- Predictors of post-treatment stenosis in cervical esophageal cancer undergoing high-dose radiotherapy. [Journal Article]
- WJWorld J Gastroenterol 2018 Feb 21; 24(7):862-869
- CONCLUSIONS: Chemoradiation for CEC was well tolerated, and a higher dose was not associated with stenosis. Patients with complete circumferential involvement require close follow-up.
- PECULIARITIES OF QUALITY OF LIFE IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE. [Journal Article]
- GMGeorgian Med News 2018; (274):88-92
- Many studies showed, that quality of life (QL ) is affected in case of gastroesophageal reflux disease (GERD). Numerous questionnaires with a wide variety of characteristics have been developed for t...
Many studies showed, that quality of life (QL ) is affected in case of gastroesophageal reflux disease (GERD). Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of GERD. The current study aimed to determine the QL changes of patients with GERD. The sample consisted of 100 patients with GERD. We also formed control group, which consist of 50 practical healthy patients (without GERD). In case group we formed two subgroups- GERD with Esophagitis and GERD without Esophagitis. For QL measure we used SF-36 questionnaire. In case group 58 patients were male and 42 were female. GERD without Esophagitis subgroup included 71 cases, 41 of which were diagnosed in men and 30 in women. The mean age of this subgroup was 35.3±5.2 years. The second clinical subgroup is gastroesophageal reflux, with eosophthalic patients, which consisted of 29 cases. 17 patients in this subgroup were male and 12 female. The mean age of this subgroup was 35,4±5,3 years. The most affected subscales of patients with GERD were "Role physical functioning", "General health", "Role emotional functioning" comparing with control group according SF-36 questionnaire. In the case of GERD without an esophagus, the most affected were "Role physical functioning" and "Role emotional functioning" subscales. Regardless of the type of subgroup, QL "Bodily pain" and "General health" subscal's scores were lowIn case group patients, who have BMI>25 kg/m2 have lower scores of QL compared to the group GERD BMI<25kg/m2.
- Reliability of histologic assessment in patients with eosinophilic oesophagitis. [Journal Article]
- APAliment Pharmacol Ther 2018 Feb 20
- CONCLUSIONS: The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials.
- Management of Esophageal Food Impaction Varies Among Gastroenterologists and Affects Identification of Eosinophilic Esophagitis. [Journal Article]
- DDDig Dis Sci 2018 Feb 20
- CONCLUSIONS: EFI management varies substantially among GIs associated with three major gastroenterology societies in USA. Based on their practice patterns, the GIs in USA are likely to miss numerous EoE patients presenting to ER with EFI. Our findings highlight the need for developing and disseminating evidence-based EFI management practice guidelines.
- Hypo-fractionated stereotactic radiation therapy for lung malignancies by means of helical tomotherapy: report of feasibility by a single-center experience. [Journal Article]
- RMRadiol Med 2018 Feb 17
- CONCLUSIONS: The use of 8-10 fractions schedule HT-SBRT for lung malignancies results in high LC and OS rates with minimal toxicities reported.
- Eosinophilic Esophagitis: an Important Comorbid Condition of Asthma? [Review]
- CRClin Rev Allergy Immunol 2018 Feb 18
- Eosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper ...
Eosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper 2 responses-driven pathophysiology and share common management strategies such as using systemic corticosteroids and targeted anti-cytokine biologic therapies. Review of the literature finds that asthma is often a comorbid condition in eosinophilic esophagitis in both children and adults; however, the EoE-asthma relationship remains poorly characterized mechanistically and clinically. EoE and asthma commonly share several comorbid conditions such as allergic rhinitis and gastroesophageal reflux disease; therefore, addressing these comorbid conditions has the potential to improve and/or maintain control in both diseases. Similar to asthma, patients with EoE frequently demonstrate elevations in serum markers of atopy, including serum IgE levels, peripheral eosinophil counts, and T helper 2-related cytokines. Gastroesophageal reflux disease is thought to affect asthma through microaspirations, airway hyperresponsiveness, and increased vagal tone. The understanding of the relationship between gastroesophageal reflux and EoE is still evolving but seems to be bidirectional and interactive. In terms of treatment, similar classes of medications have been used in both EoE and asthma. In both children and adults, EoE remission can be achieved by food trigger avoidance and use of corticosteroids and biologic therapies. Asthma control is mostly achieved through inhaled corticosteroids, and long but biologic therapies are increasingly used in severe subsets of the disease. Significant clinical and mechanistic work needs to be accomplished to better understand the relationship between asthma, EoE, and their interaction with other allergic diseases. Understanding whether shared mechanisms exist can lead to the development of new diagnostic and therapeutic strategies. The following review examines the existing literature regarding prevalence, common comorbidities, and potential therapeutic approach and identifies gaps in knowledge and future directions.
