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https://www.readbyqxmd.com/read/29905893/s093-pneumatic-balloon-dilation-for-palliation-of-recurrent-symptoms-of-achalasia-after-esophagomyotomy
#1
Riley D Stewart, Jeffrey Hawel, Daniel French, Drew Bethune, James Ellsmere
BACKGROUND: Achalasia is a chronic disease affecting the myenteric plexus of the esophagus and lower esophageal sphincter. Treatment is aimed at palliating symptoms to improve quality of life. Treatment options for symptom relapse after esophagomyotomy include botox injection, repeat myotomy, per-oral endoscopic myotomy, or pneumatic balloon dilation (PBD). Data demonstrating the safety and efficacy of PBD for recurrence are scarce. With a lack of published data, guidelines have suggested avoiding PBD for recurrent achalasia because of concern for a high risk of perforation...
June 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29892807/impact-of-preoperative-balloon-dilatation-on-outcomes-of-laparoscopic-surgery-in-young-patients-with-esophageal-achalasia
#2
Kazuto Tsuboi, Nobuo Omura, Fumiaki Yano, Masato Hoshino, Se-Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
BACKGROUND: Balloon dilatation is reportedly less effective for young patients with esophageal achalasia than for older patients. However, there is no consensus on the impact of prior balloon dilatation on outcomes of surgical treatment. This study investigated the significance of preoperative balloon dilatation on surgical outcomes in young patients with esophageal achalasia. METHODS: Of patients aged less than 40 years who had undergone a laparoscopic Heller-Dor operation for esophageal achalasia, 201 with a postoperative follow-up period of at least 1 year were included...
January 2018: Esophagus: Official Journal of the Japan Esophageal Society
https://www.readbyqxmd.com/read/29868282/unilateral-application-of-an-external-pneumatic-compression-therapy-improves-skin-blood-flow-and-vascular-reactivity-bilaterally
#3
Jeffrey S Martin, Allison M Martin, Petey W Mumford, Lorena P Salom, Angelique N Moore, David D Pascoe
Background: We sought to determine the effects of unilateral lower-limb external pneumatic compression (EPC) on bilateral lower-limb vascular reactivity and skin blood flow. Methods: Thirty-two participants completed this two-aim study. In AIM1 ( n  = 18, age: 25.5 ± 4.7 years; BMI: 25.6 ± 3.5 kg/m2 ), bilateral femoral artery blood flow and reactivity (flow mediated dilation [FMD]) measurements were performed via ultrasonography at baseline (PRE) and immediately following 30-min of unilateral EPC treatment (POST)...
2018: PeerJ
https://www.readbyqxmd.com/read/29804476/esophageal-achalasia-current-diagnosis-and-treatment
#4
Francisco Schlottmann, Marco G Patti
Esophageal achalasia is a primary esophageal motility disorder of unknown origin, characterized by lack of peristalsis and by incomplete or absent relaxation of the lower esophageal sphincter in response to swallowing. The goal of treatment is to eliminate the functional obstruction at the level of the gastroesophageal junction Areas covered: This comprehensive review will evaluate the current literature, illustrating the diagnostic evaluation and providing an evidence-based treatment algorithm for this disease Expert commentary: Today we have three very effective therapeutic modalities to treat patients with achalasia - pneumatic dilatation, per-oral endoscopic myotomy and laparoscopic Heller myotomy with fundoplication...
May 27, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29788157/weight-loss-in-achalasia-is-determined-by-its-phenotype
#5
D A Patel, R Naik, J C Slaughter, T Higginbotham, H Silver, M F Vaezi
Patients with achalasia present with dysphagia, regurgitation, and varying degrees of weight loss. However, despite it being a disorder of the lower esophageal sphincter with functional obstruction in all patients, it is unclear why certain patients lose significantly more weight compared to others. The aims of this study are to assess demographic, clinical, and manometric characteristics of a large cohort of patients with achalasia to determine potential correlates of weight loss in this population. Patients with diagnosis of achalasia referred to our center between 2009 and 2016 were evaluated...
