1,721,021 research outputs found
Nonachalasic esophageal motor disorders, from diagnosis to therapy
No full textIntroduction: Investigations conducted using conventional manometry and, recently, using high-resolution manometry (HRM), allowed us to explore the field of esophageal motility and understand the potential link between motor features and gastroesophageal reflux disease (GERD) pathogenesis. The management of patients with nonachalasic esophageal motor disorders is often challenging, due to the clinical heterogeneous presentation and the multifactorial nature of the mechanisms underlying symptoms. Areas covered: Several studies, carried out using HRM, have better interpreted the esophageal motor function in patients with esophagogastric junction outflow obstruction (EGJOO), distal esophageal spasm (DES), hypertensive esophagus, and hypomotility disorders. Moreover, HRM studies have shown a direct correlation between reduced esophageal motility, disruption of the esophagogastric junction, and gastroesophageal reflux burden. Expert opinion: Pathogenesis, clinical presentation, diagnosis, and treatment of nonachalasic esophageal motor disorders still represent a challenging area, requiring future evaluation by multicenter outcome studies carried out in a large cohort of patients and asymptomatic subjects. However, we believe that an accurate clinical, endoscopic, and HRM evaluation is, nowadays, helpful in addressing patients with nonachalasic esophageal motor disorders to optimal treatment options
Idiopathic pulmonary fibrosis and gerd: Links and risks
Full text linkGastroesophageal reflux disease (GERD) and idiopathic pulmonary fibrosis (IPF) are two pathological conditions often strictly related, even if a clear relationship of causality has not been demonstrated. GERD is a frequent comorbidity in IPF patients, as demonstrated using combined multichannel intraluminal impedance-pH, despite being mostly clinically silent. According to that, it has been hypothesized that microaspiration of gastric material may play a fundamental role in the fibrotic transformation of pulmonary parenchyma. In contrast, it cannot be excluded that IPF may favor GERD by increasing the negative intrathoracic pressure. Therefore, this relationship is uncertain as well as not univocal. Nevertheless, the latest international guidelines recommend the use of proton pump inhibitors (PPIs) in IPF based on several data showing that PPIs can stabilize lung function, reduce disease flares and hospitalizations. On the contrary, recent studies not only question the relevance of these results, but also associate the use of PPIs with an increased risk of lung infections and a negative prognostic outcome. The aim of this review is to analyze the possible links between GERD and IPF and their possible therapeutic implications, trying to translate this scientific evidence into useful information for clinical practice
Gastrointestinal: An unusual rectal finding in a patient with ulcerative colitis
No full textA 67‐year‐old man, with an acute flare of severe ulcerative colitis, on therapy with azathioprine for steroid‐dependent disease for 6 years was referred to our Inflammatory Bowel Disease Unit in 2015 because of severe anal pain and bloody diarrhea. Rectosigmoidoscopy showed multiple inflammatory pseudopolyps, erosions, and, close to the anal verge, a large ulceration of about 5 cm with irregular border (Fig. 1). Histology of the lesion showed a framework compatible with active severe ulcerative colitis. He underwent a pelvic magnetic resonance imaging, which excluded the presence of complications (i.e. abscess or neoplasia). Thereafter, after a negative screening (hepatitis B virus DNA load in the blood was lower than 1000 copies/mL with negative Epstein–Barr virus [EBV] immunoglobulin M), infliximab 5 mg/kg i.v. was started. However, the patient was admitted to the Neurology Department because of neurological changes (psychomotor retardation, confusional state, asthenia, and tremors). A diagnosis of postinfectious encephalitis from EBV reactivation (EBV‐DNA 2378 copies/mL; microbiological investigations on liquor were negative) was performed, and acyclovir therapy was started with rapid resolution. Infliximab was stopped, and due to the severe persisting condition, a proctocolectomy was performed. The histological report was positive for a typical complication associated to inflammatory bowel disease (IBD) patients on thiopurine treatment that is colorectal lymphoma (Fig. 2)
Reorganization of the functional gastrointestinal disorders unit during the SARS-CoV-2 outbreak - Practical Recommendations
Full text linkVonoprazan may provide better results than ppis in helicobacter pylori eradication and beyond – is it time for a change?
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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