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https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#1
REVIEW
Santosh Sanagapalli, Rami Sweis
PURPOSE OF REVIEW: This review aims to shed light on subtleties of achalasia diagnosis, including potential pitfalls that may lead to errors. Optimal methods for assessment of disease severity and the relationship between achalasia and other motility disorders will also be reviewed with an emphasis on recent findings from the literature. RECENT FINDINGS: Adjunctive testing with viscous substances or larger water volumes should be used routinely as it improves the accuracy of achalasia diagnosis...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#2
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
April 19, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28417135/a-training-model-for-introducing-a-novel-surgical-procedure-into-clinical-practice-our-experience-on-peroral-endoscopic-myotomy-for-achalasia
#3
Dedrick Kh Chan, Reuben Km Wong, Janelle Ns Phua, Asim Shabbir, Khek Yu Ho, Philip Wy Chiu, Jimmy By So
No abstract text is available yet for this article.
March 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28416923/esophageal-achalasia-predictive-value-of-preoperative-resting-pressure-of-les-correlated-with-type-of-fundoplication
#4
Antonio Tancredi, Antonello Cuttitta, Roberto Scaramuzzi, Gerardo Scaramuzzi, Marco Taurchini
OBJECTIVE: The aim of the present study is to show the predictive value of the preoperative resting pressure of the lower esophageal sphincter (LES) correlated with the type of fundoplication (Nissen or Dor) after Heller myotomy in our series. MATERIALS AND METHODS: From January 1998 to June 2010, 88 patients affected by esophageal achalasia underwent surgery at our unit. However, our study focused on a sample of 36 patients, because many data were lost or was never recorded...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28411346/peroral-endoscopic-myotomy-compared-with-pneumatic-dilation-for-newly-diagnosed-achalasia
#5
Fandong Meng, Peng Li, Yongjun Wang, Ming Ji, Yongdong Wu, Li Yu, Yinglin Niu, Fujing Lv, Wei Li, Wenyan Li, Huihong Zhai, Shanshan Wu, Shutian Zhang
BACKGROUND: This study retrospectively compared the safety and efficacy of two endoscopic techniques for treating newly diagnosed achalasia, pneumatic dilation (PD), and peroral endoscopic myotomy (POEM). METHODS: Demographics, clinical and manometric data, and outcomes were collected from the medical records of patients who received POEM or PD as the primary therapy for achalasia at our hospital from January 2012 to August 2015. RESULTS: Of 72 patients, 32 and 40 received POEM and PD, respectively...
April 14, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28396032/dissatisfaction-after-laparoscopic-heller-myotomy-the-truth-is-easy-to-swallow
#6
Alexander Rosemurgy, Darrell Downs, Gianvanna Jadick, Forat Swaid, Kenneth Luberice, Carrie Ryan, Sharona Ross
BACKGROUND: Although laparoscopic Heller myotomy has been shown to well palliate symptoms of achalasia, we have observed a small subset of patients who are "Dissatisfied". This study was undertaken to identify the causes of their dissatisfaction. STUDY DESIGN: Patients undergoing laparoscopic Heller myotomy from 1992 to 2015 were prospectively followed. Using a Likert scale, patients rated their symptom frequency/severity before and after the procedure. Patients graded their experience from "Very Satisfying" to "Very Unsatisfying...
April 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28395280/triple-a-syndrome-preliminary-response-to-the-antioxidant-n-acetylcysteine-treatment-in-a-child
#7
Maria Candida Barisson Villares Fragoso, Edoarda Vasco de Albuquerque Albuquerque, Ana Luiza de Almeida Cardoso, Paula Waki Lopes da Rosa, Rodrigo Bomeny de Paulo, Maria Heloisa Massola Schimizu, Antonio Carlos Seguro, Marisa Passarelli, Katrin Koehler, Angela Huebner, Madson Q Almeida, Ana Claudia Latronico, Ivo Jorge Prado Arnhold, Berenice Bilharinho Mendonca
INTRODUCTION: Triple A syndrome (AAAS) is a rare autosomal recessive disorder characterized by alacrima, achalasia, ACTH-resistant adrenal insufficiency, autonomic dysfunction, and progressive neurodegeneration. Increased oxidative stress, demonstrated in patients' fibroblasts in vitro, may be a central disease mechanism. N-acetylcysteine protects renal function in patients with kidney injuries associated with increased oxidative stress and improves viability of AAAS-knockdown adrenal cells in vitro...
