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https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#1
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the U.S. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may ensue with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid induced ileus may ensue...
May 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28514384/-innovative-endoscopic-technologies-in-multi-field-medical-facility
#2
O E Karpov, P S Vetshev, A S Maady, K I Alekseev, A S Osipov, I V Vasiliev
The modern clinical practice is characterized by intensive introduction of innovative technologies for improving treatment and diagnostic procedures, minimizing their impact on the patient, complications rate and economic reasons. One of the priorities in this area is both diagnostic and therapeutic endoscopy. The degree of practical use of innovative endoscopic technologies depends on not only the quality of care, but also their economic reasons. Endoscopic treatment has become the method of choice for gastrointestional bleeding, extraction of foreign bodies, obstructive jaundice, polyps of the gastrointestinal tract, achalasia, esophageal strictures, etc...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28502210/-esophageal-complications-of-gastroesophageal-reflux-disease-consequences-or-defensive-reactions
#3
Örs Péter Horváth, Laura Bognár, András Papp, András Vereczkei
Gastroesophageal reflux disease affects more than 10% of the adult population. Most patients can be effectively treated with lifestyle changes and adequate acid-reducing therapy. However, about 10% of the patients remain symptomatic despite treatment and severe complications may develop. Interestingly, some of these complications seem to be a sort of defensive mechanism that may either alleviate the patient's symptoms or prevent developing further complications. In Barrett's esophagus, which can be unambigously considered as a complication of gastroesophageal reflux disease, reflux symptoms ruining the quality of life may significantly improve, since the metaplastic Barrett epithelium is much more resistent to gastric acid, than the normal epithelial lining of the esophagus...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28496526/changing-trends-in-age-gender-racial-distribution-and-inpatient-burden-of-achalasia
#4
Vaibhav Wadhwa, Prashanthi N Thota, Malav P Parikh, Rocio Lopez, Madhusudhan R Sanaka
BACKGROUND: Achalasia is an idiopathic esophageal motility disorder characterized by dysphagia, regurgitation, chest discomfort and weight loss. The aim of this study was to evaluate the temporal trends in demographic variables, interventions, and inpatient burden in achalasia-related hospitalizations. METHODS: We evaluated the National Inpatient Sample Database (NIS) for all patients in whom achalasia (ICD-9 code: 530.0) was the principal discharge diagnosis from 1997 to 2013...
April 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28485000/simultaneous-diagnosis-of-familial-achalasia-report-of-two-cases
#5
Masato Hoshino, Nobuo Omura, Fumiaki Yano, Se Ryung Yamamoto, Minoru Matsuda, Katsuhiko Yanaga
BACKGROUND: Achalasia is a rare disease with a morbidity of 1 in 100,000, for which the exact mechanism of pathogenesis has not been clarified due to the small total number of patients. We herein report on our experience with two cases of familial achalasia in which the involvement of genetic inheritance was suspected. CASE PRESENTATION: These cases consist of a man in his thirties and his mother in her sixties. The son consulted the Department of Gastrointestinal Medicine at our institute with dysphagia, and an upper gastrointestinal endoscopy revealed a gastric submucosal tumor with a maximal diameter of approximately 50 mm...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28484733/per-oral-endoscopic-myotomy-for-achalasia-cardia-outcomes-in-over-400-consecutive-patients
#6
Zaheer Nabi, Mohan Ramchandani, Radhika Chavan, Rakesh Kalapala, Santosh Darisetty, Guduru Venkat Rao, Nageshwar Reddy
Background and study aims Per-oral endoscopic myotomy (POEM) has emerged as an efficacious treatment modality for the management of achalasia cardia (AC) and non-achalasia spastic esophageal motility disorders. Initial results are encouraging. We analyzed the safety and efficacy of POEM in a large cohort of patients with AC. Patients and methods The data from patients who underwent POEM (from January 2013 to June 2016) was prospectively collected and analyzed. Clinical success was defined as Eckardt score ≤ 3 after POEM procedure...
