1,702 research outputs found
The hypercontractile esophagus: Still a tough nut to crack
No full textHypercontractile esophagus (HE), also known as jackhammer esophagus, is an esophageal motility disorder. Nowadays, high-resolution manometry (HRM) is used to diagnose the disorder. According to the latest iteration of the Chicago classification, HE is present when at least 2 out 10 liquid swallow-induced peristaltic waves have an abnormally high Distal Contractile Integral. In the era of conventional manometry, a similar condition, referred to as nutcracker esophagus, was diagnosed when the peristaltic contractions had an abnormally high mean amplitude. Although the HRM diagnosis of HE is relatively straight-forward, effective management of the disorder is challenging as the correlation with symptoms is variable and treatment effects are dubious. In this mini-review, we discuss the most troublesome uncertainties that still surround HE, in the light of new data on etiology and epidemiology published in this issue of Neurogastroenterology and Motility
Development of the Valuing Questionnaire (VQ)
No full textAbstract not availableMatthew Smout, Matthew Davies, Nicholas Burns, Alison Christi
Understanding the causes of bile duct liver cancer
No full textWhy does south-east Asia have such a high prevalence of bile duct liver cancer? Dr Michael Smout of James Cook University, winner of science communication competition FameLab in Australia, explains the link between the deadly disease and a parasitic worm found in uncooked fish. Michael is competing at the FameLab international final in Cheltenham on 3-5 June 2014
Understanding the causes of bile duct liver cancer
No full textWhy does south-east Asia have such a high prevalence of bile duct liver cancer? Dr Michael Smout of James Cook University, winner of science communication competition FameLab in Australia, explains the link between the deadly disease and a parasitic worm found in uncooked fish. Michael is competing at the FameLab international final in Cheltenham on 3-5 June 2014
Concomitant functional dyspepsia and irritable bowel syndrome decrease health-related quality of life in gastroesophageal reflux disease
No full textDurk R. De Vries ; Margot A. Van Herwaarden ; Astrid Baron ; Andre J. P. M. Smout ; Melvin Samso
European Society for Neurogastroenterology and Motility (ESNM) recommendations for the use of high-resolution manometry of the esophagus
No full textBACKGROUND: Several patients in gastroenterology practice present with esophageal symptoms, and in case of normal endoscopy with biopsies, high-resolution manometry (HRM) is often the next step. Our aim was to develop a European consensus on the clinical application of esophageal HRM, to offer the clinician guidance in selecting patients for HRM and using its results to optimize clinical outcome. METHODS: A Delphi consensus was initiated with 38 multidisciplinary experts from 16 European countries who conducted a literature summary and voting process on 71 statements. Quality of evidence was evaluated using grading of recommendations assessment, development, and evaluation (GRADE) criteria. Consensus (defined as >80% agreement) was reached for 33 statements. RESULTS: The process generated guidance on when to consider esophageal HRM, how to perform it, and how to generate the report. The Delphi process also identified several areas of uncertainty, such as the choice of catheters, the duration of fasting and the position in which HRM is performed, but recommended to perform at least 10 5-ml swallows in supine position for each study. Postprandial combined HRM impedance is considered useful for diagnosing rumination. There is a large lack of consensus on treatment implications of HRM findings, which is probably the single area requiring future targeted research. CONCLUSIONS AND INFERENCES: A multinational and multidisciplinary group of European experts summarized the current state of consensus on technical aspects, indications, performance, analysis, diagnosis, and therapeutic implications of esophageal HRM.status: Publishe
Restless Landscapes
No full textThis article discusses the work of the architectural design research and teaching partnership of Smout Allen around the theme of Restless Landscapes. The work proposes that the intrinsic features of the landscape such as topography, geography, climate, and man’s manipulation of rural and urban environments provides the designer with a language that can inform design. Can one exploit the conditions that physically and perceptually shape the landscape to augment architectural design and bring to it a sense of nature and environment illuminated? Two design cases conceived between the realms of architectural and landscape design, architectural competitions and conceptual art illustrate this argument. An iterative design process of drawing, modelling and test prototyping is employed that compliments the notion of the restless landscape
Role of alimentation in irritable bowel syndrome
No full textRole of alimentation in irritable bowel syndrome. Dapoigny M, Stockbrugger RW, Azpiroz F, Collins S, Coremans G, Muller-Lissner S, Oberndorff A, Pace F, Smout A, Vatn M, Whorwell P. Service de Gastroenterologie, Hotel-Dieu, Clermont-Ferrand, France. [email protected] BACKGROUND: Different food items are made responsible for irritable bowel syndrome (IBS) symptoms, but the physiopathology of IBS remains unclear. AIMS: During a meeting in Nice, France, experts of the European Working Team of the IBiS Club discussed selected data regarding the relationships between alimentation, food items (including fibers) and IBS symptoms. METHODS/RESULTS: Food allergy remains a difficult diagnosis, but medical and general history, presence of general symptoms such as skin rash, and hypersensitivity tests may help in achieving a positive diagnosis. On the other hand, food intolerance is more confusing because of the subjectivity of the relationship between ingestion of certain foods and the appearance of clinical symptoms. Different food items which are commonly implicated in adverse reactions mimicking IBS were found to be stimulants for the gut, suggesting that patients with predominant diarrhea IBS have to be carefully questioned about consumption of different kinds of food (i.e., coffee, alcohol, chewing gum, soft drinks) and not only on lactose ingestion. Gas production is discussed on the basis of retention of intestinal gas as well as on malabsorption of fermentable substrates. The role of a large amount of this kind of substrate reaching the colon is suggested as a potential mechanism of IBS-type symptoms in overeating patients. Regarding the role of fiber in IBS, the expert group concluded that fibers are not inert substances and that they could trigger pain or bloating in some IBS patients. CONCLUSION: Despite numerous reviews on this subject, it is very difficult to give general dietary advice to IBS patients, but dieteticians may have a positive role in managing such patients. Copyright 2003 S. Karger AG, Base
Irrigation project evaluation, Takeo, Cambodia
No full textWith the absence of official aid organisations from Cambodia until the 1990s, NGOs have been the main support to development in the country. In June 1990,
Oxfam initiated the Takeo Irrigation Structures Project (KAM 215) in Takeo Province, southern Cambodia, to increase the technical skills of provincial level irrigation technicians; support locally managed irrigation schemes; and develop contacts with local communities which
would enable Oxfam to develop other community-based programmes. The major inputs were Technical Assistance
(an Engineer), construction materials and equipment, capital for a loan scheme to farmers in a pilot project, salary subsidies for Takeo Provincial Office of
Hydrology counterparts, and operation and maintenance of vehicles and equipment.
Ian Smout and Peter Robertson undertook an external evaluation of the project for Oxfam in April-May 1993. This paper is drawn from the evaluation report
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