scholarly journals Сapabilitу of 24-hour esophageal pH-impedance monitoring in the diagnosis of GERD-associated laryngeal diseases

2020 ◽  
pp. 62-72
Author(s):  
S. V. Starostina ◽  
V. M. Makhov ◽  
O. A. Storonova ◽  
A. V. Bolshakov ◽  
I. V. Kuprina ◽  
...  
Keyword(s):  
Ph Value ◽  
Laryngopharyngeal Reflux ◽  
Morphological Changes ◽  
Upper Esophageal Sphincter ◽  
Diagnostic Methods ◽  
Laryngeal Diseases ◽  
Esophageal Clearance ◽  
Pharyngeal Muscles ◽  
Reflux Laryngitis ◽  
Impedance Monitoring

Extraesophageal manifestations of gastroesophageal reflux disease (GERD), despite the improvement of methods of diagnosis and treatment of patients with this pathology, still remain an urgent problem of medicine and cause increased attention of clinicians and researchers. In some cases, patients with GERD do not present typical complaints of heartburn, regurgitation; the disease may manifest extraesophageal manifestations, such as chronic cough, hoarseness, reflux laryngitis, and others caused by the presence of laryngopharyngeal reflux (LFR) – inflammation of the mucous membrane of the upper digestive and respiratory tracts with possible morphological changes associated with direct and indirect (reflex) exposure to gastroduodenal reflux. The occurrence of LFR is possible due to a violation of the motor function of the esophagus and insufficiency of the upper esophageal sphincter, as well as a decrease in the tone of the pharyngeal muscles. The most accessible methods of diagnosis of LFR are registration of complaints according to the questionnaire “index of reflux symptoms”, assessment of the clinical and functional state of the larynx using a visually analog “scale of reflux signs”. A positive response to the empirical use of proton pump inhibitors in combination with procinetics and determination of pepsin content in saliva can also be alternative diagnostic methods. To date, 24-hour pH-impedance monitoring is a method that allows the most accurate diagnosis of all types of reflux, regardless of the pH value, to verify high reflux in combination with its physical properties, as well as to estimate the time of chemical and volumetric esophageal clearance. In addition to performing esophagogastroduodenoscopy, the use of this method is indicated in patients with suspected extraesophageal manifestations of GERD. The article presents clinical examples of patients with extraesophageal manifestations of GERD, describes the possibilities of 24-hour pH-impedance monitoring of the esophagus in the diagnosis of LFR and reflux-associated diseases of the larynx.

scholarly journals Laryngopharyngeal reflux diagnostics: review article

2021 ◽  
pp. 48-57
Author(s):  
I. B. Angotoeva ◽  
A. K. Aylarov ◽  
S. Ya. Kosyakov ◽  
I. D. Loranskaya ◽  
E. E. Rumyantseva
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Direct Action ◽  
Abdominal Ultrasound ◽  
Placebo Treatment ◽  
Upper Esophageal Sphincter ◽  
Diagnostic Methods ◽  
Response To Treatment ◽  
Modern Problem ◽  
Ph Metry

Laryngopharyngeal reflux (LPR) is an actual, modern problem for the practice of an ENT doctor, because majority of complaints lead the patient, first of all, to an otorhinolaryngologist. LPR is an extraesophageal manifestation of gastroesophageal reflux disease (GERD), which leads to a recurrent course of symptoms resulting from the direct action of gastric contents on the mucous membrane of the laryngopharynx when ingested through the upper esophageal sphincter, as well as a decrease in the quality of life. Patients with LPR represent 4% to 10% of outpatients visiting an ENT physician. The main problem of diagnosing of LPR is that there are not any exact researches for this disease, such as PCR-test or biopsy. GERD diagnostic methods performed by gastroenterologists include: assessment of complaints, esophagogastroduodenoscopy (EGDS), intraesophageal pH-metry, esophageal manometry, impedance-pH-metry with the placement of 2 probes in the esophagus and pharynx, gastrointestinal fluoroscopy (GI) with barium, gastroesophageal scintigraphy, abdominal ultrasound (abdominal ultrasound), and pepsin test. All these tests are widely using for diagnosis and sometimes helps us. But the question remains: do all these research methods allow to establish the presence of LPR? Interpretation of existing studies is difficult due to the ambiguous diagnostic criteria for LPR, varying rates of response to treatment, and the significant effect of placebo treatment. Therefore, diagnostic methods for LFR require further study and development.

