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https://www.readbyqxmd.com/read/29038193/recurrent-episodes-of-esophageal-candidiasis-without-dysphagia-post-guillain-barr%C3%A3-syndrome-an-unusual-presentation-of-achalasia
#1
Daniel Runggaldier, Michael Fried, Daniel Pohl
Here, we present a case of a 50-year-old male with a history of a Guillain-Barré-syndrome, who was referred to our clinic with recurrent esophageal candidiasis and long-standing intermittent retrosternal cramps for further evaluation. Other symptoms such as dysphagia, regurgitations and weight loss were denied, and prior repeated endoscopy was otherwise unremarkable. Using high resolution impedance manometry, we could demonstrate a panesophageal pressure increase on water swallows and complete aperistalsis of the tubular esophagus, indicating achalasia type II...
October 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29026592/yield-of-prolonged-wireless-ph-monitoring-in-achalasia-patients-successfully-treated-with-pneumatic-dilation
#2
Aurelio Mauro, Marianna Franchina, Alessandra Elvevi, Delia Pugliese, Andrea Tenca, Dario Conte, Roberto Penagini
BACKGROUND: Gastro-oesophageal reflux disease (GORD) is a long-term complication of achalasia treatments. The aim of our study was to evaluate the yield of prolonged wireless pH monitoring in patients with successfully treated achalasia and its influence on proton pump inhibitor (PPI) use. METHODS: Twenty-five patients with achalasia who underwent prolonged wireless pH monitoring after a successful treatment with pneumatic dilation were enrolled. pH variables were analysed in the first 24 hours of monitoring to determine if tracings were indicative of GORD; the same variables were analysed in the following 24-hour period in order to obtain a worst-day diagnosis of GORD...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026325/laparoscopic-esophageal-myotomy-versus-pneumatic-dilation-in-the-treatment-of-idiopathic-achalasia-a-meta-analysis-of-randomized-controlled-trials
#3
Ramkaji Baniya, Sunil Upadhaya, Jahangir Khan, Suresh Kumar Subedi, Tabrez Shaik Mohammed, Balvant K Ganatra, Ghassan Bachuwa
BACKGROUND: Achalasia is a primary esophageal motility disorder of unknown etiology associated with abnormalities in peristalsis and lower esophageal sphincter relaxation. The disease is incurable; however, definitive treatment procedures like pneumatic dilation (PD)/balloon dilation and laparoscopic esophageal myotomy (LEM) are performed to relieve dysphagia and related symptoms. Currently, there is paucity of data comparing the outcomes of these procedures. The aim of this meta-analysis is to compare the short- and long-term success rates of PD and LEM...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/29024314/clinicomanometric-factors-associated-with-clinically-relevant-esophagogastric-junction-outflow-obstruction-from-the-sandhill-high-resolution-manometry-system
#4
B G Song, Y W Min, H Lee, B-H Min, J H Lee, P-L Rhee, J J Kim
BACKGROUND: Integrated relaxation pressure (IRP) is a key metric for diagnosing esophagogastric junction outflow obstruction (EGJOO). However, its normal value might be different according to the manufacturer of high-resolution manometry (HRM). This study aimed to investigate optimal value of IRP for diagnosing EGJOO in Sandhill HRM and to find clinicomanometric variables to segregate clinically relevant EGJOO. METHODS: We analyzed 262 consecutive subjects who underwent HRM between June 2011 and December 2016 showing elevated median IRP (> 15 mm Hg) but did not satisfy criteria for achalasia...
October 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28951579/expert-consensus-document-advances-in-the-management-of-oesophageal-motility-disorders-in-the-era-of-high-resolution-manometry-a-focus-on-achalasia-syndromes
#5
REVIEW
Peter J Kahrilas, Albert J Bredenoord, Mark Fox, C Prakash Gyawali, Sabine Roman, André J P M Smout, John E Pandolfino
High-resolution manometry (HRM) and new analysis algorithms, summarized in the Chicago Classification, have led to a restructured classification of oesophageal motility disorders. This advance has led to increased detection of clinically relevant disorders, in particular achalasia. It has become apparent that the cardinal feature of achalasia - impaired lower oesophageal sphincter (LES) relaxation - can occur in several disease phenotypes: without peristalsis (type I), with pan-oesophageal pressurization (type II), with premature (spastic) distal oesophageal contractions (type III), or with preserved peristalsis (outlet obstruction)...
