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1

Dalmat, Yann-Mickael. "Bréve : Antiacides et risque d’allergie." Option/Bio 30, no. 605-606 (October 2019): 9. http://dx.doi.org/10.1016/s0992-5945(19)30426-x.

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2

Skopinski, S., J. Constans, A. Amara, C. Chaugier, P. Barbeau, J. L. Pellegrin, M. Geffard, B. Leng, and C. Conri. "Autoanticorps antiacides gras au cours du lupus érythémateux disséminé." La Revue de Médecine Interne 17 (January 1996): 408s. http://dx.doi.org/10.1016/s0248-8663(97)80969-1.

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3

Chevalier, Isabelle, Carolyn E. Beck, Marie-Joëlle Doré-Bergeron, and Julia Orkin. "La prise en charge médicale du reflux gastro-œsophagien chez les nourrissons en santé." Paediatrics & Child Health 27, no. 8 (December 2, 2022): 507–11. http://dx.doi.org/10.1093/pch/pxac069.

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Анотація:
Abstract Les symptômes cliniques attribués au reflux gastro-œsophagien pathologique chez les nourrissons nés à terme et en santé sont non spécifiques et rappellent des comportements adaptés à l’âge. Le présent point de pratique analyse les données probantes sur la prise en charge médicale recommandée de cette affection courante. Les recommandations à jour en vue de la prise en charge de ce type de reflux comprennent les modifications à l’alimentation, telles que l’épaississement des aliments ou l’évitement des protéines du lait de vache. Les données probantes à l’égard d’une prise en charge pharmacologique, y compris les traitements antiacides ou les agents procinétiques, sont limitées et démontrent que leurs risques sont souvent supérieurs à leurs éventuels avantages en raison des importantes préoccupations liées à l’innocuité et aux effets secondaires. Les traitements antiacides ne doivent pas être utilisés systématiquement chez les nourrissons présentant un reflux gastro-œsophagien pathologique. Ils sont plus susceptibles d’être utiles pour soigner des symptômes évocateurs d’une œsophagite érosive. Les données probantes sur la prise en charge des symptômes attribués à ce type de reflux chez les nourrissons de moins d’un an qui sont nés à terme et sont autrement en santé sont exposées, et la surprescription de médicaments est déconseillée dans cette population. Les conseils préventifs sur la résolution naturelle des symptômes de reflux sont recommandés.
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4

Canonne-Guibert, Morgane. "Affections respiratoires supérieures." Le Nouveau Praticien Vétérinaire canine & féline 19, no. 81 (June 2022): 17–26. http://dx.doi.org/10.1051/npvcafe/2022054.

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Parmi les affections des voies respiratoires supérieures, selon le site anatomique touché, l’exploration diagnostique nécessitera souvent a minima un examen endoscopique, celui-ci pouvant suffire dans de nombreux cas. À ce titre, pour les atteintes laryngées et trachéales ou dans l’exploration d’un syndrome obstructif respiratoire des races brachycéphales, il convient de réaliser l’endoscopie chez un animal non intubé pour parfaitement visualiser les voies respiratoires dans leur position et leur mouvement naturels. Pour les atteintes nasales et nasopharyngées, l’examen tomodensitométrique pourra s’avérer complémentaire ; pour les atteintes trachéales, la radiographie reste un très bon examen dans le cadre des affections obstructives (collapsus, sténose, tumeur) compte tenu du contraste apporté par l’air luminal. De nombreuses affections conduiront à la programmation d’une intervention chirurgicale (syndrome obstructif respiratoire des races brachycéphales, paralysie laryngée, polype nasopharyngé, rétroversion épiglottique), d’autres motiveront une prise en charge mini-invasive (sténose nasopharyngée) ou une prise en charge plus spécifique comme lors de processus tumoral. Au détour de la démarche diagnostique de confirmation, il convient également de rechercher les éventuelles complications d’une atteinte obstructive : bronchopneumonie par aspiration, hyperthermie, anomalies œsophagiennes (dilatation aérique majeure, redondance, hernie hiatale, œsophagite). Dans le contexte d’urgence, la stabilisation d’une atteinte obstructive est peu spécifique et repose sur trois piliers : une oxygénothérapie, une sédation comprenant le plus souvent du butorphanol +/- alpha-2 mimétique et le traitement des complications éventuelles (antibiotique lors d’aspiration, antiacides et pansements lors de conséquences œsophagiennes). Enfin, toute obstruction respiratoire s’accompagne d’une inflammation et d’un œdème des muqueuses respiratoires et doit conduire à l’initiation d’une corticothérapie efficace et temporaire.
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5

WORCESTER, SHARON. "Antiacids, Advanced Age Hike Up Recurrent C. difficile Risk." Internal Medicine News 45, no. 6 (April 2012): 18. http://dx.doi.org/10.1016/s1097-8690(12)70290-1.

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6

Sato, Kiminori, and Tadashi Nakashima. "Laryngopharyngeal Reflux Disease Resistant to Antiacid Therapy." Nihon Kikan Shokudoka Gakkai Kaiho 55, no. 5 (2004): 414–22. http://dx.doi.org/10.2468/jbes.55.414.