Usefulness of Matrix Metalloproteinase-7 in Saliva as a Diagnostic Biomarker for Laryngopharyngeal Reflux Disease.

2021 ◽  
Author(s):  
Nu-Ri Im ◽  
Byoungjae Kim ◽  
Kwang-Yoon Jung ◽  
Seung-Kuk Baek
Keyword(s):  
Matrix Metalloproteinase ◽  
Sensitivity And Specificity ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Diagnostic Methods ◽  
Reflux Symptom Index ◽  
Enzyme Activity Assay ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Matrix Metalloproteinase 7

Abstract Introduction Several diagnostic methods are currently being used to diagnose LPRD (laryngopharyngeal reflux disease), but have the disadvantage of being invasive, subjective, or expensive. Objectives Our purpose in this study was to investigate the correlation between pepsin and MMP-7 (Matrix Metalloproteinase-7) in pharyngeal secretions of subjects according to RSI (Reflux Symptom Index) score to find out the diagnostic value of MMP-7. Method We recruited 173 subjects aged between 19 and 85 years who completed the RSI scale. All samples were taken after waking up, and the amount of the pepsin and MMP-7 in saliva were measured by means of an enzyme activity assay. Results There was a significant increase of pepsin and MMP-7 activity in the study group with an RSI score of 13 or higher. The sensitivity and specificity of MMP-7 for predicting the possibility of an RSI of 13 or more was higher than that of pepsin. When MMP-7 and pepsin were combined, this sensitivity and specificity increased. Conclusion An enzyme assay of MMP-7 in saliva may be a noninvasive and easy technique for diagnosing LPRD.

scholarly journals SPECIFICS AND DIAGNOSTIC PROCEDURE IN REFLUX-RELATED DYSPHONIA

2020 ◽  
Vol 73 (4) ◽  
pp. 814-817
Author(s):  
Klaudia Sowa ◽  
Anna Łobaczuk-Sitnik ◽  
Bartosz Piszczatowski ◽  
Emilia Duchnowska ◽  
Bożena Kosztyła-Hojna ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Morphological Changes ◽  
Voice Disorders ◽  
Vocal Folds ◽  
Congenital Defects ◽  
Upper Respiratory Tract ◽  
Laryngopharyngeal Reflux Disease ◽  
Pharynx Cancer

Voice is a work tool for many professional groups. Currently, cases of dysphonia of multiple origin consist a growing issue. Voice disorders may result from disturbed voice production process, congenital defects, post-traumatic conditions, chronic diseases or hormonal disorders. Chronic diseases causing voice disorders include laryngopharyngeal reflux disease and esophageal reflux disease. The chronic character of reflux causes the formation of numerous morphological changes of the larynx, including: hyperemia of the mucosa limited to arytenoid and intraarytenoid area, edema of the vocal folds, edema of the larynx mucosa. These changes contribute to voice disorders. Among the pathological changes of voice organ etiologically associated with reflux, the following disease units may be distinguished: reflux laryngitis, subglottic edema, contact ulceration, larynx granuloma, larynx and pharynx cancer. Many of disorders in the upper respiratory tract are etiologically related to reflux, e.g. dysphonia, grunting, coughing and dyspnoea.

scholarly journals Influence of Fluoride Concentration and pH Value of 35% Hydrogen Peroxide on the Hardness, Roughness and Morphology of Bovine Enamel

2014 ◽  
Vol 15 (4) ◽  
pp. 392-398 ◽  
Author(s):  
Wilcilene Costa Nascimento ◽  
Yasmin do Socorro Batista de Lima Gomes ◽  
Larissa Dias Alexandrino ◽  
Hilton Tulio Costi ◽  
José Otávio Carrera Silva ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Ph Value ◽  
Morphological Changes ◽  
Fluoride Concentration ◽  
Knoop Hardness ◽  
Scanning Electron Micrographs ◽  
High Concentration ◽  
Acidic Group ◽  
Bovine Enamel

