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John pandolfino

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https://www.readbyqxmd.com/read/29081541/a-continuum-mechanics-based-musculo-mechanical-model-for-esophageal-transport
#1
Wenjun Kou, Boyce E Griffith, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
In this work, we extend our previous esophageal transport model using an immersed boundary (IB) method with discrete fiber-based structural model, to one using a continuum mechanics-based model that is approximated based on finite elements (IB-FE). To deal with the leakage of flow when the Lagrangian mesh becomes coarser than the fluid mesh, we employ adaptive interaction quadrature points to deal with Lagrangian-Eulerian interaction equations based on a previous work (Griffith and Luo [1]). In particular, we introduce a new anisotropic adaptive interaction quadrature rule...
October 1, 2017: Journal of Computational Physics
https://www.readbyqxmd.com/read/29037470/pathophysiology-of-gastroesophageal-reflux-disease
#2
Jan Tack, John E Pandolfino
The pathogenesis of gastroesophageal reflux disease (GERD) is complex and involves changes in reflux exposure, epithelial resistance, and visceral sensitivity. The gastric refluxate is a noxious material that injures the esophagus and elicits symptoms. Esophageal exposure to gastric refluxate is the primary determinant of disease severity. This exposure arises via compromise of the anti-reflux barrier and reduced ability of the esophagus to clear and buffer the refluxate, leading to reflux disease. However, complications and symptoms also occur in the context of normal reflux burden, when there is either poor epithelial resistance or increased visceral sensitivity...
October 13, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29016559/the-reflux-improvement-and-monitoring-trim-program-is-associated-with-symptom-improvement-and-weight-reduction-for-patients-with-obesity-and-gastroesophageal-reflux-disease
#3
Rena Yadlapati, John E Pandolfino, Olga Alexeeva, Dyanna L Gregory, Meredith R Craven, David Liebovitz, Abbey Lichten, Erin Seger, Moira Workman, Nora St Peter, Jenna Craft, Bethany Doerfler, Rajesh N Keswani
OBJECTIVES: Current healthcare systems do not effectively promote weight reduction in patients with obesity and gastroesophageal reflux disease (GERD). The Reflux Improvement and Monitoring (TRIM) program provides personalized, multidisciplinary, health education and monitoring over 6 months. In this study we aimed to (i) measure the effectiveness of TRIM on GERD symptoms, quality of life, and weight, and (ii) examine patient health beliefs related to TRIM. METHODS: This prospective mixed methods feasibility study was performed at a single center between September 2015 and February 2017, and included adult patients with GERD and a body mass index ≥30 kg/m(2)...
October 10, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28981080/improvement-in-esophageal-distensibility-in-response-to-medical-and-diet-therapy-in-eosinophilic-esophagitis
#4
Dustin A Carlson, Ikuo Hirano, Angelika Zalewski, Nirmala Gonsalves, Zhiyue Lin, John E Pandolfino
OBJECTIVES: We aimed to evaluate the effect of medical and diet therapies on esophageal distensibility assessed using the functional lumen imaging probe (FLIP) and the association of changes in esophageal distensibility with clinical outcomes in eosinophilic esophagitis (EoE). METHODS: Patients with EoE were evaluated with FLIP during endoscopy at baseline and following therapy without interval dilatation. Evaluation also included a validated patient-reported outcome (PRO; a positive PRO was considered at a 30% score improvement), mucosal biopsies, and scoring of endoscopic features of EoE...
October 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28951582/expert-consensus-document-advances-in-the-physiological-assessment-and-diagnosis-of-gerd
#5
REVIEW
Edoardo Savarino, Albert J Bredenoord, Mark Fox, John E Pandolfino, Sabine Roman, C Prakash Gyawali
GERD is a common condition worldwide. Key mechanisms of disease include abnormal oesophagogastric junction structure and function, and impaired oesophageal clearance. A therapeutic trial of acid-suppressive PPI therapy is often the initial management, with endoscopy performed in the setting of alarm symptoms and to exclude other conditions. If symptoms persist and endoscopy does not reveal evidence of GERD, oesophageal function tests are performed, including oesophageal manometry and ambulatory reflux monitoring...
November 2017: Nature Reviews. Gastroenterology & Hepatology
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
#6
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)...