April 10, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28395277/exploratory-research-on-latent-esophageal-motility-disorders-in-dysphagia-patients
#8
Shinpei Kawaguchi, Toshihisa Takeuchi, Yousuke Inoue, Yoshiaki Takahashi, Haruhiko Ozaki, Kazuhiro Ota, Satoshi Harada, Shoko Edogawa, Yuichi Kojima, Hiroshi Yamashita, Takumi Fukuchi, Kiyoshi Ashida, Kazuhide Higuchi
BACKGROUND/AIMS: High-resolution manometry (HRM) has been applied to assess esophageal motility disorders. However, the frequency and types of motility disorders in patients with dysphagia, which are frequently seen in clinical practice, are not clear. We evaluated latent esophageal motility disorders associated with dysphagia. METHODS: The study included patients without erosive esophageal mucosal damage and with dysphagia symptoms refractory to at least 8 weeks of standard-dose proton pump inhibitors...
April 11, 2017: Digestion
https://www.readbyqxmd.com/read/28382674/diagnostic-features-of-malignancy-associated-pseudoachalasia
#9
F A Ponds, M I van Raath, S M M Mohamed, A J P M Smout, A J Bredenoord
BACKGROUND: Pseudoachalasia is a condition in which clinical and manometric signs of achalasia are mimicked by another abnormality, most often a malignancy. AIM: To identify risk factors that suggest presence of malignancy-associated pseudoachalasia. METHODS: In this retrospective cohort study, achalasia patients newly diagnosed by manometry were included. Patients with a normal initial endoscopy, clinical and manometric signs of achalasia who were afterwards found to have an underlying malignant cause were classified as pseudoachalasia...
April 6, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28382500/impact-of-esophageal-flexion-level-on-the-surgical-outcome-in-patients-with-sigmoid-esophageal-achalasia
#10
Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
PURPOSE: Esophageal achalasia can be roughly divided into non-sigmoid and sigmoid types. Laparoscopic surgery has been reported to be less than optimally effective for sigmoid type. The aim of this study was to examine the impact of the esophageal flexion level on the clinical condition and surgical outcomes of patients with sigmoid esophageal achalasia. METHODS: The subjects were 36 patients with sigmoid esophageal achalasia who had been observed for >1 year after surgery...
April 5, 2017: Surgery Today
https://www.readbyqxmd.com/read/28375487/the-role-of-heller-myotomy-and-poem-for-nonachalasia-motility-disorders
#11
F Schlottmann, N J Shaheen, R D Madanick, M G Patti
The best-defined primary esophageal motor disorder is achalasia. However, symptoms such as dysphagia, regurgitation and chest pain can be caused by other esophageal motility disorders such as Diffuse Esophageal Spasm (DES), Nutcracker Esophagus (NE) and the Hypertensive Lower Esophageal Sphincter (HTN-LES). Most patients with DES and HTN-LES who complain of dysphagia improve after a myotomy. Patients with NE whose main complaint is chest pain, often do not have relief of the pain and can even develop dysphagia as a consequence of the myotomy...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375484/mutational-profile-of-tp53-in-esophageal-squamous-cell-carcinoma-associated-with-chagasic-megaesophagus
#12
C F Lacerda, A Cruvinel-Carloni, A T Torres de Oliveira, C Scapulatempo-Neto, R V M López, E Crema, S J Adad, M A M Rodrigues, M A C A Henry, D P Guimarães, R M Reis
Chaga's disease is an important communicable neglected disease that is gaining wider attention due to its increasing incidence worldwide. Achalasia due to chagasic megaesophagus (CM), a complication of this disease, is a known-yet, poorly understood-etiological factor for esophageal squamous cell carcinoma (ESCC) development. In this study, we aimed to perform the analysis of TP53 mutations in a series of Brazilian patients with ESCC that developed in the context CM (ESCC/CM), and to compare with the TP53 mutation profile of patients with benign CM and patients with nonchagasic ESCC...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375482/clinical-and-manometric-characteristics-of-patients-with-parkinson-s-disease-and-esophageal-symptoms
#13
A Su, R Gandhy, C Barlow, G Triadafilopoulos
Dysphagia is a common problem in patients with Parkinson's disease (PD); its etiology is multifactorial and its management is challenging. In this retrospective cohort analysis using prospectively collected data, we aimed to objectively characterize dysphagia and/or other esophageal symptoms in patients with PD, assess the prevalence of outflow obstruction as well as major or minor disorders of esophageal peristalsis leading to impaired esophageal clearance and highlight objective parameters that can help in the current management algorithm...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375470/endoscopic-stent-suture-fixation-for-prevention-of-esophageal-stent-migration-during-prolonged-dilatation-for-achalasia-treatment
#14
E Rieder, R Asari, M Paireder, J Lenglinger, S F Schoppmann
