MedWorm: Acid Reflux

Barrett's metaplasia: molecular mechanisms and nutritional influences.

Biochemical Society Transactions — Sun, 21 Mar 2010 03:09:29 +0100

Authors: Slack JM, Colleypriest BJ, Quinlan JM, Yu WY, Farrant MJ, Tosh D Barrett's metaplasia is discussed in the context of a general theory for the formation of metaplasias based on developmental biology. The phenotype of a particular tissue type becomes established during embryonic development by the expression of a specific set of transcription factors. If this combination becomes altered, then the tissue type can be altered. Such events may occur by mutation or by environmental effects on gene expression, normally within the stem cell population of the tissue. A macroscopic patch of metaplastic tissue will arise only if the new gene activity state is self-sustaining in the absence of its original causes, and if the new tissue type can outgrow the parent tissue type. An important ...

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The role of acid and bile reflux in oesophagitis and Barrett's metaplasia.

Biochemical Society Transactions — Sun, 21 Mar 2010 03:09:06 +0100

Authors: Souza RF The precise mechanisms whereby gastro-oesophageal reflux disease causes reflux oesophagitis and Barrett's oesophagus are not clear, even though these diseases have been known to be linked for many years. Recent studies indicate a role for the reflux-induced inflammatory response of oesophageal squamous epithelial cells and the immune cells in the pathogenesis of reflux oesophagitis. Although reflux oesophagitis commonly heals with oesophageal squamous cell regeneration, in some individuals the oesophagus heals through the process of metaplasia, a condition termed Barrett's oesophagus. Recent studies indicate that individual differences in the reflux-mediated response of oesophageal squamous epithelial cells in the type of immune response and/or in signalling pathways ...

Cellular origin of Barrett's metaplasia and oesophageal stem cells.

Biochemical Society Transactions — Sun, 21 Mar 2010 03:08:40 +0100

Authors: Barbera M, Fitzgerald RC Barrett's oesophagus is a metaplastic pre-malignant disorder and the only established precursor lesion for oesophageal adenocarcinoma. Barrett's oesophagus develops when the normal stratified squamous epithelium of the lower oesophagus is replaced by a columnar lined mucosa with intestinal differentiation, usually in the context of chronic gastro-oesophageal reflux disease. The cellular and molecular mechanisms by which this metaplastic transformation occurs are poorly understood. Abnormal differentiation of multipotent stem cells in the squamous oesophagus, triggered by exposure to refluxate, is one potential mechanism. These stem cells could be located in the basal layer of the squamous oesophageal epithelium and/or in the neck region of the oesophag...

Medical versus surgical management for gastro-oesophageal reflux disease (GORD) in adults.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: There is evidence that laparoscopic fundoplication surgery is more effective than medical management for the treatment of GORD at least in the short to medium term. Surgery does carry some risk and whether the benefits of surgery are sustained in the long term remains uncertain. Treatment decisions for GORD should be based on patient and surgeon preference. PMID: 20238321 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

A review of the potential applications and controversies of non-invasive testing for biomarkers of aspiration in the lung transplant population

Clinical Transplantation — Sat, 20 Mar 2010 00:00:00 +0100

Davis CS, Gagermeier J, Dilling D, Alex C, Lowery E, Kovacs EJ, Love RB, Fisichella PM. A review of the potential applications and controversies of non-invasive testing for biomarkers of aspiration in the lung transplant population.Clin Transplant 2010 DOI: 10.1111/j.1399-0012.2010.01243.x.© 2010 John Wiley & Sons A/S.Abstract: Despite improvements in one-yr survival following lung transplantation, five-yr survival lags significantly behind the transplantation of other solid organs. The contrast in survival persists despite advancements in anti-rejection regimens, suggesting a non-alloimmune mechanism to chronic lung transplant failure. Notably, markers of aspiration have been demonstrated in bronchoalveolar lavage (BAL) fluid concurrent with bronchiolitis obliterans syndrome (BOS). This ...

Fundoplication After Laparoscopic Heller Myotomy for Esophageal Achalasia: What Type?

Journal of Gastrointestinal Surgery — Fri, 19 Mar 2010 06:52:10 +0100

Abstract Because of the high success rate of minimally invasive surgery, a radical shift in the treatment algorithm of esophageal achalasia has occurred. Today, a laparoscopic Heller myotomy is the preferred treatment modality for achalasia. This remarkable change is due to the recognition by gastroenterologists and patients that a laparoscopic Heller myotomy gives better and more durable results than pneumatic dilatation and intrasphincteric injection of botulinum toxin injection, while it is associated to a short hospital stay and a fast recovery time. While there is agreement about the need of a fundoplication in conjunction to the myotomy, some questions still remain about the type of fundoplication: Should the fundoplication be total or partial, and in case a partial ...

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Anticentromere antibody positive Sjogren's Syndrome: a retrospective descriptive analysis

Arthritis Research and Therapy — Fri, 19 Mar 2010 00:00:00 +0100

Conclusions: ACA+/SS has a clinical phenotype intermediate between ACA-/SS and SSc and shows little tendency to evolve to SSc. (Source: Arthritis Research and Therapy)

Postoperative recurrence factors of GERD in the elderly after laparoscopic fundoplication

Esophagus — Thu, 18 Mar 2010 15:10:37 +0100

Conclusions The risk factors for recurrence were different between nonelderly patients and elderly patients. The laparoscopic Collis-Nissen methods should be indicated with caution in elderly GERD patients with a short esophagus. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10388-009-0220-1Authors Nobuo Omura, Jikei University School of Medicine Department of Surgery 3-25-8 Nishi-shinbashi, Minato-ku Tokyo 105-8461 JapanHideyuki Kashiwagi, Jikei University School of Medicine Department of Surgery 3-25-8 Nishi-shinbashi, Minato-ku Tokyo 105-8461 JapanFumiaki Yano, Jikei University School of Medicine Department of Surgery 3-25-8 Nishi-shinbashi, Minato-ku Tokyo 105-8461 JapanKazuto Tsuboi, Jikei University School of Medicine Department of Surgery 3...

Induced Opening of the Gastroesophageal Junction Occurs at a Lower Gastric Pressure in Gerd Patients and in Hiatal Hernia Subjects than in Normal Control Subjects

Gastroenterology Research and Practice — Thu, 18 Mar 2010 14:25:05 +0100

Conclusions. GEJ opening is induced at a significantly lower pressure in subjects with hiatal hernia and in patients with gastroesophageal reflux disease than in normal volunteers. (Source: Gastroenterology Research and Practice)

Fundoplication Surgery Effective in the Short to Medium Term for GERD Treatment

About Heartburn / Acid Reflux — Thu, 18 Mar 2010 00:00:00 +0100

A new Cochrane Systematic Review study has shown that stomach wrap (fundoplication) surgeries may be more effective than acid suppression medication over the short to medium term for the treatment of gastroesophageal reflux disease (GERD). This new study has shown a more pronounced improvement of symptoms shortly after this type of surgery than the patients had with medication treatment (such as the use of proton pump inhibitors). The authors of the study reviewed data from four trials, which together involved 1232 participants. Their drew their conclusions from the findings from follow-up on the participants for up to one year after treatment. They found that fundoplication operations performed by keyhole surgery were more effective at reducing the symptoms of GERD over this first year....

Inflammatory Mediators in Gastroesophageal Reflux Disease (GERD): Impact on Esophageal Motility, Fibrosis and Carcinogenesis.

American Journal of Physiology. Gastrointestinal and Liver Physiology — Thu, 18 Mar 2010 00:00:00 +0100

Authors: Rieder F, Biancani P, Harnett KM, Yerian LM, Falk GW Gastroesophageal reflux disease (GERD) is one of the most common problems in clinical practice today. It is widely believed that functional and structural abnormalities of the gastroesophageal junction as well as an abnormal exposure to gastroduodenal contents are the main contributors to its pathogenesis. Novel findings of the inflammatory process in GERD suggest a far more complex process involving multifaceted inflammatory mechanisms. This review summarizes knowledge about the expression of inflammatory mediators in GERD, their potential cellular sources and provides an integrated concept of disease pathogenesis. In addition we evaluate the contribution of inflammatory mediators to well-known complications of GERD, namely...

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Severe acid reflux: Stomach wraps effective in short to medium term

ScienceDaily Headlines — Wed, 17 Mar 2010 16:16:50 +0100

Stomach wrap operations may be more effective than acid suppression tablets in the treatment of severe acid reflux, according to a new review. The study shows a more pronounced improvement in symptoms shortly after surgery than with drug treatment. (Source: ScienceDaily Headlines)

Stomach Wraps Effective In Short To Medium Term For Severe Acid Reflux

Health News from Medical News Today — Wed, 17 Mar 2010 11:00:00 +0100

Stomach wrap operations may be more effective than acid suppression tablets in the treatment of severe acid reflux, according to a new Cochrane Systematic Review. The study shows a more pronounced improvement in symptoms shortly after surgery than with drug treatment. Gastro-oesophageal reflux disease (GORD) is a common chronic disease in which acid reflux causes heartburn, acid regurgitation, vomiting and difficulty swallowing. GORD can be treated by changes to diet and acid suppression tablets, but in the most severe cases a surgical operation called a fundoplication can be carried out... (Source: Health News from Medical News Today)

Stomach Wrap Operations for Acid Reflux

Disabled World — Wed, 17 Mar 2010 03:25:30 +0100

Severe acid reflux: Stomach wraps effective in short to medium term... (Source: Disabled World)

Does obesity produce a distinct asthma phenotype?

Journal of Applied Physiology — Tue, 16 Mar 2010 14:01:59 +0100

Obesity and asthma prevalence have been increasing over the past decade. Epidemiological evidence demonstrates that obesity results in an increased risk of developing incident asthma. Even modest levels of increased weight increase asthma risk. Recently published data suggest that obese asthma patients may represent a distinct phenotype of asthma. Obese asthma patients demonstrate increased asthma severity, as indicated by increased exacerbations and decreased asthma control; however, they do not appear to have increased airway cellular inflammation. It seems likely that obesity does not contribute to asthma through conventional Th type 2-mediated inflammatory pathways but, rather, through separate mechanisms that are specific to the obese state. This may explain the variable responses of ...

The heartburn healer: New op can cure the agony of acid reflux - with no scarring

the Mail online | Health — Tue, 16 Mar 2010 08:29:31 +0100

Alex Harding, 16, from Sheffield, was one of the first to have a new, less invasive operation to treat the problem. (Source: the Mail online | Health)

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Mechanism of gastroesophageal reflux in patients with obstructive sleep apnea syndrome

Neurogastroenterology and Motility — Tue, 16 Mar 2010 00:00:00 +0100

Conclusions & Inferences In OSA patients, sleep-GER was mainly caused by TLESR, but not by negative intra-esophageal pressure due to OSA. (Source: Neurogastroenterology and Motility)

Efficacy, tolerability and pharmacokinetics of a modified release formulation of ADX10059, a negative allosteric modulator of metabotropic glutamate receptor 5: an esophageal pH-impedance study in healthy subjects

Neurogastroenterology and Motility — Tue, 16 Mar 2010 00:00:00 +0100

Conclusions & Inferences ADX10059 decreased reflux episodes in healthy subjects. The MR formulation is suitable for longer-term treatment to evaluate symptom control in GERD patients. (Source: Neurogastroenterology and Motility)

Peptic Ulcers

About Heartburn / Acid Reflux — Tue, 16 Mar 2010 00:00:00 +0100

Whether you suspect you have a peptic ulcer or you are newly diagnosed, you will want to know the symptoms, the causes, and the treatment of peptic ulcers. Peptic Ulcer Screening Quiz Symptoms of Peptic Ulcers Causes of Peptic Ulcers Diagnosing Peptic Ulcers Peptic Ulcer Treatment When Surgery is Needed For Peptic Ulcers Complications of Peptic Ulcers Peptic Ulcers Warning Signs Peptic Ulcers in Children Peptic Ulcers originally appeared on About.com Heartburn / GERD on Tuesday, March 16th, 2010 at 20:50:57.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Hiatal Hernias

About Heartburn / Acid Reflux — Tue, 16 Mar 2010 00:00:00 +0100

Whether you suspect you have a hiatal hernia or you are newly diagnosed, you will want to know the symptoms, the causes, and the treatment of hiatal hernias. Hiatal Hernia Screening Quiz Symptoms of a Hiatal Hernia What can cause a hiatal hernia? Diagnosing Hiatal Hernias Treating Hiatal Hernias Hiatal Hernia Diet Tips Paraesophageal Hiatal Hernia Hiatal Hernias originally appeared on About.com Heartburn / GERD on Tuesday, March 16th, 2010 at 20:40:08.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Adverse effects of proton pump inhibitors

Best Practice & Research. Clinical Gastroenterology — Sat, 13 Mar 2010 14:21:59 +0100

Proton pump inhibitors (PPI) are very effective drugs used largely in acid related disorders. During the last years concern have been raised regarding their overutilisation in benign condition, such as gastroesophageal reflux disease. The debate focussed also on the risk of adverse events related to long term use of PPI. Apart of the case of Helicobacter Pylori (H. Pylori) positive patients, in whose long term acid suppression lead to the development of corpus predominant atrophic gastritis, precursor of cancer; the other assumed adverse events, have never been demonstrated in prospective studies. The attention should move towards the appropriate prescription of PPI, rather than the fear adverse effects of PPI. In fact, in clinical practise, PPI are often prescribed in patients without a s...

