Prospective Study of Lactose Intolerance as a Potential Cause of Gas Bloat Syndrome in Patients Treated Surgically for Gastroesophageal Reflux

2019 ◽  
Vol 27 (2) ◽  
pp. 160-164
Author(s):  
Francisco Javier Pérez Lara ◽  
Jose Manuel Hernández Gonzalez ◽  
Juan Doblas Fernández ◽  
Elena Corrales Valero ◽  
Herman Oehling de los Reyes
Keyword(s):  
Gastroesophageal Reflux ◽  
Prospective Study ◽  
Lactose Intolerance ◽  
Intestinal Gas ◽  
Number Of Patients ◽  
Before And After ◽  
Significant Probability ◽  
Study Participants

Introduction. The high incidence of lactose intolerance leads us to consider that many of our patients could suffer from this alteration. Therefore, as its main sign (even when asymptomatic) is increased intestinal gas, patients recovering from a Nissen fundoplication have a significant probability of suffering from gas bloat syndrome. Materials and Methods. This prospective study was conducted from November 2012 to January 2017, we included all the patients who had been treated by the Nissen technique for gastroesophageal reflux disease with gas bloat syndrome detected during follow-up and tested positive for lactose intolerance. The study participants were then prescribed a lactose-poor diet to be followed for 3 months. The patients were asked to complete quality of life and symptomatology questionnaires before and after diet. The pre- and post-diet results were then compared. Results. The pre- and post-diet results showed statistically significant improvements in both questionnaires. Conclusion. Lactose intolerance may account for the symptoms presented by a significant number of patients with gas bloat syndrome following antireflux surgery; these patients could benefit from consuming a lactose-free diet, which we expect to alleviate or, in some cases, eliminate the above symptoms.

scholarly journals Learning from the crowd while mapping to LOINC

2015 ◽  
Vol 22 (6) ◽  
pp. 1205-1211 ◽  
Author(s):  
Daniel J Vreeman ◽  
John Hook ◽  
Brian E Dixon
Keyword(s):  
Community Members ◽  
General Satisfaction ◽  
Community Mapping ◽  
Before And After ◽  
Study Participants ◽  
Automated Methods

Abstract Objective To describe the perspectives of Regenstrief LOINC Mapping Assistant (RELMA) users before and after the deployment of Community Mapping features, characterize the usage of these new features, and analyze the quality of mappings submitted to the community mapping repository. Methods We evaluated Logical Observation Identifiers Names and Codes (LOINC) community members’ perceptions about new “wisdom of the crowd” information and how they used the new RELMA features. We conducted a pre-launch survey to capture users’ perceptions of the proposed functionality of these new features; monitored how the new features and data available via those features were accessed; conducted a follow-up survey about the use of RELMA with the Community Mapping features; and analyzed community mappings using automated methods to detect potential errors. Results Despite general satisfaction with RELMA, nearly 80% of 155 respondents to our pre-launch survey indicated that having information on how often other users had mapped to a particular LOINC term would be helpful. During the study period, 200 participants logged into the RELMA Community Mapping features an average of 610 times per month and viewed the mapping detail pages a total of 6686 times. Fifty respondents (25%) completed our post-launch survey, and those who accessed the Community Mapping features unanimously indicated that they were useful. Overall, 95.3% of the submitted mappings passed our automated validation checks. Conclusion When information about other institutions’ mappings was made available, study participants who accessed it agreed that it was useful and informed their mapping choices. Our findings suggest that a crowd-sourced repository of mappings is valuable to users who are mapping local terms to LOINC terms.

