Search results for "Reflux"
showing 10 items of 178 documents
Evaluation of esophageal motility and reflux in children treated for congenital diaphragmatic hernia with the use of combined multichannel intralumin…
2011
Abstract Background Gastroesophageal reflux (GER) is frequently observed in children treated for congenital diaphragmatic hernia (CDH) at birth, as well as esophageal dysmotility, that has been hypothesized to be caused by innervatory anomalies. The aim of this study is to evaluate GER and dysmotility in young patients with CDH using pH-multichannel intraluminal impedance. Methods Thirty children (17 boys and 13 girls) who underwent repair for CDH between 2002 and 2007 with a median age of 5.2 years (range, 3-10 years) were included in the study. All patients were operated on with a subcostal laparotomy incision and had a left-sided diaphragmatic defect. The defect repair required an artifi…
Supra-esophageal manifestations of gastroesophageal reflux, a different diagnostic approach and an indication for laparoscopic Nissen fundoplication:…
2004
24-hour oesophageal pH monitoring with a dual pH probe is considered to be the most sensitive test for diagnosing GORD-related otolaryngological manifestations. In this study we evaluate an initial diagnostic approach with digital videofluorography associated to the water siphon test and primary "ex juvantibus" therapy with proton pump inhibitors for patients with supra-oesophageal symptoms of GORD. The results of Nissen fundoplication surgical treatment are also assessed in some of these patients. Two hundred and thirty patients with suspected GORD-related supra-oesophageal symptoms were referred for videofluorography and the water siphon test. When hiatal hernia and/or reflux were found, …
Rubinstein–Taybi syndrome 2 with cerebellar abnormality and neural tube defect
2019
Rubinstein-Taybi syndrome (RSTS) is a rare dominant disorder with intellectual disability, postnatal growth deficiency, and multiple congenital anomalies. Approximately 50-70% of the patients have a mutation in the CREBBP gene (RSTS1) and 5-10% display an EP300 gene mutation (RSTS2). Craniospinal abnormalities such as microcranium, scoliosis, and lordosis are frequent findings in RSTS1, but malformations of the brain or spinal cord are seen only occasionally. Here, we report on a 3-year-old boy with facial abnormalities of RSTS, broad thumbs and halluces, developmental delay, autistic features, cerebellar underdevelopment, and a neural tube defect. Molecular diagnostic of the CREBBP and EP3…
Urinary tract infections in children: EAU/ESPU guidelines.
2015
Context: In 30% of children with urinary tract anomalies, urinary tract infection (UTI) can be the first sign. Failure to identify patients at risk can result in damage to the upper urinary tract.Objective: To provide recommendations for the diagnosis, treatment, and imaging of children presenting with UTI.Evidence acquisition: The recommendations were developed after a review of the literature and a search of PubMed and Embase. A consensus decision was adopted when evidence was low.Evidence synthesis: UTIs are classified according to site, episode, symptoms, and complicating factors. For acute treatment, site and severity are the most important. Urine sampling by suprapubic aspiration or c…
Persistent and recurrent achalasia after Heller myotomy: analysis of different patterns and long-term results of reoperation.
2007
Hypothesis Two groups of patients with inadequate therapeutic success after surgical treatment for achalasia can be identified, patients with type 1 recurrence (early recurrence after technical failure of myotomy or a scarring process requiring remyotomy) and patients with type 2 recurrence (late recurrence with irreversible progression of the disease and development of megaesophagus requiring esophagectomy). Design Prospective study. Setting University-based tertiary care center. Patients One hundred sixty-three patients undergoing surgery for achalasia during 20.3 years. Interventions Conventional remyotomy for type 1 recurrence (group 1) and esophagectomy (transhiatal or transthoracic) f…
Effects of pneumatic dilation and myotomy on esophageal function and morphology in patients with achalasia.
2005
Only two treatment modalities–pneumatic dilation and Heller myotomy–promise long-term relief from dysphagia and regurgitation in patients with achalasia. The objective of this study was to determine whether both options differ in their effects on esophageal function, morphology, and improvement in symptoms. Eighty-nine patients diagnosed with achalasia between January 1980 and December 2002 at a single center were enrolled in this study. Sixty-four patients underwent pneumatic dilation and 25 Heller myotomy in combination with an anterior semifundoplication (Dor procedure). Clinical evaluation (Eckardt-Score), esophageal manometry, and barium swallow were performed before and within 6 mont…
Double-J stent insertion across vesicoureteral junction--is it a valuable initial approach in neonates and infants with severe primary nonrefluxing m…
2006
Abstract Objectives To evaluate the role of double- J stent insertion in perinatally detected primary nonrefluxing megaureters as a method to temporize treatment in patients with impaired renal function or to prevent function loss in patients treated expectantly, but deemed at high risk of deterioration. Methods Two neonates and 8 infants with a ureter greater than 10 mm and an obstructive excretion pattern, including 3 cases with renal function less than 40%, were selected to undergo double- J stent insertion for a 6-month period. Patients underwent surgery if the ureter redilated and the excretion pattern was obstructive at reassessment 3 months after stent removal. Results Stents were pl…
An evaluation of the antireflux properties of sodium alginate by means of combined multichannel intraluminal impedance and pH-metry.
2005
Summary Background : Alginate-based preparations act as mechanical antireflux barrier, which can reduce both acid and non-acid reflux events and limit the proximal migration of oesophageal refluxate. Aim : To evaluate all the above features with a novel technique, multichannel electrical impedance and pH-metry. Methods : Ten reflux patients underwent stationary impedancemetry and pH-metry after eating a refluxogenic meal. They were studied 1 h in basal conditions and 1 h after taking 10 mL of Gaviscon Advance. In both sessions, measurements were obtained in right lateral and supine decubitus. Results : Alginate preparation was able to decrease significantly (P < 0.05) the number of acid ref…
Economic impact of mepolizumab in uncontrolled severe eosinophilic asthma, in real life
2021
Abstract Background and aims Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids (OCS) which worsen patients’ health and increase healthcare spending. Aim of this study was to assess the clinical and economic effect of adding mepolizumab (MEP) for the treatment of these patients. Methods Patients >18 years old, referred to 8 asthma clinics, starting MEP between May 2017 and December 2018, were enrolled and followed-up for 12 months. Information in the 12 months before mepolizumab were collected retrospectively. The evaluation parameters included: OCS use, number of exacerbations/hospitalizations, concomitant therapies, comorbidity, and annual number of workin…