May 18, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29783914/early-application-of-an-intermittent-pneumatic-compression-device-is-safe-and-results-in-proximal-arteriovenous-fistula-enlargement
#6
Sanjay Desai, Amit Mitra, Ed Arkans, Tej M Singh
INTRODUCTION: Delays in arteriovenous fistula maturation can cause care delays and increased costs. Increased distention pressure and intermittent wall shear stress may dilate veins based on prior research. Early use of non-invasive devices may help assist clinical arteriovenous fistula dilation. METHODS: This was an Institutional Review Board approved study. After arteriovenous fistula creation, a novel, intermittent pneumatic compression device (Fist Assist® ) was applied 15 cm proximal to arteriovenous fistula enabling 60 mmHg of cyclic compression for 6 h daily for 30 days...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29766515/results-of-pneumatic-dilation-in-treating-achalasia-predictive-factors
#7
REVIEW
Valter Nilton Felix
Forced pneumatic dilatation (PD) of the cardia is one of the most consecrated therapeutic measures for esophageal achalasia. The procedure only achieved better standardization with the appearance of the Rigiflex balloon. Results and predictive factors of success and failure of PD are reviewed, right after the description of the main technical aspects of the procedure. The success rates, providing control of dysphagia for about 1 year from the procedure using the Rigiflex balloon, are quite satisfactory, with success in more than 75% of patients...
May 16, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29756656/pathophysiology-and-treatment-of-achalasia-in-a-muscle-mechanical-perspective
#8
REVIEW
Hans Gregersen, Kar Man Lo
This review provides a biomechanical perspective on the pathophysiology and treatment of achalasia. The esophagus is efficient in transporting ingested material to the stomach in healthy subjects. A fine balance exists between the peristaltic forces generated in the esophageal body (which herein is defined as the preload) and the resistance in the outlet, the esophago-gastric junction (which is defined as the afterload). Achalasia is a rare esophageal disease that progressively over many years challenges esophageal efficacy...
May 14, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29712591/endoscopic-pneumatic-dilation-for-esophageal-achalasia
#9
Sheraz Markar, Giovanni Zaninotto
Pneumatic dilation is a well-established treatment modality that has withstood the test of time. Prospective and randomized trials have shown that in expert hands, it provides results similar to a laparoscopic Heller myotomy with fundoplication. In addition, it should be considered the primary form of treatment in patients who experience recurrence of symptoms after a surgical myotomy.
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29702296/advances-in-management-of-esophageal-motility-disorders
#10
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Dustin A Carlson, John E Pandolfino
The widespread adoption of high-resolution manometry (HRM) has led to a restructuring in the classification of esophageal motility disorder classification summarized in the Chicago Classification, currently in version 3.0. It has become apparent that the cardinal feature of achalasia, impaired lower esophageal sphincter relaxation, can occur in several disease phenotypes: without peristalsis, with premature (spastic) distal esophageal contractions, with panesophageal pressurization, or even with preserved peristalsis...
April 24, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29670781/-candida-krusei-empyema-thoracis-a-community-acquired-infection-requiring-a-high-index-of-suspicion
#11
Hazim Bukamur, Waseem Ahmed, Yazan Numan, Ibrahim Shahoub, Fuad Zeid
Empyema thoracis is a serious condition characterized by the accumulation of purulent fluid in the pleural cavity, typically following a pneumonia, subdiaphragmatic abscess, or esophageal rupture. Fungal empyema thoracis is a rare form of this condition with especially high mortality, in which the most frequently isolated fungus is Candida spp. This article presents a 74-year-old female with Candida krusei pneumonia and a complicated hospital course, initially presenting with nausea, vomiting, and dysphagia...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29660156/evaluation-of-symptomatic-esophagogastric-junction-outflow-obstruction
#12
Andrew Ming Liang Ong, Vikneswaran Namasivayam, Yu Tien Wang
BACKGROUND AND AIM: Esophagogastric junction outflow obstruction (EGJOO) may be due to anatomical abnormalities, but it is unclear how to evaluate them after high-resolution manometry. We aimed to determine (i) clinical and high-resolution manometry parameters differentiating anatomical EGJOO from functional EGJOO, (ii) investigations chosen and yield for anatomical EGJOO, and (iii) clinical outcomes of functional EGJOO. METHODS: Medical records of consecutive patients with symptomatic EGJOO from February 2012 to December 2015 were reviewed...
April 16, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29603141/population-based-cohort-study-of-surgical-myotomy-and-pneumatic-dilatation-as-primary-interventions-for-oesophageal-achalasia
#13
S R Markar, H Mackenzie, A Askari, O Faiz, J Hoare, G Zaninotto, G B Hanna
BACKGROUND: The aim of this national population-based cohort study was to compare rates of reintervention after surgical myotomy versus sequential pneumatic dilatation for the primary management of oesophageal achalasia. METHODS: Patients with oesophageal achalasia diagnosed between 2002 and 2012, and without an intervention in the preceding 5 years were identified from the Hospital Episode Statistics database. Patients were divided into two groups based on the primary treatment, and propensity score matching was used to compensate for differences in baseline characteristics...
