Reflux aspiration associated with oesophageal dysmotility but not delayed liquid gastric emptying

2020 ◽  
Author(s):  
Oleksandr Khoma ◽  
Maite Jeanne Mendu ◽  
Amita Nandini Sen ◽  
Hans Van der Wall ◽  
Gregory Leighton Falk
Keyword(s):  
Gastric Emptying ◽  
Reflux Disease ◽  
Inclusion Criteria ◽  
Treatment Resistant ◽  
Oesophageal Motility ◽  
Oesophageal Manometry ◽  
Oesophageal Dysmotility ◽  
The Relationship ◽  
Clinical Subtype

Abstract Introduction Severe oesophageal dysmotility is associated with treatment resistant reflux and pulmonary reflux aspiration. Delayed solid gastric emptying (SGE) has been associated with oesophageal dysmotility, however the role of delayed liquid gastric emptying (LGE) in the pathophysiology of severe reflux disease remains unknown. The purpose of this study is to examine the relationship between delayed LGE, reflux aspiration and oesophageal dysmotility. Methods Data was extracted from a prospectively populated database of patients with severe treatment resistant gastro-oesophageal reflux disease (GORD). All patients with validated reflux aspiration scintigraphy (RASP) and oesophageal manometry were included in the analysis. Patients were classified by predominant clinical subtype as gastro-oesophageal (GOR) or laryngo-pharyngeal (LPR) reflux. LGE time of 22 minutes or longer was considered delayed. Results Inclusion criteria were met by 631 patients. Normal LGE time was found in 450 patients, whilst 181 had evidence of delayed LGE. Mean liquid half-clearance was 22.81min. Refux aspiration was evident in 240 patients (38%). Difference in the aspiration rates between delayed LGE (42%) and normal LGE (36%) was not significant (p=0.16). Severe ineffective oesophageal motility (IOM) was found in 70 patients (35%) and was independent of LGE time. Severe IOM was strongly associated with reflux aspiration (p<0.001). GOR dominant symptoms were more common in patients with delayed LGE (p=0.03). Conclusion Severe IOM was strongly associated with reflux aspiration. Delayed LGE is not associated with reflux aspiration or severe IOM. Delayed LGE is more prevalent in patients presenting with GOR dominant symptoms.

Role of scintigraphic labeling techniques in the relationship between 13C-acid octanoic breath test and scintigraphy for studying gastric emptying

2001 ◽  
Vol 33 ◽  
pp. A88
Author(s):  
M.G. Marry ◽  
D. Pinto ◽  
V. Stanghellini ◽  
M. Marengo ◽  
N. Monetti ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Breath Test ◽  
The Relationship

Delayed gastric emptying in gastroesophageal reflux disease: the role of malrotation

2005 ◽  
Vol 21 (6) ◽  
pp. 423-427 ◽  
Author(s):  
Savaş Demirbilek ◽  
Abdurrahman Karaman ◽  
Kubilay Gürünlüoğlu ◽  
Melih Akın ◽  
Erkan Taş ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Delayed Gastric Emptying

scholarly journals PERILAKU IBU RUMAH TANGGA DALAM PEMBERANTASAN SARANG NYAMUK DI KAWASAN PESISIR WAIHERU AMBON 2019

2020 ◽  
Vol 4 (2) ◽  
pp. 204-209
Author(s):  
Rahwan Ahmad ◽  
Prasetyawati Prasetyawati
Keyword(s):  
Mosquito Species ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Inclusion Criteria ◽  
Chi Square ◽  
Cross Sectional ◽  
Low Education ◽  
And Behavior ◽  
The Relationship

Introduction: Education and behavior (knowledge, attitudes and actions) about healthy living are important things, especially applied in life, so as not to fall sick so that they can carry out activities properly. Worldwide, there are more than 2500 species of mosquitoes, although most of these mosquito species are not associated with disease. Larva eradication practice can be done with 3M plus. The role of the community in eradicating mosquito nests is prioritized by housewives because they are generally responsible for taking care of the household including household hygiene problems. The purpose of this study was to determine the relationship between education and knowledge with the behavior of housewives in eradicating mosquito nests. The method used was cross-sectional analytic, the sampling technique used simple random sampling and inclusion criteria in order to obtain 50 respondents. Data analysis used Chi-Square with a significant level of 95% with a significance value of 5%. Results: Respondents with higher education and good behavior were 73.1%. Respondents with low education and bad behavior were 70.8%. Respondents with good knowledge and good behavior were 75%, respondents with bad knowledge and bad behavior were 77.3%. Conclusion: There is a relationship between education and the behavior of housewives in eradicating mosquito nests, and there is a relationship between knowledge and behavior of housewives in eradicating mosquito nests. Keyword : Household, Education, Knowledge, Behavior

