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[PMID]:28449422
[Au] Autor:Jeong J; Kim SE; Park MI; Park SJ; Moon W; Kim JH; Jung K; Choi YJ; Lee JY; Lee YD
[Ad] Endereço:Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
[Ti] Título:The Effect of Anti-reflux Therapy on Patients Diagnosed with Minor Disorders of Peristalsis in High-resolution Manometry.
[So] Source:Korean J Gastroenterol;69(4):212-219, 2017 Apr 25.
[Is] ISSN:2233-6869
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background/Aims: Minor disorders of peristalsis are esophageal motility disorders categorized by the Chicago Classification (CC), version 3.0, which was announced in 2014. This study evaluated the efficacy of anti-reflux therapy in patients with minor peristaltic disorders. Methods: Patients with minor peristaltic disorders in accordance with CC v3.0 were included. We reviewed the medical records of patients with esophageal high-resolution manometry findings, and investigated the demographic and clinical information as well as the medical therapy. Thereafter, the response to treatment was assessed after at least 4 weeks of treatment. Results: A total of 24 patients were identified as having minor disorders of peristalsis from January 2010 to December 2015. The mean follow-up period was 497 days, and there were 17 patients (70.8%) patients with ineffective esophageal motility. In terms of anti-reflux therapy, proton pump inhibitors (PPIs) with prokinetic agents and PPIs alone were prescribed in 19 patients (79.2%) and 5 patients (20.8%), respectively. When the rate of response to the treatment was assessed, the responders rate (complete+satisfactory [≥50%] responses) was 54.2% and the non-responders rate (partial [<50%]+refractory responses) was 45.8%. Patients in the responder group were younger than those in the non-responder group (p=0.020). Among them, 13 patients underwent 24-hour multichannel intraluminal impedance-pH, and 10 patients (76.9%) were pathologic gastroesophageal reflux. Conclusions: The majority of esophageal minor peristaltic disorders were accompanied by gastroesophageal reflux, and therefore, they might respond to acid inhibitor. Further well-designed, prospective studies are necessary to confirm the effect of anti-reflux therapy in these patients.
[Mh] Termos MeSH primário: Transtornos da Motilidade Esofágica/diagnóstico
Refluxo Gastroesofágico/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Transtornos da Motilidade Esofágica/complicações
Esfíncter Esofágico Inferior/fisiologia
Monitoramento do pH Esofágico
Junção Esofagogástrica/fisiologia
Esofagoscopia
Feminino
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/tratamento farmacológico
Seres Humanos
Masculino
Manometria
Meia-Idade
Peristaltismo
Inibidores da Bomba de Prótons/uso terapêutico
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.4166/kjg.2017.69.4.212


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[PMID]:29065146
[Au] Autor:Siwinska N; Zak A; Baron M; Cylna M; Borowicz H
[Ad] Endereço:Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, University of Environmental and Life Sciences, Wroclaw, Poland.
[Ti] Título:Right dorsal colon ultrasonography in normal adult ponies and miniature horses.
[So] Source:PLoS One;12(10):e0186825, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to determine the normal location, wall thickness and motility of the right dorsal colon in adult ponies and miniature horses. The abdominal ultrasonography examination was performed in a study group consisting of 23 ponies and miniature horses and in a control group comprising ten Thoroughbred horses. The procedure was performed in unsedated standing animals. The location and the thickness of the right dorsal colonic wall was examined on the right side of the abdomen between the 10th and the 14th intercostal space. The contractility was recorded in the 12th intercostal space. A comparative analysis between the study group and control group was carried out using the Student's t-test. Pearson's linear correlation coefficient was used to calculate the correlation between the thickness of the colonic wall as well as the number of peristaltic movements and age, wither height and body mass of the animals. The right dorsal colon was identified in all the horses in the 12th intercostal space. In all the intercostal spaces the mean ± standard deviation (SD) wall thickness of the right dorsal colon was 0.27 ± 0.03 cm in the horses from the study group and 0.37 ± 0.03 cm in the control horses. The mean number of peristaltic contractions was 4.05 ± 1.07 per minute in the animals from the study group and 1.7 ± 0.46 contractions per minute in the control group. The values of the ultrasonographic wall thickness and peristaltic motility in small breed horses in the present study were different from the values obtained for large breed horses. The study also found that the right dorsal colon in small breed horses is physiologically located in the 12th intercostal space. This suggests that different reference values should be used in small horse breeds when performing an ultrasound examination.
