Short-term and long-term effect of diaphragm biofeedback training in gastroesophageal reflux disease: an open-label, pilot, randomized trial

Introduction. Hiatal hernia occupies a third place in the structure of the gastrointestinal tract pathology. The association of hiatal hernia with gastroesophageal reflux disease can lead to severe complications and requires a surgical treatment. Objective. To analyze short-term and long-term results of a surgical treatment of patients with hiatal hernia complicated by gastroesophageal reflux disease (GERD). Methods. A retrospective analysis of the short-term and long-term treatment results of 62 patients suffering from hiatal hernia complicated by gastroesophageal reflux disease was performed. All the patients underwent a laparoscopic hiatal hernia repair supplemented by Toupet fundoplication. Results. The hospital stay duration was 7.21.6 days. The postoperative complication rate was 6.5%. Mild functional dysphagia was noted in 8(12.9%). Persistent long-term dysphagia in the late postoperative period was observed in 2(3.2%) patients. The recurrences of hiatal hernia or GERD were noted in 15(24.2%) patients in 5 years after the surgery. The total GERD-HRQL questionnaire score 5 years after the surgery was 5.73.9. Сonclusion. Laparoscopic interventions are safe, less traumatic, provide the possibility of early rehabilitation of patients, can achieve positive functional results in 85% of patients and should be used in the treatment of patients suffering from hiatal hernia complicated by GERD.

Download Full-text

Protocol for long-term effect of pulmonary rehabilitation under nintedanib in IPF

ERJ Open Research ◽

10.1183/23120541.00321-2021 ◽

2021 ◽

pp. 00321-2021

Author(s):

Osamu Nishiyama ◽

Kensuke Kataoka ◽

Masahiko Ando ◽

Shinichi Arizono ◽

Akira Morino ◽

...

Keyword(s):

Pulmonary Rehabilitation ◽

Term Effect ◽

Controlled Study ◽

Control Group ◽

Long Term Effects ◽

Short Term ◽

Open Label ◽

Long Term Effect ◽

Term Maintenance

BackgroundPulmonary rehabilitation (PR) causes short-term improvement in exercise capacity, dyspnea, and health-related quality of life in idiopathic pulmonary fibrosis (IPF); however, long-term maintenance of the improvement is difficult. Nintedanib, an antifibrotic drug, has been shown to delay the worsening of pulmonary function in IPF. Therefore, the concomitant use of nintedanib with PR is anticipated to contribute to the long-term maintenance of the PR effects. The long-term effect of PR under nintedanib treatment in IPF (FITNESS) study is a multicenter, randomised, prospective, parallel-group, open-label trial.MethodsThe study will enroll 82 patients with IPF who have been treated with nintedanib. Patients in the PR group will receive a programmed short-term induction PR program, followed by a maintenance home-based PR program, while patients in the control group will receive usual outpatient care. Patients in both groups will continue to receive nintedanib treatment throughout the study period. The primary endpoint of the study is to compare the change in the 6-min walk distance from the baseline to 12-months between the PR and control groups. The main secondary endpoint is endurance exercise time, measured using a bicycle ergometer.DiscussionFITNESS is the first randomised controlled study to evaluate the long-term effects of PR in IPF treated with nintedanib. This study will address the hypothesis that concomitant use of nintedanib contributes to the maintenance of long-term effects of PR, thus leading to a comprehensive therapeutic approach of “nintedanib and PR” in the antifibrotic era.

Download Full-text

Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results

Endoscopy International Open ◽

10.1055/a-0573-1194 ◽

2018 ◽

Vol 06 (05) ◽

pp. E630-E636 ◽

Cited By ~ 4

Author(s):

Eduardo De Moura ◽

Rubens Sallum ◽

Ary Nasi ◽

Martin Coronel ◽

Diogo De Moura ◽

...

