- EGG DWPack: System for Multi-Channel Electrogastrographic Signals Recording and Analysis. [Journal Article]
- JMJ Med Syst 2018 Sep 17; 42(11):201
- Electrogastrography (EGG) is a non-invasive examination method for investigating the myolectrical activity of a stomach. Nowadays, abdominal surface electrogastrography is the one of methods of stoma...
Electrogastrography (EGG) is a non-invasive examination method for investigating the myolectrical activity of a stomach. Nowadays, abdominal surface electrogastrography is the one of methods of stomach examination that is used for diagnosing patients with chronic intractable nausea, vomiting and gastroparesis. The electrogastrographic signals are recorded by using cutaneous electrodes placed on the stomach surface. EGG DWPack system is a highly developed and easy to use software package for four channel electrogastrography recording and analysis. The part of the software for analysis is a MATLAB based software and requires the specific ASCII format of the EGG data. The analyzed EGG signals could be conditioned with the wide range of sampling frequency and various resolutions of analog to digital conversion. Additionally, if the EGG data fulfills certain conditions associated with sampling frequency, the software can be used to study the basic parameters of heart rate variability (HRV) simultaneously with the EGG parameters. The software includes different digital filters for the EGG signal extraction and tools for artifacts exclusion. The software computes the majority of EGG parameters which are commonly used in a clinical practice. The EGG analysis can be made for several adjustable analysis settings and various methods, and it can optimize the analysis methods for different preferences or requirements. The analysis result can be saved in a MAT-file, and exported to MS Excel and ASCII files. Validation of the software was performed using synthetic and real EGG signals. This paper contains, as an example of use, an analysis of four synthetic, and fourteen human 4-channel EGG data recording with water, yogurt and a solid meal stimulation. The mean values of the dominant frequency for fast, and postprandial stage were found to be 2.96±0.21 cpm (cycle per minute), and 3.05±0.33 cpm, respectively. The values established in the validation process are consistent with typical human physiological values. In addition, the results were compared to outcomes from commercial system. The results of validation have proved that EGG DWPack software produces reliable outcomes. The software is available for free of charge for Windows operating system for the all possible non commercial use.
- Prokinetics and their use in gastroenterology. [Journal Article]
- VLVnitr Lek 2018; 64(6):673-678
- Gastrointestinal motility disorders are reflected in clinical medicine not only in the form of functional disorders but also as primary organic units or secondary manifestations of other diseases and...
Gastrointestinal motility disorders are reflected in clinical medicine not only in the form of functional disorders but also as primary organic units or secondary manifestations of other diseases and physicochemical effects. Recent sophisticated diagnostic methods and basic research in the field of digestive tract motility have shown significant development. However, causal treatment of prokinetic motility disorders is still marginalized. A number of new effective drugs have been withdrawn from the market due to their significant side effects. The efficacy of others is limited to individual parts of the gastrointestinal tract (GIT), e.g. only the stomach or the intestine. The article presents an overview of prokinetic indications with an effect on selected pathological conditions. In addition to isolated administering of prokinetics, they can also be used in combination with other drugs, for example in the treatment of gastroesophageal reflux disease with proton pump inhibitors. There is currently no "gold standard" prokinetic, which would globally therapeutically and, at the same time, causally affect such a complicated pathophysiological chain of GIT dysmotility. There is ongoing research to develop new drugs with a beneficial effect on the propulsion activity disorder which, while maintaining a prokinetic effect over the full length of the GIT, would not show any adverse or side effects. Patient access in this case needs to be individualized according to the proven type of motility disorder. Key words: gastroesophageal reflux disease - gastrointestinal dysmotility - gastroparesis - intestinal pseudo-obstruction - obstipation.
- [Relamorelin in patients with diabetic gastroparesis]. [Journal Article]
- ZGZ Gastroenterol 2018; 56(9):1170-1171
- Gastroduodenal motility disorders. [Journal Article]
- COCurr Opin Gastroenterol 2018 Sep 07
- CONCLUSIONS: Pathophysiological research has focused on cellular changes in gastroparesis and gastroduodenal motility disorders. New treatments include relamorelin and aprepitant for gastroparesis.
- Update on the Management of Diabetic Neuropathy. [Journal Article]
- DSDiabetes Spectr 2018; 31(3):224-233
- IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, ...