[Mh] Termos MeSH primário: Colo/diagnóstico por imagem
Doenças dos Cavalos/diagnóstico por imagem
Ultrassonografia/métodos
[Mh] Termos MeSH secundário: Animais
Colo/fisiopatologia
Doenças dos Cavalos/fisiopatologia
Cavalos
Peristaltismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186825


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[PMID]:28762235
[Au] Autor:Lai NM; Ahmad Kamar A; Choo YM; Kong JY; Ngim CF
[Ad] Endereço:School of Medicine, Taylor's University, Subang Jaya, Malaysia.
[Ti] Título:Fluid supplementation for neonatal unconjugated hyperbilirubinaemia.
[So] Source:Cochrane Database Syst Rev;8:CD011891, 2017 08 01.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Neonatal hyperbilirubinaemia is a common problem which carries a risk of neurotoxicity. Certain infants who have hyperbilirubinaemia develop bilirubin encephalopathy and kernicterus which may lead to long-term disability. Phototherapy is currently the mainstay of treatment for neonatal hyperbilirubinaemia. Among the adjunctive measures to compliment the effects of phototherapy, fluid supplementation has been proposed to reduce serum bilirubin levels. The mechanism of action proposed includes direct dilutional effects of intravenous (IV) fluids, or enhancement of peristalsis to reduce enterohepatic circulation by oral fluid supplementation. OBJECTIVES: To assess the risks and benefits of fluid supplementation compared to standard fluid management in term and preterm newborn infants with unconjugated hyperbilirubinaemia who require phototherapy. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5), MEDLINE via PubMed (1966 to 7 June 2017), Embase (1980 to 7 June 2017), and CINAHL (1982 to 7 June 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: We included randomised controlled trials that compared fluid supplementation against no fluid supplementation, or one form of fluid supplementation against another. DATA COLLECTION AND ANALYSIS: We extracted data using the standard methods of the Cochrane Neonatal Review Group using the Covidence platform. Two review authors independently assessed the eligibility and risk of bias of the retrieved records. We expressed our results using mean difference (MD), risk difference (RD), and risk ratio (RR) with 95% confidence intervals (CIs). MAIN RESULTS: Out of 1449 articles screened, seven studies were included. Three articles were awaiting classification, among them, two completed trials identified from the trial registry appeared to be unpublished so far.There were two major comparisons: IV fluid supplementation versus no fluid supplementation (six studies) and IV fluid supplementation versus oral fluid supplementation (one study). A total of 494 term, healthy newborn infants with unconjugated hyperbilirubinaemia were evaluated. All studies were at high risk of bias for blinding of care personnel, five studies had unclear risk of bias for blinding of outcome assessors, and most studies had unclear risk of bias in allocation concealment. There was low- to moderate-quality evidence for all major outcomes.In the comparison between IV fluid supplementation and no supplementation, no infant in either group developed bilirubin encephalopathy in the one study that reported this outcome. Serum bilirubin was lower at four hours postintervention for infants who received IV fluid supplementation (MD -34.00 µmol/L (-1.99 mg/dL), 95% CI -52.29 (3.06) to -15.71 (0.92); participants = 67, study = 1) (low quality of evidence, downgraded one level for indirectness and one level for suspected publication bias). Beyond eight hours postintervention, serum bilirubin was similar between the two groups. Duration of phototherapy was significantly shorter for fluid-supplemented infants, but the estimate was affected by heterogeneity which was not clearly explained (MD -10.70 hours, 95% CI -15.55 to -5.85; participants = 218; studies = 3; I² = 67%). Fluid-supplemented infants were less likely to require exchange transfusion (RR 0.39, 95% CI 0.21 to 0.71; RD -0.01, 95% CI -0.04 to 0.02; participants = 462; studies = 6; I² = 72%) (low quality of evidence, downgraded one level due to inconsistency, and another level due to suspected publication bias), and the estimate was similarly affected by unexplained heterogeneity. The frequencies of breastfeeding were similar between the fluid-supplemented and non-supplemented infants in days one to three based on one study (estimate on day three: MD 0.90 feeds, 95% CI -0.40 to 2.20; participants = 60) (moderate quality of evidence, downgraded one level for imprecision).One study contributed to all outcome data in the comparison of IV versus oral fluid supplementation. In this comparison, no infant in either group developed abnormal neurological signs. Serum bilirubin, as well as the rate of change of serum bilirubin, were similar between the two groups at four hours after phototherapy (serum bilirubin: MD 11.00 µmol/L (0.64 mg/dL), 95% CI -21.58 (-1.26) to 43.58 (2.55); rate of change of serum bilirubin: MD 0.80 µmol/L/hour (0.05 mg/dL/hour), 95% CI -2.55 (-0.15) to 4.15 (0.24); participants = 54 in both outcomes) (moderate quality of evidence for both outcomes, downgraded one level for indirectness). The number of infants who required exchange transfusion was similar between the two groups (RR 1.60, 95% CI 0.60 to 4.27; RD 0.11, 95% CI -0.12 to 0.34; participants = 54). No infant in either group developed adverse effects including vomiting or abdominal distension. AUTHORS' CONCLUSIONS: There is no evidence that IV fluid supplementation affects important clinical outcomes such as bilirubin encephalopathy, kernicterus, or cerebral palsy in healthy, term newborn infants with unconjugated hyperbilirubinaemia requiring phototherapy. In this review, no infant developed these bilirubin-associated clinical complications. Low- to moderate-quality evidence shows that there are differences in total serum bilirubin levels between fluid-supplemented and control groups at some time points but not at others, the clinical significance of which is uncertain. There is no evidence of a difference between the effectiveness of IV and oral fluid supplementations in reducing serum bilirubin. Similarly, no infant developed adverse events or complications from fluid supplementation such as vomiting or abdominal distension. This suggests a need for future research to focus on different population groups with possibly higher baseline risks of bilirubin-related neurological complications, such as preterm or low birthweight infants, infants with haemolytic hyperbilirubinaemia, as well as infants with dehydration for comparison of different fluid supplementation regimen.
[Mh] Termos MeSH primário: Hidratação/efeitos adversos
Hiperbilirrubinemia Neonatal/terapia
Kernicterus/prevenção & controle
Fototerapia
[Mh] Termos MeSH secundário: Administração Intravenosa
Administração Oral
Bilirrubina/sangue
Aleitamento Materno/estatística & dados numéricos
Paralisia Cerebral/prevenção & controle
Transfusão Total/estatística & dados numéricos
Hidratação/métodos
Seres Humanos
Hiperbilirrubinemia Neonatal/sangue
Recém-Nascido
Peristaltismo
Fototerapia/métodos
Fototerapia/estatística & dados numéricos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
RFM9X3LJ49 (Bilirubin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011891.pub2


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[PMID]:28550489
[Au] Autor:Frazzoni M; de Bortoli N; Frazzoni L; Tolone S; Savarino V; Savarino E
[Ad] Endereço:Digestive Pathophysiology Unit, Baggiovara Hospital, Viale Giardini 1355, 41100, Modena, Italy. marziofrazzoni@gmail.com.
[Ti] Título:Impedance-pH Monitoring for Diagnosis of Reflux Disease: New Perspectives.
[So] Source:Dig Dis Sci;62(8):1881-1889, 2017 Aug.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Heartburn is the most specific symptom of gastroesophageal reflux disease (GERD). In clinical practice, heartburn relief by a proton pump inhibitor (PPI) trial does suffice to confirm GERD. However, an objective diagnosis of GERD is required before anti-reflux endoscopic or surgical interventions, independently from PPI response. Thus, since normal findings at upper endoscopy are detected in the majority of patients with heartburn, reflux monitoring is often required. When traditional catheter-based or wireless pH tests are used, reflux episodes are conventionally identified by pH drops below 4.0 units. Combined impedance-pH monitoring has the advantage to provide a comprehensive assessment of both physical and chemical properties of refluxate and the distinction between acid and weakly acidic refluxes, both proven to cause heartburn. Unfortunately, the conventional impedance-pH parameters, namely acid exposure time and number of reflux events, are characterized by suboptimal diagnostic sensitivity, and the reliability of symptom-reflux association indexes remains questionable. Therefore, novel impedance parameters, namely the post-reflux swallow-induced peristaltic wave (PSPW) index and the mean nocturnal baseline impedance (MNBI), have recently been proposed in order to achieve a better diagnostic yield. In fact, they proved to be highly accurate in distinguishing reflux-related from reflux-unrelated heartburn, off- as well as on-PPI therapy. Currently, manual review of impedance-pH tracings is needed because of the modest accuracy of available software tools for automated analysis. PSPW index and MNBI are highly applicable and reproducible, and their calculation requires a few additional minutes during the manual review of impedance-pH tracings. So far, we believe that PSPW index and MNBI are ready for prime time and should become part of the standard analysis of impedance-pH tracings for GERD diagnosis in patients with endoscopy-negative heartburn.