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Adverse effects of drugs on the esophagus

Best Practice & Research. Clinical Gastroenterology — Sat, 13 Mar 2010 14:21:57 +0100

Given the function of the esophagus to transport orally ingested solids and liquids into the stomach there are several medications with adverse effect on esophageal structures and function. Various pharmacologic agents can induce esophageal injury, promote gastroesophageal reflux by decreasing lower esophageal sphincter tone or affect esophageal perception and motility. The risks of bisphosphonates, doxycycline, ferrous sulfate, ascorbic acid, aspirin/NSAIDs and chemotherapeutic agents to induce esophageal lesions have been documented in case reports and short series. In addition to direct mucosal injury, many commonly used medications including nitroglycerins, anticholinergics, β-adrenergic agonists, aminophyllines, and benzodiazepines promote/facilitate gastroesophageal reflux by reduci...

Overlapping gastroesophageal reflux disease and irritable bowel syndrome: Increased dysfunctional symptoms.

World Journal of Gastroenterology : WJG — Fri, 12 Mar 2010 17:04:45 +0100

CONCLUSION: This finding shows that in overlapping GERD and IBS, other functional abnormalities of the GI tract are also highly prevalent, suggesting a common underlying dysfunction. PMID: 20222167 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

'My wife suffers from a foul taste in her mouth that wakes her up at night'

Telegraph Health — Fri, 12 Mar 2010 13:55:03 +0100

Telegraph Readers' Clinic: send your health and wellbeing questions to our panel of experts. (Source: Telegraph Health)

Extraction of Nitraria tangutorum seed lipid using different extraction methods and analysis of its fatty acids by HPLC fluorescence detection and on-line MS identification

European Journal of Lipid Science and Technology — Fri, 12 Mar 2010 00:00:00 +0100

The seed lipid of Nitraria tangutorum was extracted by supercritical carbon dioxide extraction, microwave-assisted reflux extraction, ultrasound-assisted extraction, or solvent reflux extraction. The experimental parameters of supercritical carbon dioxide extraction including pressure, temperature, particle size, and extraction time were investigated. A facile and sensitive method for the simultaneous determination of 30 saturated and 9 unsaturated fatty acids by HPLC with fluorescence detection after pre-column derivatization was developed. Fatty acid derivatives were separated on a reversed-phase Eclipse XDB-C8 column in conjunction with gradient elution. Identification of fatty acid derivatives was carried out by on-line APCI/MS in positive-ion mode. Excellent quantitative linear respon...

Characterization of cardiorespiratory events following gastroesophageal reflux in preterm infants

Journal of Perinatology — Thu, 11 Mar 2010 00:00:00 +0100

Authors: J Di Fiore, M Arko, B Herynk, R Martin & A M Hibbs (Source: Journal of Perinatology)

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The Potential Therapeutic Effect of Melatonin in Gastro-Esophageal Reflux Disease

Medscape Gastroenterology Headlines — Tue, 09 Mar 2010 16:33:33 +0100

Can melatonin, alone or in combination with a proton pump inhibitor, relieve symptoms of GERD? BMC Gastroenterology (Source: Medscape Gastroenterology Headlines)

The effect of argon plasma coagulation ablation on esophageal motility and chemoreceptor sensitivity in Barrett's esophagus patients

Diseases of the Esophagus — Tue, 09 Mar 2010 00:00:00 +0100

In conclusion, we have shown no substantive changes in esophageal motility after ablation of Barrett's esophagus cells, but have demonstrated reduced sensitivity to reflux type solutions. (Source: Diseases of the Esophagus)

Anti-Hypertensive Drugs To Enhance Esophageal Contraction

Health News from Medical News Today — Mon, 08 Mar 2010 10:00:00 +0100

Nifedipine, a calcium-channel blocker, was shown to decrease lower esophageal sphincter pressure and increase esophageal acid exposure time, while atenolol, a b1 blocker, was shown to inhibit relaxation of the smooth muscle of the esophagus. However, the influence of these anti-hypertensive drugs on the segment of esophageal body contraction using high-resolution manometry was not fully investigated. A research team from Japan observed esophageal body contraction using high-resolution manometry with 36 intraruminal transducers... (Source: Health News from Medical News Today)

Anti-Hypertensive Drugs To Enhance Esophageal Contraction

GastroIntestinal News From Medical News Today — Mon, 08 Mar 2010 10:00:00 +0100

Laryngeal mucosa: Its susceptibility to damage by acid and pepsin

The Laryngoscope — Mon, 08 Mar 2010 00:00:00 +0100

This study aims to quantitate damage caused to laryngeal tissue by acid alone, and acid and pepsin, and also to determine if the extent of this damage depends on the tissue site.Prospective translational research study.An excised porcine laryngeal damage model in a small Ussing chamber was used to measure the effect of pepsin and acid on five sites (ventricles, vocal folds, posterior commissure, supraglottic, and subglottic mucosa). The tissue samples were incubated on the lumenal side for 1 hour with pH 2 and 4 HCl, pH 2 plus 1 mg/mL pepsin, and pH 4 plus 1 mg/mL pepsin. Damage was assessed by changes in absorbance of the bathing solution at optical density (OD) 260 nm and OD 280 nm and by measurement of released DNA compared to tissues bathed in pH 7.4 buffer. Damage was also assessed hi...

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Factors influencing intercellular spaces in the rat esophageal epithelium.

World Journal of Gastroenterology : WJG — Sun, 07 Mar 2010 00:00:00 +0100

CONCLUSION: Acute stress and aspirin can induce DIS of the esophageal epithelium in rats, and it is not correlated with acid reflux. PMID: 20205275 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

Poll: Has a Pharmacy Ever Given You the Wrong Medication?

About Heartburn / Acid Reflux — Sun, 07 Mar 2010 00:00:00 +0100

(Source: About Heartburn / Acid Reflux)

When Biotech Layoffs Come (XNPT)

BioHealth Investor — Fri, 05 Mar 2010 19:34:55 +0100

When conglomerates and consumer products lay off workers and employees, shareholders generally cheer the company for saving money and cutting costs by figuring out productivity measures that milk more output per employee. That leaves more income and ultimately brings more dividends down the road. But biotech firms are far from being thought of in the same light. These are growth stories and investors generally get more excited about expanding operations. So here comes XenoPort, Inc. (NASDAQ: XNPT) announcing on a Friday that HALF of its workers just won the pink-slip lotto ticket from the HR department. Today just officially became National Employee Morale Day at XenoPort. XenoPort just announced a restructuring plan today that more narrowly focuses its R&D pipeline, and one ...

FDA Okays New GERD Drug Name

MedPage Today Gastroenterology — Fri, 05 Mar 2010 13:13:04 +0100

WASHINGTON (MedPage Today) -- The FDA approved a name change for the gastroesophageal reflux disease (GERD) treatment dexlansoprazole (Kapidex) due to confusion over its marketed name with other, very different drugs. (Source: MedPage Today Gastroenterology)

Kapidex to Change Name in U.S. to Avoid Dispensing Errors

About Heartburn / Acid Reflux — Thu, 04 Mar 2010 00:00:00 +0100

After receiving reports of dispensing errors between Kapidex and the products Casodex® (bicalutamide) and Kadian® (morphine sulfate extended-release), Takeda Pharmaceuticals North America, Inc., in coordination with the U.S. Food and Drug Administration (FDA), determined that, in the interest of patient safety, a name change would be the best way to minimize future medication errors with Kapidex. Kapidex will be marketed in the United States under the new product trade name DEXILANT While it is important for drug companies, doctors, and pharmacies to minimize the risk of medication errors, it is also important for patients to double-check their medications. Check the labels to verify the name of the medication is correct and the directions are the same. Look at the medication. Do your...

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An update on gastro-oesophageal reflux including endoscopic treatment

NLH - Gastroenterology & Liver Diseases - Events — Wed, 03 Mar 2010 14:29:56 +0100

(Source: NLH - Gastroenterology & Liver Diseases - Events)

Can intraoperative manometry during laparoscopic fundoplication predict postoperative dysphagia?

Surgical Endoscopy — Wed, 03 Mar 2010 08:51:13 +0100

Conclusion Intraoperative manometry may be a useful tool compared with postoperative manometry in identifying patients who may experience postfundoplication dysphagia. Content Type Journal ArticleDOI 10.1007/s00464-010-0949-6Authors M. Khan, Royal Hallamshire Hospital Department of Surgery Glossop Road Sheffield S10 2JF UKA. Smythe, Royal Hallamshire Hospital Department of Surgery Glossop Road Sheffield S10 2JF UKK. Elghellal, Royal Hallamshire Hospital Department of Surgery Glossop Road Sheffield S10 2JF UKR. Ackroyd, Royal Hallamshire Hospital Department of Surgery Glossop Road Sheffield S10 2JF UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

Prospective randomized controlled trial of an injectable esophageal prosthesis versus a sham procedure for endoscopic treatment of gastroesophageal reflux disease

Surgical Endoscopy — Wed, 03 Mar 2010 08:51:11 +0100

Conclusions The GK procedure was associated with some serious but infrequent complications. No statistically significant difference in outcomes was observed between the treatment and control groups at 6 months compared with baseline. Content Type Journal ArticleDOI 10.1007/s00464-009-0784-9Authors Paul Fockens, Academic Medical Center, University of Amsterdam P.O. Box 22700 1100 DE Amsterdam the NetherlandsLawrence Cohen, The Mount Sinai School of Medicine New York NY USASteven A. Edmundowicz, Washington University School of Medicine 660 S. Euclid Ave. Campus Box 8124 St. Louis MO 63110 USAKenneth Binmoeller, California Pacific Medical Center San Francisco CA USARichard I. Rothstein, Dartmouth Medical School, Dartmouth Hitchcock Medical Center 1 Medical Center D...