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7

Abd Razak, Razwan, Victoria Kunene, and Yuk Ting Ma. "Concomitant use of antiacids in patients with advanced hepatocellular carcinoma (HCC) receiving sorafenib therapy." Journal of Clinical Oncology 34, no. 15_suppl (May 20, 2016): e14103-e14103. http://dx.doi.org/10.1200/jco.2016.34.15_suppl.e14103.

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8

Teixeira, F., Boas L. F. Vilas, V. M. S. Gil, M. Helena, and S. F. Teixeira. "Complexes of ciprofloxacin with metal ions contained in antiacid drugs." European Journal of Pharmacology 183, no. 6 (July 1990): 2099. http://dx.doi.org/10.1016/0014-2999(90)93614-v.

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9

Bouchikhi, I., H. Kaddouri, A. M. Boumédiène, O. Kheroua, and D. Saidi. "Profil de sensibilisation de souris immunisées aux protéines de l’œuf en présence d’un antiacide, l’oméprazole." Revue Française d'Allergologie 55, no. 3 (April 2015): 239. http://dx.doi.org/10.1016/j.reval.2015.02.087.

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10

Ersoy, Süleyman, Fevzi Yilmaz, Bedriye Sönmez, Murat Ongar, Miray Özlem, and Ebru Can. "Cardiac Arrest Following Inadvertent Intravenous Administration of an Oral Antiacid: Hydrotalcite." British Journal of Medicine and Medical Research 4, no. 35 (January 10, 2014): 5519–23. http://dx.doi.org/10.9734/bjmmr/2014/12509.

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11

Iliescu, Mădălina, and Dan L. Dumitraşcu. "PREVALENCE OF GASTROESOPHAGEAL REFLUX DISEASE IN THE ROMANIAN COUNTY GORJ PREVALENŢA REFLUXULUI GASTROESOFAGIAN ÎN JUDEŢUL GORJ, ROMÂNIA." Jurnal Medical Brasovean, no. 1 (August 10, 2020): 69–73. http://dx.doi.org/10.31926/jmb.2020.1.11.

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Анотація:
Background și scop:Boala de reflux gastroesofagian (BRGE) este o afecțiune comună,despre care există puține date epidemiologice din România. Studiul de faţă şi-a propus obţinerea de date epidemiologice din judeţul Gorj din sud-vestul României.Metode:A fost efectuat un studiu prospectiv bazat pe auto-raportareapirozisului și a unor simptome extradigestive atribuite BRGE. Un eșantion de500 de participanți înscriși înbayele de date ale medicilor de familie a fost investigat cu ajutorul unui chestionar dedicat.Rezultate:Eșantionul a avut orată mare de răspuns (90%). Dintre respondenţi,o treime nu a avut niciodată pirozissau alt simptom BRGE. Cu toate acestea, 17% au raportat pirozis(scor 2 și 3 pe o scalaLikert de la 0-3); 11% au raportat gust acru; jumătate au utilizat medicamente antiacide; 15-20% au prezentat tulburări de somn. Nu a fost observată nicio diferență de gen.Concluzii:Considerând doar cazurilecu pirozis supărătorcaavândBRGE, în sud-vestul României prevalenta BRGE este de 17%. Rezultatele noastre pot reprezenta baza unor acţiuni de diagnostic şi tratament al BRGE.
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12

Skrzydło-Radomańska, Barbara. "10 reasons for choosing pantoprazole for patients on polytherapy." Medycyna Faktów 14, no. 2 (June 30, 2021): 139–44. http://dx.doi.org/10.24292/01.mf.0221.2.

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Proton pump inhibitors are the most effective therapy for all the acid-dependent diseases. Pantoprazole has been used since 1997 and it has a precise and predictable profile of activity. Pantoprazole maintains its stability in higher gastric pH with concomittant antiacids. Its constant bioavaibility and maximal blood levels are achieved after the first dose. Pantoprazole is approved for a variety of gastric acid-related diseases: gastroesophageal reflux disease, peptic ulcer disease, Helicobacter pylori eradication, functional dyspepsia, NSAID-induced gastropathy treatment and prevention, and Zollinger-Ellison syndrome. Pantoprazole has been shown to have no significant interactions with other medications: especially important with antiplatelet drugs (clopidogrel), but also antipyrine, carbamazepine, ciclosporin, clarithromycin, diclofenac, naproxen, nifedipine, oral contraceptives, tacrolimus, theophylline, warfarin, and also ethanol. Pantoprazole is the very good choice particularly in patients taking multiple concomitant medications – such as the elderly or those receiving drugs with a narrow therapeutic window. Even in the long-term therapy, pantoprazole seems to be well tolerated with no identified safety concerns.
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13

Karateke, Faruk, Ebru Menekşe, Koray Das, Sefa Ozyazici, and Pelin Demirtürk. "Isolated Duodenal Crohn's Disease: A Case Report and a Review of the Surgical Management." Case Reports in Surgery 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/421961.