November 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28911949/postprandial-high-resolution-impedance-manometry-identifies-mechanisms-of-nonresponse-to-proton-pump-inhibitors
#7
Rena Yadlapati, Michael Tye, Sabine Roman, Peter J Kahrilas, Katherine Ritter, John E Pandolfino
BACKGROUND & AIMS: Recognition of rumination and supragastric belching is often delayed as symptoms may be mistakenly attributed to gastroesophageal reflux disease. However, distinct from gastroesophageal reflux disease, rumination and supragastric belching are more responsive to behavioral interventions than to acid-suppressive and antireflux therapies. Postprandial high-resolution impedance manometry (PP-HRIM) is an efficient method to identify rumination and belches. We investigated the distribution of postprandial profiles determined by PP-HRIM, and identified patient features associated with postprandial profiles among patients with nonresponse to proton pump inhibitors (PPIs)...
September 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28895583/psychosocial-distress-and-quality-of-life-impairment-are-associated-with-symptom-severity-in-ppi-non-responders-with-normal-impedance-ph-profiles
#8
Rena Yadlapati, Michael Tye, Laurie Keefer, Peter J Kahrilas, John E Pandolfino
OBJECTIVES: Up to 50% of patients with reflux symptoms do not manifest a satisfactory symptom response to proton pump inhibitor (PPI) therapy. Our primary aim in this study was to identify factors associated with symptom perception among PPI non-responder phenotypes. METHODS: This prospective observational cohort study was performed from September 2014 to January 2017 at a single academic medical center and included PPI non-responders who underwent 24-h impedance-pH monitoring and completed a questionnaire set measuring patient-reported symptom severity, quality of life (QOL), and psychosocial distress...
September 12, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28469219/response-to-song-et-al
#9
Rena Yadlapati, John E Pandolfino, Bruce K Tan
No abstract text is available yet for this article.
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28426463/treatments-for-achalasia-in-2017-how-to-choose-among-them
#10
Peter J Kahrilas, John E Pandolfino
PURPOSE OF REVIEW: To review recent advances in achalasia diagnostics and therapeutics. RECENT FINDINGS: The cardinal feature of achalasia, impaired lower esophageal sphincter (LES) relaxation, can occur in association with varied patterns of esophageal contractility. The Chicago Classification distinguishes among these as follows: without contractility (type I), with panesophageal pressurization (type II), with premature (spastic) distal esophageal contractions (type III), or even with preserved peristalsis [esophagogastric junction (EGJ) outlet obstruction]...
July 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28378424/novel-3d-high-resolution-manometry-metrics-for-quantifying-esophagogastric-junction-contractility
#11
Zhiyue Lin, Yinglian Xiao, Yuwen Li, John E Pandolfino, Minhu Chen, Peter J Kahrilas
BACKGROUND: The esophagogastric junction (EGJ) is a complex sphincter composed of both the crural diaphragm (CD) and lower esophageal sphincter (LES). Three dimensional high-resolution manometry (3D-HRM) provides a dynamic 360° representation of EGJ pressure in which the CD has a distinct pressure signature. We aimed to develop 3D-HRM metrics to: (i) quantify the vigor of CD contractility, (ii) best eliminate the CD contribution and thereby isolate the LES component of EGJ contractility, and (iii) compare these metrics with conventional HRM metric of EGJ contractility...
August 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28344064/white-paper-aga-optimal-strategies-to-define-and-diagnose-gastroesophageal-reflux-disease
#12
Michael F Vaezi, John E Pandolfino, Marcelo F Vela, Nicholas J Shaheen
No abstract text is available yet for this article.
August 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28212976/functional-lumen-imaging-probe-for-the-management-of-esophageal-disorders-expert-review-from-the-clinical-practice-updates-committee-of-the-aga-institute
#13
REVIEW
Ikuo Hirano, John E Pandolfino, Guy E Boeckxstaens
The functional luminal imaging probe is a Food and Drug Administration-approved measurement tool used to measure simultaneous pressure and diameter to guide management of various upper gastrointestinal disorders. Additionally, this tool is also approved to guide therapy during bariatric procedures and specialized esophageal surgery. Although it has been commercially available since 2009 as the endolumenal functional lumen imaging probe (EndoFLIP), the functional luminal imaging probe has had limited penetrance into clinical settings outside of specialized centers...
March 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28195178/recurrence-of-barrett-s-esophagus-is-rare-following-endoscopic-eradication-therapy-coupled-with-effective-reflux-control
#14
Srinadh Komanduri, Peter J Kahrilas, Kumar Krishnan, Tim McGorisk, Kiran Bidari, David Grande, Laurie Keefer, John Pandolfino
OBJECTIVES: Recent data suggest that effective control of gastroesophageal reflux improves outcomes associated with endoscopic eradication therapy (EET) for Barrett's esophagus (BE). However, the impact of reflux control on preventing recurrent intestinal metaplasia and/or dysplasia is unclear. The aims of the study were: (a) to determine the effectiveness and durability of EET under a structured reflux management protocol and (b) to determine the impact of optimizing anti-reflux therapy on achieving complete eradication of intestinal metaplasia (CE-IM)...
