History of Medical and Surgical Antireflux Therapy

2017 ◽  
pp. 1-11
Author(s):  
Fernando A. M. Herbella ◽  
Ana Cristina C. Amaral
Keyword(s):  
History Of ◽  
Antireflux Therapy

scholarly journals Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed Fathi Abdallah ◽  
Tarek El-Desoky ◽  
Khalid Fathi ◽  
Wagdy Fawzi Elkashef ◽  
Ahmed Zaki
Keyword(s):  
Gastroesophageal Reflux ◽  
Bronchoalveolar Lavage ◽  
Ph Monitoring ◽  
Standard Test ◽  
Respiratory Problems ◽  
Healthy Infants ◽  
Healthy Control ◽  
History Of ◽  
Antireflux Therapy ◽  
Gerd Symptoms

Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing.Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants.Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin.Results. Wheezy infants with silent reflux and wheezy infants with typical GERD symptoms but normal MII-pH had significantly higher BAL pepsin compared to healthy control (45.3 ± 8.6 and 42.8 ± 8 versus 29 ± 2.6,P<0.0001andP=0.011, resp.). BAL pepsin had sensitivity (61.7%, 72 %, and 70%) and specificity (55.5%, 52.9%, and 53%) to diagnose GERD associated infantile wheeze compared to abnormal MII-pH, reflux esophagitis, and lipid laden macrophage index, respectively.Conclusion. A stepwise approach for assessment of GERD in wheezy infants is advised. In those with silent reflux, a trial of antireflux therapy is warranted with no need for further pepsin assay. But when combined MII-pH is negative despite the presence of typical GERD symptoms, pepsin assay will be needed to rule out GERD related aspiration.

The Social Origins and Provenance of the English Bishops during the Reign of Edward II

1959 ◽  
Vol 9 ◽  
pp. 51-79
Author(s):  
K. Edwards
Keyword(s):  
Middle Ages ◽  
Social Background ◽  
Early Career ◽  
The Political ◽  
Social Origins ◽  
Political Activities ◽  
Edward Ii ◽  
The Social ◽  
Complete Study ◽  
History Of

During the last twenty or twenty-five years medieval historians have been much interested in the composition of the English episcopate. A number of studies of it have been published on periods ranging from the eleventh to the fifteenth and early sixteenth centuries. A further paper might well seem superfluous. My reason for offering one is that most previous writers have concentrated on analysing the professional circles from which the bishops were drawn, and suggesting the influences which their early careers as royal clerks, university masters and students, secular or regular clergy, may have had on their later work as bishops. They have shown comparatively little interest in their social background and provenance, except for those bishops who belonged to magnate families. Some years ago, when working on the political activities of Edward II's bishops, it seemed to me that social origins, family connexions and provenance might in a number of cases have had at least as much influence on a bishop's attitude to politics as his early career. I there fore collected information about the origins and provenance of these bishops. I now think that a rather more careful and complete study of this subject might throw further light not only on the political history of the reign, but on other problems connected with the character and work of the English episcopate. There is a general impression that in England in the later middle ages the bishops' ties with their dioceses were becoming less close, and that they were normally spending less time in diocesan work than their predecessors in the thirteenth century.

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