scholarly journals High-Resolution Esophageal Manometry: A Time Motion Study

2008 ◽  
Vol 22 (4) ◽  
pp. 365-368 ◽  
Author(s):  
Daniel C Sadowski ◽  
Linda Broenink
Keyword(s):  
High Resolution ◽  
Esophageal Manometry ◽  
Clinical Investigation ◽  
Study Quality ◽  
Procedure Time ◽  
High Resolution Manometry ◽  
Time Motion ◽  
Motion Study ◽  
Significant Difference ◽  
End Times

INTRODUCTION: High-resolution manometry (HRM) of the esophagus is a new technique that provides a more precise assessment of esophageal motility than conventional techniques. Because HRM measures pressure events along the entire length of the esophagus simultaneously, clinical procedure time should be shorter because less catheter manipulation is required. According to manufacturer advertising, the new HRM system is more accurate and up to 50% faster than conventional methods.OBJECTIVE: To test the hypothesis that clinical testing with HRM requires less procedural time than a standard water perfusion (WP) method.METHODS: Forty-one consecutive patients were studied (20 underwent WP and 21 underwent HRM). Using time-motion analysis, the start and end times for each task associated with performing the study were recorded. Patient discomfort and study quality were also assessed by using five- and four-point qualitative scales, respectively.RESULTS: Total procedure time was reduced on average by 25.6% in the HRM group (from 41.8 minutes with WP to 30.7 minutes with HRM, P<0.05). There was no significant difference in the discomfort scores reported by the study subjects and no difference in study quality.CONCLUSIONS: HRM requires less time to complete than conventional manometry and should therefore shorten the wait-times of patients scheduled for esophageal manometry and have a significant impact on the cost of performing this commonly used clinical investigation.

scholarly journals ESOPHAGEAL MOTILITY IN MEN AND WOMEN EVALUATED BY HIGH-RESOLUTION MANOMETRY

2017 ◽  
Vol 54 (2) ◽  
pp. 145-147 ◽  
Author(s):  
Tarciana Vieira COSTA ◽  
Roberto Oliveira DANTAS
Keyword(s):  
High Resolution ◽  
Esophageal Motility ◽  
Esophageal Manometry ◽  
Sitting Position ◽  
Men And Women ◽  
Proximal Contraction ◽  
High Resolution Manometry ◽  
Contraction Duration ◽  
Significant Difference ◽  
Esophageal Sphincter

ABSTRACT BACKGROUND Esophageal motility has been described in the literature as having differences between men and women. Most of these investigations use the water perfusion method for esophageal manometry. In this investigation the esophageal motility of men and women was compared with high-resolution manometry of the esophagus. OBJECTIVE To compare the esophageal motility of men and women with the high-resolution manometry method for esophageal manometry, performed in the sitting position. The hypothesis was that men and women have differences in esophageal motility. METHODS High-resolution manometry was performed in normal volunteers, 10 men [mean age: 37.5 (8.1) years] and 12 women [mean age: 38.7 (7.5) years], in the sitting position and with 10 swallows of a 5 mL bolus of saline, with an interval of at least 30 seconds between consecutive swallows. We evaluated the integrated relaxation pressure of the lower esophageal sphincter, contraction front velocity, distal contraction integral, distal latency, proximal contraction extension, proximal contraction duration >30 mmHg, proximal contraction duration, proximal contraction integral and maximal upper esophageal sphincter pressure. RESULTS There was no significant difference between men and women in the variables measured. CONCLUSION There was no difference in esophageal motility of men and women evaluated by the high resolution manometry method, in the sitting position with swallows of a liquid bolus.

