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https://www.readbyqxmd.com/read/29333061/critical-appraisal-of-rome-iv-criteria-hypersensitive-esophagus-does-belong-to-gastroesophageal-reflux-disease-spectrum
#1
REVIEW
Leonardo Frazzoni, Marzio Frazzoni, Nicola de Bortoli, Salvatore Tolone, Irene Martinucci, Lorenzo Fuccio, Vincenzo Savarino, Edoardo Savarino
The Rome IV Committee introduced a major change in the classification of functional gastrointestinal disorders, proposing a more restrictive definition of gastroesophageal reflux disease (GERD). It was suggested that hypersensitive esophagus (HE) may sit more firmly within the functional realm. It was suggested that GERD diagnosis should be based upon abnormal acid exposure time (AET) only, implying no advantage of impedance-pH over pH monitoring. Symptom association probability (SAP), symptom index (SI) and heartburn relief with proton pump inhibitor (PPI) therapy were regarded as unreliable, whereas a lack of response to PPI was considered as evidence of functional heartburn...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29319718/effects-of-periarticular-injection-on-analgesic-effects-and-nsaid-use-in-total-knee-arthroplasty-and-total-hip-arthroplasty
#2
Wen-Rui Ban, Ery-Ang Zhang, Lei-Feng Lv, Xiao-Qian Dang, Chen Zhang
OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group...
December 2017: Clinics
https://www.readbyqxmd.com/read/29319257/bottle-gourd-lagenaria-siceraria-juice-poisoning
#3
Pravin M Rathi, Pinakin S Patel
We present the case of a young woman who presented to us with multiple episodes of vomiting, followed by hematemesis and abdominal pain after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors and antiemetics and discharged in stable condition. As a member of the Cucurbitaceae family, bottle gourd contains toxic tetracyclic triterpenoid compounds called cucurbitacins which are responsible for the bitter taste and toxicity. There is no known antidote for this toxicity, and clinicians treat such patients symptomatically only...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29316945/the-implementation-of-academic-detailing-and-its-effectiveness-on-appropriate-prescribing-of-pain-relief-medication-a-real-world-cluster-randomized-trial-in-belgian-general-practices
#4
Robin Bruyndonckx, Veronique Verhoeven, Sibyl Anthierens, Koen Cornelis, Katelijne Ackaert, Birgit Gielen, Samuel Coenen
BACKGROUND: In Belgium, the debate about the effect of the national academic detailing service (ADS) on prescribing quality in general practice is ongoing. In order to evaluate both the implementation strategies of the ADS and its effectiveness on appropriate prescribing of pain relief medication, we conducted a real-world cluster randomized controlled trial (cRCT). METHODS: In a pragmatic cRCT, all Belgian general practices previously visited by Farmaka were assessed for eligibility and randomized...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29316850/demographics-and-clinical-characteristics-of-primary-lateral-sclerosis-case-series-and-a-review-of-literature
#5
Ramnath Santosh Ramanathan, Sandeep Rana
AIM: Primary lateral sclerosis (PLS) is a form of motor neuron disease involving only upper motor neurons. In some patients presenting as PLS, the disease progresses to involve lower motor neurons and thereby converting to amyotrophic lateral sclerosis (ALS). However, pure forms of PLS do exist. Our aim was to study epidemiological and clinical characteristics of pure PLS patients treated at our neuromuscular clinic. METHODS: We retrospectively reviewed 15 patients from July 2011 to October 2014 with PLS treated at the neuromuscular disorder clinic at our hospital...
January 10, 2018: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29307163/isolated-right-atrial-mass-in-a-candidate-of-coronary-bypass-grafting
#6
Feridoun Sabzi, Aghigh Heidari, Reza Faraji
Hepatocellular carcinoma (HCC) is not uncommon neoplasm, and its occurrences with coronary artery disease (CAD) is more confronted by cardiac surgeon today. In most cases, when the HCC is detected, it has invaded to regional or distant sites. The most frequent location of HCC metastasis includes pulmonary system, musculoskeletal, lymphatic system, and central nervous system. Indeed, intra-atrial metastasis is a rare phenomenon and associated with poor outcome. We report a case of CAD with known HCC that referred for CABG before scheduling for hepatic tumor management...
November 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29300279/disease-modifying-actions-of-il-6-blockade-in-a-rat-model-of-bone-cancer-pain
#7
Bethany Remeniuk, Tamara King, Devki Suktankhar, Amy Nippert, Nancy Li, Fuying Li, Kejun Cheng, Kenner C Rice, Frank Porreca
Metastasis of cancer to the skeleton represents a debilitating turning point in the lives of patients. Skeletal metastasis leads to moderate to severe ongoing pain along with bone remodeling that can result in fracture, events that dramatically diminish quality of life. IL-6 levels are elevated in metastatic breast cancer patients and are associated with a lower survival rate. We therefore determined the consequences of inhibition of IL-6 signaling using a novel small molecule antagonist, TB-2-081, on bone integrity, tumor progression, and pain in a rodent model of breast cancer...