Management of Recurrence of Symptoms of Gastroesophageal Reflux Disease: Synergistic Effect of Rebamipide with 15 mg Lansoprazole

Digestive Diseases and Sciences — Wed, 03 Mar 2010 08:05:09 +0100

Conclusions Combination therapy with rebamipide and lansoprazole appears to be highly effective in preventing recurrence of symptoms during long-term maintenance treatment for GERD. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-010-1166-9Authors Norimasa Yoshida, Japanese Red Cross Kyoto Daiichi Hospital Gastroenterology 15-749 Honmachi Higashiyama-ku Kyoto 605-0981 JapanKazuhiro Kamada, Japanese Red Cross Kyoto Daiichi Hospital Gastroenterology 15-749 Honmachi Higashiyama-ku Kyoto 605-0981 JapanNaoya Tomatsuri, Japanese Red Cross Kyoto Daiichi Hospital Gastroenterology 15-749 Honmachi Higashiyama-ku Kyoto 605-0981 JapanTakahiro Suzuki, Japanese Red Cross Kyoto Daiichi Hospital Gastroenterology 15-749 Honmachi Higashiyama-ku Kyoto 605-0981 J...

Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies

Journal of Policy and Practice in Intellectual Disabilities — Wed, 03 Mar 2010 00:00:00 +0100

The authors examined the health-related literature on aging and intellectual disabilities (ID) published since 1999, with specific focus on examining findings on age-associated health risk factors, such as cardiovascular, gastrointestinal, and musculoskeletal system health issues, and age-related oral health. They also examined studies of lifestyle health risks, primarily the contributions to overweight or obesity. Although the review revealed varying differences in the prevalence of health risk factors, significant evidence is emerging that cardiovascular disease is as prevalent among people with ID and is as common a cause of death as in the general population. However, the review showed that the variations in prevalence were culturally dependent. Digestive system problems were evident w...

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Helicobacter pylori and its role in vocal folds' minimal lesions

The Clinical Respiratory Journal — Tue, 02 Mar 2010 00:00:00 +0100

Conclusion: HP is a common finding in cases of VFML; its eradication should be considered when dealing with a patient with VFML. Please cite this paper as: Tiba M, Fawaz S and Osman H. Helicobacter pylori and its role in vocal folds' minimal lesions. Clin Respir J 2010; DOI:10.1111/j.1752-699X.2009.00182.x. (Source: The Clinical Respiratory Journal)

Validation of the PAGI-SYM and PAGI-QOL among healing and maintenance of erosive esophagitis clinical trial participants

Quality of Life Research — Mon, 01 Mar 2010 18:12:03 +0100

Conclusion The findings of this study support the consideration of the PAGI-QOL and PAGI-SYM in future clinical trials and in the general EE population. Content Type Journal ArticleDOI 10.1007/s11136-010-9620-xAuthors Kathleen W. Wyrwich, United BioSource Corporation 7101 Wisconsin Avenue, Suite 600 Bethesda MD 20814 USAReema Mody, Takeda Pharmaceuticals North America, Inc. Deerfield IL USALois M. Larsen, TAP Pharmaceutical Products Inc. Deerfield IL USAMisun Lee, TAP Pharmaceutical Products Inc. Deerfield IL USANeesha Harnam, United BioSource Corporation 7101 Wisconsin Avenue, Suite 600 Bethesda MD 20814 USADennis A. Revicki, United BioSource Corporation 7101 Wisconsin Avenue, Suite 600 Bethesda MD 20814 USA Journal Quality of Life ResearchOnline ISSN 1573-26...

Proximal Esophageal pH Monitoring: Improved Definition of Normal Values and Determination of a Composite pH Score

Journal of the American College of Surgeons — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: In a large population of normal subjects, we have defined the normal values and calculated a composite pH score for proximal esophageal acid exposure. The total percent time pH < 4 was similar to previously published normal values, but the number of reflux episodes was greater. (Source: Journal of the American College of Surgeons)

Relationship between Silent Gastroesophageal Reflux and Food Sensitization in Infants and Young Children with Recurrent Wheezing.

J Korean Med Sci — Mon, 01 Mar 2010 00:00:00 +0100

In conclusion, about half of infants and young children with recurrent wheezing and no gastrointestinal symptoms have silent GER. The silent GER may not contribute to food sensitization in infants and young children with recurrent wheezing. PMID: 20191042 [PubMed - in process] (Source: J Korean Med Sci)

Gastroesophageal Reflux Disease and Obesity

Gastroenterology Clinics of North America — Mon, 01 Mar 2010 00:00:00 +0100

Gastroesophageal reflux disease (GERD) is a common condition, with multifactorial pathogenesis, affecting up to 40% of the population. Obesity is also common. Obesity and GERD are clearly related, both from a prevalence and causality association. GERD symptoms increase in severity when people gain weight. Obese patients tend to have more severe erosive esophagitis and obesity is a risk factor for the development of Barrett's esophagus and adenocarcinoma of the esophagus. Patients report improvement in GERD when they lose weight and there are several reports suggesting a decrease in GERD symptoms after bariatric surgery. At present, there is little evidence that obesity has any effect on the efficacy of antisecretory therapy, with conflicting data on surgical outcomes. This review attempts ...

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CICADA: Cough in Children and Adults: Diagnosis and Assessment. Australian Cough Guidelines summary statement.

Med J Aust — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Gibson PG, Chang AB, Glasgow NJ, Holmes PW, Katelaris P, Kemp AS, Landau LI, Mazzone S, Newcombe P, Van Asperen P, Vertigan AE Cough is a common and distressing symptom that results in significant health care costs from medical consultations and medication use. Cough is a reflex activity with elements of voluntary control that forms part of the somatosensory system involving visceral sensation, a reflex motor response and associated behavioural responses. At the initial assessment for chronic cough, the clinician should elicit any alarm symptoms that might indicate a serious underlying disease and identify whether there is a specific disease present that is associated with chronic cough. If the examination, chest x-ray and spirometry are normal, the most common diagnoses in AD...

Journal of Pediatric Surgery — Mon, 01 Mar 2010 00:00:00 +0100

The loss of normal anatomical barriers in neonates with congenital diaphragmatic hernia (CDH) can predispose children to gastroesophageal reflux (GER). In an attempt to improve postoperative feeding, the authors have added a modified anterior fundoplication to restore natural gastric and esophageal positioning. (Source: Journal of Pediatric Surgery)

William H. Harridge Memorial Lecture: “Progress and its unintended consequences”

American Journal of Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Remarkable advances in care have transpired, but improved survival may lead to new problems not previously experienced. Appropriate modifications in patient care and long-term follow-up are essential to maintain excellent survival and lessen the adverse consequences of treatment to ensure good quality of life. (Source: American Journal of Surgery)

Esophageal hamartoma as an unusual cause of neonatal apnea and bradycardia.

Ear, Nose and Throat Journal — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Coury J, Steinfeld J, Zwillenberg D, Zwillenberg S Esophageal hamartoma is a rare entity, as only 7 cases have been previously reported in the English-language literature. Common symptoms include dysphagia, weight loss, and vomiting. Life-threatening airway obstruction can also occur. Because of the nonspecific nature of the symptoms, patients with these dangerous polyps are often misdiagnosed as having more common entities such as gastroesophageal reflux, peptic ulcer disease, or achalasia. Most of these tumors are missed on esophagoscopy and radiologic studies, and they can go undiagnosed for years. We diagnosed an esophageal hamartoma in an infant girl who had first presented when she was 8 days old with symptoms of apnea and cyanosis. The patient had undergone a multitude ...

PTSD, Gastrointestinal Problems Affecting Trade Center Workers

Clinical Psychiatry News — Mon, 01 Mar 2010 00:00:00 +0100

SAN DIEGO — Workers who responded to the scene and cleaned up after the Sept. 11, 2001, attack on New York's World Trade Center continued to have high rates of mental health disorders and gastroesophageal reflux disease 4 to 6 years later, a study of 697 patients has shown. (Source: Clinical Psychiatry News)

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New Cancer-Fighting Strategy That May Help Barrett's Esophagus Patients

About Heartburn / Acid Reflux — Sun, 28 Feb 2010 00:00:00 +0100

A new study out of UCSF Helen Diller Family Comprehensive Cancer Center, one which has been studying the immune system, has identified a set of targets and bio-markers to battle solid tumors. Findings of this study center on discovery of signaling molecules that are major players in a biochemical mechanism linking certain actions of B cells to solid tumor growth. Lisa Coussens, PhD, lead author of the study, stated that the most notable implication of the study is that a drug in use for more than decade to treat non-Hodgkin's lymphoma, which is a cancer of the B cells, might be effective against other solid tumors. What does this mean for those individuals diagnosed with Barrett's esophagus? Biochemical and cellular studies during the past decade have shown that inflammation can promote ...

Scarless Surgery to Treat Achalasia

About Heartburn / Acid Reflux — Sun, 28 Feb 2010 00:00:00 +0100

Surgeons at UC San Diego Medical Center have performed the nation's first incision-free myotomy, a procedure to treat achalasia, a disorder which causes difficulty swallowing (dysphagia), vomiting and chest pain. This surgery is performed through the mouth Santiago Horgan, MD, chief of minimally invasive surgery and director of the UC San Diego Center for the Future of Surgery, stated, "With dramatic advancements in medical devices, we can now perform complex surgeries through the mouth with no external incisions. What we are seeing is the evolution of laparoscopic surgery into more specialized procedures that require no incisions at all." Laparoscopic surgery to treat achalasia is called the Heller Myotomy, a two hour procedure requiring up to six small incisions in the abdomen to divid...

Effects of anti-hypertensive drugs on esophageal body contraction.

World Journal of Gastroenterology : WJG — Thu, 25 Feb 2010 17:40:48 +0100

CONCLUSION: Among the anti-hypertensive drugs tested, atenolol enhanced esophageal motor activity, which was in contrast to nifedipine. PMID: 20180238 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

Incidence of use of acid suppression medications in infants with oral clefting.

The Cleft Palate-Craniofacial Journal — Wed, 24 Feb 2010 00:00:00 +0100

CONCLUSIONS: The incidence of anti-GERD pharmacologic therapy among infants with oral clefts (9%) is significantly higher than that of the general pediatric population (<1%). Furthermore, palatal clefts impart a greater risk of GERD symptoms than clefts of the alveolus, lip, or nose. In order to minimize the long term consequences of GERD, a standardized interdisciplinary clinical protocol [truncated]. Key Words: Oral Clefts, Feeding, Regurgitation, and Reflux. PMID: 20187739 [PubMed - as supplied by publisher] (Source: The Cleft Palate-Craniofacial Journal)

A rehabilitation program for patients with gastroesophageal cancer—a pilot study

Supportive Care in Cancer — Tue, 23 Feb 2010 07:55:52 +0100

Conclusion The Cancer Nutrition and Rehabilitation program offers a multidimensional, holistic treatment approach emphasizing the patient as an individual. Participation in a cancer rehabilitation program ameliorates symptoms, improves nutrition, decreases global distress, and increases physical activities. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00520-010-0828-7Authors Martin Robert Chasen, McGill University Gerald Bronfman Centre for Clinical Research in Oncology 546 Pine Avenue West Montreal QC H2W 1S6 CanadaRavi Bhargava, McGill University Gerald Bronfman Centre for Clinical Research in Oncology 546 Pine Avenue West Montreal QC H2W 1S6 Canada Journal Supportive Care in CancerOnline ISSN 1433-7339Print ISSN 0941-4355 (Source: Supp...

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Laparoscopic tailored Nissen fundoplication

Surgical Endoscopy — Tue, 23 Feb 2010 07:08:12 +0100

Conclusions Our new procedure is very safe and effective to create a proper Nissen fundoplication. In addition, our preliminary findings highlight the feasibility of precise localization of suture points without the need to measure the circumference of the esophagus and that LNF could be performed without a bougie. Content Type Journal ArticleDOI 10.1007/s00464-010-0936-yAuthors Hitoshi Idani, Fukuyama City Hospital Department of Surgery 5-23-1 Zao-cho Fukuyama City, Hiroshima 721-8511 JapanShinya Asami, Fukuyama City Hospital Department of Surgery 5-23-1 Zao-cho Fukuyama City, Hiroshima 721-8511 JapanTakashi Ishikawa, Fukuyama City Hospital Department of Surgery 5-23-1 Zao-cho Fukuyama City, Hiroshima 721-8511 JapanShinichiro Kubo, Fukuyama City Hospital Department...