[Mh] Termos MeSH primário: Impedância Elétrica
Monitoramento do pH Esofágico/métodos
Refluxo Gastroesofágico/diagnóstico
[Mh] Termos MeSH secundário: Esôfago/química
Esôfago/fisiopatologia
Refluxo Gastroesofágico/complicações
Refluxo Gastroesofágico/fisiopatologia
Azia/tratamento farmacológico
Azia/etiologia
Seres Humanos
Concentração de Íons de Hidrogênio
Peristaltismo
Inibidores da Bomba de Prótons/uso terapêutico
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Proton Pump Inhibitors)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170528
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-017-4625-8


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[PMID]:28542509
[Au] Autor:Huh CW; Youn YH; Chung H; Lee YC; Park H
[Ad] Endereço:Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Functional restoration of the esophagus after peroral endoscopic myotomy for achalasia.
[So] Source:PLoS One;12(5):e0178414, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define "esophageal remodeling" as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate "esophageal remodeling" after POEM for achalasia. MATERIALS AND METHODS: We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE). We recruited 23 patients (13 male; mean age: 53.9 years) whose preoperative and postoperative HRM and BE results were available, from among 30 patients with achalasia who underwent POEM at two institutions between July 2013 and December 2015. RESULTS: All patients achieved clinical treatment success (Eckardt score≤3). Partial recovery of esophageal body peristalsis was noted in 1/5 patients with type I (20%), 6/11 with type II (54.5%), and 7/7 with type III (100%) achalasia after POEM. Pan-esophageal pressurization disappeared after POEM in 10/11 type II achalasia patients. The average diameter of the esophageal body after POEM was significantly decreased in all types of achalasia. CONCLUSION: POEM provided excellent clinical symptomatic relief and esophageal remodeling in terms of restoration of peristalsis and reduction in diameter of the esophageal body, especially in patients with type III achalasia.
[Mh] Termos MeSH primário: Acalasia Esofágica/cirurgia
Esofagoscopia
Esôfago/cirurgia
Cirurgia Endoscópica por Orifício Natural
Recuperação de Função Fisiológica
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Acalasia Esofágica/patologia
Acalasia Esofágica/fisiopatologia
Esôfago/patologia
Esôfago/fisiopatologia
Feminino
Seres Humanos
Masculino
Manometria
Meia-Idade
Músculo Liso/patologia
Músculo Liso/fisiopatologia
Músculo Liso/cirurgia
Tamanho do Órgão
Peristaltismo
Estudos Prospectivos
Estudos Retrospectivos
Índice de Gravidade de Doença
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178414


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[PMID]:28375482
[Au] Autor:Su A; Gandhy R; Barlow C; Triadafilopoulos G
[Ad] Endereço:Medicine, Stanford University School of Medicine, Stanford, CA, USA.
[Ti] Título:Clinical and manometric characteristics of patients with Parkinson's disease and esophageal symptoms.
[So] Source:Dis Esophagus;30(4):1-6, 2017 Apr 01.