Quality of Life Before and After Endovascular and Open Repair of Asymptomatic AAAs: A Prospective Study

2000 ◽  
Vol 7 (5) ◽  
pp. 372-379 ◽  
Author(s):  
Martin Malina ◽  
Marie Nilsson ◽  
Jan Brunkwall ◽  
Krasnodar Ivancev ◽  
Timothy Resch ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Open Repair ◽  
Before And After ◽  
A Prospective Study

Obesity management through Ayurveda - A Case Study

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Dheeraj Kumar Tyagi ◽  
Shivakumar .
Keyword(s):  
Clinical Findings ◽  
Dietary Habit ◽  
Unhealthy Lifestyle ◽  
Lifestyle Management ◽  
Before And After ◽  
Effect Of Treatment ◽  
And Control

Lifestyle disorders are one of the biggest threats for the population living unhealthy lifestyle. Sthoulya (Obesity) is one such disorder which creates lot of physical as well as mental disorder to the sufferer. Due to changing lifestyle, comforts and dietary habit lots of individuals changed their life totally. Obesity is a growing disease in developed and developing countries. Prevalence is drastically hike in past few years. Ayurveda, the science of life with which we can manage and control lots of lifestyle disorders. Focusing on dietary and lifestyle management along with treatment, we can overcome the hazards of obesity which is growing in a uncontrolled manner. The available data is based on the clinical findings only. Aim and objective: To assess the effect of “Guru Cha Atarpanam Chikitsa” in the management of Sthoulya. Setting: Swastharakshana evam Yoga, OPD and IPD, SDMCAH, Hassan. Method: Udwarthana, Parisheka, Shamana Aushadhis, Ahara, and Vihara was followed within the treatment duration and effect of treatment was assessed before and after treatment, advised for follow up. Results: The treatment adopted is effective in the management of Sthoulya and to improve the quality of life.

scholarly journals POSTOPERATIVE DYSPHAGIA AFTER LAPAROSCOPIC FUNDOPLICATION AS A TREATMENT FOR GASTROESOPHAGEAL REFLUX DISEASE

2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
B Carrasco Aguilera ◽  
S Amoza Pais ◽  
T Diaz Vico ◽  
E O Turienzo Santos ◽  
M Moreno Gijon ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Surgical Technique ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Reflux Disease ◽  
Laparoscopic Fundoplication ◽  
Descriptive Study ◽  
Postoperative Dysphagia

Abstract INTRODUCTION Laparoscopic Fundoplication (LF) as a treatment for gastroesophageal reflux disease (GERD) has positive clinical outcomes. However, postoperative dysphagia (PD) may appear as a side effect. Our objective is to analyze PD in patients operated on for LF in our center. MATERIAL AND METHODS Retrospective and descriptive study of patients operated on for GERD from September 1997 to February 2019. RESULTS 248 patients (60.5% men), with a mean age of 49.7 (21-82), were operated. 66.1% of the patients presented associated comorbidities, highlighting obesity (19.8%). 75% manifested typical symptoms, 19% presenting with Barrett’s esophagus. Sliding hiatal, paraesophageal, mixed and complex hernia were diagnosed in 151 (60.9%), 23 (9.3%), 12 (4.8%), and 4 (1.6%) patients, respectively. The LF Nissen was the most frequent technique (91.5%), using a caliper in 46% of the cases. PD was the most frequent symptom, present in 57 (23%) patients. It was resolved with dilation in 9 patients, requiring 6 patients surgical reintervention. In those PD cases, a caliper was used in 28 (49.1%) patients, without finding significant differences between them (P = .586). Nor were there significant differences between PD and obesity (P = .510), type of hiatal hernia (P = .326), or surgical technique (P = .428). After a median follow-up of 50.5 months, quality of life was classified as Visick I-II, III, and IV in 76.6%, 6.9% and 1.2% of the cases, respectively. CONCLUSION No association between PD and the use of calipers, surgical technique or type of hiatal hernia was found in our series.