Keyword(s):

Quality Of Life ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Endoscopic Treatment ◽

Short Term ◽

Polymer Injection ◽

Number Of Patients

Abstract Background and study aims Us of proton pump inhibitors (PPIs) has made endoscopic treatment of gastroesophageal reflux disease (GERD) more efficient, with reduction in morbidity and complications. However, some patients persist with symptoms despite medical treatment and some are not compliant with it or cannot afford it for financial reasons, and thus they require non-pharmacological therapeutic options such as surgical fundoplication. Surgery may be effective in the short term, but there is related morbidity and concern about its long-term efficacy. The possibility of minimally invasive endoluminal surgeries has resulted in interest in and development of newly endoscopic devices. Good short-term results with surgical fundoplication lack of studies of is with long follow-up justify our interest in this study. The aim of this study was to investigate the efficacy of endoscopic polymer injection and endoluminal full-thickness plication in the long-term control of GERD. Patients and methods Forty-seven patients with GERD who underwent an endoscopic procedure were followed up for 60 months and evaluated for total response (RT), partial response (RP) and no response (SR) to endoscopic treatment with reintroduction of PPIs. Results Twenty-one patients received polymer injection (G0) and 26 endoluminal plication (G1). The number of patients with no response to endoscopic treatment with reintroduction of PPIs increased in time for both techniques (G0 P = 0.006; G1 P < 0.001). There was symptomatic improvement up to 12 months, with progressive loss of this trending up to 60 months in G0 and G1 (P < 0.001). Health-related quality of life score (GERD-HRQL) demonstrated TR in G0 and G1 at 1, 3, 6 and 12 months. The 60-month analysis showed an increased number of patients with SR in both groups. The quality of life assessment (SF-36) showed benefit in G0 up to 3 months. G0 showed a higher rate of complications. There were no deaths. There was healing of esophagitis at 3 months in 45 % of patients in G0 and 40 % in G1. There was no improvement in manometric or pH findings. Conclusion Endoscopic therapies were ineffective in controlling GERD in the long term.

Download Full-text

Long-term results of a randomised trial comparing a total fundoplication (Nissen-Rossetti) and a partial posterior fundoplication (Toupét) for chronic gastroesophageal reflux disease

Gastroenterology ◽

10.1016/s0016-5085(01)81713-3 ◽

2001 ◽

Vol 120 (5) ◽

pp. A344-A344

Author(s):

C HAGEDORN ◽

H LSNROTH ◽

L RYDBERG ◽

KSRNSJUKHUSET ◽

L LUNDELL

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Randomised Trial ◽

Long Term Results ◽

Total Fundoplication

Download Full-text

Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression

The British Journal of Psychiatry ◽

10.1192/bjp.182.5.412 ◽

2003 ◽

Vol 182 (5) ◽

pp. 412-419 ◽

Cited By ~ 255

Author(s):

Peter J. Cooper ◽

Lynne Murray ◽

Anji Wilson ◽

Helena Romaniuk

Keyword(s):

Primary Care ◽

Postnatal Depression ◽

Post Partum ◽

Psychodynamic Therapy ◽

Term Effect ◽

Short Term ◽

Post Partum Depression ◽

Maternal Mood ◽

Long Term Effect

BackgroundPsychological interventions for postnatal depression can be beneficial in the short term but their longer-term impact is unknown.AimsTo evaluate the long-term effect on maternal mood of three psychological treatments in relation to routine primary care.MethodWomen with post-partum depression (n=193) were assigned randomly to one of four conditions: routine primary care, non-directive counselling, cognitive–behavioural therapy or psychodynamic therapy. They were assessed immediately after the treatment phase (at 4.5 months) and at 9, 18 and 60 months post-partum.ResultsCompared with the control, all three treatments had a significant impact at 4.5 months on maternal mood (Edinburgh Postnatal Depression Scale, EPDS). Only psychodynamic therapy produced a rate of reduction in depression (Structured Clinical Interview for DSM–III–R) significantly superior to that of the control. The benefit of treatment was no longer apparent by 9 months post-partum. Treatment did not reduce subsequent episodes of post-partum depression.ConclusionsPsychological intervention for post-partum depression improves maternal mood (EPDS) in the short term. However, this benefit is not superior to spontaneous remission in the long term.

Download Full-text