[Is] ISSN:1442-2050
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Dysphagia is a common problem in patients with Parkinson's disease (PD); its etiology is multifactorial and its management is challenging. In this retrospective cohort analysis using prospectively collected data, we aimed to objectively characterize dysphagia and/or other esophageal symptoms in patients with PD, assess the prevalence of outflow obstruction as well as major or minor disorders of esophageal peristalsis leading to impaired esophageal clearance and highlight objective parameters that can help in the current management algorithm. Thirty-three consecutive patients with PD presenting with dysphagia, odynophagia, heartburn, regurgitation, chest pain, and weight loss underwent clinical and functional evaluation by high-resolution manometry (HRM). Esophagogastric junction (EGJ) outflow obstruction and major as well as minor disorders of peristalsis were then assessed using the Chicago classification (v3). Thirty-three PD patients with esophageal symptoms were enrolled in the study; 12 of them reported weight loss that was considered as potentially reflecting underlying esophageal dysfunction. The median age of the patients was 70 years (range: 53-89 years), 24 (75%) were men. The majority (62%) experienced dysphagia, likely contributing to weight loss in 41% of patients. Odynophagia was rare (6%) while GER symptoms, such as heartburn, regurgitation, and chest pain were noted in 37%, 31%, and 28% of patients, respectively. Using the hierarchy of the Chicago classification, 12 patients (39%) exhibited EGJ outflow obstruction, 16 (48%) diffuse esophageal spasm (DES), 18 (55%), ineffective esophageal peristalsis (IEM), 16 (48%) fragmented peristalsis, and only 2 patients (6%) had normal HRM tracings. There were no patients with HRM features of achalasia. Dysphagia is common in patients with PD and is associated with a high prevalence of underlying motility disturbances as identified by HRM. The exact impact of these motility abnormalities on symptom induction and their role in influencing clinical management are unclear and will require further study.
[Mh] Termos MeSH primário: Transtornos de Deglutição/etiologia
Gerenciamento Clínico
Esôfago/fisiopatologia
Manometria/métodos
Doença de Parkinson/complicações
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Algoritmos
Dor no Peito/etiologia
Dor no Peito/fisiopatologia
Transtornos de Deglutição/fisiopatologia
Junção Esofagogástrica/fisiopatologia
Feminino
Azia/etiologia
Azia/fisiopatologia
Seres Humanos
Refluxo Laringofaríngeo/etiologia
Refluxo Laringofaríngeo/fisiopatologia
Masculino
Meia-Idade
Doença de Parkinson/fisiopatologia
Peristaltismo/fisiologia
Estudos Prospectivos
Estudos Retrospectivos
Perda de Peso
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.1093/dote/dow038


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[PMID]:28336550
[Au] Autor:Broers C; Melchior C; Van Oudenhove L; Vanuytsel T; Van Houtte B; Scheerens C; Rommel N; Tack J; Pauwels A
[Ad] Endereço:Translational Research Center for Gastrointestinal Disorders, Department of Clinical and Experimental Medicine, KU Leuven, Belgium.
[Ti] Título:The effect of intravenous corticotropin-releasing hormone administration on esophageal sensitivity and motility in health.
[So] Source:Am J Physiol Gastrointest Liver Physiol;312(5):G526-G534, 2017 May 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Esophageal hypersensitivity is important in gastroesophageal reflux disease (GERD) patients who are refractory to acid-suppressive therapy. Stress affects visceral sensitivity and exacerbates heartburn in GERD. Peripheral CRH is a key mediator of the gut stress response. We hypothesize that CRH increases esophageal sensitivity and alters esophageal motility in health. Esophageal sensitivity to thermal, mechanical, electrical, and chemical stimuli was assessed in 14 healthy subjects after administration of placebo or CRH (100 µg iv). Perception scores were assessed for first perception, pain perception threshold (PPT), and pain tolerance threshold (PTT). Esophageal motility was investigated by high-resolution impedance manometry, before and after CRH and evaluated by distal contractile integral (DCI) and intrabolus pressure (IBP). Pressure flow analysis assessed bolus clearance (impedance ratio), degree of pressurization needed to propel bolus onward (IBP slope), and pressure flow (pressure flow index, PFI). Stress and mood were assessed during the study. Sensitivity to mechanical distention was increased after CRH compared with placebo (PPT: = 0.0023; PTT: = 0.0253). CRH had no influence on the other stimulations. DCI was increased for all boluses (liquid, = 0.0012; semisolid, = 0.0017; solid, = 0.0107). Impedance ratio for liquid ( < 0.0001) and semisolid swallows ( = 0.0327) decreased after CRH. IBP slope increased after CRH for semisolid ( = 0.0041) and solid ( = 0.0003) swallows. PFI increased for semisolid ( = 0.0017) and solid swallows ( = 0.0031). CRH increased esophageal sensitivity to mechanical distention, not to the other stimulation modalities. CRH increased esophageal contractility and tone, decreased LES relaxation, increased esophageal bolus pressurization, improved esophageal bolus clearance, and increased pressure flow. This is the first study to address the effect of corticotropin-releasing hormone (CRH) on esophageal sensitivity and alterations in motility in health. CRH administration increased esophageal sensitivity to mechanical distention. This effect is accompanied by an increase in esophageal contractility and tone and a decrease in lower esophageal sphincter relaxation. CRH increased esophageal bolus pressurization, improved esophageal bolus clearance, and increased pressure flow. The changes in esophageal contractile properties may underlie the increased sensitivity to mechanical distention after CRH.