Prospective Study of Functional Status and Quality of Life Before and After Lung Transplantation

CHEST Journal ◽  
2000 ◽  
Vol 118 (1) ◽  
pp. 115-122 ◽  
Author(s):  
Dorothy M. Lanuza ◽  
Cheryl Lefaiver ◽  
Mary Mc Cabe ◽  
Gabriella A. Farcas ◽  
Edward Garrity
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Lung Transplantation ◽  
Functional Status ◽  
Before And After

536 QUALITY OF LIFE AND FOLLOW-UP AFTER ESOPHAGEAL AND GASTRIC CANCER SURGERY. PROTOCOL FOR DEVELOPING AND TESTING A NEW FOLLOW-UP MODEL

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
I Hovdenak Jakobsen ◽  
D Kjaer
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Adverse Effects ◽  
Prospective Study ◽  
Patient Involvement ◽  
Complex Interventions ◽  
National Implementation ◽  
Patient Reported

Abstract   Esophageal and gastric cancers are aggressive diseases. Due to extensive treatment, many patients experience adverse effects such as dysphagia, dumping, pain, fatigue, fear of recurrence and depression—all negatively impacting quality of life (QoL). The purpose of this study is to develop and test a follow-up model for patients after surgery for esophageal and gastric cancer. The model targets handling of adverse effects and psychosocial distress, aiming at improving patients’ QoL and functional level. Methods Development of the model follows recognized principles for complex interventions by the Medical Research Counsil. Extensive patient involvement is included in the development process, by means of a national patient advisory board. The assumed effect of the new model will be tested in a national two-part prospective study, executed before and after national implementation of the model, in both parts including approximately200 patients. Participants will be recruited prior to surgery, and follow-up is one year. Patient-reported data will be collected pre-operatively, at 3, 6, 9 and 12 months postoperatively, along with clinical and sociodemographic data. Results Development of the follow-up model after surgery will be completed in august 2020 and inclusion of patients for the prospective study part one, before implementation of the model, will commence summer 2020. Conclusion The perspectives of this study may be crucial for future follow-up of esophageal and gastric cancer patients. First, the extensive patient involvement in developing the model will ensure a patient-centred approach to follow-up. And second, the follow-up studies will provide important and up-to-date knowledge about clinical and patient-reported outcomes in a population-based, national cohort.

scholarly journals Education in Neurology Resident Documentation Using Payroll Simulation

2017 ◽  
Vol 9 (2) ◽  
pp. 231-236 ◽  
Author(s):  
John W. Liang ◽  
Vicki L. Shanker
Keyword(s):  
Medical Decision ◽  
Financial Loss ◽  
Income Loss ◽  
Face To Face ◽  
Number Of Patients ◽  
Specific Feedback ◽  
Didactic Lecture ◽  
E Mail

ABSTRACT Background Approaches for teaching neurology documentation include didactic lectures, workshops, and face-to-face meetings. Few studies have assessed their effectiveness. Objective To improve the quality of neurology resident documentation through payroll simulation. Methods A documentation checklist was created based on Medicaid and Medicare evaluation and management (E/M) guidelines. In the preintervention phase, neurology follow-up clinic charts were reviewed over a 16-week period by evaluators blinded to the notes' authors. Current E/M level, ideal E/M level, and financial loss were calculated by the evaluators. Ideal E/M level was defined as the highest billable level based on the documented problems, alongside a supporting history and examination. We implemented an educational intervention that consisted of a 1-hour didactic lecture, followed by e-mail feedback “paystubs” every 2 weeks detailing the number of patients seen, income generated, income loss, and areas for improvement. Follow-up charts were assessed in a similar fashion over a 16-week postintervention period. Results Ten of 11 residents (91%) participated. Of 214 charts that were reviewed preintervention, 114 (53%) had insufficient documentation to support the ideal E/M level, leading to a financial loss of 24% ($5,800). Inadequate documentation was seen in all 3 components: history (47%), examination (27%), and medical decision making (37%). Underdocumentation did not differ across residency years. Postintervention, underdocumentation was reduced to 14% of 273 visits (P < .001), with a reduction in the financial loss to 6% ($1,880). Conclusions Improved documentation and increased potential reimbursement was attained following a didactic lecture and a 16-week period in which individual, specific feedback to neurology residents was provided.

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