Modulation of growth in human esophageal adenocarcinoma cells by group IIa secretory phospholipase A2

The Journal of Thoracic and Cardiovascular Surgery — Mon, 22 Feb 2010 17:07:58 +0100

Conclusions: Group IIa secretory phospholipase A2 appears significant in growth and proliferation of human esophageal adenocarcinoma cells. Secretory phospholipase A2 inhibition should be studied further regarding potential chemopreventive and therapeutic properties in esophageal adenocarcinoma. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Long-term proton pump induced hypergastrinaemia does induce lineage-specific restitution but not clonal expansion in benign Barrett's oesophagus in vivo

Gut — Mon, 22 Feb 2010 10:58:23 +0100

Conclusion While the short-term effects of gastrin enhance epithelial restitution in Barrett's oesophagus (but not squamous mucosa) there is no clinical evidence that Barrett's oesophagus length expands over time. This study, which is the largest and longest term randomised controlled trial of gastrin biology in Barrett's oesophagus, is further proof of the clinical safety of PPI therapy. (Source: Gut)

Acid and weakly acidic solutions impair mucosal integrity of distal exposed and proximal non-exposed human oesophagus

Gut — Mon, 22 Feb 2010 10:58:23 +0100

Conclusions The human oesophageal mucosa is very sensitive to continuous exposure with acidic and weakly acidic solutions. In spite of the presence of intraluminal acid and DIS, healthy subjects did not experience heartburn, suggesting that NERD patients should have other critical factors underlying their symptoms. (Source: Gut)

Urological and Nephrological Findings of Renal Ectopia

The Journal of Urology — Mon, 22 Feb 2010 00:00:00 +0100

Conclusions: Our data suggest no adverse effects on blood pressure or kidney function in children with renal ectopia. However, periodic followup seems warranted, at least until young adulthood. (Source: The Journal of Urology)

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Gastric emptying evaluation in children with erosive gastroesophageal reflux disease

Pediatric Surgery International — Sun, 21 Feb 2010 06:54:22 +0100

Conclusion Delayed gastric emptying is not associated with erosive esophagitis in children with GERD, when compared to controls. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-010-2579-4Authors Rodrigo Strehl Machado, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP) Pediatric Gasteroenterology Division, Department of Pediatrics Rua Pedro de Toledo 441 São Paulo 04039-031 BrazilÉrica Yamamoto, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP) Pediatric Gasteroenterology Division, Department of Pediatrics Rua Pedro de Toledo 441 São Paulo 04039-031 BrazilFrancy Reis da Silva Patrício, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP) Department of Pathology Rua Pedr...

New Endoscopic Treatment May Spare Barrett's Esophagus Patients From Surgery

Health News from Medical News Today — Sat, 20 Feb 2010 08:00:00 +0100

Early tumor formation in Barrett's esophagus (BE) can be effectively and safely treated with radiofrequency ablation (RFA), in combination with prior endoscopic removal of visible lesions, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. "Barrett's esophagus is the most important risk factor for the development of esophageal cancer, but there is no generally accepted management strategy for patients with early neoplasia in Barrett's esophagus," said Jacques J.G. H. M... (Source: Health News from Medical News Today)

New Endoscopic Treatment May Spare Barrett's Esophagus Patients From Surgery

Cancer / Oncology News From Medical News Today — Sat, 20 Feb 2010 08:00:00 +0100

Endoscopic and manometric position-related characteristics of the normal gastroesophageal junction

Surgical Endoscopy — Sat, 20 Feb 2010 06:50:48 +0100

Conclusions In normal individuals, the GEV exhibits a temporary weakening when moved from LLD to upright position. However, the normal GEV is able to maintain LESP in upright position. In contrast, in patients with early GERD, a greater degree of valve incompetence at the GEJ is seen. This is correlated manometrically with a trend toward shorter LES length and lower LESP when moved from LLD to upright position. This upright incompetence of the GEV may be one of the earliest manifestations in GERD. Proper evaluation of the GEV should include endoscopic evaluation in both recumbent and upright positions. Further studies are needed to evaluate the corresponding changes of the GEV in varying degrees of symptomatic GERD. Content Type Journal ArticleDOI 10.1007/s00464-01...

WITHDRAWN: Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease.

Cochrane Database of Systematic Reviews — Sat, 20 Feb 2010 04:58:05 +0100

CONCLUSIONS: The findings in this review support the long-term treatment of oesophagitis to prevent relapse, both endoscopically and symptomatically. Healing doses of PPIs are more effective than all other therapies, although there is an increase in overall adverse effects compared to placebo, and headache occurrence compared to H2RAs. H2RAs prevent relapse more effectively than placebo, demonstrating a role for PPI-intolerant patients. Prokinetics and sucralfate both show benefit over placebo, but the former is no longer licenced. There is only limited data for ENRD. PMID: 20166065 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

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Supradiaphragmatic acid pocket position linked to GERD pathogenesis

MedWire News - Gastroenterology — Fri, 19 Feb 2010 14:23:52 +0100

Researchers have found that supradiaphragmatic positioning of the postprandial acid pocket, which is largely determined by the presence of a hiatal hernia, represents an important mechanism promoting acid reflux into the distal esophagus. (Source: MedWire News - Gastroenterology)

Radiofrequency Ablation Treatment for Barrett's Esophagus

About Heartburn / Acid Reflux — Fri, 19 Feb 2010 00:00:00 +0100

As I wrote in May 2009 about radiofrequency ablation treatment for Barrett's esophagus, a condition that could lead to esophageal cancer, a study conducted showed it's success rate over traditional treatments. A new study, conducted by the European Academic Medical Center and published in Clinical Gastroenterology and Hepatology, further showed the effectiveness of this treatment. "Barrett's esophagus is the most important risk factor for the development of esophageal cancer, but there is no generally accepted management strategy for patients with early neoplasia in Barrett's esophagus," said Jacques J.G. H. M. Bergman, MD, of the Academic Medical Center and lead author of the study. "Combining endoscopic resection with complete removal of residual Barrett cells with radiofrequency ablati...

The novel, peripherally acting GABA(B) receptor agonist lesogaberan (AZD3355) inhibits acid reflux and reduces esophageal acid exposure as measured with 24-h pHmetry in dogs.

European Journal of Pharmacology — Fri, 19 Feb 2010 00:00:00 +0100

Authors: Brändén L, Fredriksson A, Harring E, Jensen J, Lehmann A While patients with symptoms of gastroesophageal reflux disease generally respond well to proton pump inhibitors, 20-30% continue to experience troublesome symptoms. In such cases, agents that target transient lower esophageal sphincter (LES) relaxation may be useful as add-on therapy to proton pump inhibitors. The GABA(B) receptor agonist baclofen inhibits transient LES relaxation but it is not an ideal agent due to central nervous system activity. Lesogaberan (AZD3355) is a peripherally acting GABA(B) receptor agonist with limited central nervous system activity that inhibits transient LES relaxation in dogs. In the present study, the comparative effects of lesogaberan (7micromol/kg) and baclofen (2.8mumol/kg...

Upper Esophageal Sphincter during Transient Lower Esophageal Sphincter Relaxation: Effects of Reflux Content & Posture.

American Journal of Physiology. Gastrointestinal and Liver Physiology — Thu, 18 Feb 2010 00:00:00 +0100

Conclusion: The nature of UES response during TLESR, relaxation or contraction, is related to the posture and the constituents of GER. We propose that the rapid rate of esophageal pressure increase associated with air reflux determines the UES relaxation response to GER. PMID: 20167874 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Gastrointestinal and Liver Physiology)

The Burden of Disrupting Gastro-Oesophageal Reflux Disease: A Database Study in US and European Cohorts

Clinical Drug Investigation — Wed, 17 Feb 2010 14:10:10 +0100

(Source: Clinical Drug Investigation)

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Impressive renal damage after acute pyelonephritis in a child

Pediatric Nephrology — Mon, 15 Feb 2010 17:59:59 +0100

This report demonstrates that one episode of acute pyelonephritis can lead to severe renal scarring. Whereas antenatal lesions are thought to have a stronger role in the causal pathway for reflux nephropathy than is UTI in addition to VUR, this observation reminds us that UTI can truly play an important role in damaging kidneys. Content Type Journal ArticleCategory Brief ReportDOI 10.1007/s00467-010-1461-xAuthors Sandrine Leroy, AP-HP, Pierre et Marie Curie University Department of Pediatric Nephrology, Armand Trousseau Hospital Paris FranceMartin Chalumeau, AP–HP, Université Paris-Descartes Department of Pediatrics, Saint-Vincent-de-Paul Hospital Paris FranceTim Ulinski, AP-HP, Pierre et Marie Curie University Department of Pediatric Nephrology, Armand Trousseau Hospital Paris F...

Gastroesophageal reflux disease and graft failure after lung transplantation

Transplantation Reviews — Mon, 15 Feb 2010 00:00:00 +0100

Abstract: In spite of advances in lung transplantation, the median survival after lung transplant remains less than 5 years, an outcome that is significantly worse than other solid organ transplants. Efforts to understand the unique hurdles faced in lung transplant have revealed gastroesophageal reflux disease (GERD) as a risk factor for ultimate graft failure. The link between GERD and chronic lung rejection parallels the association between GERD and other forms of lung disease such as idiopathic pulmonary fibrosis. Understanding how GERD predisposes to graft failure is an important issue as it may lead to therapies such as surgical correction that aim to lessen the exposure of the pulmonary epithelium to gastric contents. Here, we review the link between GERD and lung disease and discuss...

Are There Alternative Treatments for Heartburn?

About Heartburn / Acid Reflux — Sun, 14 Feb 2010 00:00:00 +0100

Many people who suffer from heartburn -- whether occasionally (once a month) or chronically (2 or more times a week) -- want natural remedies for heartburn. While there are drug treatment options available, such as antacids, H2 blockers, and proton pump inhibitors (PPIs), they'd rather try home remedies first, or as an alternative if they have been taking medications for some time. Read more.... Related Resources: Baking soda Apple vinegar cider DGL Licorice Are There Alternative Treatments for Heartburn? originally appeared on About.com Heartburn / GERD on Sunday, February 14th, 2010 at 15:30:52.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Changing What and How You Eat Can Help Prevent Heartburn

About Heartburn / Acid Reflux — Sun, 14 Feb 2010 00:00:00 +0100

There are some foods that can trigger different responses from the body that allow heartburn to happen. Are you avoiding these foods? Read more.... Related Resources: Meal planning tips to prevent heartburn Dining out guide for heartburn sufferers Heartburn friendly recipes Changing What and How You Eat Can Help Prevent Heartburn originally appeared on About.com Heartburn / GERD on Sunday, February 14th, 2010 at 15:28:24.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Lifestyle Modifications Can Help You Prevent Heartburn

About Heartburn / Acid Reflux — Sun, 14 Feb 2010 00:00:00 +0100

One of the first steps doctors advise their patients to take when treating chronic heartburn is to make lifestyle changes. Read more.... Related Resources: Preventing nighttime heartburn Preventing heartburn during pregnancy Preventing heartburn at school Lifestyle Modifications Can Help You Prevent Heartburn originally appeared on About.com Heartburn / GERD on Sunday, February 14th, 2010 at 15:21:05.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

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Gastroesophageal reflux symptoms in infants in a rural population: longitudinal data over the first six months

BMC Pediatrics - Latest articles — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: Symptoms of gastroesophageal reflux as measured by the I-GERQ-R decrease with age in the first six months of life in otherwise healthy infants; however the I-GERQ-R may have difficulty differentiating gastroesophageal reflux disease from colic in those under 3 months of age. (Source: BMC Pediatrics - Latest articles)

Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease

Alimentary Pharmacology and Therapeutics — Wed, 10 Feb 2010 14:06:54 +0100

Conclusions Based on the currently available literature, it appears that there is no direct evidence that carbonated beverages promote or exacerbate GERD. (Source: Alimentary Pharmacology and Therapeutics)

Urinary tract infection in children

Clinical Evidence — Tue, 09 Feb 2010 23:00:00 +0100

New evidence; conclusions changed for: Prophylactic antibiotics One systematic review (search date 2006) and two subsequent RCTs added, which compared antibiotic prophylaxis versus no treatment. The systematic review included children with primary vesicoureteric reflux (VUR), and identified one RCT; the first subsequent RCT included children with febrile UTI and primary VUR; and the second subsequent RCT included children with a febrile UTI, with or without VUR. The systematic review and subsequent RCTs found no significant differences in the recurrence of febrile UTI and parenchymal defects between antibiotic prophylaxis and no treatment. One further RCT added, which compared trimethoprim–sulfamethoxazole versus nitrofurantoin in children with a previ...