May 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28483605/intramural-surgery-a-new-vista-in-minimally-invasive-therapy
#7
Andrew T Strong, John Rodriguez, Matthew Kroh, Jeffrey L Ponsky
Endoscopic therapy for lesions of the gastrointestinal tract has become commonplace. Endoscopic excision of polyps was introduced over four decades ago. Today, removal of large, sessile lesions by means of endoscopic mucosal resection or endoscopic submucosal dissection is increasingly employed throughout the gastrointestinal tract. A decade ago, the concept of trans-lumenal endoscopic surgery was introduced. Although not widely practiced, it ushered in development of new concepts and technology which have contributed extensively to the growth of endoscopic and laparoscopic surgical practice...
May 5, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28476452/vigorous-achalasia
#8
Carmen Del Pozo Calzada, Helena Molina Llorente, María González Gutiérrez
No abstract text is available yet for this article.
May 2, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28475827/muscular-thickness-of-lower-esophageal-sphincter-and-therapeutic-outcomes-in-achalasia-a-prospective-study-using-high-frequency-endoscopic-ultrasound
#9
Shih-Wei Li, Ping-Huei Tseng, Chien-Chuan Chen, Wei-Chih Liao, Kao-Lang Liu, Jang-Ming Lee, Yi-Chia Lee, Seng-Kee Chuah, Ming-Shiang Wu, Hsiu-Po Wang
BACKGROUND AND AIM: Patients with achalasia typically have thicker lower esophageal sphincter muscles, which can affect the distensibility of the esophagogastric junction. We aimed to assess whether these muscular features, measured using high-frequency endoscopic ultrasound, affect treatment outcomes. METHODS: Consecutive adult patients with suspected achalasia were enrolled prospectively. They underwent a comprehensive diagnostic work-up, including endoscopic ultrasound...
May 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28475741/clinical-presentation-and-disease-course-of-patients-with-esophagogastric-junction-outflow-obstruction
#10
K L Lynch, Y-X Yang, D C Metz, G W Falk
Esophagogastric junction outflow obstruction, characterized by preserved peristalsis in conjunction with an elevated integrated relaxation pressure, can result from specific anatomic variants or may represent achalasia in evolution. There is limited information on the clinical significance of this diagnosis. The aim of this study is to describe the clinical characteristics and outcomes in our cohort of patients with esophagogastric junction outflow obstruction.Consecutive adult patients who had undergone high-resolution esophageal manometry between February 2013 and November 2015 with a diagnosis of esophagogastric junction outflow obstruction were identified...
June 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28472017/systematic-review-and-meta-analysis-of-perioperative-outcomes-of-peroral-endoscopic-myotomy-poem-and-laparoscopic-heller-myotomy-lhm-for-achalasia
#11
Aiman Awaiz, Rossita M Yunus, Shahjahan Khan, Breda Memon, Muhammed A Memon
AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed...
May 3, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28471776/achalasia-microcephaly-syndrome-a-further-case-report
#12
Mohamed Wafik, Usha Kini
No abstract text is available yet for this article.
May 3, 2017: Clinical Dysmorphology
https://www.readbyqxmd.com/read/28470488/an-algorithmic-approach-to-the-management-of-gastric-stenosis-following-laparoscopic-sleeve-gastrectomy
#13
Abhishek Agnihotri, Sindhu Barola, Christine Hill, Manoel Galvao Neto, Josemberg Campos, Vikesh K Singh, Michael Schweitzer, Mouen A Khashab, Vivek Kumbhari
BACKGROUND: Gastric stenosis (GS) is a potential adverse event post-laparoscopic sleeve gastrectomy (LSG). Endoscopic management is preferred; however, there is significant variation in therapeutic strategies with no defined algorithm. This study aims to describe the safety and efficacy of a predefined step-wise algorithm for endoscopic management of GS post-LSG. METHODS: Consecutive patients with symptomatic GS post-LSG, presenting between July 2015 and August 2016, were subjected to a predefined treatment algorithm of serial dilations using achalasia balloons, followed by a fully covered self-expanding metal stent (FCSEMS) if dilations were inadequate...