ABSTRACT Aim The aim of this in vitro study was to evaluate the effects of different sodium fluoride (NaF) concentrations and pH values on the Knoop hardness (KHN), surface roughness (SR), and morphology of bovine incisors bleached with 35% hydrogen peroxide (HP). Materials and methods Sixty-five bovine incisors were fragmented (5 mm2 × 2 mm) and distributed in 5 groups: Control (unbleached), Low NaF/Acidic (35% HP + 1.3% NaF, pH 5.5), Low NaF/Neutral (35% HP + 1.3% NaF, pH 7.0), High NaF/ Acidic (35% HP + 2% NaF, pH 5.5), and High NaF/Neutral (35% HP + 2% NaF, pH 7.0). KHN analysis was performed with a microhardness tester under a load of 25 gf for 5 seconds. The average SR was obtained with a rugosimeter. KHN and SR were analyzed before and after treatments. For morphological analysis, specimens were dehydrated and gold-sputtered, and scanning electron micrographs were obtained and analyzed by 3 examiners with a double-blinded technique. KHN and SR results were analyzed by one-way ANOVA and Tukey's test (p < 0.05). Results Only the Low NaF/Acidic and Low NaF/Neutral groups showed significant differences between the initial and final KHN values. All bleached groups presented significant differences between the initial and final SR values. Among the bleached groups, the least and most morphological changes were shown by the High NaF/Neutral and the Low NaF/Acidic group, respectively. Conclusion Treatment with 35% HP and 2% NaF at pH 7.0 promoted the least changes in morphology, hardness and roughness among the bleached groups. Clinical significance In-office bleaching with high-concentration HP and 2% NaF at neutral pH promoted the least changes in enamel hardness, SR, and morphology compared to other treatments. How to cite this article Nascimento WC, Gomes YSBL, Alexandrino LD, Costi HT, Silva JOC Jr, Silva CM. Influence of Fluoride Concentration and pH Value of 35% Hydrogen Peroxide on the Hardness, Roughness and Morphology of Bovine Enamel. J Contemp Dent Pract 2014;15(4):392-398.

First Agreement Analysis and Day-to-Day Comparison of Pharyngeal pH Monitoring with pH/Impedance Monitoring in Patients with Suspected Laryngopharyngeal Reflux

2012 ◽  
Vol 16 (6) ◽  
pp. 1096-1101 ◽  
Author(s):  
Valentin Becker ◽  
Simone Graf ◽  
Christoph Schlag ◽  
Tibor Schuster ◽  
Hubertus Feussner ◽  
...  
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Impedance Monitoring

Microscopic characterization of acidic paper manuscripts

2019 ◽  
Vol 48 (2) ◽  
pp. 119-128 ◽  
Author(s):  
Safa Abd El kader Mohamed Hamed ◽  
Rushdya Rabee Ali Hassan
Keyword(s):  
Ph Value ◽  
Morphological Changes ◽  
Environmental Scanning ◽  
X Ray Diffraction ◽  
Arabic Gum ◽  
Content Type ◽  
Cellulosic Fibers ◽  
Fiber Degradation ◽  
Historical Samples

Purpose This paper aims to investigate the effect of acidity on the morphology of archeological paper, especially in the presence of colors and whether natural pigments play a role in the process of degradation. Design/methodology/approach The morphological changes in the cellulosic fibers of the manuscripts because of acidity were investigated using environmental scanning electron microscope (ESEM). Ten historical samples were collected from different manuscripts suffering from acidity. X-ray diffraction was used to identify the inks and pigments that were used in some samples. Additionally, Fourier transform infrared microscopy was used to identify the binding medium. Findings The results confirmed that carbon ink, ultramarine, cinnabar and gold pigments were applied to some manuscripts with Arabic gum. As for ESEM investigation, the results proved that acidity badly affected the integrity of the cellulosic fibers resulting in their embrittlement. The micrographs showed differences in fiber degradation according to pH value. The presence of inks and pigments increased the degradation extent resulting from acidity. Originality/value This paper addresses a specific need to study the behavior of degradation in paper manuscripts, thus helping the conservators find solutions to the phenomenon.

scholarly journals 260. Detection of Aspergillus fumigatus Infection in Mice with 2-Deoxy-2-[18F]fluorosorbitol

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S144-S145
Author(s):  
Yohan Yu ◽  
Seung ji Kang ◽  
Dong-Yeon Kim ◽  
Ayoung Pyo ◽  
Sehyeon Ji ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Pet Imaging ◽  
Ph Value ◽  
Diagnostic Methods ◽  
Bacterial Strains ◽  
Brain Infection ◽  
Uptake Assay ◽  
Uptake Test

