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Silent reflux

Omar N Atta, Hussein H Alhawari, Muayyad M Murshidi, Emad Tarawneh, Mujalli M Murshidi
INTRODUCTION: Ureterocele is a cystic dilatation of the lower part of the ureter. It is a congenital anomaly that is associated with other anomalies such as a duplicated system, and other diseases. It poses a great challenge owing to its numerous types and clinical presentations. Its incidence is 1 in every 4000 individuals. One of its presentations in the adult population is the presence of a stone, usually a solitary stone, inside the ureterocele. CASE PRESENTATION: We are reporting a case of an adult ureterocele complicated by a large calculus; managed endoscopically with transurethral deroofing of the ureterocele followed by cystolitholapaxy...
2018: International Journal of Surgery Case Reports
Susanne Vetter-Laracy, Borja Osona, Antonia Roca, Jose A Peña-Zarza, Jose A Gil, Joan Figuerola
OBJECTIVES: Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments...
April 2018: Pediatric Pulmonology
Kristen Capel, Richard Dee Shih
A previously healthy 55-year-old woman presented with worsening dyspnoea on exertion. The patient lived at altitude, did not smoke and had no exposure to occupational or environmental toxins. Her physical examination, including pulmonary, was unremarkable. Pulmonary function tests showed forced expiratory volume in 1 s/forced vital capacity ratio 74% predicted, diffusing capacity for carbon monoxide (DLCO) 92% predicted and residual volume 213% predicted. Rheumatological workup was negative. Chest radiograph showed hyperinflation without consolidation, and high-resolution chest CT showed mosaic attenuation with air trapping on expiratory imaging...
December 15, 2017: BMJ Case Reports
C Broers, J Tack, A Pauwels
BACKGROUND: When gastro-oesophageal reflux is causing symptoms or lesions in the oesophagus, this is referred to as gastro-oesophageal reflux disease (GERD). GERD can manifest itself through typical symptoms (heartburn, regurgitation) or may lead to extra-oesophageal symptoms. Extra-oesophageal manifestations of GERD gained increasing attention over the last decade, especially respiratory disorders, because of the prevalent co-occurrence with GERD. The role of GERD in the pathogenesis of respiratory disorders has become a topic of intense discussion...
January 2018: Alimentary Pharmacology & Therapeutics
Mohamed Samy Elhammady, Sudheer Ambekar, Roberto C Heros
Dural arteriovenous fistulas are abnormal communications, within the dural leaflets, between meningeal arteries and dural venous sinuses and/or subarachnoid veins. Although many fistulas remain clinically silent and do not require treatment, presence of cortical venous reflux, intracranial bleed, and intolerable symptoms are the main indications for treatment. A thorough understanding of the natural history is of prime importance in the decision making and management of these lesions. In this chapter we discuss the epidemiology and natural history of intracranial dural arteriovenous fistulae...
2017: Handbook of Clinical Neurology
Sung Eun Kim
No abstract text is available yet for this article.
May 15, 2017: Gut and Liver
Ariel Fernando Mariaca, Jose Manuel Valdueza, Christian Gaebel, Manuel Gomez-Choco
A 61-year-old man suffered an episode of transient confusion and anterograde amnesia after a Valsalva-related manoeuvre. The MRI diffusion weighted imaging (DWI) sequences showed a left hippocampal and two right parietal lesions that were deemed as acute. The MR angiography disclosed a high-grade stenosis in the right middle cerebral artery as was described by a transcranial colour-coded ultrasound as well. Ultrasound investigation of the jugular veins showed a right jugular venous reflux after a Valsalva manoeuvre...
April 22, 2017: BMJ Case Reports
Marco E Allaix, Fabrizio Rebecchi, Mario Morino, Francisco Schlottmann, Marco G Patti
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease of unknown origin that affects about 40,000 new patients every year in the USA. Albeit the disease is labelled as idiopathic, it is thought that pathologic reflux, often silent, plays a role in its pathogenesis through a process of microaspiration of gastric contents. AIMS: The aim of this study was to review the available evidence linking reflux to IPF, and to study the effect of medical and surgical therapy on the natural history of this disease...
July 2017: World Journal of Surgery
Christine Royston, Karna D Bardhan
INTRODUCTION: We present demographic differences across the gastro-oesophageal reflux disease (GORD) spectrum in a UK District General Hospital. PATIENTS AND METHODS: Data were prospectively collected over 37 years. At endoscopy patients were categorized as: erosive oesophagitis (EO), Barrett's oesophagus (BO) or nonerosive reflux disease (NER). Analysis 1: comparison of EO, BO and NER 1977-2001 when the database for GORD without BO closed. Analysis 2: demographic differences in oesophageal adenocarcinoma (OAC) in total BO population diagnosed 1977-2011...
June 2017: European Journal of Gastroenterology & Hepatology
Vicente Ortiz, Diego Alvarez-Sotomayor, Esteban Sáez-González, Francia Carolina Díaz-Jaime, Marisa Iborra, Julio Ponce, Vicente Garrigues
Background/Aims: To evaluate esophageal sensitivity to acid between morbidly obese (MO) patients and non-MO controls with abnormal esophageal acid exposure. Methods: We conducted a cross-sectional study of 58 patients: 30 MO (cases) and 28 non-MO (controls). Esophageal symptoms and esophageal sensitivity to 0.1 M hydrochloric acid solution (Bernstein test) were compared between MO and non-MO patients with a prior diagnosis of abnormal esophageal acid exposure. Results: MO patients were less symptomatic than non-MO controls (14% vs 96%; odds ratio [OR], 0...