PS01.011: PATHOPHYSIOLOGY OF LARYNGOPHARYNGEAL REFLUX DISEASE: ASSOCIATION WITH PULMONARY ASPIRATION ON SCINTIGRAPHY AND INEFFECTIVE OESOPHAGEAL MOTILITY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 52-53
Author(s):  
Oleksandr Khoma ◽  
Michael Falk ◽  
Hans Van Der Wall ◽  
Leticia Burton ◽  
Gregory Falk
Keyword(s):  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Pulmonary Aspiration ◽  
Research Database ◽  
Oesophageal Motility ◽  
Upper Airways ◽  
Time Activity ◽  
Predictive Values ◽  
Symptom Profile ◽  
Oesophageal Dysmotility

Abstract Background Gastro-oesophageal reflux disease (GORD) can present with typical symptoms or atypical or laryngopharyngeal reflux (LPR) symptoms. The role of impaired oesophageal motility in these two clinically distinct groups has not been previously examined. Methods This study is a retrospective analysis of 361 consecutive patient records that was extracted from a prospectively populated research database. Patients were categorised by symptom profile as predominantly LPR or GORD (98 GOR and 263 LPR). Presenting symptom profile, pH studies, oesophageal manometry and scintigraphy and the relationship between the above were analysed. Results Severe oesophageal dysmotility was more prevalent in LPR group (P = 0.037). Severe oesophageal dysmotility was strongly associated with isotope aspiration in both groups (P = 0.001). 24 per cent of patients showed evidence of pulmonary aspiration on scintigraphy. Significant correlation was established between total proximal acid on 24-hour pH monitoring and isotope aspiration in both groups (P = 0.00). Rising pharyngeal curves on scintigraphy were the strongest predictors of isotope aspiration (P = 0.00). Conclusion Early research on oesophageal dysmotility has suggested reduced oesophageal clearance in individuals with IOM. This selected group of patients showed a high degree of impaired oesophageal motility, which was associated with rising time-activity curves in both the upper oesophagus and pharynx. The presence of refluxate in the upper oesophagus can stimulate cough via ‘reflex’ afferent pathways and the presence of gastric contents in the pharynx can cause direct irritation to upper airways, both resulting in cough. Reduced pressures in the lower oesophageal sphincter were equally prevalent in LPR and GORD groups and therefore were not discriminatory between the clinical groups. The impairment of oesophageal clearance secondary to diminished oesophageal motility, may offer a plausible explanation for the development of symptoms via combined ‘reflux’ and ‘reflex’ pathways, allowing continued oesophageal exposure or proximal exposure to refluxate. The ROC and cluster analysis demonstrated strong predictive values and linkages between ineffective oesophageal motility and rising pharyngeal time-activity curves for the prediction of lung aspiration. This may form the basis of a new approach to the definitive diagnosis of LPR and lung aspiration. Oesophageal dysmotility is a key factor in pathophysiology of LPR. Severe impaired oesophageal motility is strongly associated with pulmonary aspiration in both LPR and GORD. Disclosure All authors have declared no conflicts of interest.

scholarly journals It’s the thought that counts: belief in suicide as an escape moderates the relationship between emotion dysregulation and suicidal ideation cross-sectionally and longitudinally

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Nadia Al-Dajani ◽  
Amanda A. Uliaszek ◽  
Kevin Hamdullahpur
Keyword(s):  
Suicidal Ideation ◽  
Emotion Dysregulation ◽  
Inclusion Criteria ◽  
Emotional Pain ◽  
Moderation Effects ◽  
Interaction Terms ◽  
The Relationship ◽  
Moderating Role ◽  
Linear Regressions

Abstract Background Previous research has illustrated a relationship between emotion dysregulation and suicidal ideation, both cross-sectionally and longitudinally. However, it is not yet understood how this relationship manifests. The aim of this study was to explore if two beliefs about suicide, (1) suicide as a way to escape from emotional pain and (2) suicide as a solution to a problem, moderate the relationship between emotion dysregulation and suicidal ideation. Methods One hundred one community participants completed questionnaires examining emotion dysregulation, suicidal ideation, and beliefs in the functions of suicide. Inclusion criteria were used to over-sample individuals within the community experiencing higher levels of suicidal ideation and emotion dysregulation. Hierarchical linear regressions with interaction terms were used to assess moderation effects. The moderating role of beliefs in the function of suicide was examined both cross-sectionally and longitudinally. Results Suicide as an escape significantly moderated the relationship between global emotion dysregulation and suicidal ideation cross-sectionally, while it moderated the relationship between a facet of emotion dysregulation and suicidal ideation longitudinally. Greater endorsement of this belief resulted in a stronger relationship between emotion dysregulation and suicidal ideation. The function of suicide as a solution to a problem did not moderate the emotion dysregulation-suicidal ideation relationship. Conclusions These findings underscore the importance of not only addressing emotion dysregulation but also addressing the underlying belief that suicide is an escape in individuals who experience both emotion dysregulation and suicidal ideation. Intervention efforts to address belief in suicide as an escape along with emotion dysregulation are delineated.