March 30, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29529126/a-concise-review-of-opioid-induced-esophageal-dysfunction-is-this-a-new-clinical-entity
#14
V Ortiz, M García-Campos, E Sáez-González, P delPozo, V Garrigues
Opioids have become the most widely prescribed analgesics in Western countries. Opioid-induced bowel dysfunction is a widely known adverse effect, with constipation the most common manifestation. Most of the opioid-related effects occur in the stomach, small intestine, and colon and have been widely studied. However, the effects related to esophageal motility are less known. Recently published retrospective studies have suggested that long-term use of opioids can cause esophageal motility dysfunction, reflecting symptoms similar to motility disorders, such as achalasia and functional esophagogastric junction outflow obstruction...
May 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29514836/uncommon-cause-of-dysphagia-paraneoplastic-achalasia
#15
Mukesh Nasa, Shashank Bhansali, Narendra Singh Choudhary, Randhir Sud
Achalasia secondary to underlying neoplasm is a rare entity. Early recognition of secondary achalasia is important as its treatment involves management of underlying malignancy, while treatment of primary achalasia mainly involves lowering the lower oesophageal sphincter pressure with pneumatic dilatation or Heller's myotomy. We discuss an interesting case of achalasia secondary to non-Hodgkin's lymphoma.
March 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29509532/high-resolution-manometry-a-mandatory-examination-in-the-pre-and-postoperative-assessment-of-patients-with-achalasia
#16
Anca Dimitriu, Cristian Gheorghe
High resolution manometry (HRM) is currently the gold standard for the diagnosis of achalasia and other functional esophageal disorders. All patients accusing dysphagia should be endoscopically evaluated prior to manometric investigations in order to rule out pseudoachalasia. The Chicago HRM classification has led to a subclassification of three manometric types of achalasia that seem to have different results to treatment. None of the actual achalasia treatment options are curative. Type II achalasia patients respond best to all treatment options compared to those with types I and III...
January 2018: Chirurgia
https://www.readbyqxmd.com/read/29492088/aaa-syndrome-case-report-of-a-rare-disease
#17
S Waqar H Shah, Arshad K Butt, K Malik, Altaf Alam, Adnan Shahzad, Anwaar A Khan
Triple A (Allgrove) syndrome, an autosomal recessive disease is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure with progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation. The triple A syndrome gene, designated AAAS, localized on chromosome 12q 13 encodes for a 546 amino acid protein called ALADIN (Alacrimia-Achlasia-Adrenal Insufficiency and Neurologic disorder). This report relates to two sisters, aged 8 and 12 years, who had vomiting, muscle weakness, alacrimia, excessive fatigue and dysphagia...
November 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29467529/editorial-assessing-esophageal-function-in-achalasia-the-old-and-the-new
#18
Joseph R Triggs, Peter J Kahrilas
Achalasia is currently diagnosed according to the Chicago Classification v3.0 using high-resolution manometry and treatment focuses on disruption of the esophagogastric junction. A paper in this issue examines the utility of a timed barium esophagram with a 13 mm tablet challenge in differentiating achalasia from other diagnoses, finding 100% sensitivity. However, a large proportion of patients with non-achalasia dysphagia are also identified. Another paper in this issue proposes utilizing intraprocedure functional luminal imaging probe measurement during pneumatic dilation as a guide for upsizing dilations...
February 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29440962/focal-achalasia-case-report-and-review-of-the-literature
#19
Marcus Joachim Herzig, Radu Tutuian
Esophageal achalasia is a primary smooth muscle motility disorder specified by aperistalsis of the tubular esophagus in combination with a poorly relaxing and occasionally hypertensive lower esophageal sphincter (LES). These changes occur secondary to the destruction of the neural network coordinating esophageal peristalsis and LES relaxation (plexus myentericus). There are limited data on segmental involvement of the esophagus in adults. We report on the case of a 54-year-old man who presented initially with complete aperistalsis limited to the distal esophagus...
2018: Clujul Medical (1957)
https://www.readbyqxmd.com/read/29439587/clinical-management-of-pediatric-achalasia
#20
Marinde van Lennep, Michiel P van Wijk, Taher I M Omari, Marc A Benninga, Maartje M J Singendonk
Achalasia is a rare esophageal motility disorder. Much of the literature is based on the adult population. In adults, guidance of therapeutic approach by manometric findings has led to improvement in patient outcome. Promising results have been achieved with novel therapies such as PerOral Endoscopic Myotomy (POEM). Areas covered: In this review, we provide an overview of the novel diagnostic and therapeutic tools for achalasia management and in what way they will relate to the future management of pediatric achalasia...
April 2018: Expert Review of Gastroenterology & Hepatology
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