Comparison of Time spent between an electronic and a paper-based laboratory information system by laboratorians at a polyclinic in Greater Accra, Ghana: A time-motion study

2020 ◽  
Author(s):  
Philip Boakye
Keyword(s):  
Information System ◽  
Negative Impact ◽  
Laboratory Information System ◽  
Time Motion ◽  
Accessible Information ◽  
Motion Study ◽  
Significant Difference ◽  
Significant Negative Impact ◽  
Key Issues ◽  
Motion Studies

The acceptance of electronic laboratory information system (LIS) is gradually increasing in developing countries. However, the issue of time effectiveness due to computerization is less clear as there is fewer accessible information. One of the key issues for laboratorians is their indecision with LISs’ would-be effect of time on their work. A polyclinic in Ghana was in the process of implementing electronic LIS. Several of the laboratorians did not have knowledge and skill in computing and there were disagreeing views on the time effectiveness of the LIS after implementation. The management of the polyclinic laboratory was concerned to assess time advantageousness of recording data when using the electronic LIS compared with paper-based LIS. <div><br></div><div>Five randomly selected laboratorians were provided two sheets of paper with tables to document the time they spent for both paper-based and electronic LIS. Data were collected for a total of 230 records,115 electronic LIS and 115 paper-based LIS. The t-test (mean-comparison test) was computed to compare the means of both electronic and paperbased LIS times. </div><div><br></div><div>There was a statistical significant difference in the time spent between electronic and paper-based LIS. The time spent between paper-based and electronic LIS was 0.41 minutes (95% CI 0.15 to 0.66) longer than in electronic LIS. </div><div><br></div><div>LIS can be adopted in polyclinics without having significant negative impact on time spent between electronic and paper-based LIS. More time–motion studies that include laboratorians are however necessary in order to get a more complete picture of time spent between electronic and paper-based LIS. </div>

scholarly journals Esophageal manometry high-resolution in clinical practice.

2018 ◽  
Vol 95 (12) ◽  
pp. 1127-1136 ◽  
Author(s):  
I. V. Maev ◽  
E. V. Barkalova ◽  
M. A. Hovsepyan ◽  
Yu. A. Kucheryavy ◽  
Dmitry N. Andreyev
Keyword(s):  
Clinical Practice ◽  
High Resolution ◽  
Motor Function ◽  
Esophageal Manometry ◽  
Promising Method ◽  
Thoracic Esophagus ◽  
Current Clinical Practice ◽  
High Resolution Manometry ◽  
Diagnostic Capabilities

At present, esophageal manometry high-resolution (high resolution manometry, HRM) is a highly informative and promising method for diagnosing patients with different disorders of the motor function of the thoracic esophagus and disorders of tone of the sphincter apparatus. This article presents a series of observations that demonstrate the diagnostic capabilities of the methodology in current clinical practice.

scholarly journals High-resolution esophageal manometry in patients with achalasia

2021 ◽  
Vol 180 (1) ◽  
pp. 45-53
Author(s):  
A. A. Smirnov ◽  
M. M. Kiriltseva ◽  
M. E. Luybchenko ◽  
L. I. Davletbaeva ◽  
A. V. Kochetkov
Keyword(s):  
High Resolution ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Esophageal Achalasia ◽  
X Rays ◽  
High Resolution Manometry ◽  
Prospective Group ◽  
Unified View ◽  
Esophageal Sphincter ◽  
Integrated Relaxation Pressure

Introduction. At present, high-resolution esophageal manometry is the «gold standard» for the diagnosis of esophageal achalasia, based on the determination of the integrated relaxation pressure of the lower esophageal sphincter, the value of which in the case of achalasia must exceed 15 mm Hg (MMS System). However, in some patients with clinically and radiologically confirmed achalasia, this value is normal. There is no unified view of the cause of this phenomenon. We assumed that low pressure figures may be affected by incorrect installation of the manometric catheter.Methods and materials. This research included 149 patients (61 by retrospective estimating the patients data and 88 new patients) with achalasia established during the period from January 2017 to March 2020. When it was impossible to localize the lower esophageal sphincter and take correct measurements during high-resolution manometry in new patients, the X-rays or upper endoscopy was performed to control the manometric catheter placement. If its’ placement was incorrect and the integrated relaxation pressure level was lower than 15 mmHg, repeated high-resolution manometry was performed with the over-the-guidewire manometric catheter placing.Results. In 36 patients of both groups (24.2 %), the manometric data did not correspond to esophageal achalasia; in the prospective group, 12 out of the 19 patients had incorrect manometric data due to inability to visualize lower esophageal sphincter. In the prospective group, the manometric catheter was reinstalled by a guidewire, which allowed visualizing the signs of the lower esophageal sphincter in all cases, and in 15 out of 19 patients (79 %), the integrated relaxation pressure of the lower esophageal sphincter was more than 15 mm Hg.Conclusions. In some cases, the over-the-guidewire installing makes it possible to pass catheter through the lower esophageal sphincter correctly, visualize the lower esophageal sphincter during the high-resolution manometry examination and obtain true pressure values.

