Esophageal Dysmotility in Patients following Total Laryngectomy

2017 ◽  
Vol 158 (2) ◽  
pp. 323-330 ◽  
Author(s):  
Teng Zhang ◽  
Julia Maclean ◽  
Michal Szczesniak ◽  
Paul P. Bertrand ◽  
Harry Quon ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Diffuse Esophageal Spasm ◽  
Esophageal Dysmotility ◽  
Cross Sectional ◽  
High Resolution Manometry ◽  
Esophageal Clearance ◽  
Esophageal Spasm ◽  
Motor Abnormalities

Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction. Study Design Multidisciplinary cross-sectional study. Setting Tertiary academic hospital. Subjects and Methods For 31 participants undergone total laryngectomy 1 to 12 years prior, clinical histories were taken by a gastroenterologist and a speech pathologist experienced in managing dysphagia. Esophageal high-resolution manometry was performed and analyzed using Chicago Classification v3.0. Results Interpretable manometric studies were obtained in 23 (1 normal manometry). Esophageal dysmotility patterns included achalasia, esophagogastric junction outflow obstruction, diffuse esophageal spasm, and other major (30%) and minor (50%) peristaltic disorders. The sensitivity of predicting any esophageal dysmotility was 28%, but it is noteworthy that patients with achalasia and diffuse esophageal spasm (DES) were predicted. Two of 4 participants with TE puncture leakage had poor esophageal clearance. Of 20 TE speakers, 12 had voice problems, no correlation between poor voice, and any dysmotility pattern. Conclusions Peristaltic and lower esophageal sphincter dysfunction are common in laryngectomees. Clinical history, while not predictive of minor motor abnormalities, predicted correctly cases with treatable spastic motor disorders. Dysmotility was not associated with poor phonation, although TE puncture leakage might be linked to poor esophageal clearance. Esophageal dysmotility should be considered in the laryngectomees with persisting dysphagia or leaking TE puncture.

High Resolution Manometry Findings in Patients with Esophageal Epiphrenic Diverticula

2011 ◽  
Vol 77 (12) ◽  
pp. 1661-1664 ◽  
Author(s):  
Fernando P. P. Vicentine ◽  
Fernando A. M. Herbella ◽  
Luciana C. Silva ◽  
Marco G. Patti
Keyword(s):  
High Resolution ◽  
Visual Analysis ◽  
Upper Esophageal Sphincter ◽  
Diffuse Esophageal Spasm ◽  
High Resolution Manometry ◽  
Esophageal Spasm ◽  
Number Of Patients ◽  
Epiphrenic Diverticula ◽  
Esophageal Sphincter ◽  
Motor Abnormalities

The pathophysiology of esophageal epiphrenic diverticula is still uncertain even though a concomitant motility disorder is found in the majority of patients in different series. High resolution manometry may allow detection of motor abnormalities in a higher number of patients with esophageal epiphrenic diverticula compared with conventional manometry. This study aims to evaluate the high resolution manometry findings in patients with esophageal epiphrenic diverticula. Nine individuals (mean age 63 ± 10 years, 4 females) with esophageal epiphrenic diverticula underwent high resolution manometry. A single diverticulum was observed in eight patients and multiple diverticula in one. Visual analysis of conventional tracings and color pressure plots for identification of segmental abnormalities was performed by two researchers experienced in high resolution manometry. Upper esophageal sphincter was normal in all patients. Esophageal body was abnormal in eight patients; lower esophageal sphincter was abnormal in seven patients. Named esophageal motility disorders were found in seven patients: achalasia in six, diffuse esophageal spasm in one. In one patient, a segmental hypercontractile zone was noticed with pressure of 196 mm Hg. High resolution manometry demonstrated motor abnormalities in all patients with esophageal epiphrenic diverticula.

scholarly journals Seroprevalence of varicella antibodies in adults without clinical history of disease

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Konrad Silva Büchele ◽  
Danusa Ferreira Correa ◽  
Mari Tuyama ◽  
Alberto dos Santos de Lemos ◽  
Marcellus Dias da Costa ◽  
...  
Keyword(s):  
Travel Medicine ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Older Individuals ◽  
Cross Sectional ◽  
Varicella Zoster ◽  
History Of Disease ◽  
Protective Antibodies ◽  
High Positive Predictive Value ◽  
History Of