May 15, 2017: Gut and Liver
Marek Chojnowski, Małgorzata Kobylecka, Marzena Olesińska
Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus...
2016: Reumatologia
Whittney A Warren, Scott S Dalane, Bryce D Warren, Paul G Peterson, Rodney D Boyum, William Kelly
A 64-year-old male former smoker with a history of prostate cancer presented to our pulmonary clinic, complaining of nonproductive cough for 10 years. Prior evaluation included treatment for upper airway cough syndrome and gastroesophageal reflux, stopping angiotensin-converting enzyme inhibitor, and initiation of inhaled β-agonists. Esophageal pH monitoring indicated silent reflux, and proton pump inhibitor therapy was started. He continued to cough and complain of dyspnea. Physical examination produced unremarkable results, with no evidence of lymphadenopathy...
September 2016: Chest
Ahmed Fathi Abdallah, Tarek El-Desoky, Khalid Fathi, Wagdy Fawzi Elkashef, Ahmed Zaki
Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing. Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants. Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Yohannes T Ghebre, Ganesh Raghu
The prevalence of abnormal acid gastroesophageal reflux (GER) is higher in patients with idiopathic pulmonary fibrosis (IPF) than in matched control subjects. Several studies demonstrated that more than one-third of patients with IPF have abnormal esophageal acid exposures. In addition, many of these studies indicate that the majority of patients with IPF have silent reflux with no symptoms of GER. Findings of abnormal reflux persist in a large proportion of patients with IPF placed on antacid therapy such as proton pump inhibitors (PPIs)...
June 15, 2016: American Journal of Respiratory and Critical Care Medicine
Eusebi Chiner, Mónica Llombart, Joan Valls, Esther Pastor, José N Sancho-Chust, Ada Luz Andreu, Manuel Sánchez-de-la-Torre, Ferran Barbé
BACKGROUND: We hypothesized that obstructive sleep apnea (OSA) can predispose individuals to lower airway infections and community-acquired pneumonia (CAP) due to upper airway microaspiration. This study evaluated the association between OSA and CAP. METHODS: We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group). The controls were matched according to age, sex and body mass index (BMI). A respiratory polygraph (RP) was performed upon admission for patients in both groups...
2016: PloS One
Sahoo Rameschandra, Vishak Acharya, Kunal, Tantry Vishwanath, Anand Ramkrishna, Preetam Acharya
BACKGROUND: There exists a complex interplay between asthma and gastroesophageal reflux disease. Both these diseases are known to aggravate each other and amelioration of one is necessary for the control of the other. There is a paucity of studies in Indian population on this subject. AIM: To evaluate the clinical features and the endoscopic findings of the upper gastrointestinal tract in patients with bronchial asthma. MATERIALS AND METHODS: Study was conducted at KMC group of hospitals, Mangalore in the Department of chest medicine in association with Department of gastroenterology...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
Robert J Yawn, Mohammad Fazili, Gwen Provo-Bell, Christopher T Wootten
INTRODUCTION: Bronchoalveolar lavage (BAL)-nucleated cell counts and the lipid-laden alveolar macrophage index (LLMI) have been investigated in predicting chronic aspiration as well as reflux esophagitis with variable results. To date, BAL neutrophil percentages and the LLMI have not been described in patients with eosinophilic esophagitis (EoE). OBJECTIVES: To evaluate BAL neutrophil percentages and LLMI levels in patients with EoE and compare these levels in patients with aerodigestive concerns without biopsy-proven EoE...
November 2015: International Journal of Pediatric Otorhinolaryngology
Peter J Kahrilas, Leila Kia
No abstract text is available yet for this article.
August 2015: Chest
Anna Morandi, Francesco Macchini, Andrea Zanini, Noemi Pasqua, Giorgio Farris, Lorena Canazza, Valerio Gentilino, Antonio Di Cesare, Ernesto Leva
Introduction Gastroesophageal reflux disease (GERD) is a frequent comorbidity after congenital diaphragmatic hernia (CDH) repair. Our aim was to evaluate the clinical and endoscopic prevalence of esophagitis in a long-term follow-up of CDH patients. Materials and Methods Patients operated on for posterolateral CDH and undergoing general anesthesia for concomitant pathologies between January and October 2013 were included in the study. GERD was investigated both clinically (Manterola questionnaire) and endoscopically...
June 2016: European Journal of Pediatric Surgery
Bettina Lange, Rainer Kubiak, Lucas M Wessel, Georg Kähler
PURPOSE: There is a lack of experience with fully covered self-expandable metal stents (SEMSs) for benign esophageal disorders in children. PATIENTS AND METHODS: Eleven children (six boys, five girls) with a median age of 30.5 months (range, 1 month-11 years) who underwent treatment with SEMSs for a benign esophageal condition between February 2006 and January 2014 were recruited to this retrospective study. Etiologies included esophageal atresia with postoperative stricture (n=4), recurrent fistula (n=1), and/or anastomotic leak (n=1), as well as iatrogenic perforation of the esophagus following endoscopy (n=4) or laparoscopic fundoplication (n=1)...
April 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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