IN BRIEF Distal symmetric polyneuropathy (DSPN) and diabetic autonomic neuropathies, particularly cardiovascular autonomic neuropathy (CAN), are prevalent diabetes complications with high morbidity, mortality, and amputation risks. The diagnosis of DSPN is principally a clinical one based on the presence of typical symptoms combined with symmetrical, distal-to-proximal stocking-glove sensory loss. CAN is an independent risk factor for cardiovascular mortality, arrhythmia, silent ischemia, major cardiovascular events, and myocardial dysfunction. Screening for CAN in high-risk patients is recommended. Symptoms of gastroparesis are nonspecific and do not correspond with its severity. Diagnosis of gastroparesis should exclude other factors well documented to affect gastric emptying such as hyperglycemia, hypoglycemia, and certain medications. There is a lack of treatment options targeting the neuropathic disease state. Managing neuropathic pain also remains a challenge. Given the high risk of addiction, abuse, psychosocial issues, and mortality, opioids are not recommended as first-, second-, or third-line agents for treating painful DSPN.
- Enhanced Gastric Emptying Scintigraphy to Assess Fundic Accommodation Using Intragastric Meal Distribution and Antral Contractility. [Journal Article]
- JNJ Nucl Med Technol 2018 Aug 23
- Gastric emptying scintigraphy (GES) as now commonly performed measures only total gastric emptying. Intragastric meal distribution (IMD) immediately post meal ingestion (t= 0 min) (IMD0) ) can assess...
Gastric emptying scintigraphy (GES) as now commonly performed measures only total gastric emptying. Intragastric meal distribution (IMD) immediately post meal ingestion (t= 0 min) (IMD0) ) can assess fundic accommodation (FA) and dynamic antral contraction scintigraphy (DACS) can assess antral motility.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Metoclopramide has been approved by the FDA specifically to treat nausea and vomiting in patients with gastroesophageal reflux disease or diabetic gastroparesis by increasing gastric motility,,...
Metoclopramide has been approved by the FDA specifically to treat nausea and vomiting in patients with gastroesophageal reflux disease or diabetic gastroparesis by increasing gastric motility,,. It is also used to control nausea and vomiting in chemotherapy patients. Additionally, metoclopramide can be administered prophylactically to prevent nausea and vomiting in postoperative patients when nasogastric suction is contraindicated or unavailable and has shown surprising success in treating migraines; however, the FDA has not explicitly approved it for these other conditions,. It is particularly useful in this role because it does not cause any concomitant increase in gastric secretions. Metoclopramide can also be used to treat hyperemesis gravidarum in pregnant patients, though it should be used cautiously because of the lack of studies on the effects of the drug in pregnant women,. Recent studies have also shown evidence of metoclopramide’s efficacy in treating Diamond Blackfan Syndrome. Metoclopramide has also been efficacious in the treatment of nausea in advanced liver disease.
- Effect of Pistacia atlantica kurdica gum on diabetic gastroparesis symptoms: a randomized, triple-blind placebo-controlled clinical trial. [Journal Article]
- EPElectron Physician 2018; 10(7):6997-7007
- CONCLUSIONS: This study showed that daily consumption of Pistacia atlantica gum for one month improves diabetic gastroparesis symptoms.
- Mediastinal metastasectomy from a primary germ cell testicular tumour resulting in occult thoracic duct injury and chylothorax. [Journal Article]
- BCBMJ Case Rep 2018 Aug 17; 2018
- A 22-year-old man underwent mediastinal metastasectomy for a testicular germ cell tumour via median sternotomy. Intraoperatively, the tumour was massive, measuring 88 mm in anterior-posterior (AP) di...
A 22-year-old man underwent mediastinal metastasectomy for a testicular germ cell tumour via median sternotomy. Intraoperatively, the tumour was massive, measuring 88 mm in anterior-posterior (AP) diameter. It was densely adherent to the trachea and aggressive debulking resulted in tracheal injury. Therefore, the patient was kept nil by mouth for 3 days postoperatively and was discharged uneventfully. He represented only 2 days later with a large right-sided chylothorax. His chylothorax was managed conservatively with insertion of an intercostal catheter (ICC) and a low-fat diet. Over the course of 9 days, the ICC drained approximately 5 L of fluid. His admission was further complicated by severe gastroparesis requiring feeding Nasojejunal (NJ) tube placement. The delayed feeding in this case resulted in late detection of the occult thoracic duct injury. This case illustrates that conservative and multidisciplinary management of a postoperative chylothorax from a suspected thoracic duct injury achieves favourable outcomes avoiding further surgical intervention.
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- Symptomatic gastric involvement in a parastomal hernia: uncommon presentation. [Journal Article]
- ACActa Chir Belg 2018 Aug 14; :1-4
- CONCLUSIONS: In patients presenting with obstructive symptoms, one should be aware of a possible gastric outlet obstruction because of its involvement in a PSH, although sporadic. Surgery might be considered as the treatment of choice because conservative treatment mostly fails. Earlier surgery might perhaps also reduce postoperative hospital stay and gastroparesis.