Abstract: Varicella in adults and immunocompromised patients can be severe. The clinical diagnosis of varicella has high accuracy and the history of disease has a high positive predictive value for protection. A significant portion of adults, however, cannot remember if they have had varicella, especially older individuals. We conducted a cross-sectional study to determine the seroprevalence of varicella protective antibodies titers in adults with no clinical history of disease, attended at a Reference Center for Special Immunobiologicals and Travel Medicine in Rio de Janeiro (Brazil). Titration of immunoglobulin G (IgG) antibodies to varicella-zoster was determined by chemiluminescence immunoassay. Among 140 adults without history of varicella, 92% had protective antibody titers. We concluded that seroprevalence of varicella-zoster protection was very high in adults with negative history of disease and the use of serology before vaccination reduced significantly unnecessary vaccine and immunoglobulin use.

scholarly journals Fetomaternal outcome in pregnancies complicated by fibroid

2021 ◽  
Vol 10 (8) ◽  
pp. 3174
Author(s):  
Leimapokpam Roshan Singh ◽  
Kaushik Mahajan ◽  
Nandeibam Balchand Singh ◽  
Wairokpam Prabinkumar Singh ◽  
Kabita Athokpam ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Placenta Previa ◽  
Uterine Fibroids ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
General Physical Examination ◽  
Obstetrics And Gynaecology ◽  
Risk Pregnancy ◽  
General Physical

Background: Fibromyoma (leiomyoma) is the most common benign tumour of the uterus. Approximately 10% to 30% of women with uterine fibroids developed complications during pregnancy. The aim of the study was planned to ascertain the fetomaternal outcome in pregnancies complicated by fibroid.Methods: A hospital based cross-sectional study was conducted among pregnant women with documented uterine fibroid who was admitted for any complication or delivered in the department of obstetrics and gynaecology, RIMS, Imphal from September 2017 to August, 2019 in the department of obstetrics and gynaecology in collaboration with department of paediatrics, Regional institute of Medical Sciences, Imphal. Detailed clinical history and socio-demographic profile were recorded in pre-designed proforma. General physical examination and systemic examination and obstetrical examination was carried out for the participants.Results: Major proportions was in the age group of 30-39 years (73.9%). Fibroids were more frequent in primigravida (76.1%) followed by P1 (15.2%) and ≥P2 (8.7%). Out of 46 patients 43 (93.5%) delivered by CS (69.76%), NVD (25.58%) and instrumental delivery (4.65%) while 3 patients (6.5%) undergo spontaneous abortions. Most common myoma found in this study was intramural (47.8%) followed by submucous (34.8%) and subserosal (17.4%). Out of 43 deliveries most common complications found was atonic PPH (6.97%) and placenta previa (6.97%) followed by degenerations (2.32%), abruptio placentae (2.32%), malpresentations (2.32%). Out of 43 deliveries 6.9% baby born with low birth weight, IUGR (6.9%), IUFD (4.6%), NICU admission (4.65%) and early neonatal death (2.32%).Conclusions: Pregnancies with fibroids are considered as high-risk pregnancy associated with complications during the antepartum, intrapartum, postpartum period. Pregnant women with myoma can be advised for regular ANC along with TAS for early diagnosis and management of complication.

scholarly journals Comparative Analysis of Clinical History, Sociodemographic, Behavioural Factors and Cardiovascular Risk Factors among Hypertensive in Awka, Nigeria

2019 ◽  
pp. 1-8
Author(s):  
Chidinma Ifeyinwa Mmaju ◽  
Peter Osezele Okonudo ◽  
Gladys Ahaneku ◽  
Ufoaroh Chinyelu Uchenna
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Marital Status ◽  
Cardiovascular Risk Factors ◽  
Occupational Status ◽  
Clinical History ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional

