma cell neoplasm. The major criteria for the syndrome are polyradiculoneuropathy, clonal plasma cell disorder (PCD), sclerotic bone lesions, elevated vascular endothelial growth factor, and the presence of Castleman disease. Minor features include organomegaly, endocrinopathy, characteristic skin changes, papilledema, extravascular volume overload, and thrombocytosis. Diagnoses are often delayed because the syndrome is rare and can be mistaken for other neurologic disorders, most commonly chronic inflammatory demyelinating polyradiculoneuropathy...
August 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28699264/poems-syndrome-an-elusive-diagnosis
#5
Jithma P Abeykoon, Wilson I Gonsalves, Jennifer Oliveira, Prashant Kapoor
No abstract text is available yet for this article.
July 11, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28691974/peroral-endoscopic-myotomy-in-children-with-achalasia-a-relatively-long-term-single-center-study
#6
Miao Shijian, Wu Jie, Lu Junping, Wang Yuhuan, Tang Zifei, Zhou Ying, Huang Zhiheng, Ying Huang, Zhou Pinghong
BACKGROUND: Achalasia is a disease caused by neuromuscular dysfunction in the esophagogastric junction, with a relatively low incidence among children. Peroral endoscopic myotomy (POEM) is a new endoscopic procedure for the treatment of achalasia, however it is rarely applied in children. OBJECTIVES: We aim to study the feasibility, safety, and effectiveness of POEM as a treatment for pediatric achalasia. METHODS: A total of 21 pediatric patients (aged from 11 months to 18 years) diagnosed with achalasia and treated with POEM from October of 2014 to October of 2016 in our hospital were included in our study...
July 6, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28691186/per-oral-endoscopic-myotomy-poem-as-a-salvation-technique-post-heller-an-international-experience
#7
Amy Tyberg, Reem Z Sharaiha, Pietro Familiari, Guido Costamagna, Fernando Casas, Nikhil A Kumta, Maximilien Barret, Amit P Desai, Felice Schnoll-Sussman, Payal Saxena, Guadalupe Martínez, Felipe Zamarripa, Monica Gaidhane, Helga Bertani, Peter V Draganov, Valerio Balassone, Ahmed Sharata, Kevin Reavis, Lee Swanstrom, Martina Invernizzi, Stefan Seewald, Hitomi Minami, Haruhiro Inoue, Michel Kahaleh
BACKGROUND: The treatment for achalasia has traditionally been Heller myotomy (HM). Despite its excellent efficacy rate, a number of patients remain symptomatic post-procedure. Limited data exists as to the best management for recurrence of symptoms post HM. We present an international, multicenter experience evaluating the efficacy and safety of post-HM per-oral endoscopic myotomy (POEM). METHODS: Patients who underwent a POEM post-HM from 13 centers from January 2012 to January 2017 were included as part of a prospective registry...
July 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28691051/peroral-endoscopic-myotomy-using-flushknife-bt-a-single-center-series
#8
Shinwa Tanaka, Takashi Toyonaga, Fumiaki Kawara, Ian S Grimm, Namiko Hoshi, Hirofumi Abe, Yoshiko Ohara, Yoshinori Morita, Eiji Umegaki, Takeshi Azuma
BACKGROUND AND STUDY AIMS : Peroral endoscopic myotomy (POEM) is an evolving new treatment strategy for achalasia. Although several kinds of electrosurgical knives have been used in performing POEM, the best device has yet to be determined. The FlushKnife BT is a waterjet-emitting short needle-knife with a small ball tip (BT) that offers the potential to perform all aspects of POEM with a single device. In this study, we evaluated the safety and efficiency of the FlushKnife BT for POEM...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28682959/paraneoplastic-neuropathies
#9
Jean-Christophe Antoine, Jean-Philippe Camdessanché
PURPOSE OF REVIEW: To review recent advances in paraneoplastic neuropathies with emphasis on their definition, different forms and therapeutic development. RECENT FINDINGS: A strict definition of definite paraneoplastic neuropathies is necessary to avoid confusion. With carcinoma, seronegative sensory neuronopathies and neuronopathies and anti-Hu and anti-CV2/Contactin Response Mediator Protein 5 antibodies are the most frequent. With lymphomas, most neuropathies occur with monoclonal gammopathy including AL amyloidosis, Polyneuropathy-Organomegaly-Endocrinopathy-M component-Skin changes (POEMS) syndrome, type I cryoglobulinemia and antimyelin-associated glycoprotein (MAG) neuropathies and Waldenström's disease...
July 5, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28678772/poem-entitled-my-mother
#10
Saher Lalani
Pediatric Research accepted article preview online, 05 July 2017. doi:10.1038/pr.2017.158.
July 5, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28671393/top-20-research-studies-of-2016-for-primary-care-physicians
#11
Mark H Ebell, Roland Grad
This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated highly because of their relevance, validity, and potential to change practice. Key hypertension treatment findings include reduced mortality (a benefit not demonstrated in lower-risk persons or persons with diabetes mellitus) but also an increase in harms with a more aggressive blood pressure target in high-risk persons with hypertension and without diabetes...