[Mh] Termos MeSH primário: Hormônio Liberador da Corticotropina/administração & dosagem
Deglutição/fisiologia
Esôfago/efeitos dos fármacos
Esôfago/fisiologia
Motilidade Gastrointestinal/fisiologia
Peristaltismo/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Deglutição/efeitos dos fármacos
Relação Dose-Resposta a Droga
Feminino
Motilidade Gastrointestinal/efeitos dos fármacos
Seres Humanos
Injeções Intravenosas
Masculino
Meia-Idade
Peristaltismo/efeitos dos fármacos
Pressão
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
9015-71-8 (Corticotropin-Releasing Hormone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00437.2016


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[PMID]:28325440
[Au] Autor:Hayat T; Farooq S; Alsaedi A
[Ad] Endereço:Department of Mathematics, Quaid-I-Azam University 45320, Islamabad 44000, Pakistan; Nonlinear Analysis and Applied Mathematics (NAAM) Research Group, Department of Mathematics, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
[Ti] Título:Mixed convection peristaltic motion of copper-water nanomaterial with velocity slip effects in a curved channel.
[So] Source:Comput Methods Programs Biomed;142:117-128, 2017 Apr.
[Is] ISSN:1872-7565
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: The primary objective of present analysis is to model the peristalsis of copper-water based nanoliquid in the presence of first order velocity and thermal slip conditions in a curved channel. Mixed convection, viscous dissipation and heat generation/absorption are also accounted. METHOD: Mathematical formulation is simplified under the assumption of small Reynolds number and large wavelength. Regular perturbation technique is employed to find the solution of the resulting equations in terms of series for small Brinkman number. The final expression for pressure gradient, pressure rise, stream function, velocity and temperature are obtained and discussed through graphs. Mathematica software is utilized to compute the solution of the system of equations and to plot the graphical results. RESULTS: Results indicates that insertion of 30% copper nanoparticles in the basefluid (water) velocity and temperature reduces by almost 3% and 40% respecively. Moreover it is seen that size of the trapped bolus also reduces almost 20% with the insertion of 20% nanoparticles (copper) in the basefluid (water). CONCLUSION: It is noted that velocity and temperature are decreasing functions of nanoparticle volume fraction. Moreover the temperature rises when heat generation parameter and Brinkman number are enhanced.
[Mh] Termos MeSH primário: Cobre/química
Nanoestruturas/química
Peristaltismo
Água/química
[Mh] Termos MeSH secundário: Simulação por Computador
Convecção
Sistemas de Liberação de Medicamentos
Temperatura Alta
Nanopartículas Metálicas
Modelos Teóricos
Movimento (Física)
Pressão
Reologia
Software
Viscosidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
059QF0KO0R (Water); 789U1901C5 (Copper)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE


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[PMID]:28254773
[Au] Autor:Kern MK; Balasubramanian G; Sanvanson P; Agrawal D; Wuerl A; Shaker R
[Ad] Endereço:Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
[Ti] Título:Pharyngeal peristaltic pressure variability, operational range, and functional reserve.
[So] Source:Am J Physiol Gastrointest Liver Physiol;312(5):G516-G525, 2017 May 01.