September 27, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28942656/use-of-self-expanding-nitinol-stents-in-the-pediatric-management-of-refractory-esophageal-caustic-stenosis
#6
Verónica Alonso, Devicka Ojha, Harsha Nalluri, Juan Carlos de Agustín
BACKGROUND: The treatment of recurrent esophageal stricture secondary to the ingestion of a caustic agent is an arduous task. Self-expanding esophageal stents may be an alternative to repeated endoscopic esophageal dilations. CASE REPORT: We present the case of a two-year-old male with a severe and long esophageal stricture successfully treated by the combination of dilations and stent placement. After five months of serial pneumatic dilations, three self-expanding nitinol stents internally coated with silicone were introduced through a gastrostomy, covering the entire esophagus...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28881875/efficacy-safety-and-long-term-outcome-of-serial-endoscopic-balloon-dilation-for-upper-gastrointestinal-crohn-s-disease-associated-strictures-a-cohort-study
#7
Amandeep Singh, Neha Agrawal, Satya Kurada, Rocio Lopez, Hermann Kessler, Jessica Philpott, Bo Shen, Bret Lashner, Florian Rieder
Background: Gastric and duodenal Crohn's disease [CD]-associated strictures are rare. Evidence on endoscopic balloon dilation [EBD] of upper gastrointestinal [GI] CD strictures is limited, in particular in respect to serial dilations. Methods: Prospective short- and long-term outcome data as well as complication rates on a cohort of upper GI CD-associated stricture dilations [stomach and duodenum] were collected from 1999 to 2015. Factors linked with clinical and technical success, long-term efficacy and complication rates were investigated...
September 1, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28877001/total-laparoscopic-approach-for-transhiatal-esophagectomy-and-gavriliu-s-esophagoplasty-in-children-with-caustic-esophageal-injuries
#8
Louise Montalva, Jérôme Viala, Daphné Michelet, Fernanda Frade, Hubert Lardy, Christine Vitoux, Arnaud Bonnard
BACKGROUND: Esophageal repair after caustic injury is a surgical challenge in children. The aim of this study was to report the first results of a total laparoscopic approach in transhiatal esophagectomy and esophageal replacement by an anisoperistaltic gastric tube. PATIENTS AND METHODS: A retrospective review of data from children operated on with a laparoscopic approach for transhiatal esophagectomy and Gavriliu's esophagoplasty between 2011 and 2015 was performed...
October 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#9
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28867969/an-overview-of-achalasia-and-its-subtypes
#10
Dhyanesh A Patel, Brian M Lappas, Michael F Vaezi
Achalasia is one of the most studied esophageal motility disorders. However, the pathophysiology and reasons that patients develop achalasia are still unclear. Patients often present with dysphagia to solids and liquids, regurgitation, and varying degrees of weight loss. There is significant latency prior to diagnosis, which can have nutritional implications. The diagnosis is suspected based on clinical history and confirmed by esophageal high-resolution manometry testing. Esophagogastroduodenoscopy is necessary to rule out potential malignancy that can mimic achalasia...
July 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28839899/poem-and-the-management-of-achalasia
#11
Matthew Banks, Rami Sweis
Achalasia is a rare oesophageal motility disorder predominantly causing dysphagia and regurgitation of food and fluids. Diagnosis is made typically after a combination of tests including endoscopy, barium swallow and oesophageal manometry. The advent of high-resolution manometry has led to the Chicago Classification which divided achalasia into three types. This improved the understanding of presentation, prognosis and might also help tailor therapy. Botulinum toxin has been shown to have good, but short-term efficacy...
April 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28770654/effects-of-intermittent-pneumatic-compression-on-leg-vascular-function-in-people-with-spinal-cord-injury-a-pilot-study
#12
Daniel P Credeur, Lena M Vana, Edward T Kelley, Lee Stoner, David R Dolbow
Objective The purpose of this pilot study was to determine whether 60 mins of intermittent pneumatic compression therapy (IPC) could acutely increase leg blood flow-induced shear stress and enhance vascular endothelial function in persons with spinal cord injury (SCI). Design Pretest with multiple posttests, within subject randomized control design. Setting University of Southern Mississippi, Spinal Cord Injury Research Program within the School of Kinesiology, recruiting from the local community in Hattiesburg, Jackson, and Gulfport, MS...