May 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28664434/clinical-outcomes-five-years-after-poem-for-treatment-of-primary-esophageal-motility-disorders
#12
Ezra N Teitelbaum, Christy M Dunst, Kevin M Reavis, Ahmed M Sharata, Marc A Ward, Steven R DeMeester, Lee L Swanström
BACKGROUND: Peroral endoscopic myotomy (POEM) is a novel operation for the treatment of achalasia and other esophageal motility disorders. While POEM has shown excellent short-term safety and efficacy, the long-term symptomatic outcomes after the procedure are unknown. METHODS: Patients from a single center that underwent POEM for treatment of esophageal motility orders and were greater than 5 years removed from their operation were studied. Patients were contacted to assess current symptoms and encouraged to undergo repeat endoscopy for objective follow-up...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28664017/coexistence-of-quasi-moyamoya-disease-and-poems-syndrome-in-a-patient-with-intracranial-hemorrhage-a-case-report-and-literature-review
#13
Izumi Yamaguchi, Junichiro Satomi, Nobuaki Yamamoto, Shotaro Yoshioka, Yoshiteru Tada, Kenji Yagi, Yasuhisa Kanematsu, Shinji Nagahiro
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare paraneoplastic syndrome elicited by plasma cell dyscrasia. Its clinical manifestations are multiple and stroke is not a recognized feature. A 44-year-old woman with a 3-month history of bilateral lower extremity sensorimotor disturbance was admitted to our hospital. Examinations revealed polyneuropathy, organomegaly, hypothyroidism, monoclonal gammopathy, pelvic plasmacytoma, and elevated serum vascular endothelial growth factor (VEGF) levels...
January 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28660419/per-oral-endoscopic-myotomy-vs-laparoscopic-heller-myotomy-does-gastric-extension-length-matter
#14
Mauricio Ramirez, Cecilia Zubieta, Franco Ciotola, Alfredo Amenabar, Adolfo Badaloni, Fabio Nachman, Alejandro Nieponice
OBJECTIVE: To report our experience in POEM vs. LHM, with particular focus on myotomy extension. BACKGROUND: POEM has been adopted worldwide as a treatment for achalasia. While resolution of dysphagia is above 90%, postoperative reflux ranges from 10 to 57%. Myotomy length has been a controversial topic. METHODS: Thirty-five cases of POEM were prospectively analyzed and compared retrospectively to the last 35 patients that underwent LHM, from December 2010 to August 2016...
June 28, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28658688/will-reflux-kill-poem
#15
Thomas Rösch, Alessandro Repici, Guy Boeckxstaens
No abstract text is available yet for this article.
July 2017: Endoscopy
https://www.readbyqxmd.com/read/28658680/submucosal-fibrosis-in-achalasia-patients-is-a-rare-cause-of-aborted-peroral-endoscopic-myotomy-procedures
#16
Qiu-Ning Wu, Xiao-Yue Xu, Xiao-Cen Zhang, Mei-Dong Xu, Yi-Qun Zhang, Wei-Feng Chen, Ming-Yan Cai, Wen-Zheng Qin, Jian-Wei Hu, Li-Qing Yao, Quan-Lin Li, Ping-Hong Zhou
Background and aims Peroral endoscopic myotomy (POEM) is now an established treatment for esophageal achalasia. The standard protocol ensures a smooth operation in most patients, but technical challenges and failures exist and little is known about the incidence, causes, and impact of aborted procedures. Here, using a large patient cohort, we attempted to answer these questions. Methods All patients admitted for planned POEM between August 2010 and July 2015 underwent chart review. Aborted POEM was defined as the inability to finish the procedure after submucosal injection...
June 28, 2017: Endoscopy
https://www.readbyqxmd.com/read/28657822/health-related-quality-of-life-and-physiological-outcomes-of-peroral-endoscopic-myotomy-for-achalasia
#17
Jacob J Benedict, Adam A Golas, Joel E Richter, Vic Velanovich
BACKGROUND: Peroral endoscopic myotomy (POEM) has gained acceptance as a treatment for achalasia. The aim of this study was to assess symptomatic, quality of life (QoL), and physiological outcomes of POEM using standardized methods. MATERIALS AND METHODS: Patients who were planned to undergo POEM were evaluated pre- and postoperatively with timed barium esophagogram (TBE), high-resolution manometry (HRM), the achalasia symptom questionnaire (ASQ) (best score 10, worst score 31), and the short form (SF)-36 (best score 100, worst score 0)...
June 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28656335/gentamicin-submucosal-lavage-during-peroral-endoscopic-myotomy-poem-a-retrospective-analysis
#18
Julia Bayer, Zuzana Vackova, Hana Svecova, Petr Stirand, Julius Spicak, Jan Martinek
BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue's technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. METHODS: A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B)...
June 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28651308/comparison-of-the-outcomes-of-peroral-endoscopic-myotomy-for-achalasia-according-to-manometric-subtype
#19
Won Hee Kim, Joo Young Cho, Weon Jin Ko, Sung Pyo Hong, Ki Baik Hahm, Jun-Hyung Cho, Tae Hee Lee, Su Jin Hong
Background/Aims: We evaluated whether manometric subtype is associated with treatment outcome in patients with achalasia treated by peroral endoscopic myotomy (POEM). Methods: High-resolution manometry data and Eckardt scores were collected from 83 cases at two tertiary referral centers where POEM is performed. Manometric tracings were classified according to the three Chicago subtypes. Results: Among the 83 cases, 48 type I, 24 type II, and 11 type III achalasia cases were identified...
June 27, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28646568/blink-r1-latency-utility-in-diagnosis-and-treatment-assessment-of-poems-and-cidp
#20
Wei Wang, William J Litchy, Michelle L Mauermann, P James B Dyck, Angela Dispenzieri, Jay Mandrekar, Peter J Dyck, Christopher J Klein
INTRODUCTION: In POEMS and CIDP, limb nerve conduction studies (NCS) are limited in identifying demyelination and detecting treatment effects in severely affected patients. Blink R1-latency may improve these assessments. METHODS: POEMS and CIDP patients having undergone NCS and blink reflex were identified. Correlations between R1-latency, limb NCS and neuropathy impairment scores (NIS) were compared. RESULTS: With182 patients (124 POEMS, 58 CIDP) identified, R1-prolongation (>13ms) occurred in 64...
June 23, 2017: Muscle & Nerve
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