April 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28119934/ineffective-esophageal-motility-progressing-into-distal-esophageal-spasm-and-then-type-iii-achalasia
#15
Salih Samo, Dustin A Carlson, Peter J Kahrilas, John E Pandolfino
The clinical significance of minor esophageal motility disorders is unclear, though they typically carry a benign course. Distal esophageal spasm progressing to achalasia has been reported, although it appears to be rare. We report a case of a patient with dysphagia and chest pain who was found to have ineffective esophageal motility on high-resolution manometry, which developed into distal esophageal spasm and then progressed to type III achalasia.
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28050744/simulation-studies-of-the-role-of-esophageal-mucosa-in-bolus-transport
#16
Wenjun Kou, John E Pandolfino, Peter J Kahrilas, Neelesh A Patankar
Based on a fully coupled computational model for esophageal transport, we analyzed the role of the mucosa (including the submucosa) in esophageal bolus transport and how bolus transport is affected by mucosal stiffness. Two groups of studies were conducted using a computational model. In the first group, a base case that represents normal esophageal transport and two hypothetical cases were simulated: (1) esophageal mucosa replaced by muscle and (2) esophagus without mucosa. For the base case, the geometric configuration of the esophageal wall was examined and the mechanical role of mucosa was analyzed...
June 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28028689/the-quality-of-care-for-gastroesophageal-reflux-disease
#17
REVIEW
Rena Yadlapati, Lara Dakhoul, John E Pandolfino, Rajesh N Keswani
Improving the quality of healthcare delivery is a cornerstone of modern medical care shared between all stakeholders. However, effectively improving quality requires both an understanding of the tenets of healthcare quality and how they relate to an individual disease process. This is especially important for common diseases, such as gastroesophageal reflux disease (GERD), where wide variations in practice exist. The high prevalence of GERD coupled with wide variation in clinical approach results in significant economic burden and poor quality of care...
March 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27979048/introduction-of-clinical-practice-update-committee-articles
#18
REVIEW
Lawrence S Friedman, John M Inadomi, Anthony M Kalloo, David A Katzka, Lawrence S Kim, Johannes Koch, David Lieberman, Gary R Lichtenstein, Joseph K Lim, John E Pandolfino, Andrea S Shin, Madelin R Siedler
No abstract text is available yet for this article.
January 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27725650/evaluation-of-esophageal-motility-utilizing-the-functional-lumen-imaging-probe
#19
Dustin A Carlson, Peter J Kahrilas, Zhiyue Lin, Ikuo Hirano, Nirmala Gonsalves, Zoe Listernick, Katherine Ritter, Michael Tye, Fraukje A Ponds, Ian Wong, John E Pandolfino
OBJECTIVES: Esophagogastric junction (EGJ) distensibility and distension-mediated peristalsis can be assessed with the functional lumen imaging probe (FLIP) during a sedated upper endoscopy. We aimed to describe esophageal motility assessment using FLIP topography in patients presenting with dysphagia. METHODS: In all, 145 patients (aged 18-85 years, 54% female) with dysphagia that completed upper endoscopy with a 16-cm FLIP assembly and high-resolution manometry (HRM) were included...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27698386/high-resolution-impedance-manometry-metrics-of-the-esophagogastric-junction-for-the-assessment-of-treatment-response-in-achalasia
#20
Dustin A Carlson, Zhiyue Lin, Peter J Kahrilas, Joel Sternbach, Eric S Hungness, Nathaniel J Soper, Michelle Balla, Zoe Listernick, Michael Tye, Katherine Ritter, Jenna Craft, Jody D Ciolino, John E Pandolfino
OBJECTIVES: We aimed to evaluate the value of novel high-resolution impedance manometry (HRIM) metrics, bolus flow time (BFT), and esophagogastric junction (EGJ) contractile integral (CI), as well as EGJ pressure (EGJP) and the integrated relaxation pressure (IRP), as indicators of treatment response in achalasia. METHODS: We prospectively evaluated 75 patients (ages 19-81, 32 female) with achalasia during follow-up after pneumatic dilation or myotomy with Eckardt score (ES), timed-barium esophagram (TBE), and HRIM...
December 2016: American Journal of Gastroenterology
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