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https://www.readbyqxmd.com/read/28740532/is-this-a-seizure
#1
Giulio Franceschet, Marta Mazzucato, Simona Censi, Stefano Simmini, Marco Boscaro, Valentina Camozzi
We describe a case of a 65-year-old woman admitted to the hospital for suspected of epileptic crisis. She was affected by diabetes and hiatal hernia for which she was taking Proton Pump Inhibitors (PPIs) for about 8 years. She showed hypocalcaemia, hypomagnesaemia, hyperparathyroidism and severe hypovitaminosis D. We exclude malabsorption and magnesium loss. After restored vitamin D levels, stopped use of PPI, start calcium and magnesium supplementation normal values of the ions were restored. This case underlies the importance of evaluate magnesium routinely, other than calcium and vitamin D, and use PPI more carefully...
January 2017: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28733735/laparoscopic-repair-of-giant-paraesophageal-hernia-are-there-factors-associated-with-anatomic-recurrence
#2
Michael Antiporda, Benjamin Veenstra, Chloe Jackson, Pujan Kandel, C Daniel Smith, Steven P Bowers
BACKGROUND: Repair of giant paraesophageal hernia (PEH) is associated with a favorably high rate of symptom improvement; however, rates of recurrence by objective measures remain high. Herein we analyze our experience with laparoscopic giant PEH repair to determine what factors if any can predict anatomic recurrence. METHODS: We prospectively collected data on PEH characteristics, variations in operative techniques, and surgeon factors for 595 patients undergoing laparoscopic PEH repair from 2008 to 2015...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28722185/valsalva-maneuver-exacerbates-left-atrial-compression-in-patients-with-large-hiatal-hernia
#3
Christopher Naoum, Leonard Kritharides, Sonali R Gnanenthiran, David Martin, Gregory L Falk, John Yiannikas
INTRODUCTION: Hiatal hernia (HH) can cause left atrial (LA) compression and impair LA filling. We evaluated the cardiac effects of preload reduction and abdominal strain induced by Valsalva maneuver (VM) in large HH patients. METHODS: LA and left ventricular (LV) dimensions were measured using 2D transthoracic echocardiography at rest and during VM in HH patients (n=55, 70±10 years) and controls (n=22, 67±6 years). Biplane LV volumes (n=39) and mitral inflow pulse-wave Doppler parameters (n=27) were also evaluated...
July 18, 2017: Echocardiography
https://www.readbyqxmd.com/read/28717556/thorax-computed-tomography-findings-in-patients-with-erectile-dysfunction
#4
Mustafa Resorlu, Muhammet Arslan, Ozan Karatag, Gurhan Adam
OBJECTIVE: Diabetes mellitus, smoking, dyslipidemia, and obesity play an important role in the etiology of erectile dysfunction, particularly in cases with vascular insufficiency. These risk factors also target the lungs due to their systemic effects. MATERIALS AND METHODS: Patients with penile vascular insufficiency determined at Doppler ultrasonography and undergoing thoracic computerized tomography for various reasons were included in this study. A history of acute thoracic trauma, pneumonic consolidation, or pelvic surgery and trauma were regarded as exclusion criteria...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28709583/interactions-between-pelvic-organ-protrusion-levator-ani-descent-and-hiatal-enlargement-in-women-with-and-without-prolapse
#5
Anne G Sammarco, Lahari Nandikanti, Emily K Kobernik, Bing Xie, Alexandra Jankowski, Carolyn W Swenson, John O L Delancey
BACKGROUND: Pelvic organ prolapse has two components; 1) protrusion of the pelvic organs beyond the hymen and 2) descent of the levator ani. The Pelvic Organ Prolapse Quantification system measures the first component, however, there remains no standard measurement protocol for the second mechanism. OBJECTIVES: Test the hypotheses that 1) difference in the protrusion area is greater than the area created by levator descent in prolapse patients compared with controls and, 2) Prolapse is more strongly associated with levator hiatus compared to urogenital hiatus...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28709560/an-alternative-view-on-the-necessity-of-egd-before-sleeve-gastrectomy
#6
Kivanc Derya Peker, Nuri Alper Sahbaz, Hakan Seyit, Osman Kones, Alpen Yahya Gumusoglu, Halil Alis
BACKGROUND: Esophagogastroduodenoscopy (EGD) is particularly recommended for choosing a surgical method to be used with asymptomatic patients and for the assessment of symptomatic patients prior to sleeve gastrectomy. The presence of hiatal hernia, for instance, is a relative contraindication. EGD is used for malignancy scanning as well as surgical planning, but seems inefficient in determining postoperative complications. OBJECTIVE: Our aim was to investigate the effectiveness of the pathological evaluation of endoscopic biopsies obtained with esophagogastroduodenoscopy (EGD) according to Sydney classification prior to sleeve gastrectomy in identifying the risk of staple line leak, independently of clinical diagnosis...