[Is] ISSN:1522-1547
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The present understanding of pharyngeal motor function remains incomplete. Among the remaining gaps of knowledge in this regard is the magnitude of variability of pharyngeal peristaltic pressure amplitude. Although variability can pose difficulty in interpretation of manometric findings, its magnitude can inform the operational range and reserve of the pharyngeal contractile function. We aimed to define the intra- and intersubject and intersession variability of select pharyngeal manometric parameters and, using this information, determine the number of swallow repetitions for acquiring reliable pharyngeal manometric data. We recorded pharyngeal peristalsis in 10 healthy subjects (age: 50 ± 25 yr, 5 women) by high-resolution manometry during two separate sessions of 20 sequences of 0.5-ml water swallows. Two-way ANOVA showed significant variation in the mean peak peristaltic pressure value across sites ( < 0.0001) as well as within the data at each site ( < 0.0001). Similarly, the pharyngeal contractile integral exhibited significant inter- ( = 0.003) and intrasubject ( < 0.001) variability. The Shapiro-Wilk normality test showed mixed results, in that some sites showed normally distributed data, whereas others did not. A robust Monte Carlo simulation showed that the nominal sample size was different for various tested metrics. For a power of 0.8, commonly accepted as an adequate threshold for acceptable statistical power, the optimal sample size for various peristaltic parameters ranged between 3 and 15. There is significant intra- and intersubject variability in site-specific and integrated parameters of pharyngeal peristalsis. The observed variance indicates a significant operational range and reserve in pharyngeal contractile function while necessitating parameter-specific sample size for reliable results. Intra- and intersubject variability are significant and different at various sites within the contractile pharynx. In addition, significant swallow-to-swallow and subject-to-subject variability exists in pharyngeal contractile integral. The range of intrasubject variability indicates the existence of broad operational range and reserve. Lastly, our variability studies informed Monte Carlo and power analyses, yielding estimates of sample size that would ensure accurate representation of pressure metric variability.
[Mh] Termos MeSH primário: Deglutição/fisiologia
Manometria/métodos
Contração Muscular/fisiologia
Peristaltismo/fisiologia
Músculos Faríngeos/fisiologia
Faringe/fisiologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Pressão
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.1152/ajpgi.00382.2016


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[PMID]:28222167
[Au] Autor:Chevalier NR; Fleury V; Dufour S; Proux-Gillardeaux V; Asnacios A
[Ad] Endereço:Laboratoire Matière et Systèmes Complexes, Université Paris Diderot/CNRS UMR 7057, Sorbonne Paris Cité, Paris, France.
[Ti] Título:Emergence and development of gut motility in the chicken embryo.
[So] Source:PLoS One;12(2):e0172511, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The gastrointestinal tract transports the food bolus by peristalsis. Gut motility starts at an early age in the developing embryo, well before it is required for nutrition of the organism. We present a comprehensive kinematic study of the emergence and physiological development of gut motility in all regions of the lower digestive tract of the chicken embryo from embryonic days E5 through E9. We characterized motility emergence time, propagation patterns, speed, frequency and amplitude of peristalsis waves. We found that the emergence of an uninterrupted circular ring of smooth muscle correlated with the appearance of propagative contractile waves, at E6 in the hindgut and midgut, and at E9 in the caecal appendix. We show that peristalsis at these stages is critically dependent on calcium and is not mediated by neurons as gut motility is insensitive to tetrodotoxin and takes place in the hindgut in the absence of neurons. We further demonstrate that motility also matures in ex-vivo organ culture. We compare our results to existing literature on zebrafish, mouse and human motility development, and discuss their chronological relationship with other major developmental events occurring in the chicken embryonic gut at these stages. Our work sets a baseline for further investigations of motility development in this important animal model.
[Mh] Termos MeSH primário: Embrião de Galinha/fisiologia
Peristaltismo
[Mh] Termos MeSH secundário: Animais
Cálcio/metabolismo
Cálcio/farmacologia
Bloqueadores dos Canais de Cálcio/farmacologia
Canais de Cálcio/fisiologia
Movimento Celular
Cobalto/farmacologia
Modelos Animais de Doenças
Doença de Hirschsprung
Intestinos/embriologia
Intestinos/inervação
Intestinos/fisiologia
Músculo Liso/embriologia
Músculo Liso/fisiologia
Plexo Mientérico/embriologia
Crista Neural/citologia
Técnicas de Cultura de Órgãos
Peristaltismo/efeitos dos fármacos
Tetrodotoxina/farmacologia
Imagem com Lapso de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Calcium Channel Blockers); 0 (Calcium Channels); 3G0H8C9362 (Cobalt); 4368-28-9 (Tetrodotoxin); EVS87XF13W (cobaltous chloride); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0172511



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