December 26, 2017: Pain
https://www.readbyqxmd.com/read/29291432/joule-heating-and-zeta-potential-effects-on-peristaltic-blood-flow-through-porous-micro-vessels-altered-by-electrohydrodynamic
#8
N K Ranjit, G C Shit, D Tripathi
In most of the medical therapies, electromagnetic field plays important role to modulate the blood flow and to reduce the pain of human body. With this fact, this paper presents a mathematical model to study the peristaltic blood flow through porous microvessels in presence of electrohydrodynamics. The effects of Joule heating and different zeta potential are also considered. Darcy law is employed for porous medium. The mathematical analysis is carried out in the form of electroosmosis, flow analysis and heat transfer analysis...
December 29, 2017: Microvascular Research
https://www.readbyqxmd.com/read/29290915/deanxit-relieves-symptoms-in-a-patient-with-jackhammer-esophagus-a-case-report
#9
Jin-Ying Li, Wen-Huan Zhang, Chun-Ling Huang, Dang Huang, Guo-Wen Zuo, Lie-Xin Liang
Jackhammer (hypercontractile) esophagus presents with dysphagia and chest pain. Current treatments are limited. We describe a 60-year-old man who presented with dysphagia, chest pain and heartburn for a period of 1 year. His workup showed Barrett's esophagus on endoscopy and high-resolution manometry demonstrated jackhammer esophagus with esophagogastric junction outflow obstruction. The patient was treated with proton pump inhibitor and nifedipine but without resolution of his symptoms. He was followed up to assess the efficacy of treatment with deanxit (flupentixol + melitracen)...
December 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29285413/minimally-invasive-repair-of-a-pseudomeningocele-caused-by-a-sheared-intrathecal-catheter-following-implantation-of-a-drug-delivery-system
#10
S Raju, P O Champagne, L Walsh, Daniel J Denis
Background: Shearing of an intrathecal catheter during implantation of a drug delivery system is an underreported complication that can be challenging to manage. Case Description: A 53-year-old man with refractory cancer pain had an intrathecal pump system implanted. The procedure was complicated with catheter shear and retention in the intrathecal space. A second catheter was successfully placed but formation of a painful pseudomeningocele and ineffective pain relief complicated the outcome...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29245985/effect-of-dexmedetomidine-infusion-for-intravenous-patient-controlled-analgesia-on-the-quality-of-recovery-after-laparotomy-surgery
#11
Juan Xin, Yabing Zhang, Leng Zhou, Fei Liu, Xiaoshuang Zhou, Bin Liu, Qian Li
Background: The Quality of Recovery-15 (QoR-15) is a patient-centered questionnaire to evaluate the recovery after surgery and anesthesia. Dexmedetomidine has sedative, analgesic, antiinflammatory and inhibitory sympathetic effects, which may contribute to early recovery. We hypothesized dexmedetomidine added to intravenous patient-controlled analgesia (PCA) could enhance the quality of recovery (QoR) in patients undergoing laparotomy surgery. Methods: In this randomized, double-blind, controlled study, 100 patients undergoing laparotomy surgery were randomly allocated into two groups: Dexmedetomidine (group D) and control (group S)...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29240019/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#12
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#13
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29208509/the-use-of-an-intraarticular-catheter-on-fast-track-primary-knee-arthroplasty-is-it-a-step-forward
#14
L Cáceres-Sánchez, J B García-Benítez, V Coronado-Hijón, M Montero-Pariente
OBJECTIVE: This study compares the efficacy in post-operative pain control of the intraarticular catheter compared to the epidural catheter after primary total knee arthroplasty. MATERIAL AND METHOD: Randomised clinical trial consisting of two groups of patients. A control group with intradural anaesthesia and an intraoperative epidural catheter (ropivacaine) and an intervention group using the same anaesthetic technique and an intraarticular catheter with an elastomeric pump (ropivacaine+dexketoprofen)...