Shape Of Barrett's Epithelium Effects Prevalence Of Erosive Esophagitis

Health News from Medical News Today — Mon, 08 Feb 2010 09:00:00 +0100

Barrett's epithelium is recognized as a complication of erosive esophagitis and is the pre-malignant condition for adenocarcinoma of the esophagus. A research team from Yokohama City University School of Medicine hypothesized that some macroscopic features of Barrett's epithelium might be useful for identifying a subgroup with a high risk for the development of esophageal adenocarcinoma. Their study was published on January 28, 2010 in the World Journal of Gastroenterology. They enrolled 869 patients who underwent endoscopy during a health checkup at their hospital... (Source: Health News from Medical News Today)

Shape Of Barrett's Epithelium Effects Prevalence Of Erosive Esophagitis

Cancer / Oncology News From Medical News Today — Mon, 08 Feb 2010 09:00:00 +0100

Barrett's epithelium is recognized as a complication of erosive esophagitis and is the pre-malignant condition for adenocarcinoma of the esophagus. A research team from Yokohama City University School of Medicine hypothesized that some macroscopic features of Barrett's epithelium might be useful for identifying a subgroup with a high risk for the development of esophageal adenocarcinoma... (Source: Cancer / Oncology News From Medical News Today)

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Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy

HIV Medicine — Mon, 08 Feb 2010 00:00:00 +0100

The current literature suggests that there has been a decrease in opportunistic diseases among HIV-infected patients since the widespread introduction of highly active antiretroviral therapy (HAART) in 1995. The aim of the study was to investigate the impact of HAART and CD4 lymphocyte count on diseases of the upper gastrointestinal (UGI) tract, digestive symptoms, and endoscopic and histological observations. A review of 706 HIV-infected patients who underwent GI endoscopy was undertaken. The cohort was divided into three groups: group 1 (G1), pre-HAART, consisting of 239 patients who underwent endoscopy between January 1991 and December 1994; group 2 (G2), early HAART, consisting of 238 patients who underwent endoscopy between January 1999 and December 2002; and group 3 (G3), recent HAAR...

Injection volumes of dextranomer/hyaluronic acid are increasing in the endoscopic management of vesicoureteral reflux

Pediatric Surgery International — Sat, 06 Feb 2010 17:59:37 +0100

Conclusion Over the study period there was an increase in the number of vials of dextranomer/hyaluronic acid being used per patient to treat children with VUR. This practice may improve success rates but will increase the cost of treatment due to the inherent expense of the material. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-010-2558-9Authors Mathew D. Sorensen, University of Washington School of Medicine Department of Urology 1959 NE Pacific Street Box 356510 Seattle WA 98195 USAMartin A. Koyle, Seattle Children’s Hospital and Regional Medical Center, University of Washington School of Medicine Division of Pediatric Urology, Department of Urology Seattle WA 98105 USACharles A. Cowan, Seattle Children’s Hospital and Regional Medical C...

H. Pylori Eradication in Peptic Ulcer Disease May up Risk of GERD

Medscape Gastroenterology Headlines — Fri, 05 Feb 2010 16:06:25 +0100

In patients with peptic ulcers, eradication of Helicobacter pylori seemed to double the risk of new-onset reflux - but only in cohort study subgroups, and not in randomized trials, according to a new meta-analysis. Reuters Health Information (Source: Medscape Gastroenterology Headlines)

Technique of open laparoscopy for supramesocolic surgery in obese patients

Surgical Endoscopy — Fri, 05 Feb 2010 08:43:19 +0100

Conclusions We present a technique of open laparoscopy in obese patients, systematically used, for supramesocolic surgery. This technique is safe, reproducible, and permits an efficient closure of the abdominal wall. Content Type Journal ArticleCategory TechniqueDOI 10.1007/s00464-009-0872-xAuthors Jean Baptiste Deguines, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceQuentin Qassemyar, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceAbdennaceur Dhahri, Université de Picardie Jules Verne Federation of Digestive Surgery, North Hospital Place Victor Pauchet 80054 Amiens Cedex 01 FranceOlivier Brehant, ...

Effort, safety, and findings of routine preoperative endoscopic evaluation of morbidly obese patients undergoing bariatric surgery

Surgical Endoscopy — Fri, 05 Feb 2010 08:43:12 +0100

Conclusions Upper gastrointestinal endoscopy can be performed safely. However, careful monitoring and anesthesiological support are required for patients with concomitant diseases and those receiving sedation. Because 80% of the patients with pathological findings were asymptomatic, every morbidly obese patient should undergo endoscopy before bariatric surgery because there may be findings that might change the surgical strategy. Content Type Journal ArticleDOI 10.1007/s00464-010-0893-5Authors M. A. Küper, Tübingen University Hospital Department of General, Visceral and Transplant Surgery Hoppe-Seyler-Strasse 3 72076 Tübingen GermanyT. Kratt, Tübingen University Hospital Department of General, Visceral and Transplant Surgery Hoppe-Seyler-Strasse 3 72076 Tübingen...

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The Yield of a Continuously Patent Gastroesophageal Junction During Upper Endoscopy as a Predictor of Esophagitis in Children

Digestive Diseases and Sciences — Fri, 05 Feb 2010 07:57:01 +0100

Conclusions A continuously patent GEJ predicts quite accurately the presence of esophagitis in biopsies and may serve an additional endoscopic finding for the diagnosis of esophagitis especially non-erosive GER. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-010-1128-2Authors Nataly Zion, Bnai Zion Medical Center, Faculty of Medicine, Technion Department of Pediatrics Haifa IsraelElena Chemodanov, Bnai Zion Medical Center, Faculty of Medicine, Technion Department of Pathology Haifa IsraelArie Levine, Tel-Aviv University Pediatric Gastroenterology Unit, E. Wolfson Medical Center, Sackler School of Medicine Tel-Aviv IsraelIgor Sukhotnik, Bnai Zion Medical Center, Faculty of Medicine, Technion Department of Pathology Haifa IsraelJacob Bejar, Bnai ...

MicroRNAs, development of Barrett's esophagus, and progression to esophageal adenocarcinoma.

World Journal of Gastroenterology : WJG — Fri, 05 Feb 2010 04:11:04 +0100

Authors: Smith CM, Watson DI, Michael MZ, Hussey DJ Barrett's esophagus is a premalignant condition caused by gastroesophageal reflux. Once developed, it can progress through varying grades of dysplasia to esophageal adenocarcinoma. Whilst it is well accepted that Barrett's esophagus is caused by gastroesophageal reflux, the molecular mechanisms of its pathogenesis and progression to cancer remain unclear. MicroRNAs (miRNAs) are short segments of RNA that have been shown to control the expression of many human genes. They have been implicated in most cellular processes, and the role of miRNAs in disease development is becoming increasingly evident. Understanding altered miRNA expression is likely to help unravel the molecular mechanisms that underpin the development of Barrett's esopha...

Risk of gastro-oesophageal reflux disease after Helicobacter pylori eradication: Meta-analysis

NeLM - News — Fri, 05 Feb 2010 00:00:00 +0100

Source: Am J Gastroenterol Area: News This meta-analysis investigated whether eradication of Helicobacter pylori (Hp) infection is associated with the development of new gastro-oesophageal reflux disease (GORD) in patients who had no evidence of GORD at entry. A literature search was carried out for RCTs and cohort studies (1983 to 2007) involving patients with Hp infection and with no evidence of GORD assigned into at least two groups, receiving either Hp eradication therapy or placebo. Twelve studies were identified (7 RCTs and 5 cohorts) and the following findings were reported: . In 6 RCTs using erosive GORD as outcome, the odds ratio (OR) for the frequency of GORD in Hp eradicated group vs. persistent Hp group was 1.11 (0.81 to 1.53, p = 0.52) .&...

Abstracts From Around the World

Clinical Gastroenterology and Hepatology — Fri, 05 Feb 2010 00:00:00 +0100

The rising incidence of adenocarcinoma of the esophagus and the link between symptomatic gastroesophageal reflux and obesity with this cancer are well recognized. This nationwide case-control study of esophageal cancer from Australia sought to identify factors associated with gastroesophageal reflux symptoms and esophageal cancer, as well as any modification by nonsteroidal anti-inflammatory drugs (NSAIDs), smoking, and proton pump inhibitor use. Symptomatic reflux was associated with an increased risk of 6.4 times for esophageal cancer, 4.6 times for gastroesophageal junction cancer (adenocarcinoma), and 2.2 times for squamous cell cancer. Heavy smokers had a markedly higher risk for esophageal cancer than non-smokers (odds ratio, 12.3 vs 6.8), with similar patterns for gastroesophageal j...

Recommended management of GORD in general practice

Prescriber — Thu, 04 Feb 2010 00:00:00 +0100

Gastro-oesophageal reflux disease is a common complaint in its mildest form and often related to lifestyle. Our Drug review describes the properties, efficacy and side-effects of the available drug options, followed by an analysis of prescription data and sources of further information. Copyright © 2010 Wiley Interface Ltd (Source: Prescriber)

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How Did You Decide What GERD Treatment to Pursue?

About Heartburn / Acid Reflux — Thu, 04 Feb 2010 00:00:00 +0100

Some people are willing to make extreme lifestyle modifications in order to get relief, while others would rather take a pill daily than give up their favorite foods. Some people are hesitant to take any medication, and would rather have some discomfort than be on medication every day. Others will take the cost of treatment into consideration. How di you decide on what sort of treatment you were going to pursue? Share your experience!How Did You Decide What GERD Treatment to Pursue? originally appeared on About.com Heartburn / GERD on Thursday, February 4th, 2010 at 23:46:50.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Share Your Story: Do You Have Barrett's Esophagus?

About Heartburn / Acid Reflux — Thu, 04 Feb 2010 00:00:00 +0100

Have you been diagnosed with Barrett's esophagus? You can share your experiences with symptoms, what prompted you to go to your doctor, and how a diagnosis was made.Share Your Story: Do You Have Barrett's Esophagus? originally appeared on About.com Heartburn / GERD on Thursday, February 4th, 2010 at 23:44:37.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

A Flexible Approach to the Chromenoquinolines under Copper/Lewis Acid Catalysis

Synlett — Wed, 03 Feb 2010 16:23:59 +0100

SynlettDOI: 10.1055/s-0029-1219364AbstractThe synthesis of chromenoquinolines via cyclization of different substituted anilines or naphthylamine with O-propargylated salicylaldehydes using CuI/La(OTf) as an efficient catalyst in the reflux temperature of acetonitrile is reported.[...]© Georg Thieme Verlag Stuttgart ˙ New YorkGet connected:Table of contents | Abstract | Full text (Source: Synlett)

Autonomic function, gastroesophageal reflux in apparent life threatening event

Clinical Autonomic Research — Wed, 03 Feb 2010 06:49:43 +0100

Conclusions Infants with history of IALTE and GER have a significant abnormality in their autonomic control that is marked in the coupled events of apnea and GER. This finding is possibly related to medullary autonomic regulation. Content Type Journal ArticleCategory Research ArticleDOI 10.1007/s10286-010-0054-xAuthors Emanuel Tirosh, Technion-Israel Institute of Technology The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine 47 Golomb St. Haifa 31048 IsraelNoga Ariov-Antebi, Technion-Israel Institute of Technology The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Bruce Rappaport Faculty of Medicine 47 Golomb St. Haifa 31048 IsraelAyala Cohen, Technion-Israel Institute of Technology Faculty of I...