Activities of the Clinical Pharmacist Practicing in the Office of a Family Practitioner

1975 ◽  
Vol 9 (3) ◽  
pp. 129-133 ◽  
Author(s):  
Paul J. Perry ◽  
Stephen C. Hurley
Keyword(s):  
Patient Care ◽  
Community Pharmacist ◽  
Clinical Pharmacist ◽  
Care Facility ◽  
Improve Patient Care ◽  
Family Practitioner ◽  
Care Services ◽  
Time Motion ◽  
Motion Study ◽  
Significant Difference

The activities of a clinical pharmacist within a primary care facility are measured in a time-motion study. This type of practice allows the pharmacist an opportunity to provide many patient-care services normally unavailable at community pharmacies. The innovative services are described in detail to establish how they produce savings of physician time and to imply how they improve patient care. The activities of the clinical pharmacist are compared to those of the community pharmacist. The indications are that a significant difference exists between the activities of the community pharmacist and a clinical pharmacist working within the office of a physician.

scholarly journals The Effect of Diet Composition Change on High-Resolution Oesophageal Manometry Metrics in Non-Erosive Gastroesophageal Reflux Disease Patients

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 54-54
Author(s):  
Sergey Morozov ◽  
Vasily Isakov
Keyword(s):  
High Resolution ◽  
Esophageal Motility ◽  
Esophageal Manometry ◽  
Diet Composition ◽  
Control Group ◽  
Study Group ◽  
Ineffective Esophageal Motility ◽  
Dietary Fiber Intake ◽  
Significant Difference ◽  
Resting Pressure

Abstract Objectives To evaluate the influence of change of diet composition on esophageal manometry metrics. Methods The data of 43 NERD patients with low (&lt;20 g/day) baseline dietary fiber intake served as a source data. These patients were examined with the use of standard food frequency questionnaire and high-resolution esophageal manometry. Thirty of them received psyllium 5.0 g TID 10 days in addition of their usual diet within registered clinical trial (NCT01882088). The other 13 were found in the database by diagnosis; their data were eligible in case of the presence of repeated high-resolution esophageal manometry examination and dietary assessments at the same time point and if no significant change in diet composition was revealed. The changes were assessed in accordance to Chicago classification 3.0. Non-parametric statistics (Wilcoxon matched pairs test, Mann-Whitney U-test) were used to assess the change in HRM metrics in these groups. Results In those who received psyllium, significant increase of minimal lower esophageal resting pressure at rest and after 10 water swallows was registered: 5.41 ± 10.1 vs 11.3 ± 9.4 mm Hg, P = 0.023 and 14.1 ± 8.0 vs 14.9 ± 6.4 mm Hg, P = 0.008, accordingly. No significant difference was found in the group with no change of diet composition by these parameters. At baseline, ineffective esophageal motility was found in 46.7% patients of the study group and 53.8% in the control group (P = 0.7). Esophageal motility became normal in 71.4% of those who had IEM initially in the study group after 10 days of treatment, and in 14.3% among the controls (P = 0.0135). This type of peristaltic abnormality was found not changed in 28.6% of the study group and in 85.7% among the control group, P = 0.014. New cases of ineffective esophageal motility revealed in 12.5% of the study group and 16.7% among the controls (P = 0.8) Conclusions Change of diet composition by additional quantity of psyllium may result in the improvement of esophageal motility. Funding Sources Federal Research Center of Nutrition and Biotechnology.

scholarly journals Spectrum of Esophageal Motility Disorders in Patients with Motor Dysphagia and Noncardiac Chest Pain ‑ A Single Center Experience

