Functional Diseases of the Esophagus: Role of Endoscopy

1978 ◽  
Vol 87 (4) ◽  
pp. 523-527 ◽  
Author(s):  
Nanjunda Swamy ◽  
John E. Rayl
Keyword(s):  
Significant Risk ◽  
Significant Risk Factor ◽  
Upper Esophageal Sphincter ◽  
Endoscopic Examination ◽  
Phase Iii ◽  
Open Tube ◽  
Risks And Benefits ◽  
Esophageal Sphincter ◽  
Rule Out

The use of endoscopic procedures in the evaluation of primary motor disorders, or functional diseases, of the esophagus is filled with both risks and benefits. Since both flexible and open-tube esophagoscopy carry a significant risk factor, it is necessary to have a clear concept of the indications and value of endoscopy in the management of functional diseases of the esophagus. A review of the literature reveals very little documentation on the value of endoscopy in diagnosing esophageal functional diseases other than Zenker's diverticulum and achalasia. Based on the current literature and the experience of the authors, observations and recommendations concerning the role of endoscopy in functional diseases of the esophagus are presented. These are: 1) In Phase I or upper esophageal sphincter dysfunctions, endoscopy contributes little to their understanding, is difficult to perform, and may be hazardous. In this group, esophagoscopy should be reserved for indications beyond the dysfunction itself. If endoscopy has to be performed, open-tube esophagoscopy should be performed by an experienced endoscopist. 2) In functional diseases of the esophageal body or Phase II dysfunction, endoscopy is frequently valuable. In spastic disorders, it helps to differentiate between primary spasm of neuromuscular origin and spasm secondary to esophagitis or an obstructive process. In scleroderma and pulsion diverticulum, endoscopy helps to identify such unsuspected complications as esophagitis, hiatal hernia, and carcinoma. 3) In Phase III or lower esophageal sphincter dysfunctions, endoscopic examination is essential both to rule out organic lesions that simulate functional disorders, and to determine the presence and extent of esophagitis.

scholarly journals The Relationship Between Bullying Victimization and Perpetration and Non-suicidal Self-injury: A Systematic Review

2021 ◽  
Author(s):  
Gianluca Serafini ◽  
Andrea Aguglia ◽  
Andrea Amerio ◽  
Giovanna Canepa ◽  
Giulia Adavastro ◽  
...  
Keyword(s):  
Peer Victimization ◽  
Significant Risk ◽  
Positive Association ◽  
Significant Risk Factor ◽  
Future Research ◽  
Bullying Victimization ◽  
Self Injury ◽  
Long Run ◽  
Bully Victims

AbstractExperience of bullying may be a significant risk factor for non-suicidal self-injury (NSSI). This study had three aims: to systematically investigate the association between bullying and NSSI, analyze the possible mechanisms underlying the two phenomena, and evaluate any differences between bullying victimization and bullying perpetration with respect to NSSI. A systematic search about the association between bullying victimization and perpetration and NSSI was conducted using specific databases (PubMed, Scopus, Science Direct). The following keywords were used in all database searches: "bullying" AND "NSSI" OR "peer victimization" and NSSI. The searches in PubMed, Scopus and Science Direct revealed a total of 88 articles about bullying or peer victimization and NSSI. However, only 29 met our inclusion criteria and were used for the present review. Overall, all studies examined victimization; four studies also evaluated the effects of perpetration and one included bully-victims. According to the main findings, both being a victim of bullying and perpetrating bullying may increase the risk of adverse psychological outcomes in terms of NSSI and suicidality in the short and the long run. To the best of our knowledge, this is the first review to systematically evaluate the relation between bullying victimization/perpetration and NSSI. The main results support a positive association. Future research should evaluate the possible role of specific mediators/moderators of the association between experience of bullying and NSSI.

scholarly journals Role of Aspirin for primary prevention of cardiovascular and all-cause mortality events in diabetes: An updated meta-analysis of randomized controlled trials.

