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https://www.readbyqxmd.com/read/29670781/-candida-krusei-empyema-thoracis-a-community-acquired-infection-requiring-a-high-index-of-suspicion
#1
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
#2
Andrew Ming Liang Ong, Vikneswaran Namasivayam, Yu Tien Wang
BACKGROUND: Esophagogastric junction outflow obstruction (EGJOO) may be due to anatomical abnormalities but it is unclear how to evaluate them after high resolution manometry (HRM). We aimed to determine 1) clinical and HRM parameters differentiating anatomical EGJOO from functional EGJOO, 2) investigations chosen and yield for anatomical EGJOO and 3) 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
#3
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
#4
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...
February 23, 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29435819/expanding-role-of-third-space-endoscopy-in-the-management-of-esophageal-diseases
#11
REVIEW
Dennis Yang, Peter V Draganov
OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders...
March 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29377271/-management-of-achalasia-cardia-expert-consensus-statements
#12
REVIEW
Mohan Ramchandani, D Nageshwar Reddy, Zaheer Nabi, Radhika Chouhan, Amol Bapaye, Shobhna Bhatia, Nilay Mehta, Pankaj Dhawan, Adarsh Chaudhary, Uday Ghoshal, Mathew Philip, Horst Neuhaus, Jacques Deviere, Haruhiro Inoue
Achalasia cardia (AC) is a frequently encountered motility disorder of the esophagus resulting from an irreversible degeneration of neurons. Treatment modalities are palliative in nature and there is no curative treatment available for AC as of now. Significant advancements have been made in the management of AC over last decade. The introduction of high resolution manometry (HRM) and per-oral endoscopic myotomy (POEM) have strengthened the diagnostic and therapeutic armamentarium of AC. HRM allows for the characterization of the type of achalasia which in turn has important therapeutic implications...
January 29, 2018: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29344561/self-expandable-metal-stent-placement-in-a-child-for-treatment-of-achalasia-after-failed-heller-myotomy
#13
Roberto Gugig, Guillermo Muñoz Jurado, Clifton Huang, Roberto Oleas, Carlos Robles-Medranda
Background and study aims  Childhood achalasia treatment remains inconclusive. What is next after myotomy failure? Repeated pneumatic-dilation put patients at greater risk of perforation with possible symptom recurrence. We report on a 12-year-old patient with a 1-year history of achalasia whom underwent Heller myotomy with fundoplication and recurred with symptoms 1 week after surgery. Pneumatic dilatation was considered but not done because of the risk of esophageal perforation. The decision was made to place a fully covered self-expanding metallic stent (FC-SEMS) for 3 months, which resolved the stenosis as confirmed by esophagram...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29319024/what-to-do-when-heller-s-myotomy-fails-pneumatic-dilatation-laparoscopic-remyotomy-or-peroral-endoscopic-myotomy-a-systematic-review
#14
REVIEW
Sonia Fernández-Ananín, Arnulfo F Fernández, Carmen Balagué, David Sacoto, Eduardo Maria Targarona
BACKGROUND: Surgical treatment of achalasia fails in 10%-20% of patients. The most frequent responsible cause is the performance of an incomplete myotomy at primary surgery. The treatment when the failure happens is not well defined. In this study, we review and evaluate the possible treatments to be carried out when surgical myotomy fails. We define its benefits and results, with the purpose of defining a therapeutic algorithm. MATERIALS AND METHODS: The systematic review was performed following the guidelines established by the Meta-analysis of Observational Studies in Epidemiology statement...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29319022/thoracoscopic-oesophagectomy-for-end-stage-achalasia
#15
Vaibhav Kumar Varshney, Subhash Chandra Soni, Manju Kumari, Pawan Kumar Garg, Ashok Puranik
Achalasia cardia is an oesophageal motility disorder characterised by aperistalsis and failure of relaxation of the lower oesophageal sphincter. The management is predominantly palliative with focus on addressing the sphincter that involves either pneumatic dilatation or Heller myotomy which relieves dysphagia in the majority of the cases. End-stage achalasia (ESA) is characterised by failed myotomy, massively dilated and tortuous oesophagus with nutritional deterioration due to progressive dysphagia and vomiting...
