Electrical Stimulation of the Lower Esophageal Sphincter to Treat Gastroesophageal Reflux After POEM.
Electrical Stimulation of the Lower Esophageal Sphincter to Treat Gastroesophageal Reflux After POEM. Surg Innov. 2018 May 01;:1553350618768129 Authors: Rieder E, Paireder M, Kristo I, Schwameis K, Schoppmann SF Abstract As per-oral endoscopic myotomy (POEM) is not followed by any anti-reflux procedure, a common concern is the risk of postoperative gastro-esophageal reflux disease (GERD). Electrical stimulation of the lower esophageal sphincter (LES-EST) could be an option for post-POEM GERD. A 68-year old male obese patient underwent successful POEM but developed GERD not responsive to proton pump inhibitors. Consecutively, the patient had implanted an electrical LES stimulation device, consisting of bipolar LES-electrodes connected to a subcutaneous pulse generator. POEM reduced the Eckardt score (9 vs. 0), the LES resting pressure (52.0 vs. 16.4 mmHg), and the Integrated Relaxation Pressure (62.0 vs. 10.0 mmHg). LES-EST substantially reduced post-POEM GERD symptoms. GERD-HRQL scores indicated the elimination of heartburn (26 vs. 7) and regurgitation (24 vs. 3) at three months. A reduced total number refluxes (82 vs. 14) was observed. The %-time of pH below 4 was only slightly reduced (8.6% to 6.2%).LES-EST appears to be a feasible option to symptomatically treat post-POEM GERD for patients not ideal for conventional anti-reflux surgery. PMID: 29742979 [PubMed - as supplied by publisher]
Abstract: The US industrial revolution led to a significant increase in the amount of dietary sugar consumed annually. The impact has become a public health crisis over the past several decades. The consequences are seen in the dramatic rise in rates of obesity, type 2 diabetes mellitus, and cardiovascular disease.
In conclusion, endoscopic MIT measurement can differentiate esophageal disorders instantly during endoscopy. It may not only serve as an important tool in diagnosing of GERD but also help guide therapy in clinically difficult situations as a surrogate to predict the treatment response.
ConclusionsWhen considering reduction of enamel microcrack formation and clinical acceptable shear bond strength, none of the groups succeeded both. Etching by Er:YAG (60 mJ) and Er,Cr:YSGG (1.5 W/15 Hz), showed the least overall microcrack incidence between groups, but Er:YAG (60 mJ) displayed significant reduction compared to phosphoric acid. However, etching by Er:YAG (80 mJ) had the most predictable results in term of shear bond strength.RésuméDonnées contextuellesL’incidence de craquelure amélaire est élevée après la dépose mé...
(Reuters Health) - Behavior changes could potentially reduce a large part of the risk for developing gout, a U.S. study suggests.
Publication date: October 2019Source: The Lancet Psychiatry, Volume 6, Issue 10Author(s): Sameer Jauhar, Aswin Ratheesh, Christopher Davey, Lakshmi N Yatham, Patrick D McGorry, Phillip McGuire, Michael Berk, Allan H Young
CONCLUSION: Serum Fetuin-B was positively associated with ba-PWV and may link liver fat accumulation to subclinical atherosclerosis via insulin resistance. PMID: 31527322 [PubMed - as supplied by publisher]
This study investigated the associations between serum ALT and body composition in an overweight and obese population. The results are based on data from a previous randomized controlled trial treating obesity with vitamin D3. A sample of 448 overweight and obese individuals underwent dual-energy X-ray absorptiometry (DEXA) and measured serum ALT along with supplementary blood samples at study baseline. Body fat mass and lean mass indexes were calculated by dividing total body fat/lean weight (kg) by body height squared (kg/m2). ALT correlated with body mass index (BMI) in men but not women (r = 0.33, P
A recent study, presented at the European Society for Paediatric Endocrinology's annual meeting in Vienna, suggests that breastfed children have a lower risk of obesity due to reduced expression of leptin.Medical Xpress
Probiotic supplements taken alongside exercise may help improve weight loss in obese children, according to a study presented at the European Society for Paediatric Endocrinology’s annual meeting in Vienna, Austria.The Independent
CONCLUSIONS: These findings suggest that smoking initiation and lifetime smoking are likely to be a causal risk factor for developing bipolar disorder. We found some evidence that liability to bipolar disorder increased smoking heaviness. Given that smoking is a modifiable risk factor, these findings further support investment into smoking prevention and treatment in order to reduce mental health problems in future generations. DECLARATION OF INTEREST: W.v.d.B received fees in the past 3 years from Indivior, C&A Pharma, Opiant and Angelini. G.M.G. is a National Institute for Health Research (NIHR) Emeritus Senior Inves...