To Bravo or not? A comparison of wireless esophageal pH monitoring and conventional pH catheter to evaluate non-erosive gastroesophageal reflux disease in a multiracial Asian cohort

Chinese Journal of Digestive Diseases — Wed, 03 Feb 2010 00:00:00 +0100

CONCLUSION: The wireless capsule was well tolerated. The diagnostic yield was similar using both modalities. With the increasing availability of impedance-pH technology, it is uncertain if devices that detect only acid-reflux events will be surpassed. (Source: Chinese Journal of Digestive Diseases)

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Effectiveness and Safety of Proton Pump Inhibitors in Infantile Gastroesophageal Reflux Disease (March).

The Annals of Pharmacotherapy — Tue, 02 Feb 2010 00:00:00 +0100

CONCLUSIONS: Clinical trials reveal that PPI therapy is not an effective treatment for common infant GERD-associated symptoms. Evidence supporting safety of PPI use in infants is conflicting, and more large-scale, randomized, placebo-controlled trials are necessary to better establish the role of PPIs in infant GERD. PMID: 20124466 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Arbaclofen Placarbil Decreases GERD Symptoms

Medscape Medical News Headlines — Mon, 01 Feb 2010 17:01:37 +0100

Arbaclofen placarbil (AP), an investigational prodrug of the active R-isomer of baclofen, significantly reduces the number of reflux episodes over a 12-hour period in patients with gastroesophageal reflux disease (GERD). Reuters Health Information (Source: Medscape Medical News Headlines)

Heal yourself in 15 days - You are what you absorb (part three)

NaturalNews.com — Mon, 01 Feb 2010 07:00:00 +0100

This article continues part three of the 15-part article series called Heal Yourself in 15 Days. In part two, we explored your innate healing potential and saw how powerful your self-healing abilities really are (http://www.naturalnews.com/028060_self_healing_immune_system.html). Here in part three, we look at a powerful principle of nutrition: You aren't what you eat; you are what you ABSORB.Many people suffer from poor digestion. In fact, you might say that most people aren't able to absorb the nutrients they swallow, so they remain in a state of nutritional starvation even though they're taking supplements that would otherwise be quite helpful.These people tend to scratch their heads, wondering why all the nutrients they're swallowing aren't having the positive effects they had hoped fo...

Bile Acid Reflux Contributes to Development of Esophageal Adenocarcinoma via Activation of Phosphatidylinositol-Specific Phospholipase C{gamma}2 and NADPH Oxidase NOX5-S

Cancer Research — Mon, 01 Feb 2010 05:08:11 +0100

Bile acid reflux may promote the development of esophageal adenocarcinoma by overproduction of NOX5-S-derived reactive oxygen species. (Source: Cancer Research)

Preventing Medical Errors: Mixups between Kapidex and Casodex

Food and Drug Adminstration (FDA): Patient Safety News — Mon, 01 Feb 2010 05:00:00 +0100

The Institute for Safe Medication Practices (ISMP) has reported medication errors due to name confusion between Kapidex (dexlansoprazole) and Casodex (bicalutamide). Kapidex is used to treat erosive esophagitis and gastroesophageal reflux disease. ... (Source: Food and Drug Adminstration (FDA): Patient Safety News)

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Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA.

Emerging Infectious Diseases — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Kutty PK, Woods CW, Sena AC, Benoit SR, Naggie S, Frederick J, Evans S, Engel J, McDonald LC We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6-48] and to have had a recent outpatient visit (aOR 5.1, 95%...

Esophageal motility and 24-h pH profiles of patients with heterotopic gastric mucosa in the cervical esophagus.

European Journal of Internal Medicine — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSION: Manometric investigation and 24-h pH monitorisation revealed that some of the patients with HGM have signs of esophageal motor dysfunction and "acid independent episodes" from the patches. These abnormalities may be responsible for some of the symptoms of HGM patients. PMID: 20122608 [PubMed - as supplied by publisher] (Source: European Journal of Internal Medicine)

A comparison of laparoscopic and open Nissen fundoplication and gastrostomy placement in the neonatal intensive care unit population

Journal of Pediatric Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Conclusion: Laparoscopic and open techniques for Nissen fundoplication with gastrostomy placement are safe and appropriate treatment methods with equivalent operating times for the treatment of gastroesophageal reflux in the NICU population. (Source: Journal of Pediatric Surgery)

Gastric emptying scans: unnecessary preoperative testing for fundoplications?

Journal of Pediatric Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: There were no differences in outcomes for GERD patients with or without preoperative GES or GEP postfundoplication. The use of GES in the management of GERD requires further evaluation. (Source: Journal of Pediatric Surgery)

Personalized medicine for patients with asthma

Journal of Allergy and Clinical Immunology — Mon, 01 Feb 2010 00:00:00 +0100

Asthma is a complex inflammatory disorder characterized by intense allergic inflammation, smooth muscle contraction, bronchial hyperresponsiveness, hypertrophy and hyperplasia of smooth muscle, hypersecretion of bronchial mucus, activation of mast cells, eosinophils, lymphocytes, epithelial cells, macrophages, disruption of the bronchial epithelium, and production of free radicals such as expired nitric oxide (eNO) and 8-isoprostane. The presence of asthma implies multiple potential targets of therapy, risk of future exacerbations, impaired quality of life, and potential for accelerated loss of FEV1. Patients with persistent asthma have a high likelihood of the comorbidities allergic rhinitis, rhinosinusitis, and gastroesophageal reflux. Furthermore, responses to pharmacotherapy vary for �...

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Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy.

Canadian Family Physician Medecin de Famille Canadien — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Law R, Maltepe C, Bozzo P, Einarson A QUESTION: In addition to suffering from nausea and vomiting of pregnancy, which is being treated with antiemetics, some of my pregnant patients complain of heartburn and acid reflux. Should these symptoms also be treated and, if so, which acid-reducing medications are safe for use during pregnancy? ANSWER: Increased severity of nausea and vomiting of pregnancy is associated with the presence of heartburn and acid reflux. Antacids, histamine-2 receptor antagonists, and proton pump inhibitors can be used safely during pregnancy, as large studies have been published with no evidence of adverse fetal effects. PMID: 20154244 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)

Proton pump inhibitor suppression of calcium absorption presenting as respiratory distress in a patient with bilateral laryngeal paralysis and hypocalcemia.

Ear, Nose and Throat Journal — Mon, 01 Feb 2010 00:00:00 +0100

We report an unusual case of hypocalcemia and respiratory distress related to acid-suppressive therapy. The patient was a 50-year-old woman with bilateral laryngeal paralysis and hypoparythyroidism resulting from a thyroidectomy performed more than 30 years previously. She required large doses of calcium supplementation to maintain a normal calcium level. Her airway had been marginally adequate. A few weeks prior to presentation, she began to experience increasing dyspnea. Examination was suggestive of laryngopharyngeal reflux, and she was started on a therapeutic trial of esomeprazole 40 mg twice daily. Three days later, she presented to the emergency room with airway distress. Laboratory studies indicated that the patient had hypocalcemia. The esomeprazole was discontinued, and she was t...

Lung transplantation, gastroesophageal reflux, and fundoplication.

The Annals of Thoracic Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Robertson AG, Ward C, Pearson JP, Corris PA, Dark JH, Griffin SM Lung transplantation is an accepted treatment strategy for end-stage lung disease; however, bronchiolitis obliterans syndrome is a major cause of morbidity and mortality. This review explores the role of gastroesophageal reflux disease in bronchiolitis obliterans syndrome and the evidence suggesting the benefits of anti-reflux surgery in improving lung function and survival. There is a high prevalence of gastroesophageal reflux in patients post lung transplantation. This may be due to a high preoperative incidence, vagal damage and immunosuppression. Reflux in these patients is associated with a worse outcome, which may be due to micro-aspiration. Anti-reflux surgery is safe in selected lung transplant recipients...

Barrett's adenocarcinoma 52 years after subtotal esophagectomy for pediatric peptic stricture.

The Annals of Thoracic Surgery — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Dunn LJ, Robertson AG, Immanuel A, Griffin SM Barrett's esophagus results from the long-term effects of both acid and bile reflux. After subtotal esophagectomy and reconstruction with a gastric tube, many patients experience profound reflux. Development of Barrett's epithelium in the esophageal remnant has been reported. Here we report the case of a man who was diagnosed with adenocarcinoma in his esophageal remnant on a background of Barrett's change 52 years after undergoing one of the first esophageal resections for benign disease as a child. PMID: 20103354 [PubMed - indexed for MEDLINE] (Source: The Annals of Thoracic Surgery)

[Clinical Analysis of Recurrence Rate and Symptom Improvement in Gastro-esophageal Reflux Disease Patients.]

Korean J Gastroenter... — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions: Forty percentage of GERD patients recurred within 6 months following the completion of 8 week therapy with lansoprazole. Recurrence rate, recurrence time, and rate of symptom improvement were not significantly different between NERD group treated with half dose and ERD group treated with full dose lansoprazole. PMID: 20168056 [PubMed - in process] (Source: Korean J Gastroenter...)

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[Health-related quality of life issues in gastroesophageal reflux disease.]

Korean J Gastroenter... — Mon, 01 Feb 2010 00:00:00 +0100

Authors: Oh JH Several studies have reported significant Health-Related Quality of life (HRQOL) impairment in gastroesophageal reflux disease (GERD) patients compared with the general population. The evaluation of quality of life is important as a parameter for the treatment. Because GERD has diverse symptoms such as esophageal and extraesophageal syndromes, HRQOL of GERD should be determined by both disease and non-disease related factors. The purpose is to overview the HRQOL instruments used in the evaluation of GERD, published reports regarding HRQOL in GERD, and the effects of medical treatments on GERD. PMID: 20168054 [PubMed - in process] (Source: Korean J Gastroenter...)

Cough: A Worldwide Problem

Otolaryngologic clinics of North America — Mon, 01 Feb 2010 00:00:00 +0100

Cough is a common and important respiratory symptom that can produce significant complications for patients and be a diagnostic challenge for physicians. An organized approach to evaluating cough begins with classifying it as acute, subacute, or chronic in duration. Acute cough lasting less than 3 weeks may indicate an acute underlying cardiorespiratory disorder but is most commonly caused by a self-limited viral upper respiratory tract infection (eg, common cold). Subacute cough lasting 3 to 8 weeks commonly has a postinfectious origin; among the causes, Bordetella pertussis infection should be included in the differential diagnosis. Chronic cough lasts longer than 8 weeks. When a patient is a nonsmoker, is not taking an angiotensin-converting enzyme inhibitor, and has a normal or near-no...

Reflux and Cough

Otolaryngologic clinics of North America — Mon, 01 Feb 2010 00:00:00 +0100

Reflux is a significant contributor to cough in otolaryngology practice; cough is just one marker of its many negative effects on the upper aerodigestive tract. Reflux causes cough both by direct irritation/inflammation and by increasing sensitivities to other noxious agents. Detailed and diligent clinical evaluation, including laryngoscopy, is useful in advancing the working diagnosis of reflux-associated cough. Supplemental testing, including impedance monitoring of esophageal refluxate, can be important to evaluate for both acidic and nonacidic reflux exposure. The mainstay of treatment continues to be dietary and other lifestyle interventions and drug therapy. Although proton-pump inhibitor therapy is effective in most patients, especially those with acid reflux disease, prokinetic the...