January 10, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29295508/additively-manufactured-pneumatically-driven-skin-electrodes
#16
Martin Schubert, Martin Schmidt, Paul Wolter, Hagen Malberg, Sebastian Zaunseder, Karlheinz Bock
Telemedicine focuses on improving the quality of health care, particularly in out-of-hospital settings. One of the most important applications is the continuous remote monitoring of vital parameters. Long-term monitoring of biopotentials requires skin-electrodes. State-of-the-art electrodes such as Ag/AgCl wet electrodes lead, especially during long-term application, to complications, e.g., skin irritations. This paper presents a low-cost, on-demand electrode approach for future long-term applications. The fully printed module comprises a polymeric substrate with electrodes on a flexible membrane, which establishes skin contact only for short time in case of measurement...
December 23, 2017: Materials
https://www.readbyqxmd.com/read/29206815/novel-intra-procedural-distensibility-measurement-accurately-predicts-immediate-outcome-of-pneumatic-dilatation-for-idiopathic-achalasia
#17
P I Wu, M M Szczesniak, P I Craig, L Choo, J Engelman, B Terkasher, J Hui, I J Cook
OBJECTIVES: Often 2-3 graduated pneumatic dilatations (PD) are required to treat achalasia as there is no current intra-procedural predictor of clinical response. Distensibility measurements using functional lumen imaging probe (FLIP) may provide an intra-procedural predictor of outcome. Our aim was to determine the optimal criterion for esophagogastric junction (EGJ) distensibility measurements during PD that predicts immediate clinical response. METHODS: EGJ distensibility was prospectively measured using FLIP immediately pre- and post-PD...
February 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29201795/pneumatic-balloon-dilatation-for-achalasia-cardia-outcome-complications-success-and-long-term-follow-up
#18
Sudhir J Gupta, Nitin R Gaikwad, Amol R Samarth, Sonal R Gattewar
Background: Achalasia is a chronic disease that can be managed with effective endoscopic modalities. Aim: To evaluate the effectiveness of single setting of pneumatic balloon dilatation for achalasia and assess the long-term success and outcomes. Materials and methods: This is a retrospective study of all achalasia patients who underwent pneumatic balloon dilatation at our institute. Patients who could be contacted were inquired regarding their symptoms and dysphagia-free interval after dilatation...
July 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29155168/improved-assessment-of-bolus-clearance-in-patients-with-achalasia-using-high-resolution-impedance-manometry
#19
Dustin A Carlson, Claire A Beveridge, Zhiyue Lin, Michelle Balla, Dyanna Gregory, Michael Tye, Katherine Ritter, Peter J Kahrilas, John E Pandolfino
BACKGROUND & AIMS: Esophageal retention is typically evaluated by timed barium esophagram in patients treated for achalasia. Esophageal bolus clearance can also be evaluated using high-resolution impedance manometry. We evaluated the associations of conventional and novel high-resolution impedance manometry metrics, esophagram, and patient-reported outcomes (PRO) in achalasia. METHODS: We performed a prospective study of 70 patients with achalasia (20-81 years old, 30 female) treated by pneumatic dilation or myotomy who underwent follow-up evaluations from April 2013 through December 2015 (median 12 months after treatment; range, 3-183 months)...
November 15, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29144018/navigated-retrograde-endoscopic-myotomy-rem-for-the-treatment-of-therapy-resistant-achalasia
#20
K D Pham, R F Havre, T Langø, E F Hofstad, G A Tangen, R Mårvik, T Pham, O H Gilja, J G Hatlebakk, A Viste
BACKGROUND: In achalasia, muscle spasm may involve the proximal esophagus. When the muscle spasm is located in the proximal esophagus, conventional per oral endoscopic myotomy (POEM) may not be sufficient to relieve symptoms. In this paper, we describe retrograde endoscopic myotomy (REM) as a novel approach to perform myotomy of the proximal esophagus, with the application of a navigation tool for anatomical guidance during REM. We aim to evaluate the feasibility and safety of REM and usefulness of the navigation during REM...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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