2021 ◽  
Author(s):  
Hua Ma ◽  
QIng Gu ◽  
Huining Niu ◽  
Xiaohua Li ◽  
Rong Wang
Keyword(s):  
Cardiovascular Disease ◽  
Primary Prevention ◽  
Meta Analysis ◽  
Significant Risk ◽  
Diabetic Patients ◽  
Primary Endpoints ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Rule Out

Background: The use of Aspirin in the primary prevention of cardiovascular disease (CVD) is still a topic of debate, especially in patients with diabetes. The present meta-analysis aims to rule out the efficacy of Aspirin in patients with diabetes and to compare the effectiveness of Aspirin with a placebo (or no treatment) for the primary prevention of CVD and all-cause mortality events in people with diabetes. Materials and Methods: An extensive and systematic search was conducted in Medline (via PubMed), Cinahl (via Ebsco), Scopus, and Web of Sciences from 1988 to December 2020. A detailed literature search was conducted using Aspirin, cardiovascular disease (CVD), diabetes, and efficacy to identify trials of patients with diabetes who received Aspirin for primary prevention of CVD. Demographic details with the primary outcome of events and bleeding outcomes were analyzed. The risk of bias (RoB) in included studies was evaluated using the QUADAS-2 tool. Results: A total of 5 studies out of 13 were included with 23,570 diabetic patients; 11,738 allocated to Aspirin and 11,832 allocated to the placebo group. In patients with diabetes, there was no difference between Aspirin and placebo with respect to the risk of all-cause death with a confidence interval (CI) varying 0.63 to 1.17. In addition, there were no differences in the bleeding outcomes with an odds ratio of 1.4411 (CI 0.47 to 4.34). Conclusion: Aspirin has no significant risk on primary endpoints of cardiovascular events and the bleeding outcomes in diabetic patients compared to placebo. More research on the use of Aspirin alone or in combination with other antiplatelet drugs is required in patients with diabetes to supplement currently available research.

Role of pharyngeal propulsion as an indicator for upper esophageal sphincter myotomy

1995 ◽  
Vol 105 (7) ◽  
pp. 723-727 ◽  
Author(s):  
Alain Moine ◽  
Sophie Périé ◽  
Christophe Bokowy ◽  
Bruno Angelard ◽  
Stanislas Chaussade ◽  
...  
Keyword(s):  
Upper Esophageal Sphincter ◽  
Esophageal Sphincter

Abstract 17312: Hand1 Impairs Angiogenesis in Heart and Placenta

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Jennifer A Courtney ◽  
Helen N Jones
Keyword(s):  
Histological Analysis ◽  
Heart Defects ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Placental Development ◽  
Hypoplastic Left Heart ◽  
Septal Defects ◽  
And Function ◽  
Left Heart Syndrome

Introduction: Congenital heart defects affect approximately 1% of live births, often requiring complex surgeries at birth. The most significant risk factor for surgery survival is birthweight. Proper placental development and function is vital for normal fetal growth. We have previously demonstrated abnormal placental development and vascularization in human CHD placentas. Hand1 has roles in heart and placental development and has been implicated in multiple types of CHD including double right outlet, hypoplastic left heart syndrome, and septal defects. We utilized the Hand1 A126fs/+ mouse to investigate the role of Hand1 in placentation and vascularization. Methods: Hand1 A126fs/+ female mice were time-mated with Nkx2.5cre or Cdh5cre males. Feto-placental units were harvested at E10.5 and E12.5 for histological analysis, vascular assessment by IHC for CD-31, and RNA expression by qPCR. Results: Nkx2.5cre/Hand1 a126fs/+ fetuses demonstrated embryonic lethality by E10.5 due to lack of placental labyrinth formation and vascularization (Figure 1). In contrast, ablation of Hand1 in vascular endothelium (Cdh5cre) did not disrupt placental labyrinth or heart at E12.5. Expression of VegFb, Ang1, Ang2, Flt1, Flk was reduced in Hand1 A126fs/+ ; Nkx2.5cre placentas compared to control littermates, but VegFa expression was increased. Conclusion: Our data demonstrate that Hand1 expression in placental trophoblast, but not endothelium, is necessary for vascularization of the labyrinth and may disrupt multiple angiogenic factors known to be expressed in trophoblast. Alterations in Hand1 may represent a mechanism for abnormal placentation in cases of CHD. Figure 1. H/E (A-C) and CD31 (D-F) images of Hand1 +/+ (A, D), Hand1 A126fs/+ ; Nkx2.5cre (B, E), and Hand1 A126fs/+ ; Cdh5cre (C, F) placentas at day E12.5. Hand1A 126fs/+ ; Nkx2.5cre placentas fail to form labyrinth and fetal vasculature, while Hand1 A126fs/+ ; Cdh5cre placentas develop normally at this timepoint.

scholarly journals The Critical Role of Biliary Candidiasis in Development of Surgical Site Infections after Pancreatoduodenectomy: Results of Prospective Study Using a Selective Culture Medium for Candida Species