Prevalence of gastroesophageal reflux disease in patients with idiopathic pulmonary fibrosis

Jornal Brasileiro de Pneumologia — Sat, 30 Jan 2010 15:33:10 +0100

CONCLUSIONS: The prevalence of GERD in the patients with IPF was high. However, the clinical and functional characteristics did not differ between the patients with GERD and those without. (Source: Jornal Brasileiro de Pneumologia)

Whether robot-assisted laparoscopic fundoplication is better for gastroesophageal reflux disease in adults: a systematic review and meta-analysis

Surgical Endoscopy — Fri, 29 Jan 2010 12:15:54 +0100

Conclusions Systematic review of the literature indicates that RALF is a feasible and safe alternative to surgical treatment of GERD. However, since it lacks obvious advantages with respect to operating time, length of hospital stay and cost, RALF has limitations for its extensive application in clinics. Content Type Journal ArticleCategory ReviewDOI 10.1007/s00464-009-0873-9Authors Jun Mi, The Second Hospital of Lanzhou University Department of Surgery Lanzhou 730030 ChinaYingxin Kang, The Second Hospital of Lanzhou University Department of Surgery Lanzhou 730030 ChinaXiao Chen, The Second Hospital of Lanzhou University Department of Surgery Lanzhou 730030 ChinaBingjun Wang, The Second Hospital of Lanzhou University Department of Surgery Lanzhou 730030 ChinaZhiping W...

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Initiation of malignancy by duodenal contents reflux and the role of ezrin in developing esophageal squamous cell carcinoma

Cancer Science — Fri, 29 Jan 2010 00:00:00 +0100

Gastroesophageal reflux has recently been implicated as a causative factor in upper aerodigestive tract carcinogenesis. Esophageal squamous cell carcinomas (ESCCs) have developed in duodenal-content reflux animals without any known carcinogen present. We established a cell line, designated ESCC-DR, from a thoracic metastatic tumor in a reflux animal. To gain insight into the genomic alterations associated with duodenal content reflux-induced carcinogenesis, we first performed comparative genomic hybridization using an Agilent rat 244K array in ESCC-DR and identified many chromosomal gains and losses. Of the many genes identified, we detected an interesting ezrin amplicon that has been recently reported in human ESCC. Ezrin, which cross-links the cytoskeleton and plasma membrane, is involve...

Propranolol for infantile hemangiomas: Early experience at a tertiary vascular anomalies center

The Laryngoscope — Fri, 29 Jan 2010 00:00:00 +0100

This study explores the impact of propranolol on both proliferative and involuting hemangiomas at a tertiary vascular anomalies center.Retrospective single institution review.We reviewed children treated with propranolol for problematic hemangiomas followed by a blinded prospective analysis of serial photographs taken during the course of their therapy. Parental questionnaires were obtained to evaluate perceived therapeutic response and complications to oral propranolol.Thirty-two children with complete photo documentation were treated with oral propranolol for infantile hemangiomas between September 2008 and June 2009. Twenty-seven patients began therapy during the proliferative phase of their lesions (mean age, 4.9 months), whereas five patients began during the involutional phase (mean ...

Reflux surgery no guard against throat cancer

Reuters: Health — Thu, 28 Jan 2010 18:30:17 +0100

NEW YORK (Reuters Health) - Patients who have surgery to treat severe heartburn -- also known as gastroesophageal reflux disease or GERD -- continue to have a very high risk of developing cancer of the esophagus even after 15 years or more, a new study has found. (Source: Reuters: Health)

Reflux Surgery No Guard Against Throat Cancer

MedlinePlus Health News — Thu, 28 Jan 2010 18:30:17 +0100

Patients who have surgery to treat severe heartburn -- also known as gastroesophageal reflux disease or GERD -- continue to have a very high risk of developing cancer of the esophagus even after 15 years or more, a new study has found. Source: Reuters Health Related MedlinePlus Topics: GERD, Head and Neck Cancer (Source: MedlinePlus Health News)

A silver lining to stroke: does ischemia generate new cortical interneurons?

Nature Neuroscience — Thu, 28 Jan 2010 17:18:43 +0100

Authors: Gord Fishell & James E Goldman New work identifies a latent population of neuronal progenitor cells in neocortical layer 1 of adult rats. These cells proliferate in response to forebrain ischemia, then integrate into the cortical network as interneurons. (Source: Nature Neuroscience)

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Effect of proximal gastric volume on hiatal hernia

Neurogastroenterology and Motility — Thu, 28 Jan 2010 00:00:00 +0100

Conclusions & Inferences (i) In GERD patients a postprandial increase in proximal gastric volume is accompanied by a decrease in hernia prevalence, which can be explained by a reduction of the intra-thoracic part of the stomach. (ii) A temporal hernia profile also occurs in healthy subjects. (iii) During the hernia profile, acid reflux is more prevalent, especially after meal ingestion. (Source: Neurogastroenterology and Motility)

Barrett's Adenocarcinoma 52 Years After Subtotal Esophagectomy for Pediatric Peptic Stricture [CASE REPORTS]

The Annals of Thoracic Surgery — Wed, 27 Jan 2010 19:27:19 +0100

Barrett's esophagus results from the long-term effects of both acid and bile reflux. After subtotal esophagectomy and reconstruction with a gastric tube, many patients experience profound reflux. Development of Barrett's epithelium in the esophageal remnant has been reported. Here we report the case of a man who was diagnosed with adenocarcinoma in his esophageal remnant on a background of Barrett's change 52 years after undergoing one of the first esophageal resections for benign disease as a child. (Source: The Annals of Thoracic Surgery)

Lung Transplantation, Gastroesophageal Reflux, and Fundoplication [REVIEWS]

The Annals of Thoracic Surgery — Wed, 27 Jan 2010 19:27:19 +0100

Lung transplantation is an accepted treatment strategy for end-stage lung disease; however, bronchiolitis obliterans syndrome is a major cause of morbidity and mortality. This review explores the role of gastroesophageal reflux disease in bronchiolitis obliterans syndrome and the evidence suggesting the benefits of anti-reflux surgery in improving lung function and survival. There is a high prevalence of gastroesophageal reflux in patients post lung transplantation. This may be due to a high preoperative incidence, vagal damage and immunosuppression. Reflux in these patients is associated with a worse outcome, which may be due to micro-aspiration. Anti-reflux surgery is safe in selected lung transplant recipients; however there has been one report of a postoperative mortality. Evidence is ...

Prompt improvement of a pressure ulcer by the administration of high viscosity semi-solid nutrition via a nasogastric tube in a man with tuberculosis: a case report

BioMed Central — Wed, 27 Jan 2010 00:00:00 +0100

Conclusion: When patients have problems with liquid nutrition, such as diarrhea or gastroesophageal reflux, semi-solid nutrition via a nasogastric tube is a useful method of achieving improvements in nutritional state in a short period of time. (Source: BioMed Central)

O,O′-Di-p-tolylpyrophosphoric bis(dimethylamide)

Acta Crystallographica Section E — Wed, 27 Jan 2010 00:00:00 +0100

The title compound, C18H26N2O5P2, was obtained accidently from the reaction between N,N-dimethylphosphoramidochloridic acid 4-methyl phenyl ester, NaNO2 and 18-crown-6 in acetonitrile under reflux conditions. The asymmetric unit contains one half-molecule, the complete molecule being generated by crystallographic twofold symmetry, with the bridging O atom lying on the rotation axis. The P atoms exhibit a tetrahedral coordination and are bridged via one O atom [P—O—P angle = 130.00 (19)°]. (Source: Acta Crystallographica Section E)

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Is There a Cure for Heartburn?

About Heartburn / Acid Reflux — Wed, 27 Jan 2010 00:00:00 +0100

If you do a search on the Internet, you will be able to find many websites that will tell you they have a cure for heartburn. When talking about a disease or other health condition, people most often think of a cure as the putting a permanent end to that disease or condition and making a person healthy again. With that in mind, can anything cure heartburn? Related resources: Symptoms of Heartburn Causes of Heartburn Foods Heartburn Sufferers Should Avoid Meal Planning Tips for Heartburn Sufferers Quick Tips for Preventing heartburn Antacids for the Treatment of Heartburn H2 Blockers for the Treatment of Heartburn Proton Pump Inhibitors for the Treatment of Heartburn Home Remedies for Treating Heartburn Fundoplication Surgery Is There a Cure for Heartburn? originally appeared on About.com...

Does Being Overweight Increase the Chance of Having Heartburn?

About Heartburn / Acid Reflux — Wed, 27 Jan 2010 00:00:00 +0100

Does that extra weight increase your risk of experiencing heartburn episodes? If so, why? Find the answer here. Related information: What You Need to Know About GERD Foods to Avoid if You Suffer From Heartburn Meal Planning Tips to Prevent Heartburn Quick Ways to Prevent Heartburn About.com's Guide to Weight Loss Does Being Overweight Increase the Chance of Having Heartburn? originally appeared on About.com Heartburn / GERD on Wednesday, January 27th, 2010 at 17:28:44.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Do You Have Barrett's Esophagus?

About Heartburn / Acid Reflux — Wed, 27 Jan 2010 00:00:00 +0100

Have you been diagnosed with Barrett's esophagus? You can share your experiences with symptoms, what prompted you to go to your doctor, and how a diagnosis was made. Share your story about living with Barrett's esophagus! Related resources: What is Barrett's esophagus? Treating Barrett's esophagus Complications of Barrett's esophagus - Esophageal Cancer Do You Have Barrett's Esophagus? originally appeared on About.com Heartburn / GERD on Wednesday, January 27th, 2010 at 17:23:05.Permalink | Comment | Email this (Source: About Heartburn / Acid Reflux)

Treatment for Barrett's oesophagus

Gastroenterology and Liver Diseases Specialist Library - Oesophagus — Tue, 26 Jan 2010 13:52:47 +0100

Background Treatments for Barrett's oesophagus, the precursor lesion of adenocarcinoma, are available but whether these therapies effectively prevent the development of adenocarcinoma, and in some cases eradicate the Barrett's oesophagus segment, remains unclear. Objectives To summarise, quantify and compare the efficacy of pharmacological, surgical and endoscopic treatments for the eradication of dysplastic and non-dysplastic Barrett's oesophagus and prevention of these states from progression to adenocarcinoma. Search strategy We searched CENTRAL (The Cochrane Library 2004, issue 4), MEDLINE (1966 to June 2008) and EMBASE (1980 to June 2008). Selection criteria Randomised controlled trials (RCTs) comparing medical, endoscopic or non-resectional surgical treatments for Barrett's oesophagu...

Gastrointestinal disorders among shift workers.

Scandinavian Journal of Work, Environment and Health — Tue, 26 Jan 2010 00:00:00 +0100

CONCLUSIONS: Our general judgment is that shift workers appear to have increased risk of GI symptoms and peptic ulcer disease. However, control for potential confounders (eg, smoking, age, socioeconomic status, and other risk factors) was often lacking or insufficient in many of the studies we examined. PMID: 20101379 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Work, Environment and Health)

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Management of children with holoprosencephaly

American Journal of Medical Genetics Part C: Seminars in Medical Genetics — Tue, 26 Jan 2010 00:00:00 +0100

Holoprosencephaly (HPE) is the most common malformation of the embryonic forebrain in humans. Although HPE occurs along a continuous spectrum, it has been categorized into four types from most severe to least severe: alobar, semilobar, lobar, and middle interhemispheric (MIH) variant. Facial malformations are often associated with HPE and usually correlate with the severity of brain malformation. With the most severely affected newborns, there is a high mortality rate in the first month of life, however, with milder forms of HPE, the majority survive beyond infancy. The Carter Centers for Brain Research in Holoprosencephaly and Related Malformations have enrolled 182 living children in a prospective research study. Based on previously published reports using this database, reports from oth...