Background: Hypertension is a major modifiable risk factor for cardiovascular diseases and research studies done in Nigeria observed prevalence rate of hypertension to range from 26.4% to 36.9%. Aim: This study aimed to evaluate the sociodemographic, clinical, behavioral and cardiovascular risk factors associated with hypertension in Awka, South East, Nigeria. Methods: Cross-sectional study was used.391 participants aged from 18 years above were recruited for this study. Structured questionnaires were constructed in line with World Health Organization Step approach was utilized for data collection. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and Diastolic blood pressure ≥ 90 mmHg. Chi-square and independent sample T test were used to test comparison between two groups. Results: The mean age of the subjects was 45.87±17. 49.33.7% of retired subjects has the highest prevalence was statistically associated with hypertension in occupational status of the subjects, marital status was statically significant with hypertension and prevalence of hypertension among the subjects were 81.1%, 8.5%, 8.6% for married, single and divorcee respectively, (P<0.001) and also no association was observed between hypertension and subjects that occasionally use high salt often(x2=0.341, P>0.001). Conclusion: The study showed that age, family history of hypertension, consistent increase in blood pressure, occupational and marital status are associated risk factors of hypertension in Awka, South East, Nigeria. There is need to create awareness on the risk factors and encourage changes in sedentary life style.

scholarly journals Anti-mullerian hormone as an emerging promising marker in the prognosis of PCOS

2021 ◽  
Vol 16 (1) ◽  
pp. 111-114
Author(s):  
Anu Meena ◽  
Amit Kyal ◽  
Partha Mukhopadhyay ◽  
Pragati Sharma
Keyword(s):  
Prognostic Marker ◽  
High Specificity ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Total Testosterone ◽  
Cross Sectional ◽  
Indian Women ◽  
Specificity And Sensitivity ◽  
Time Period ◽  
Ultrasound Findings

Aims: To correlation of AMH with clinical, hormonal and ultrasound findings; and determine the role of AMH as prognostic marker. Methods: This was a prospective cross sectional study on women attending Gynaecology outpatient department of Medial College and Hospital, Kolkata, from January 2018 to June 2019. Study comprised of 70 newly diagnosed cases of PCOS using Rotterdam criteria 2003. Clinical history included menstrual complaint, hirsutism and weight gain; examination included BMI and Ferriman-Gallwey score; and investigations included FBS, 2hr PPBS, TSH, Prolactin, total testosterone, LH, AMH level and pelvic USG before starting intervention and same parameters were rechecked after 3 months of treatment completion. Results: A total of 70 PCOS patients were included in a study conducted within 1 year time period. The most common Phenotype in our study is Phenotype A (O+H+P) which was almost 85.71%, followed by Phenotype B (O+H) 7.14% and the least we got Phenotype C (H+P) that is 2.86%. There was statistically significant (p<0.05) decrease in AMH level following treatment of PCOS (before treatment mean AMH level was 9.634.42 and after treatment the level was 5.812.77). Conclusions: The most frequent PCOS phenotype in Indian women is A (O+H+P). Therapy in PCOS women with raised AMH reduces the AMH levels. Measurement of serum AMH provides a high specificity and sensitivity by which it can act as a prognostic marker for PCOS.

CLINICOEPIDEMIOLOGICAL STUDY OF CHILDHOOD PSORIASIS PATIENTS AND ITS ASSOCIATION WITH HLA-CW6 IN A TERTIARY CARE CENTRE OF EASTERN INDIA

2021 ◽  
pp. 10-11
Author(s):  
Akhilesh Behra
Keyword(s):  
Tertiary Care ◽  
Epidemiological Data ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Eastern India ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Plaque Type ◽  
Worldwide Population

BACKGROUND- Psoriasis is chronic common papulosquamous disorder. Its aetiology included various environmental and genetic factors. In genetics, HLA-Cw6 is most commonly associated with psoriasis. Childhood psoriasis is also common in worldwide population. However, very few studies done on epidemiological data and HLA-Cw6 analysis in childhood psoriasis patients. AIMS AND OBJECTIVE- Clinicoepidemiological study of childhood psoriasis patients and its association with HLA-Cw6 in a tertiary care centre of Eastern India MATERIALAND METHOD- We conducted a cross-sectional study in a tertiary care centre and recruited 20 patients of psoriasis with age group below 18 years after taking proper consent. Clinical history and blood was taken from them and HLA-Cw6 analysis was done by PCR method. Data compilation was done by Microsoft excel using SPSS software. RESULTS- A total of the 20 childhood psoriasis patients, 9 were males and 11 were females. Generalized plaque type psoriasis (N=19) is commonest followed by guttate psoriasis (N=1). None of the patients had arthalgia. Family history was present in only 3 patients. Higher numbers of childhood psoriasis patients (N=14) were positive for HLA-Cw6. Also Higher numbers of females (N=10) were positive for HLA-Cw6. ve patients had nail changes. CONCLUSION- We found HLA-Cw6 is strongly associated with childhood psoriasis and also HLA-Cw6 frequency is higher in female than male childhood psoriasis patients.