Abstract Background Invasive aspergillosis is a major cause of infectious morbidity and mortality in immunocompromised patients.However, definitive diagnosis of invasive Aspergillus infection is still difficult due to the lack of a rapid, sensitive and specific diagnostic methods. In this studies, we investigated 2-deoxy-2-[18F]fluorosorbitol ([18F]FDS) which has been reported to be accumulated in Gram-negative bacteria but not in Gram-positive bacteria or healthy mammalian or cancer cells, for the imaging detection of Aspergullus fumigatus infections with PET in vivo. Methods [18F]FDS was synthesized by reduction of 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) using NaBH4. When the reaction was complete, the mixture was adjusted to a pH value to 6.5–7.5. Subsequently, the solution was filtered directly into a sterile product vial through a Sep-Pak Alumina N cartridge with a sterile filter. The probe uptake assay was performed by incubating bacterial cell and fungi with [18F]FDS (20 µCi) at 37°C for 2 h. Female BALB/c were immunosuppressed with cyclophosphamide and cortisone acetate prior to A. fumigatus intranasal, intramuscular, brain infection. The mircoPET images were obtained at 2 h after i.v. injection of [18F]FDS in infected mice. Results In vitro uptake test revealed significantly higher accumulation of [18F]FDS at 2 hin A. fumigatus, C. albicans and R. oryzae rather than with bacterial strains (Figure 1). PET imaging of BALB/c mice with pulmonary A. fumigatus infections showed obvious accumulation of [18F]FDS in the infected lungs compared with control (Figure 2). [18F]FDS PET imaging also detected A. fumigatus muscle and brain infection in mice. In infected shoulder muscle of mice, [18F]FDS PET imaging showed high legion-to-background ratio at 2 h. (4.05 ± 1.59, Figure 3). Conclusion [18F]FDS PET study demonstrated stable uptake in infected tissue with A. fumigatus and rapid clearance from the blood and other organs. [18F]FDS could be a useful imaging probe visualizing the invasive aspergillosis in vivo. Disclosures All authors: No reported disclosures.

scholarly journals Feline caliciviruses (FCVs) isolated from cats with virulent systemic disease possess in vitro phenotypes distinct from those of other FCV isolates

2007 ◽  
Vol 88 (2) ◽  
pp. 506-517 ◽  
Author(s):  
Robert J. Ossiboff ◽  
Alexander Sheh ◽  
Justine Shotton ◽  
Patricia A. Pesavento ◽  
John S. L. Parker
Keyword(s):  
Tissue Culture ◽  
Morphological Changes ◽  
Phylogenetic Analyses ◽  
Systemic Disease ◽  
Growth Conditions ◽  
Diagnostic Methods ◽  
Culture Cells ◽  
The Usa ◽  
Multiple Cycle

During the past decade, several outbreaks of severe systemic disease associated with Feline calicivirus (FCV) have occurred in the USA and the UK. This new disease has caused high mortality in the affected animals and has been termed virulent systemic (VS)-FCV disease. Currently, there are no genetic or in vitro diagnostic methods to distinguish viruses isolated from cases of VS-FCV disease from other isolates. Here, five in vitro properties, as well as the capsid and proteinase–polymerase (pro–pol) sequences, of a set of FCV isolates that included seven isolates from five distinct VS-FCV outbreaks (‘VS isolates’) were investigated. Although all of the FCV isolates investigated had similar kinetics of growth under single-cycle conditions, VS isolates infected tissue-culture cells more efficiently under multiple-cycle growth conditions. Moreover, it was found that cells infected with VS isolates showed cytopathic effects earlier than cells infected with non-VS isolates, although no difference in relative ATP levels were noted at times when morphological changes were first seen. Both VS- and other (non-VS) isolates of FCV demonstrated similar temperature stabilities. Phylogenetic analyses and alignments of the capsid and pro–pol regions of the genome did not reveal any conserved changes that correlated with virulence, and the VS isolates did not segregate into a unique clade. These results suggest that VS isolates have arisen independently several times since first being described and can spread more efficiently in tissue culture than other isolates when infected at low multiplicity.

scholarly journals Effects of laryngeal restriction on pharyngeal peristalsis and biomechanics: Clinical implications