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Hiroyuki Kato ◽  
Yusuke Iizawa ◽  
Kei Nakamura ◽  
Kazuyuki Gyoten ◽  
Aoi Hayasaki ◽  
...  
Keyword(s):  
Risk Factor ◽  
Candida Species ◽  
Critical Role ◽  
Significant Risk ◽  
Surgical Site Infections ◽  
Preoperative Assessment ◽  
Significant Risk Factor ◽  
High Level ◽  
New Evidence

In accordance with previous reports, the incidence of biliary candidiasis (BC) after pancreaticoduodenectomy (PD) was reported to be 0 to 5%, and the clinical significance of BC still has been elusive. In this study, we prospectively evaluated the precise incidence of BC after PD using the CHROMagar Candida plate in an attempt to elucidate whether BC has a significant impact on the clinical outcomes after PD.Patients and Method. From November 2014 to March 2016, the consecutive 51 patients who underwent PD were enrolled for this study. The bile juice was prospectively collected through the biliary stent tube on postoperative days (POD) 3, 7, and 14 and directly incubated onto the CHROMagar Candida plate for the cultivation of various Candida species. In the presence or absence of BC, we compared the incidence of SSIs.Results. The incidence of postoperative BC was 15% on POD 3, 24% on POD 7, and 39% on POD 14, respectively. Taken together, 22 patients out of 51 (43.1%) developed BC after PD. Moreover, the incidence of SSIs was significantly higher in patients with BC than in those without it (71% versus 7%, p=0.005). BC was selected as the only significant risk factor of SSIs after PD among the various risk factors. Even though a cause of BC is unknown, high level of alkaline phosphatase (cut-off line >300 IU/L) was selected as the only preoperative risk factor of the development of BC.Conclusion. We elucidated new evidence in which BC could be the independent cause of SSIs after PD and should not be recognized as just contamination artifacts. Preoperative assessment for identifying carriers of Candida species might be essential for reducing the incidence of SSIs after PD.

Canine gallbladder cyclic motor activity

1988 ◽  
Vol 255 (4) ◽  
pp. G409-G416 ◽  
Author(s):  
T. Matsumoto ◽  
S. K. Sarna ◽  
R. E. Condon ◽  
W. J. Dodds ◽  
N. Mochinaga
Keyword(s):  
Motor Activity ◽  
Short Duration ◽  
Sphincter Of Oddi ◽  
The Body ◽  
Phase Iii ◽  
Fasted State ◽  
Long Duration ◽  
The Mean ◽  
Esophageal Sphincter

We investigated whether the gallbladder has cyclic motor activity similar to that of the stomach, lower esophageal sphincter, and sphincter of Oddi in the fasted state. We found that the canine gallbladder infundibulum exhibited a cyclic burst of short duration (69 +/- 3 s) contractions that were closely associated with phase III activity of the antrum. The cyclic motor activity was sometimes less prominent or absent in the body and the fundus of the gallbladder. The mean period of gallbladder cyclic motor activity was not significantly different from the mean period of phase III activity in the stomach and the duodenum. The cyclic bursts of gallbladder contractions lasted for 21 +/- 2 min. The gallbladder cyclic motor activity started at about the same time as the antral phase III activity, and both of these activities started approximately 12 min earlier than the duodenal phase III activity. In addition to the aforementioned cyclic bursts of contractions, the gallbladder sometimes exhibited long duration (6.4 +/- 0.6 min) contractions that occurred irregularly and unpredictably during the duodenal migrating motor complex cycle. We conclude that during fasting the canine gallbladder has a cyclic motor activity that is temporally related to phase III activity of the stomach and the duodenum. The role of short duration phasic contractions during cyclic motor activity may be to periodically stir gallbladder contents, whereas the long duration contractions may partially empty the gallbladder in the fasted state.

scholarly journals Axin-mediated regulation of lifespan and muscle health in C. elegans involves AMPK-FOXO signaling

2020 ◽  
Author(s):  
Avijit Mallick ◽  
Ayush Ranawade ◽  
Bhagwati P Gupta
Keyword(s):  
Muscle Function ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Mitochondrial Morphology ◽  
Dependent Manner ◽  
C Elegans ◽  
Muscle Aging ◽  
Muscle Health ◽  
Multiple Signaling