December 2, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29199160/what-is-the-place-of-empirical-proton-pump-inhibitor-testing-in-the-diagnosis-of-gastroesophageal-reflux-disease-description-duration-and-dosage
#15
Rukiye Vardar, Muharrem Keskin
Empirical acid suppression tests that are performed with proton pump inhibitors (PPI) are used to detect both the presence of acid-related gastrointestinal symptoms and gastroesophageal reflux disease (GERD). In comparison to other diagnostic methods, it is non-invasive, easily applicable, and cost-effective in the diagnosis of GERD. In addition to typical reflux symptoms, it can also be used for diagnostic purposes in patients with non-cardiac chest pain (NCCP). If the symptom response is 50% and above when obtained using the PPI test in patients with NCCP, it can be considered as positive and the treatment should be continued sensitivity of the PPI test in patients with typical symptoms of GERD is 27%-89%, while its specificity is 35%-83%...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29195500/an-implantable-pump-lenus-pro%C3%A2-in-the-treatment-of-pulmonary-arterial-hypertension-with-intravenous-treprostinil
#16
Marcin Kurzyna, Katarzyna Małaczyńska-Rajpold, Andrzej Koteja, Agnieszka Pawlak, Łukasz Chrzanowski, Michał Furdal, Zbigniew Gąsior, Wojciech Jacheć, Bożena Sobkowicz, Justyna Norwa, Tatiana Mularek-Kubzdela, Adam Torbicki
BACKGROUND: Subcutaneous treprostinil is a prostacyclin analogue used to treat pulmonary arterial hypertension (PAH). Due to local pain it can cause a deterioration of heart related quality of life (HRQoL) or even abandonment of treatment. The aim of this paper was to assess the feasibility of treatment with intravenous treprostinil administered by means of the Lenus Pro® implantable pump. METHODS: This was a retrospective, multi-center study involving 12 patients (8 females) with PAH treated with a subcutaneous infusion of treprostinil with intolerable pain at the infusion site...
December 2, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29183690/home-based-intravenous-analgesia-with-elastomeric-pump-as-an-outpatient-procedure-for-pain-control-after-anterior-cruciate-ligament-repair
#17
J Villalba, J Peñalver, P Torner, M Serra, J Planell
OBJECTIVE: To follow up pain in the immediate postoperative period, using an elastomeric pump in anterior cruciate ligament surgery. MATERIAL AND METHODS: 309 patients who had undergone anterior cruciate ligament repair with bone-tendon-bone allograft. Pain control was assessed with a visual analogue scale (VAS) during the immediate postoperative period, in the postoperative care unit, in the recovery room, and after the first 24-48-72hours following home discharge...
November 25, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29181825/a-primary-hepatic-gastrinoma-accompanied-by-hyperplasia-of-multi-nodular-brunner-s-glands
#18
Takaomi Hagi, Yohei Hosoda, Izumi Komoto, Shinji Uemoto, Susumu Hijioka, Yoshiro Taki, Kazuhiro Nishiyama, Masayuki Imamura
BACKGROUND: Primary hepatic gastrinoma causing severe ulcerogenic syndrome is extremely rare. Herein, we report a case of primary hepatic gastrinoma accompanied by hyperplasia of multi-nodular Brunner's glands in a patient who instead, preoperatively, was suspected of having multiple duodenal gastrinomas and hepatic metastasis. CASE PRESENTATION: A 57-year-old woman consulted a clinic complaining of melena, intermittent abdominal pain, diarrhea, and vomiting which had persisted for about 3 years...
November 28, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/29176494/pancreatic-enzyme-replacement-therapy-use-in-infants-with-cystic-fibrosis-diagnosed-by-newborn-screening
#19
Daniel Gelfond, Sonya L Heltshe, Michelle Skalland, James E Heubi, Margaret Kloster, Daniel H Leung, Bonnie W Ramsey, Drucy Borowitz
OBJECTIVES: To describe pancreatic enzyme practices during the first year of life in infants with cystic fibrosis (CF) and evaluate associations between dosing and outcomes, including growth and gastrointestinal symptoms. METHODS: We analyzed data from a subset of infants who were in a prospective cohort study conducted at 28 US CF centers. Anthropometric measurements and medications were recorded at each visit. Diaries with infant diet, pancreatic enzyme replacement therapy (PERT) dosing, stool frequency and consistency and pain were completed by a parent/guardian for three days prior to each visit...
November 15, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29168409/how-do-swiss-general-practitioners-agree-with-and-report-adhering-to-a-top-five-list-of-unnecessary-tests-and-treatments-results-of-a-cross-sectional-survey
#20
Kevin Selby, Jacques Cornuz, Christine Cohidon, Jean-Michel Gaspoz, Nicolas Senn
BACKGROUND: In 2014, the 'Smarter Medicine' campaign released a top five list of unnecessary tests and treatments in Swiss primary care, such as imaging for acute low-back pain and long-term prescribing of proton pump inhibitors. OBJECTIVES: Measure general practitioners' (GPs) agreement with the recommendations and self-reported adherence. METHODS: Cross-sectional, online survey of GPs in the 'Swiss primary care active monitoring' (SPAM) network, which assessed awareness of 'Smarter Medicine' and views on each recommendation...
November 23, 2017: European Journal of General Practice
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