2017 ◽  
Vol 08 (02) ◽  
pp. 068-071
Author(s):  
Rinkesh Kumar Bansal ◽  
Mukesh Nasa ◽  
Gaurav Kumar Patil ◽  
Vinit Shah ◽  
Narendra S. Choudhary ◽  
...  
Keyword(s):  
Chest Pain ◽  
High Resolution ◽  
Esophageal Motility ◽  
Esophageal Manometry ◽  
Motility Disorder ◽  
Esophageal Motility Disorders ◽  
Noncardiac Chest Pain ◽  
Esophageal Motility Disorder ◽  
Motility Disorders ◽  
High Resolution Manometry

ABSTRACT Aims and Objective: High‑resolution esophageal manometry is the most important investigation for the evaluation of patients with dysphagia and noncardiac chest pain (NCCP). Chicago Classification (CC) utilizing an algorithmic approach in analyzing high‑resolution manometry has been accepted worldwide, and an updated version, CC v3.0, of this classification has been developed by the International high‑resolution manometry working Group in 2014. Data on the spectrum of esophageal motility disorders in Indian population are scarce as well as a newer version of CC has not been used to classify. The aim of our study is to evaluate clinical presentation and manometric profile of patients with suspected esophageal motility disorders using CC v3.0. Methodology: In this retrospective study, consecutive patients referred for esophageal manometry at our center from 2010 to 2015 were included in the study. High‑resolution esophageal manometry was performed with 22‑channel water‑perfusion system (MMS, The Netherlands). Newer version of CC (CC v3.0) was used to classify motility disorders. Results: A total of 400 patients were included, with a mean age of 44 years and 67.5% were males. Out of these, 60% (n = 240) patients presented with motor dysphagia while 40% (n = 160) had NCCP. Motility disorder was present in 50.5% (n = 202) of the patients while 49.5% (n = 198) patients had normal manometry. Disorders of esophagogastric junction outflow were the predominant type of disorder, found in 33.75% (n = 135). About 14.25% (n = 57) of the patients had minor disorders of peristalsis while 5% (n = 20) of the patients had other major disorders of peristalsis. Achalasia was the most common motility disorder present in 30% (n = 120) patients. Conclusion: Dysphagia was the most common esophageal symptom followed by NCCP in our series. Achalasia was the most common esophageal motility disorder followed by fragmented peristalsis.

scholarly journals Upper esophageal sphincter resting pressure varies during esophageal manometry

2014 ◽  
Vol 27 (3) ◽  
pp. 182-183 ◽  
Author(s):  
Daniel Tavares REZENDE ◽  
Fernando A. M. HERBELLA ◽  
Luciana C. SILVA ◽  
Sebastião PANOCCHIA-NETO ◽  
Marco G. PATTI
Keyword(s):  
High Resolution ◽  
Esophageal Manometry ◽  
Striated Muscle ◽  
Upper Esophageal Sphincter ◽  
Standard Test ◽  
Sphincter Pressure ◽  
High Resolution Manometry ◽  
Basal Pressure ◽  
Resting Pressure ◽  
Esophageal Sphincter

BACKGROUND: The upper esophageal sphincter is composed of striated muscle. The stress of intubation and the need to inhibit dry swallows during an esophageal manometry test may lead to variations in basal pressure of this sphincter. Upper esophageal sphincter is usually only studied at the final part of the test. Was observed during the performance of high resolution manometry that sphincter pressure may vary significantly over the course of the test. AIM: To evaluate the variation of the resting pressure of the upper esophageal sphincter during high resolution manometry. METHODS: Was evaluated the variation of the basal pressure of the upper esophageal sphincter during high resolution manometry. Were reviewed the high resolution manometry tests of 36 healthy volunteers (mean age 31 years, 55% females). The basal pressure of the upper esophageal sphincter was measured at the beginning and at the end of a standard test. RESULTS: The mean time of the test was eight minutes. The basal pressure of the upper esophageal sphincter was 100 mmHg at the beginning of the test and 70 mmHg at the end (p<0.001). At the beginning, one patient had hypotonic upper esophageal sphincter and 14 hypertonic. At the end of the test, one patient had hypotonic upper esophageal sphincter (same patient as the beginning) and seven hypertonic upper esophageal sphincter. CONCLUSION: A significant variation of the basal pressure of the upper esophageal sphincter was observed in the course of high resolution manometry. Probably, the value obtained at the end of the test may be more clinically relevant.