Demonstration of Abnormal Esophageal Function in Lung Transplant Candidates

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:34 +0100

Conclusions: Our current study demonstrates numerous anatomic as well as motor abnormalities of the esophagus present in a large proportion of end stage lung disease patients awaiting transplantation. We believe HRM is a valid tool to use, as we previously presented our initial data on the applicability of HRM in identifying esophageal motor abnormalities in a test group of 7 patients. The abnormalities we identified in our current study may be representative of this unique patient population. HRM will likely be important in identifying and stratifying patients at risk of aspiration with subclinical as well as clinically apparent esophageal disorders. Additionally, post-lung transplant patients should be evaluated with HRM to determine if they are at risk, as this may predict a worse post-...

Age and BMI Should Not Preclude Elective Pararesophageal Hernia Repair

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:26 +0100

Introduction: There has been a paradigm shift in the management of paraesophageal hernias (PEH), in that elective surgical repair is usually limited to symptomatic patients. These operations represent a considerable technical challenge in patients who are older and have multiple comorbidities, especially in comparison to patients undergoing operations for gastroesophageal reflux disease (GERD). Given the modified indications for repair of PEHs, it is necessary to identify factors that are associated with increased rates of mortality and morbidity and to determine exclusion criteria, if any, to optimize outcomes in these complex patients. Methods: Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) from 2005 through 2007. Patients undergoing anti-reflux opera...

Recent Advances in Gastroenterology

Gastroenterology — Mon, 25 Jan 2010 00:00:00 +0100

Chris Probert's Recent Advances in Gastroenterology provides a review of recent “hot topics” in gastroenterology. The primary aim of this 220-page review book, as stated by Dr Probert, the book's editor, is to help educate gastroenterology fellows, medical residents, and general practitioners who are developing subspecialty clinics. The book is also intended to help update gastroenterologists in a variety of topics. I believe that Dr Probert and his colleagues have achieved their goals. With respect to general content, including chapters on eosinophilic esophagitis, Barrett's esophagus, bariatric surgery, nonalcoholic fatty liver disease, irritable bowel syndrome, and inflammatory bowel disease is appropriate and necessary given not only the recent advances made in these fields, but al...

Small Intestinal Bacterial Overgrowth Common Among Long-Term PPI Users

Medscape Pharmacist Headlines — Fri, 22 Jan 2010 16:53:33 +0100

In patients with gastroesophageal reflux disease (GERD), long-term use of proton pump inhibitors (PPI) contributes to bacterial overgrowth in the small intestine, new research from Italy shows. Reuters Health Information (Source: Medscape Pharmacist Headlines)

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Effect of Transoral Incisionless Fundoplication on Symptoms, PPI Use, and pH-Impedance Refluxes of GERD Patients

World Journal of Surgery — Fri, 22 Jan 2010 02:59:29 +0100

Conclusions At 6-month follow-up, TIF performed using the EsophyX device reduces symptoms and pH-impedance refluxes, allowing interruption or reduction of PPI use in 78% of patients with GERD. Content Type Journal ArticleDOI 10.1007/s00268-010-0394-7Authors Pier Alberto Testoni, Vita-Salute San Raffaele University Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute via Olgettina 58 20132 Milan ItalyMaura Corsetti, Vita-Salute San Raffaele University Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute via Olgettina 58 20132 Milan ItalySalvatore Di Pietro, Vita-Salute San Raffaele University Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute v...

Pharyngolaryngeal reflux in patients who underwent cervical esophago-gastrostomy following esophagectomy

Diseases of the Esophagus — Fri, 22 Jan 2010 00:00:00 +0100

Pharyngolaryngeal reflux has been generally accepted as a cause for pharyngolaryngitis, hoarseness, aspiration pneumonia, chronic cough, and nocturnal asthma. Although patients who have undergone gastric conduit reconstruction after esophagectomy are at a high risk to pharyngolaryngeal reflux disease (PLRD), PLRD after esophagectomy is still unknown. The aim of this study is to investigate the correlation between reflux pharyngolaryngitis and acid reflux into the hypopharynx and into the cervical esophagus in patients who have undergone cervical esophagogastrostomy. We enrolled 62 patients who received follow-up endoscopy and 24-h pH monitoring after cervical esophagogastrostomy. These included 26 at 1 month after surgery and 36 at 1 year or more after surgery. We investigated: (i) the cor...

This Month in Pediatric Urology

The Journal of Urology — Fri, 22 Jan 2010 00:00:00 +0100

High grade vesicoureteral reflux (VUR) in infants is a distinct entity compared to high grade VUR detected later in childhood because of its greater rate of spontaneous resolution or improvement and relatively frequent congenital renal function abnormalities. Sjostrom et al (page 1177) from Goteborg, Sweden report an observational study of 80 male and 35 female infants diagnosed at a median age of 2.7 months after a urinary tract infection (UTI) in 72% and after an abnormal prenatal ultrasound in 26%. Reflux was grade III in 16% of cases, grade IV in 45% and grade V in 39%. Patients were evaluated with video cystometry, renal scintigraphy and chromium edetic acid clearance scan. Median followup was 36 months. VUR resolved spontaneously in 30 cases and was downgraded to I to II in 14 at a m...

Predictive Factors for Acute Renal Cortical Scintigraphic Lesion and Ultimate Scar Formation in Children With First Febrile Urinary Tract Infection

The Journal of Urology — Fri, 22 Jan 2010 00:00:00 +0100

Conclusions: Since vesicoureteral reflux is the common risk factor for acute scintigraphic lesion and ultimate scar formation, voiding cystourethrogram must be considered as an initial study in patients with acute febrile urinary tract infection. (Source: The Journal of Urology)

Predictive Factors for Resolution of Congenital High Grade Vesicoureteral Reflux in Infants: Results of Univariate and Multivariate Analyses

The Journal of Urology — Fri, 22 Jan 2010 00:00:00 +0100

Purpose: We studied variables with impact on cessation of congenital high grade vesicoureteral reflux in univariate analyses and provide a multivariate model for prediction of reflux resolution.Materials and Methods: A total of 80 male and 35 female infants (median age 2.7 months) were included in this prospective observational study. Of the cases 71% were diagnosed after urinary tract infection and 26% after prenatal ultrasound. Reflux was bilateral in 70% of the patients and maximum grade was III in 16%, IV in 45% and V in 39%. The study protocol included repeat videocystometries, renal scintigrams, chromium edetic acid clearances and free voiding observations. Median followup was 36 months.Results: Overall spontaneous reflux resolution, including cases downgraded to grade I to II, was 3...

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Review article: percutaneous endoscopic gastrostomy in infants and children

Alimentary Pharmacology and Therapeutics — Fri, 22 Jan 2010 00:00:00 +0100

Conclusions Percutaneous endoscopic gastrostomy insertion for enteral nutrition in children and adolescents is an efficient and safe technique, even in small children, and is associated with a tolerable complication rate. (Source: Alimentary Pharmacology and Therapeutics)

The influence of environmental risk factors in hospitalization for gastro-oesophageal reflux disease-related diagnoses in the United States

Alimentary Pharmacology and Therapeutics — Fri, 22 Jan 2010 00:00:00 +0100

Conclusion The large numbers of inpatients with a discharge diagnosis of GERD-related conditions attest to the frequent occurrence and relevance of GERD in contributing to hospitalization in the US. (Source: Alimentary Pharmacology and Therapeutics)

Opioid-induced bowel disorders and narcotic bowel syndrome in patients with chronic non-cancer pain

Neurogastroenterology and Motility — Thu, 21 Jan 2010 00:00:00 +0100

Conclusion & Inferences Bowel disorders including chronic abdominal pain and NBS are common in patients taking opioids for CNCP. Decreased HRQoL in patients with CNCP is driven by chronic abdominal pain. (Source: Neurogastroenterology and Motility)

Randomized controlled trial of laparoscopic anterior versus posterior fundoplication for gastro-oesophageal reflux disease

ANZ Journal of Surgery — Thu, 21 Jan 2010 00:00:00 +0100

Conclusion: Anterior and posterior fundoplication each have their advantages and disadvantages. There is an increased risk of early post-operative dysphagia after posterior fundoplication. Anterior fundoplication carries a greater risk of persistent or recurrent reflux. Overall, a posterior fundoplication produces a better management option for controlling gastro-oesophageal reflux disease when compared with an anterior fundoplication technique which utilizes unilateral fixation of the gastric fundus. (Source: ANZ Journal of Surgery)

CCN1 is critical for acid-induced esophageal epithelial cell transformation.

Biochemical and Biophysical Research communications — Thu, 21 Jan 2010 00:00:00 +0100

Authors: Modak C, Mouazzen W, Narvaez R, Reavis KM, Chai J CCN1 is a matricellular protein involved in both wound healing and cancer cell invasion. Increased CCN1 expression has been associated with the development of Barrett's esophagus and the increased risk of progression to esophageal adenocarcinoma. In both cases, acid reflux is a major contributor. Low pH has been shown to induce CCN1 gene expression in esophageal epithelial cells. Here we demonstrated that both CCN1 and low pH could cause esophageal epithelial cell transformation, including loss of E-cadherin, disruption of cell-cell junctions, and expression of mesenchymal markers. Furthermore, knockdown of CCN1 through RNA interference sufficiently attenuated acid-driven cell phenotypic changes, while over-expression of CCN1 e...

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Excessive belching and aerophagia: two different disorders

Diseases of the Esophagus — Wed, 20 Jan 2010 00:00:00 +0100

Belching is physiological venting of excessive gastric air. Excessive and bothersome belching is a common symptom, which is often seen in patients with functional dyspepsia and gastroesophageal reflux disease. Other symptoms are usually predominant. However, a small group of patients complain of isolated excessive belching, with a frequency of several belches per minute. In these patients, the eructated air does not originate from the stomach but is sucked or injected in the esophagus from the pharynx and expelled immediately afterward in oral direction. This behavior is called supragastric belching because the air does not originate from the stomach and does not reach the stomach either. Excessive belching can be treated by speech therapy or behavior therapy. The term aerophagia should be...

Steeply Sloped Bed Reduces Regurgitation in Infants

Medscape Gastroenterology Headlines — Tue, 19 Jan 2010 19:07:07 +0100

An infant bed with a 40-degree slope helps minimize gastroesophageal reflux and associated problems, according to the findings of a pilot study from Belgium. Reuters Health Information (Source: Medscape Gastroenterology Headlines)

The Pathogenesis of Systemic Sclerosis Revisited

Clinical Reviews in Allergy and Immunology — Tue, 19 Jan 2010 17:29:33 +0100

Abstract Although infectiological stimuli, environmental factors and genotypic features are known to contribute to the initiation and perpetuation of systemic sclerosis (SSc), its etiology still remains to be enigmatic, and less elusive insights are to be achieved by ongoing and future investigations. Being characterized, however, as chronic autoimmune disease with excessive collagen accumulation in skin, synovia and visceral organs such as lung, heart, and digestive tract along with obliterating angiopathy, the pathophysiology of SSc can be summarized as being based on imbalances of the cellular and humoral immune system, vascular dysfunction and activation of resident connective tissue cells. A complex interplay between these major components manages to establish and mai...

Antacid Recall

About Heartburn / Acid Reflux — Tue, 19 Jan 2010 00:00:00 +0100

You may have heard about the Tylenol recall. That recall has been expanded to include other products, including Rolaids. Rolaids is an antacid that some heartburn sufferers use to get quick relief of their heartburn symptoms. Various Johnson & Johnson products are being recalled because of reported moldy or chemical odor, with some individuals being sickened by it (including nausea, stomach pain, vomiting and diarrhea). Products recalled include: Tylenol Motrin (Source: About Heartburn / Acid Reflux)