2016 ◽  
Vol 310 (11) ◽  
pp. G1036-G1043 ◽  
Author(s):  
Reza Shaker ◽  
Patrick Sanvanson ◽  
Gokulakrishnan Balasubramanian ◽  
Mark Kern ◽  
Ashley Wuerl ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Contractile Function ◽  
Significant Negative Correlation ◽  
Upper Esophageal Sphincter ◽  
Resistive Load ◽  
Video Recordings ◽  
Pharyngeal Muscles ◽  
Esophageal Sphincter ◽  
Group 2 ◽  
Ues Opening

To date, rehabilitative exercises aimed at strengthening the pharyngeal muscles have not been developed due to the inability to successfully overload and fatigue these muscles during their contraction, a necessary requirement for strength training. The purpose of this study was to test the hypothesis that applying resistance against anterosuperior movement of the hyolaryngeal complex will overload the pharyngeal muscles and by repetitive swallowing will result in their fatigue manifested by a reduction in pharyngeal peristaltic amplitude. Studies were done in two groups. In group 1 studies 15 healthy subjects (age: 42 ± 14 yr, 11 females) were studied to determine whether imposing resistance to swallowing using a handmade device can affect the swallow-induced hyolaryngeal excursion and related upper esophageal sphincter (UES) opening. In group 2, an additional 15 healthy subjects (age 56 ± 25 yr, 7 females) were studied to determine whether imposing resistance to the anterosuperior excursion of the hyolaryngeal complex induces fatigue manifested as reduction in pharyngeal contractile pressure during repeated swallowing. Analysis of the video recordings showed significant decrease in maximum deglutitive superior laryngeal excursion and UES opening diameter ( P < 0.01) due to resistive load. Consecutive swallows against the resistive load showed significant decrease in pharyngeal contractile integral (PhCI) values ( P < 0.01). Correlation analysis showed a significant negative correlation between PhCI and successive swallows, suggesting “fatigue” ( P < 0.001). In conclusion, repeated swallows against a resistive load induced by restricting the anterosuperior excursion of the larynx safely induces fatigue in pharyngeal peristalsis and thus has the potential to strengthen the pharyngeal contractile function.

scholarly journals Videostroboscopy in Laryngopharyngeal Reflux Disorder

2011 ◽  
Vol 1 (2) ◽  
pp. 52-56
Author(s):  
S Raghunandhan ◽  
Kiran Natarajan ◽  
S Raghunandhan ◽  
Jawahar Nagasundaram ◽  
Srividya Prashanth
Keyword(s):  
Early Diagnosis ◽  
World Literature ◽  
Laryngopharyngeal Reflux ◽  
Acid Reflux ◽  
Voice Analysis ◽  
Reflux Laryngitis ◽  
Sensitive Tool ◽  
Separate Clinical Entity ◽  
Life Threatening ◽  
Chronic Laryngitis

ABSTRACT Introduction Acid reflux disease of the larynx has been established as a separate clinical entity in the present day, requiring the nuances of a skilled laryngologist for its early diagnosis and appropriate management. Clinical presentations of laryngopharyngeal reflux disorder may vary from very subtle to mammoth proportions, ranging across a panorama of features like chronic laryngitis, indolent laryngeal ulcers or granulomas, onto life-threatening glottic/sub-glottic stenosis and laryngeal malignancies very rarely. With the advent of videostroboscopy, laryngologists have now acquired a ‘cutting-edge’ sensitive tool to look into the intricacies of the larynx and thereby study the pathological effects of laryngopharyngeal reflux in great detail. Objective To assess the efficacy of videostroboscopy with voice analysis, as a diagnostic and prognostic tool in a cohort of patients with laryngopharyngeal reflux disorder. Study method This prospective study was conducted over a two-year period, among 50 patients with hoarseness of voice and features of reflux laryngitis, who underwent videostroboscopy with voice analysis at initial diagnosis and at routine follow-up, to objectively study the response and outcome of anti-reflux therapy on the larynx. Observation and result Videostroboscopy provided a vivid picture of the changes in larynx due to chronic acid reflux and proved efficacious in precisely judging the treatment responses. Conclusion Our study reflects the recent concept highlighted in world literature that videostroboscopy is an ideal, sensitive tool for early diagnosis and in prognosis of acid induced laryngeal disorder.

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