Evaluation of pharyngeal swallowing pressure using high-resolution manometry during transoral surgery for oropharyngeal cancer

2021 ◽  
Vol 135 (2) ◽  
pp. 153-158
Author(s):  
K Fujiwara ◽  
S Koyama ◽  
K Taira ◽  
K Kawamoto ◽  
T Fukuhara ◽  
...  
Keyword(s):  
High Resolution ◽  
Oropharyngeal Cancer ◽  
Objective Evaluation ◽  
Transoral Surgery ◽  
Swallowing Function ◽  
High Resolution Manometry ◽  
Pharyngeal Pressure ◽  
Significant Difference ◽  
Upper Oesophageal Sphincter ◽  
The Impact

AbstractBackgroundTransoral robotic surgery is frequently described, driven by the desire to offer a less morbid alternative to chemoradiation. However, the objective evaluation of post-operative function has rarely been reported. Therefore, high-resolution manometry was used in this study to evaluate the impact of changes in peri-operative swallowing function on pharyngeal pressure events.MethodsTen patients with various stages of oropharyngeal cancer underwent transoral surgery. High-resolution manometry and videofluoroscopic swallow studies were performed before surgery and two months afterwards. The following parameters were obtained: velopharyngeal and mesopharyngeal post-deglutitive upper oesophageal sphincter pressures, velo-meso-hypopharyngeal contractile integral, upper oesophageal sphincter relaxation pressure, and pharyngeal velocity.ResultsThere was no significant difference in pharyngeal pressure or contractile integral pre- versus post-operatively. However, pharyngeal velocity was significantly higher post-operatively than pre-operatively.ConclusionHigh-resolution manometry showed that transoral surgery in patients without pre-operative dysphagia preserved pharyngeal constriction. However, transoral surgery might produce scar formation in the pharynx, which could lead to narrowing of the pharynx.

scholarly journals Comparison of Time spent between an electronic and a paper-based laboratory information system by laboratorians at a polyclinic in Greater Accra, Ghana: A time-motion study

2020 ◽  
Author(s):  
Philip Boakye
Keyword(s):  
Information System ◽  
Negative Impact ◽  
Laboratory Information System ◽  
Time Motion ◽  
Accessible Information ◽  
Motion Study ◽  
Significant Difference ◽  
Significant Negative Impact ◽  
Key Issues ◽  
Motion Studies

The acceptance of electronic laboratory information system (LIS) is gradually increasing in developing countries. However, the issue of time effectiveness due to computerization is less clear as there is fewer accessible information. One of the key issues for laboratorians is their indecision with LISs’ would-be effect of time on their work. A polyclinic in Ghana was in the process of implementing electronic LIS. Several of the laboratorians did not have knowledge and skill in computing and there were disagreeing views on the time effectiveness of the LIS after implementation. The management of the polyclinic laboratory was concerned to assess time advantageousness of recording data when using the electronic LIS compared with paper-based LIS. <div><br></div><div>Five randomly selected laboratorians were provided two sheets of paper with tables to document the time they spent for both paper-based and electronic LIS. Data were collected for a total of 230 records,115 electronic LIS and 115 paper-based LIS. The t-test (mean-comparison test) was computed to compare the means of both electronic and paperbased LIS times. </div><div><br></div><div>There was a statistical significant difference in the time spent between electronic and paper-based LIS. The time spent between paper-based and electronic LIS was 0.41 minutes (95% CI 0.15 to 0.66) longer than in electronic LIS. </div><div><br></div><div>LIS can be adopted in polyclinics without having significant negative impact on time spent between electronic and paper-based LIS. More time–motion studies that include laboratorians are however necessary in order to get a more complete picture of time spent between electronic and paper-based LIS. </div>

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