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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Condition:   Cough Interventions:   Other: Induction of cough with inhaled citric acid;   Procedure: Peptest™ analysis of saliva pepsin;   Diagnostic Test: Peptest™ Sponsor:   Hull and East Yorkshire Hospitals NHS Trust Completed
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
The objective data comes from what you measure as an outcome. The device is the trainer. Again, use pressure threshold and then set out to measure the outcomes, a scale, a swallow exam, a cough flow rate, a voice quality, etc. Participant: How do you establish goals? There are norms for peak cough, is this what you use? Kiourkas: Respiratory uses cough peak flow to qualify for noninvasive ventilation for ALS and neuromuscular patients. The norms are different for each person. Suggested ranges are used as a guide to assist in determining if the patient is getting worse at subsequent visits. We also use a SNIP (sniffing pres...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Academia & Research Health Care Private Practice Schools Slider Speech-Language Pathology Dysphagia dyspnea muscle strength skilled nursing facility Swallowing Disorders Source Type: blogs
Authors: Kardos P, Dinh QT, Fuchs KH, Gillissen A, Klimek L, Koehler M, Sitter H, Worth H Abstract The present 2019 S2k consensus guideline of the German Respiratory Society was written - in contrast to the predecessor more general S3 guidelines from 2004 and 2010 - for pneumologists, since 2014 the German College of General Practitioners and Family Physicians (DEGAM) published his own cough guidelines.The guideline contains 48 recommendations agreed by consensus and 16 statements, which are explained in the background text in the following nine chapters: epidemiology, physiology, classification, acute, subacute or...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
Publication date: Available online 13 February 2019Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Louis-Philippe Boulet, Julie TurmelAbstractIn the general population, particularly in individuals with asthma, cough is a common symptom, often reported after exertion, although regular exercise may be associated with a reduction in the prevalence of cough. In athletes, exercise-induced cough is also a particularly frequent symptom. The main etiologies of cough in athletes are somewhat similar to non-athletes, including asthma/airway hyperresponsiveness, upper airways disorders such as allergic or non-allergic rhin...
Source: Pulmonary Pharmacology and Therapeutics - Category: Respiratory Medicine Source Type: research
A 48-year-old man with a history of chronic rhinosinusitis, gastroesophageal reflux disease, and diet-controlled non –insulin-dependent diabetes mellitus presented to our pulmonary consultation clinic with chronic dry cough, dyspnea, fatigue, and anorexia of 4 months' duration. The patient was taking montelukast, 10 mg once daily, and fluticasone nasal spray twice daily. Physical examination revealed normal vita l signs with an oxygen saturation of 95% while the patient breathed room air in addition to scattered fine lung crackles on auscultation bilaterally.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' Clinic Source Type: research
Discussion Gastrostomy tubes (GT or GTubes) have been used to support patients for about a century. They are placed between the abdominal skin and the stomach either percutaneously or surgically. The tubes can be a standard long tube with either a bumper or inflatable balloon internally and externally they have a retention piece to hold the GT in place. A button or low profile tube are similar but extend just beyond the skin. Reasons for GT placement include: Nutritional support Hydration maintenance Medication management Aspiration avoidance Gastric stasis decompression Obstruction bypass Quality of life improvement for...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
CONCLUSIONS: These data showed that GERD is present in a quarter of ABG patients, suggesting that hypochlorhydria not exclude per se arising of oesophageal symptoms. In ABG we found that ME is a frequent finding but its clinical relevance remains to be investigated with further studies. PMID: 30638085 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Semin Respir Crit Care Med 2018; 39: 667-673 DOI: 10.1055/s-0038-1676571Excessive central airway collapse (ECAC) is characterized by excessive narrowing of the airway lumen during exhalation leading to dyspnea, cough, mucostasis, recurrent respiratory infections, and poor quality of life. Tracheobronchomalacia and excessive dynamic airway collapse are heterogeneous entities of ECAC and are characterized by a diverse nonspecific symptom profile. Although the pathophysiology of airway mechanics as well as morphology in both entities is different, current evidence so far shows no practical benefit in making such distinction s...
Source: Seminars in Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Review Article Source Type: research
MK Abstract BACKGROUND: Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms. AIMS/OBJECTIVES: To investigate whether BMI has significance on IQoro® neuromuscular training (IQNT) effectiveness in treating HH-related symptoms. MATERIAL AND METHODS: Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite pr...
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
This study aims to analyze the etiology of nonspecific chronic cough in children of 5 years and younger, in order to improve the diagnostic and treatment levels of pediatricians for nonspecific chronic cough in young children. The clinical data of 85 cases of children of 5 years old and below, who suffered from nonspecific chronic cough between the period of January 2015 and August 2016 were retrospectively analyzed. The etiology distribution of 85 cases of children with nonspecific chronic cough were as follows: 27 cases had cough variant asthma (31.8%), 32 cases had upper airway cough syndrome (37.6%), 16 cases had cou...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
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