June 15, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28696816/pre-existing-mesh-at-the-hiatus-in-revisional-surgery-does-not-result-in-increased-morbidity-a-case-control-evaluation
#7
Rana M Higgins, Max Schumm, Matthew E Bosler, Jon C Gould
BACKGROUND: Mesh is sometimes used to reinforce the hiatus during primary and reoperative fundoplication. This is a controversial practice as it is not clear that this leads to a decreased rate of failure of the hiatal closure, and concerns about morbidity related to the presence of mesh in this location exist. One of these concerns is that if reoperation is ever required (fundoplication herniates through the hiatus, for example), revisional surgery would be significantly more difficult and associated with a higher rate of morbidity than if mesh had not been placed at the hiatus in a previous procedure...
July 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28695461/is-endoscopy-really-necessary-for-placing-intragastric-balloons
#8
Elisabeth M H Mathus-Vliegen
BACKGROUND: Gastric balloons for weight loss have historically been placed after a screening endoscopy. However, the utility and yield of these endoscopies has not been studied. Therefore, we wanted to evaluate the utility of screening endoscopy and to assess patients who had balloons placed without endoscopy. METHODS: Data was collected on two cohorts. Cohort 1 consisted of patients who had a screening endoscopy prior to or upon balloon placement. Cohort 2 consisted of patients who were followed after having a balloon placed under fluoroscopic guidance without endoscopy...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28693045/hiatal-hernia-repair-current-evidence-for-use-of-absorbable-mesh-to-reinforce-hiatal-closure
#9
Lucian Panait, Yuri W Novitsky
INTRODUCTION: There continues to be debate regarding the best surgical technique for the treatment of paraesophageal hernias. While laparoscopic and robotic approaches are widely employed around the world, the benefits of mesh use to reinforce hiatal closure are still not well established. The goal of this manuscript is to describe the currently available results with biologic and bioabsorbable meshes for treatment of paraesophageal hernias, particularly with reference to the rate of recurrence...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28687434/prevalence-of-barrett-s-esophagus-an-observational-study-from-a-gastroenterology-clinic
#10
J L Herrera Elizondo, R Monreal Robles, D García Compean, E I González Moreno, O D Borjas Almaguer, H J Maldonado Garza, J A González González
INTRODUCTION AND AIMS: Barrett's esophagus is a condition that predisposes to esophageal adenocarcinoma. Our aim was to establish the prevalence of Barrett's esophagus at our center, as well as determine its associated factors. MATERIALS AND METHODS: We retrospectively assessed the endoscopic reports of 500 outpatients seen at our Gastroenterology Service from November 2014 to April 2016. We determined the prevalence of Barrett's esophagus and analyzed the demographic, clinical, and endoscopic findings associated with that pathology...
July 4, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28686537/far-from-standardized-using-surgical-videos-to-identify-variation-in-technique-for-laparoscopic-sleeve-gastrectomy
#11
Oliver A Varban, Adam Niemann, Amanda Stricklen, Rachel Ross, Amir A Ghaferi, Jonathan F Finks, Justin B Dimick
BACKGROUND: Video assessment is an emerging tool for understanding variation in surgical technique. METHODS: Representative videos of laparoscopic sleeve gastrectomy (LSG) were voluntarily submitted by 20 surgeons who participated in a statewide quality improvement collaborative. The amount of time required to complete the salient steps of the operation was measured and variations in the tasks performed during each step were captured. RESULTS: Twenty-two videos of LSG were submitted and 11 videos included concurrent hiatal hernia repair...
July 7, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28685362/is-routine-preoperative-esophagogastroduodenscopy-screening-necessary-prior-to-laparoscopic-sleeve-gastrectomy-review-of-1555-cases-and-comparison-with-current-literature
#12
Asaad Salama, Tamer Saafan, Walid El Ansari, Mohsen Karam, Moataz Bashah
BACKGROUND: Controversy exists as to whether routine preoperative esophagogastroduodenoscopy (p-OGD) in bariatric surgery should be routinely undertaken or undertaken selectively based on patients' symptoms. As very few studies have focused on the role of p-OGD prior to the increasingly common laparoscopic sleeve gastrectomy (LSG), we assessed the role/impact of p-OGD in LSG patients. METHODS: Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (2011-2014, n = 1555)...