scholarly journals Prevalence and correlates of depression among Nigerian stroke survivors

2019 ◽  
Vol 25 ◽  
Author(s):  
Olushola Olibamoyo ◽  
Abiodun Adewuya ◽  
Bolanle Ola ◽  
Olurotimi Coker ◽  
Olayinka Atilola
Keyword(s):  
Social Support ◽  
Cognitive Impairment ◽  
Economic Status ◽  
Binary Logistic Regression ◽  
Clinical History ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Cross Sectional

Background: There is mixed evidence for the hypothesis that the risk of depression after stroke is influenced by the location of lesions in the hemispheres, demographic and clinical factors, and disability of stroke survivors.Aim: The current study determined the prevalence of depression and its socio-demographic and clinico-pathological correlates among stroke survivors in a tertiary hospital in Lagos, Nigeria.Method: The cross-sectional study was carried out among 112 adult patients with a clinical history of stroke confirmed by neuroimaging. Depression was diagnosed using Mini International Neuropsychiatric Interview. The socio-demographic profile was obtained, and cognitive impairment was assessed using the Mini-Mental State Examination. Stroke severity was assessed retrospectively using the National Institute of Health Stroke Scale and current disability was measured using the Modified Rankin Scale.Results: There were 48 (42.9%) stroke survivors with a clinical diagnosis of depression. Using binary logistic regression, the independent determinants of depression were younger age, unemployment, perceived poor social support, increasing number of previous admissions because of stroke, cognitive impairment, severity of stroke and current disability status. However, there was no significant association between depression and lesion location.Conclusion: Depression is a common associate of stroke, and there is a need for sustained focus on young stroke survivors with severe stroke, especially those who do not have social support and have low socio-economic status, who may have a higher risk of developing depression following stroke.

scholarly journals Lung Function Abnormalities in Sickle Cell Anaemia

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Yvonne A. Dei-Adomakoh ◽  
Jane S. Afriyie-Mensah ◽  
Audrey Forson ◽  
Martin Adadey ◽  
Thomas A. Ndanu ◽  
...  
Keyword(s):  
Steady State ◽  
Lung Function ◽  
Sickle Cell ◽  
Clinical History ◽  
Cross Sectional Study ◽  
Cell Disease ◽  
Cross Sectional ◽  
Plasma Haemoglobin ◽  
Free Plasma Haemoglobin ◽  
Free Plasma

Background. Abnormalities in lung function tests have been shown to commonly occur in a majority of patients with sickle cell disease (SCD) even at steady state. The prevalence and pattern of these lung function abnormalities have been described in other populations but this is unknown among our sickle cell cohort. There is generally little information available on risk factors associated with the lung function abnormalities and its relevance in patient care. Method. This was an analytical cross-sectional study involving 76 clinically stable, hydroxyurea-naive adult Hb-SS participants and 76 nonsickle cell disease (non-SCD) controls. A structured questionnaire was used to obtain sociodemographic data and clinical history of the participants. Investigations performed included spirometry, pulse oximetry, tricuspid regurgitant jet velocity (TRV) measurements via echocardiogram, complete blood counts, free plasma haemoglobin, serum urea, and creatinine. Results. Weight, BMI, mean FVC, and FEV1% predicted values were comparatively lower among the Hb-SS patients (p < 0.001). Abnormal spirometry outcome occurred in 70.4% of Hb-SS patients, predominantly restrictive defects (p < 0.001), and showed no significant association with steady-state Hb, WBC count, free plasma haemoglobin, frequency of sickling crisis, chronic leg ulcers, and TRV measurements (p > 0.05). The mean oxygen saturation was comparatively lower among Hb-SS patients (p < 0.001). Conclusion. Measured lung volumes were significantly lower in Hb-SS patients when compared to non-SCD controls and this difference was not influenced by anthropometric variance. Lung function abnormalities, particularly restrictive defects, are prevalent in Hb-SS patients but showed no significant association with recognized markers of disease severity.

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