SUMMARYAging is a significant risk factor for several diseases. Studies have uncovered multiple signaling pathways that modulate the process of aging including the Insulin/IGF-1 signaling (IIS). In C. elegans the key regulator of IIS is DAF-16/FOXO whose activity is regulated by phosphorylation. A major kinase involved in DAF-16-mediated lifespan extension is the AMPK catalytic subunit homolog, AAK-2. In this study, we demonstrate a novel role of PRY-1/Axin in AAK-2 activation to regulate DAF-16 function. The pry-1 transcriptome contains many genes associated with aging and muscle function. Consistent with this, pry-1 is strongly expressed in muscles and muscle-specific overexpression of pry-1 extends the lifespan, delays muscle aging, and improves mitochondrial morphology in DAF-16-dependent manner. Furthermore, PRY-1 is necessary for AAK-2 phosphorylation. Together, our data demonstrate a crucial role of PRY-1 in maintaining the lifespan and muscle health. Since muscle health declines with age, our study offers new possibilities to manipulate Axin function to delay muscle aging and improve lifespan.

scholarly journals Antibody-mediated rejection in heart transplantation

2021 ◽  
Vol 23 (4) ◽  
pp. 47-61
Author(s):  
V. S. Kvan ◽  
N. N. Koloskova ◽  
Yu. A. Kachanova ◽  
N. N. Sayfullina ◽  
A. Yu. Goncharova ◽  
...  
Keyword(s):  
Significant Risk ◽  
Significant Risk Factor ◽  
Humoral Immune ◽  
Treatment Regimens ◽  
Antibody Mediated Rejection ◽  
Humoral Immune System ◽  
Graft Vasculopathy ◽  
Donor Specific Antibodies ◽  
The Complement System

The role of antibody-mediated rejection in predicting survival among heart recipients has been studied in clinical transplantology for over 20 years. This condition is a significant risk factor for heart failure and graft vasculopathy. Antibody-mediated rejection results from activation of the humoral immune system and production of donorspecific antibodies that cause myocardial injury through the complement system. The presence of donor-specific antibodies is associated with lower allograft survival. Treatment of antibody-mediated rejection should take into account the rejection category and the presence or absence of graft dysfunction. The main principle of treatment is to suppress humoral immunity at different levels. World clinical practice has made significant inroads into the study of this issue. However, further research is required to identify and develop optimal treatment regimens for patients with humoral rejection in cardiac transplantation.

Parent-Based Models of Adolescent Substance Use

2018 ◽  
Author(s):  
Andrea M. Hussong ◽  
Ruth K. Smith
Keyword(s):  
Substance Use ◽  
Low Income ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Adolescent Substance Use ◽  
Low Income Countries ◽  
Negative Consequences ◽  
Adolescent Substance ◽  
Typical Time

Adolescence is the typical time of substance use onset and escalation around the world, though prevalence rates vary dramatically across countries. Given that substance use is a significant risk factor contributing to global disease burden, the consequences of substance abuse are staggering. Substantial evidence, primarily from high-income countries but increasingly corroborated by that from middle- and low-income countries, suggests that parents and families can play a key role in mitigating risk for substance use involvement and related negative consequences. This chapter reviews that evidence as well as features of family evidence-based interventions for adolescent substance use, highlighting two in particular, and discusses the role of such interventions in a multisectoral approach to prevention.

Atrial fibrillation and obesity

ESC CardioMed ◽  
2018 ◽  
pp. 2232-2235
Author(s):  
Rajiv Mahajan ◽  
Dennis H. Lau ◽  
Prashanthan Sanders
Keyword(s):  
Atrial Fibrillation ◽  
Randomized Study ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Therapeutic Benefit ◽  
Sleep Apnoea ◽  
Attributable Risk ◽  
Associated Risk Factors ◽  
Epidemiological Link

Obesity is increasingly recognized as a significant risk factor for the burgeoning prevalence of atrial fibrillation (AF). With the growing epidemic of obesity, it is poised to soon have the highest attributable risk of AF. While often associated with co-morbid conditions such as hypertension, diabetes, and sleep apnoea, all known to be associated with AF, there is increasing evidence of a direct pathogenic role of obesity in forming the substrate for AF. Interestingly, a randomized study and observational cohorts have reported that weight loss and treatment of associated risk factors is associated with a reduction in AF symptoms and burden and improved likelihood of maintaining sinus rhythm. This chapter focuses on the epidemiological link between these conditions, the potential mechanisms of this association, and the emerging evidence that treating obesity may have a therapeutic benefit in the management of AF.

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