Role of Ghrelin in the Relationship Between Hyperphagia and Accelerated Gastric Emptying in Diabetic Mice

2008 ◽  
Vol 135 (4) ◽  
pp. 1267-1276 ◽  
Author(s):  
Pieter–Jan Verhulst ◽  
Betty De Smet ◽  
Inge Saels ◽  
Theo Thijs ◽  
Luc Ver Donck ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Diabetic Mice ◽  
The Relationship

scholarly journals Relation between Attachment and Obesity in Preschool Years: A Systematic Review of the Literature

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3572
Author(s):  
Ana F. Santos ◽  
Mariana C. Martins ◽  
Carla Fernandes ◽  
Kelly K. Bost ◽  
Manuela Veríssimo
Keyword(s):  
Empirical Studies ◽  
Intervention Programs ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Attachment Quality ◽  
Underlying Mechanisms ◽  
The Relationship

Increasing evidence suggests that attachment plays an important role in obesity. However, few studies examined this relationship in preschool children. This study aimed to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and obesity in the preschool years. Using established guidelines, relevant peer-reviewed literature published between 2000 and July 2021 was searched through EBSCO. This yielded a total of 1124 records for review. Established inclusion criteria comprised: empirical studies published in peer-review journals; include at least one anthropometric measure and/or food consumption measure. Exclusion criteria comprised: attachment measures not following Bowlby-Ainsworth conceptualization of the construct; children in institutionalized settings; context of severe mental illness, documented substance use disorders, or eating disorders; include only a measure of the psychological aspects of eating; intervention programs. After exclusions, eight studies with a total of 9225 participants met the inclusion criteria. Results support the role of attachment in weight-related outcomes, suggesting that considering attachment in the risk of obesity could contribute to the elaboration of effective prevention and intervention programs. Limitations included the small number of studies, predominately cross-sectional designs, the diversity of methodologies, most samples not including fathers, and lack of evidence about the developmental mechanisms underlying the association between attachment and obesity. More evidence is needed to determine how attachment and obesity are linked, and the potential underlying mechanisms accounting for this relationship.

Benign oesophageal disease

2018 ◽  
Author(s):  
Satish Keshav ◽  
Alexandra Kent
Keyword(s):  
Chest Pain ◽  
Reflux Disease ◽  
Mucosal Injury ◽  
High Amplitude ◽  
Lower Oesophageal Sphincter ◽  
Oesophageal Motility ◽  
Eosinophilic Oesophagitis ◽  
Distal Oesophagus ◽  
Low Amplitude ◽  
Oesophageal Dysmotility

Benign oesophageal disease includes several conditions. Gastro-oesophageal reflux disease (GORD) is the reflux of gastric juices into the oesophagus with or without mucosal injury (oesophagitis). Achalasia is an oesophageal dysmotility disorder characterized by aperistalsis in the distal oesophagus, and failure of lower oesophageal sphincter relaxation. Motility disorders include oesophageal spasm, which is characterized by simultaneous, non-propagated contractions; nutcracker oesophagus, which is diagnosed by high-amplitude (≥180 mm Hg) contractions associated with chest pain; and ineffective oesophageal motility, which is characterized by low-amplitude contractions (≤30 mm Hg) in the distal oesophagus. Eosinophilic oesophagitis is diagnosed on a combination of clinical features and oesophageal biopsies confirming the presence of >15 eosinophils per high-powered film

Unconjugated bilirubin and schizophrenia: a systematic review

CNS Spectrums ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 577-588 ◽  
Author(s):  
Erik Pommerening Dornelles ◽  
João Gama Marques ◽  
Sílvia Ouakinin
Keyword(s):  
Antioxidant Defense ◽  
Biological Marker ◽  
Review Article ◽  
Unconjugated Bilirubin ◽  
Unknown Etiology ◽  
Buffer System ◽  
Inclusion Criteria ◽  
Unconjugated Hyperbilirubinemia ◽  
The Relationship

Schizophrenia is a complex syndrome of unknown etiology and difficult to manage. Unconjugated bilirubin has been researched as a potential biological marker of this syndrome. The objective of this review article was to gather the studies published to date on the relationship between this molecule and schizophrenia. Broad inclusion criteria have been used (PRISMA) to include as many relevant studies as possible. Fourteen studies were selected: 3 analyzed the effects of unconjugated hyperbilirubinemia in animal models; 6 demonstrated an increased incidence of schizophrenia in patients with increased unconjugated bilirubin; 2 reported an increased incidence of the disease in patients with decreased unconjugated bilirubin; and 3 linked an increased incidence of schizophrenia with an increased excretion of the oxidative product of bilirubin, the so-called biopyrrins. Because of apparently contradictory reported results, the hypothesis that the relationship between schizophrenia and unconjugated bilirubin was not linear and that there was an inflammatory dysfunction explaining this was considered. The 2 most accepted models for the pathophysiology of schizophrenia are described, and the possible role of the molecule in each is clarified. The bilirubin buffer system and its role in antioxidant defense was explored. The average levels of unconjugated bilirubin in patients with schizophrenia, schizoaffective disorder, and bipolar disorder were also compared, having been hypothesized that these diseases could be different points of a same pathological spectrum. Finally, it was concluded that unconjugated bilirubin is a promising molecule that could be used as a possible biological marker for schizophrenia, and the necessity of subsequent efforts for its research was considered.

Sign in / Sign up

Export Citation Format

Share Document