The aim of this study is to compare endoscopic stent suture fixation with endoscopic clip attachment or the use of partially covered stents (PCS) regarding their capability to prevent stent migration during prolonged dilatation in achalasia. Large-diameter self-expanding metal stents (30 mm × 80 mm) were placed across the gastroesophageal junction in 11 patients with achalasia. Stent removal was scheduled after 4 to 7 days. To prevent stent dislocation, endoscopic clip attachment, endoscopic stent suture fixation, or PCS were used...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375450/patient-reported-outcome-measures-in-dysphagia-a-systematic-review-of-instrument-development-and-validation
#15
D A Patel, R Sharda, K L Hovis, E E Nichols, N Sathe, D F Penson, I D Feurer, M L McPheeters, M F Vaezi, David O Francis
OBJECTIVE: Patient-reported outcome (PRO) measures are commonly used to capture patient experience with dysphagia and to evaluate treatment effectiveness. Inappropriate application can lead to distorted results in clinical studies. A systematic review of the literature on dysphagia-related PRO measures was performed to (1) identify all currently available measures and (2) to evaluate each for the presence of important measurement properties that would affect their applicability. DESIGN: MEDLINE via the PubMed interface, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument database were searched using relevant vocabulary terms and key terms related to PRO measures and dysphagia...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375443/long-term-outcomes-of-peroral-endoscopic-myotomy-for-patients-with-achalasia-a-retrospective-single-center-study
#16
H Guo, H Yang, X Zhang, L Wang, Y Lv, X Zou, T Ling
Peroral endoscopic myotomy (POEM) has been widely applied to the treatment of achalasia. The aim of this study is to retrospectively investigate the long-term outcome of POEM in patients with achalasia. Patients undergoing POEM at our center with a minimum follow-up of 3 years were enrolled in this study. Relief of patients' symptom was defined as the primary outcome. Secondary outcomes included lower esophageal sphincter pressure, esophageal emptying, symptoms relapse, and clinical reflux adverse events. The Chi-square test was performed to determine the potential predictors of surgical failure...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375440/high-resolution-manometry-findings-in-patients-with-achalasia-and-massive-dilated-megaesophagus
#17
M A Menezes, C Andolfi, F A M Herbella, M G Patti
Achalasia may present in a non-advanced or an advanced (end stage) stage based on the degree of esophageal dilatation. Manometric parameters and esophageal caliber may be prognostic for the outcome of treatment. The correlation between manometry and disease stage has not been yet fully studied. This study aims to describe high-resolution manometry findings in patients with achalasia and massive dilated megaesophagus. Eighteen patients (mean age 61 years, 55% females) with achalasia and massive dilated megaesophagus, as defined by a maximum esophageal dilatation >10 cm at the barium esophagram, were studied...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375437/achalasia-an-unnecessary-long-way-to-diagnosis
#18
S Niebisch, E Hadzijusufovic, M Mehdorn, M Müller, U Scheuermann, O Lyros, H G Schulz, B Jansen-Winkeln, H Lang, I Gockel
Although achalasia presents with typical symptoms such as dysphagia, regurgitation, weight loss, and atypical chest pain, the time until first diagnosis often takes years and is frustrating for patients and nevertheless associated with high costs for the healthcare system. A total of 563 patients were interviewed with confirmed diagnosis of achalasia regarding their symptoms leading to diagnosis along with past clinical examinations and treatments. Included were patients who had undergone their medical investigations in Germany...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28371804/muscle-pathology-as-a-diagnostic-clue-to-allgrove-syndrome
#19
Jens Reimann, Nicolai Kohlschmidt, Karen Tolksdorf, Joachim Weis, Klaus Kuchelmeister, Andreas Roos
Allgrove or triple A syndrome is a rare autosomal recessive disorder that can present with a variable range of multi-system manifestations, including optic atrophy, cerebellar ataxia, upper and lower motoneuron signs and various neuropathic abnormalities. These cases are a diagnostic challenge, particularly when the eponymous combination of achalasia, Addisonianism and alacrima is incomplete. Therefore, it is in the differential diagnosis for multisystem conditions and should be known to pathologists who diagnose disorders of skeletal muscle...
March 22, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28361839/peroral-endoscopic-myotomy-achieves-similar-clinical-response-but-incurs-lesser-charges-compared-to-robotic-heller-myotomy
#20
Mouen A Khashab, Vivek Kumbhari, Alan H Tieu, Mohamad H El Zein, Amr Ismail, Saowanee Ngamruengphong, Vikesh K Singh, Anthony N Kalloo, John O Clarke, Ellen M Stein
BACKGROUND/AIM: Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. PATIENTS AND METHODS: A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014)...
March 2017: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
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