July 6, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28678999/association-of-centers-for-medicare-medicaid-services-overall-hospital-quality-star-rating-with-outcomes-in-advanced-laparoscopic-abdominal-surgery
#13
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Ninh T Nguyen
Importance: The Centers for Medicare & Medicaid Services (CMS) recently released the Overall Hospital Quality Star Rating to help patients compare hospitals based on a 5-star scale. The star rating was designed to assess overall quality of the institution; thus, its validity toward specifically assessing surgical quality is unknown. Objective: To examine whether CMS high-star hospitals (HSHs) have improved patient outcomes and resource use in advanced laparoscopic abdominal surgery compared with low-star hospitals (LSHs)...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28670060/deglutition-syncope
#14
Nachiket Patel, Saif Ibrahim, Jainil Shah, Menfil A Orellana-Barrios, Timothy E Paterick, A Jamil Tajik
Deglutition syncope, also known as swallow syncope, is a neurally mediated reflex syndrome. The common intervention of the heart, esophagus, and stomach by the vagus nerve is central to its pathogenesis, whereby swallowing causes inhibition of the cardiac conduction system. It is most commonly associated with disorders of the esophagus, both organic and functional. Herein we describe the case of a 48-year-old man presenting with transient syncopal episodes that occurred while eating caused by an intrathoracic stomach due to a hiatal hernia...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28664605/case-of-giant-paraesophageal-hiatal-hernia-associated-with-morgagni-hernia
#15
Hiroki Ozawa, Hiroharu Shinozaki, Masaru Kimata, Soji Ozawa
Simultaneous paraesophageal and Morgagni hernias are very rare. Here, we report a case involving a 91-year-old woman with simultaneous paraesophageal and Morgagni hernias. Both hernias were repaired laparoscopically. The postoperative course was uneventful. Laparoscopic repair for hernias seems to be feasible and minimally invasive, but only a few reports have described such repairs of hernial orifices.
June 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28664434/clinical-outcomes-five-years-after-poem-for-treatment-of-primary-esophageal-motility-disorders
#16
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/28664433/factors-influencing-the-outcome-of-magnetic-sphincter-augmentation-for-chronic-gastroesophageal-reflux-disease
#17
Heather F Warren, Lisa M Brown, Matias Mihura, Alexander S Farivar, Ralph W Aye, Brian E Louie
OBJECTIVES: Magnetic sphincter augmentation (MSA) is a surgical treatment option for patients with gastroesophageal reflux disease (GERD). MSA consistently improves quality of life, maintains freedom from PPIs, and objectively controls GERD. However, up to 24% of patients did not achieve these outcomes. We sought to identify factors predicting outcomes after MSA placement with the aim of refining selection criteria. METHODS: We retrospectively analyzed clinical, endoscopic, manometric, pH data, and intraoperative factors from two databases: Pivotal Trial (N = 99) and our prospectively maintained esophageal database (N = 71)...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28645009/case-report-of-robotic-dor-fundoplication-for-scleroderma-esophagus-with-aperistalsis-on-manometry
#18
Alonso Andrade, Matthew K Folstein, Brian R Davis
Scleroderma is a systemic disease of collagen deposition resulting in fibrosis of small arteries and arterioles. It commonly affects the skin, lungs, and gastrointestinal tract. The most common site of GI tract involvement is the esophagus. We present the case report of a 44year old female with scleroderma esophagus and severe reflux which was successfully treated with robotic dor fundoplication. Because of the wide variety of symptoms with which this problem can present, a tailored approach taking into consideration the patient's symptomatology and findings during diagnostic work-up was implemented with good results...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28644313/unique-clinical-features-of-los-angeles-grade-d-esophagitis-suggest-that-factors-other-than-gastroesophageal-reflux-contribute-to-its-pathogenesis
#19
Anh D Nguyen, Stuart J Spechler, Monique N Shuler, Rhonda F Souza, Kerry B Dunbar
BACKGROUND: The Los Angeles (LA) grade of reflux esophagitis (A to D) is assumed to reflect severity of the underlying gastroesophageal reflux disease (GERD). Thus, LA-D esophagitis patients might be expected to have the most conditions predisposing to GERD (eg, obesity, hiatal hernia), and the highest frequency of GERD symptoms. GOALS: The main goal of this study is to compare clinical features of patients with the most severe (LA-D) and mildest (LA-A) grades of esophagitis...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643980/-hiatal-hernia-current-diagnostic-and-therapeutic-management
#20
Pierre Allemann, Valentine Guarnero, Alain Schoepfer, Nicolas Demartines, Markus Schäfer
Hiatal hernia is a frequent pathology. Two types have been described : sliding hernia and paraesophageal hernia (PEH). The first one is the most frequent and is associated with reflux disease. Patients with PEH have a large variety of symptoms, such as chest pain, dyspnea, regurgitation, iterative pneumonia and iron-deficiency anemia. Operative management is necessary for sliding hernia with reflux disease and for symptomatic PEH, respectively. In patients with asymptomatic PEH, operative risk must be balanced with the risk of postoperative complications...
June 14, 2017: Revue Médicale Suisse
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