August 3, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#13
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28717439/achalasia-current-therapeutic-options
#14
REVIEW
Zubin Arora, Prashanthi N Thota, Madhusudhan R Sanaka
Achalasia is a chronic incurable esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis. Although rare, it is currently the most common primary esophageal motility disorder, with an annual incidence of around 1.6 per 100,000 persons and prevalence of around 10.8/100,000 persons. Symptoms of achalasia include dysphagia to both solids and liquids, regurgitation, aspiration, chest pain and weight loss. As the underlying etiology of achalasia remains unclear, there is currently no curative treatment for achalasia...
June 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28702097/pediatric-achalasia-single-center-study-of-interventional-treatment
#15
Andrzej Grabowski, Wojciech Korlacki, Michał Pasierbek, Roksana Pułtorak, Filip Achtelik, Maciej Ilewicz
INTRODUCTION: Esophageal achalasia is a rare entity in children. However, young age is a factor of failure of conservative treatment, emphasizing the role of surgery. In our institution laparoscopic Heller's cardiomyotomy is the chosen procedure for surgical treatment. AIM: To assess the outcome of surgery for achalasia treatment in children operated on in a single institution. MATERIAL AND METHODS: A retrospective analysis of consecutive patient records from the years 1997 to 2014 was performed...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28692204/the-new-generation-super-mini-percutaneous-nephrolithotomy-smp-system-a-step-by-step-guide
#16
Guohua Zeng, Wei Zhu, Yang Liu, Junhong Fan, Zhijian Zhao, Chao Cai
OBJECTIVE: To present our novel miniaturised endoscopic system and describe a step-by-step guide for successful implementation of the super-mini percutaneous nephrolithotomy (SMP). PATIENTS AND METHODS: The new-generation SMP endoscopic system consists of (i) a 40 000-pixel super-mini nephroscope with an 8.0-F outer diameter and 7.5-F inner diameter dismountable sheath, and (ii) a newly designed irrigation-suction sheath available in either 12 F or 14 F. The irrigation-suction sheath is a two-layered metal structure...
July 10, 2017: BJU International
https://www.readbyqxmd.com/read/28685156/road-map-fluoroscopy-successfully-guides-endoscopic-interventions-in-the-esophagus
#17
Jochen Weigt, Wilfried Obst, Arne Kandulski, Maciej Pech, Ali Canbay, Peter Malfertheiner
BACKGROUND AND STUDY AIMS : Road Map (RM) fluoroscopy is a radiological technique that enables visualization of anatomic structures using image subtraction at peak opacification. RM fluoroscopy has never previously been evaluated for use in endoscopy. The aim of this study was to evaluate the usefulness of RM in guiding endoscopic intervention in the esophagus. PATIENTS AND METHODS : This was a monocentric observational trial of consecutive patients with esophageal strictures in a university hospital...
July 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28617027/efficacy-of-peroral-endoscopic-myotomy-compared-with-other-invasive-treatment-options-for-the-different-esophageal-motor-disorders
#18
Fermín Estremera-Arévalo, Eduardo Albéniz, María Rullán, Irene Areste, Rosa Iglesias, Juan José Vila
INTRODUCTION: Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. METHODS: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined...
August 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28616407/peroral-endoscopic-myotomy-poem-for-treating-esophageal-motility-disorders
#19
REVIEW
Ian Wong, Simon Law
Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients...
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28602724/achalasia-treatment-outcomes-utilization-and-costs-a-population-based-study-from-the-united-states
#20
COMPARATIVE STUDY
Anne P Ehlers, Brant K Oelschlager, Carlos A Pellegrini, Andrew S Wright, Michael D Saunders, David R Flum, Hao He, Farhood Farjah
BACKGROUND: Randomized trials show that pneumatic dilation (PD) ≥30 mm and laparoscopic myotomy (LM) provide equivalent symptom relief and disease-related quality of life for patients with achalasia. However, questions remain about the safety, burden, and costs of treatment options. STUDY DESIGN: We performed a retrospective cohort study of achalasia patients initially treated with PD or LM (2009 to 2014) using the Truven Health MarketScan Research Databases. All patients had 1 year of follow-up after initial treatment...
September 2017: Journal of the American College of Surgeons
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