May 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28466506/bolus-clearance-in-esophagogastric-junction-outflow-obstruction-is-associated-with-strength-of-peristalsis
#14
A Jain, J R Baker, J H Rubenstein, J W Chen
BACKGROUND: A manometric diagnosis of esophagogastric junction outflow obstruction (EGJOO) without a mechanical cause creates a therapeutic conundrum. The aim of this study was to assess esophageal bolus clearance in EGJOO and assess manometric factors associated with clearance in EGJOO. METHODS: Bolus clearance was assessed using line-tracing method and contour method to determine Complete Bolus Transit (CBT) and Functional Clearance (FC), respectively, on combined High-Resolution Impedance Manometry (HRIM)...
May 3, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28460739/twenty-year-trends-in-the-utilization-of-heller-myotomy-for-achalasia-in-the-united-states
#15
Kelly R Haisley, Jennifer F Preston, James P Dolan, Brian S Diggs, John G Hunter
INTRODUCTION: Trends in the utilization of Heller myotomy for achalasia in the U.S. over time have not been previously described. MATERIALS AND METHODS: Using the Nationwide Inpatient Sample (NIS) database, we analyzed patients undergoing Heller myotomy for achalasia over a 20-year period (1992-2011) to estimate rates of Heller myotomy, locations where the procedures were performed (rural, urban or teaching) and changes in technique (laparoscopic vs open) as well as outcomes of length of stay and in-hospital mortality...
March 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28455798/internal-anal-sphincter-achalasia-data-from-a-nationwide-survey-of-allied-disorders-of-hirschsprung-s-disease-in-japan
#16
Satoshi Obata, Suguru Fukahori, Minoru Yagi, Makoto Suzuki, Shigeru Ueno, Kosuke Ushijima, Tomoaki Taguchi
PURPOSE: To investigate the incidence and treatment of internal anal sphincter achalasia (IASA) in Japan based on an analysis of data from a nationwide retrospective cohort study of the allied disorders of Hirschsprung's disease. METHODS: Five cases of definitive IASA were collected from a nationwide retrospective cohort study conducted from 2001 to 2010 and a search of the Japanese literature. RESULTS: Symptoms developed during the neonatal period in two patients, during early childhood in two, and at school age in one...
April 28, 2017: Surgery Today
https://www.readbyqxmd.com/read/28451814/the-relationship-between-manometric-subtype-and-outcomes-of-surgical-treatment-for-patients-with-achalasia-achalasia-manometric-subtypes
#17
Oscar Maximiliano Crespin, Roger Perry Tatum, Keliang Xiao, Ana Valeria Martin, Saurabh Khandelwal, Carlos Alberto Pellegrini, Brant Kurt Oelschlager
BACKGROUND: The Chicago Classification describes three distinct subtypes of achalasia and it appears to be a promising tool in predicting results of treatment with standard Heller Myotomy. The aim of this study is to analyze the outcomes of surgical treatment for achalasia using an extended Heller myotomy for each subtype and to identify additional parameters that may predict the success of therapy. METHODS: 72 consecutive patients with achalasia were evaluated at the University of Washington between 2008 and 2013...
April 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28446976/per-oral-endoscopic-myotomy-for-achalasia
#18
REVIEW
Steven R DeMeester
Symptoms in patients with achalasia are produced by outflow obstruction at the level of the lower esophageal sphincter (LES). As a consequence of neural destruction the LES does not undergo normal swallow-induced relaxation. In addition, the esophageal body loses normal peristaltic function and esophageal emptying is on the basis of gravity. All therapies for achalasia are palliative in that normal LES or esophageal body function cannot be restored. The efficacy of any therapy for achalasia is directly related to its ability to reduce the outflow obstruction at the LES...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445340/patients-with-esophageal-achalasia-keeping-them-safe
#19
Linda S Smith
No abstract text is available yet for this article.
May 2017: Nursing
https://www.readbyqxmd.com/read/28429200/achalasia-it-is-not-all-black-and-white
#20
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
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