- Gender is a risk factor in patients with gastroesophageal reflux disease. [Journal Article]
- MJMed J Islam Repub Iran 2017; 31:58
- Background: Prevalence of gastroesophageal reflux disease (GERD) has increased in the last decades, and it is now one of the most common chronic and recurrent diseases. The presen...
Background: Prevalence of gastroesophageal reflux disease (GERD) has increased in the last decades, and it is now one of the most common chronic and recurrent diseases. The present study aimed at determining the frequency of gender (sex) and age in Iranian patients with GERD symptoms.Methods:In this study, 803 patients aged 11 to 84 years, with erosive and nonerosive gastroesophageal reflux diseases, based on the questionnaire and esophagogastroduodenoscopy findings, participated. The female group was compared with the male group with respect to age, symptoms, esophageal injury, and hiatus hernia.Results:Of the 803 participants, 60.5% (n= 486) were female, and 69.2% (n= 555) were younger than 50 years. Of those patients older than 50 years, 32.8% (n= 81) were female. Moreover, 31.0% (n= 249) of the patients had erosive esophagitis (ERD), and 69.0% (n= 254) had normal esophageal mucosa (NERD).The female to male ratio was 1/1.06 and 1.94/1 in ERD and NERD patients, respectively. Hiatal hernia was more prevalent in females than in males.Conclusion:Nonerosive reflux disease, as a gastroesophageal reflux disease (GERD), was more common in females than in males. GERD became more prevalent with increase in age. Gender and hiatal hernias were 2 potential risk factors of GERD.
- Effectiveness of modified oral steroid administration for preventing esophageal stricture after entire circumferential endoscopic submucosal dissection. [Journal Article]
- DEDis Esophagus 2018 Feb 09
- Esophageal stricture occurs at a high rate after endoscopic submucosal dissection, especially after entire circumferential dissection, leading to poor quality of life. This retrospective cohort study...
Esophageal stricture occurs at a high rate after endoscopic submucosal dissection, especially after entire circumferential dissection, leading to poor quality of life. This retrospective cohort study evaluated the stricture rate in circumferential mucosal defect cases following modified steroid administration. We enrolled 22 consecutive patients who underwent entire circumferential endoscopic submucosal dissection for superficial esophageal cancer between April 2010 and April 2015 at our hospital. Until January 2013, a systemic steroid-prednisolone-was administered at 30 mg/day and tapered over 8 weeks in the original method group (original group). From February 2013, 30 mg of prednisolone was administered orally for 3 weeks and then the dose was reduced in 5 mg decrements every 3 weeks. This group was classified as the modified method group (modified group). We retrospectively compared the stricture rates between the two groups. The postoperative stricture rate was significantly lower in the modified group (36.4%; 4/11 patients) than in the original group (82%; 9/11 patients; P = 0.04). The mean number of endoscopic balloon dilatation procedures was significantly lower in the modified group (6.2 ± 11.3) than in the original group (19.4 ± 15.3; P = 0.023). Pneumonia and oral herpes infection, which are adverse events potentially associated with steroid administration, were observed in the original group. Candida esophagitis, arthritis, and steroid-related myopathy were observed in the modified group. This modified systemic steroid administration was effective for patients with entire circumferential mucosal defect. The safety of this method was also demonstrated.
- Inguinal hernia repair in day surgery: the role of MAC (Monitored Anesthesia Care) with remifentanil. [Journal Article]
- GCG Chir 2017 Nov-Dec; 38(6):273-279
- CONCLUSIONS: Remifentanil, is an excellent drug for pain control during intra-operative procedures, that allows an optimal hemodynamic stability for IH repairs in a DS setting, due to its pharmacokinetic and pharmacodynamic properties and few adverse effects.
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- International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. [Journal Article]
- IFInt Forum Allergy Rhinol 2018; 8(2):108-352
- CONCLUSIONS: This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.