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Effects of Esophageal Acidification on Troublesome Symptoms: An Approach to Characterize True Acid GERD in Dysphagic Neonates

AbstractTo quantify and compare maximal extent (height) of acid reflux events (AREs) on symptom generation in dysphagic neonates. Dysphagic neonates (N = 53), born at 30 ± 5.3 weeks gestation, underwent 24-hour pH-impedance study for the evaluation of troublesome symptoms purported to be due to gastroesophageal reflux disease (GERD). AREs (pH 4  s) detected by impedance (Z) were categorized by maximal extent as refluxate reaching distal (Z6, Z5), middle (Z4, Z3), or proximal (Z2, Z1) impedance channels. AREs reaching the pH sensor only were categorized as distal. Symptom correlation (%, symptom index, symptom sensitivity index, and sympto m associated probability) and temporal characteristics (clearance times) of AREs were analyzed using linear mixed and GEE models comparing height categories presented as mean ± SEM, median (IQR), and OR (95% CI). Of the 2003 AREs, 1) distal extent AREs (n = 1642) had increased frequency (p 
Source: Dysphagia - Category: Speech Therapy Source Type: research

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Background: Symptom index (SI) and symptom association probability (SAP) are popular methods used to measure symptom association in patients with gastroesophageal reflux disease (GERD). Aim: To investigate whether these 2 methods yield similar results in analysis of both typical and atypical GERD symptoms. Materials and Methods: Combined impedance-pH reflux studies of 1471 patients tested for possible GERD symptoms from January 2010 to May 2015 were reviewed. SI and SAP were analyzed for typical and atypical GERD symptoms including heartburn, regurgitation, indigestion, chest pain, cough, and throat clearing (TC). ...
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: ONLINE ARTICLES: Original Articles Source Type: research
Conclusion: Peptest is a very sensitive marker of GERD and EER in progressive and /or symptomatic respiratory diseases. Even if the PPI was used as the standard therapy it does not work in all pts. The reasons for PPI failure should be investigated and solved. Increased frequency of proximal reflux episodes was found to be a very sensitive marker of clinicaly significant EER.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
Conclusions: Close follow-up and multidisciplinary approach is recommended in children with EA-TEF, even after corrective surgery
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric Bronchology Source Type: research
Conclusions: Risk factors for chronic cough differ at the level of the individual and community, and by smoking status. Strategies to prevent and treat modifiable chronic cough risk factors should be tailored accordingly.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
Conclusions: Esophageal dysfunction may be an underlying mechanism for refractory GERC. Baclofen is probably more effective in refractory GERC with the LES pressure of ≤11.5mmHg.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
Although gastroesophageal reflux (GER) is a common cause of chronic cough, treatment efficacy of GER-related cough is often perceived unsatisfactory.Aim: to analyze the factors associated with the efficacy of treatment of chronic cough related to GER.A retrospective analysis of the clinical data of patients with cough due to GER was performed. GER was confirmed by either 24 hour esophageal pH measurement or combined impedance and pH monitoring. Modification of diet and PPI were recommended as treatment. Response to therapy was assessed by telephone survey, 6 weeks after onset of treatment. The patient was classified as a r...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
Upper airway cough syndrome (UACS), described as chronic cough associated with allergic and non-allergic rhinitis (AR and NAR) or chronic rhinosinusitis, is one of the major causes of chronic cough.The aim of the study is to characterize a cohort of UACS patients with special attention to differences between patients with AR and NAR.A retrospective analysis of the clinical data of patients with UACS, diagnosed in 2015 and 2016, was performed. The comparison between patients with AR and NAR was accomplished using Mann-Whitney U or chi square tests.There were 43 patients diagnosed with UACS, of these 20 (46%) had AR and 23 (...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Allergy and immunology Source Type: research
Conclusions: As compatible with previous research, we recognized asthma and PBB as the most frequent causes of chronic cough. We believe that implementation of a standardized algorithm including investigation of OSA as an etiological factor of chronic cough in children may improve clinical outcomes.Figure-1: Etiologies of patients (n=251)*: Three patients were diagnosed as astma and gastroesophageal reflux
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
Conclusion: Patients with chronic cough caused by gastroesophageal reflux have mostly neutrophilic and partially lymphocytic airway inflammation.Supported by AZV 16-32318A
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
CONCLUSION: Proton pump inhibitors or histamine H2 receptor antagonists may be used to treat children with gastroesophageal reflux disease, but not to treat asthma or unspecific symptoms.RESUMO CONTEXTO: Inibidores de bomba de pr ótons e antagonistas dos receptores H2 da histamina são duas das mais comumente prescritas classes de medicações para a doença do refluxo gastroesofágico pediátrica, mas sua eficácia é controversa. Muitos pacientes são tratados com essas drogas por manifestações atípicas atribuídas ao refluxo gastroes...
Source: Arquivos de Gastroenterologia - Category: Gastroenterology Source Type: research
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