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Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn’s diseases, and reviewed the surgical options in the literature.
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14

Schmidt, Gary L., Anne M. Karinch, and Gordon L. Kauffman. "SR48692 pretreatment blocks the protective and antiacid secretory effects of ICV neurotensin in rats." Gastroenterology 114 (April 1998): A1179. http://dx.doi.org/10.1016/s0016-5085(98)84792-6.

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15

Yang, Hyun Mo, Ariana Campos Yang, Keity Souza Santos, Clovis Eduardo Galvão, and Fabio Fernandes Morato Castro. "The Assessment of the Arising of Food Allergy among Antiacid Users Using Mathematical Model." Applied Mathematics 03, no. 03 (2012): 293–307. http://dx.doi.org/10.4236/am.2012.33045.

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16

Kong, Lirong, Xiaofeng Lu, Xiujie Bian, Wanjin Zhang, and Ce Wang. "Constructing Carbon-Coated Fe3O4 Microspheres as Antiacid and Magnetic Support for Palladium Nanoparticles for Catalytic Applications." ACS Applied Materials & Interfaces 3, no. 1 (December 14, 2010): 35–42. http://dx.doi.org/10.1021/am101077a.

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17

Zhou, Xianqing, Cuijuan Niu, and Ruyong Sun. "The effects of vitamin E on antiacid stress ability in juvenile soft-shelled turtles (Pelodiscus sinensis)." Comparative Biochemistry and Physiology Part C: Toxicology & Pharmacology 137, no. 4 (April 2004): 299–305. http://dx.doi.org/10.1016/j.cca.2004.01.009.

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18

Oussou, N’Guessan Jean-Baptiste, Ehilé Hervé Ehile, Kouakou Léandre Kouakou, Mathieu Nitiema, Kouamé Landry Yoboue, Angoué Paul Yapo, and Ehouan Etienne Ehile. "Acute Toxicity Study, Anti-Secretory and Antiacid Activities of a Herbal Formulation on Induced Gastric Ulcer." Journal of Pharmacology and Toxicology 18, no. 3 (June 15, 2023): 132–38. http://dx.doi.org/10.3923/jpt.2023.132.138.

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19

Ayala Pío, Salomón, David Díaz, Manuel Palomino, Segundo Armas, and Juan Paz. "Efecto Protector de Croton palanostigma y Aloe frente a Injuria Aguda de Mucosa Gástrica inducida por Etanol en Ratas." Anales de la Facultad de Medicina 60, no. 1 (April 7, 2014): 22. http://dx.doi.org/10.15381/anales.v60i1.4498.

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OBJETIVOS: Evaluar el grado de protección frente a la necrosis de la mucosa gástrica inducida por etanol con Croton palanostigma (Sangre de Grado) y Aloe vera, y compararlo con el de sucralfato y una suspensión de antiácido (AlOH3 +MgOH3+simeticona), en un modelo experimental estandarizado en ratas. MATERIAL Y MÉTODOS: Se evaluó a 56 animales, administrándoles en ayunas uno de 7 pretratamientos: solución salina, C. palanostigma (0,4 ó 0,8 mL/kg), A. vera (7,5 ó 3,2 mL/kg), sucralfato (500 mg/kg) o antiácido. Una hora más tarde, se administró por vía intragástrica 2 mL de etanol al 100%. Se realizó una evaluación cualitativa y cuantitativa, macroscópica y microscópica, de las lesiones gástricas. RESULTADOS: El pretratamiento con C. palanostigma redujo significativamente la aparición de necrosis hemorrágica inducida por etanol, A. vera no presentó efecto protector, mientras que sí lo presentaron el sucralfato, en grado significativo, y el antiacido, en menor grado. CONCLUSIÓN: En nuestras condiciones experimentales, Croton palanostigma presentó un importante efecto protector y potencial terapéutico.
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20

Zhang, Liyan, Lin Shen, Yuhan Lu, and Jing Xue. "Cancer immunotherapy and toxic epidermal necrolysis." BMJ Supportive & Palliative Care 10, no. 3 (April 27, 2020): 314–15. http://dx.doi.org/10.1136/bmjspcare-2019-002135.

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ObjectivesImmunotherapy has come to play an increasingly important role in cancer treatment. Accordingly, immune-related adverse events (irAEs) have drawn considerable attention. In this case, a young female patient developed immune-related toxic epidermal necrolysis (TEN). The same irAEs have been rarely reported in previous studies. In this study, we describe the treatment and care methods used in this case in detail in order to provide a reference for clinical practice.MethodsAfter being diagnosed with TEN, the patient accepted systemic glucocorticoid therapy, timely care of skin and mucous membranes, nutrition support, antiacid therapy, anti-inflammatory, analgesics and other supportive measures.ResultsThe patient’s skin recovered completely, and no serious adverse outcomes, such as secondary infection or multiple organ failure, occurred during treatment.ConclusionMedical staff should be able to identify the performance of rare irAEs such as TENs and actively explore comprehensive treatments to ensure patient safety and avoid adverse outcomes.
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21

Gespach, C., S. Emami, E. Chastre, J. M. Launay, and G. Rosselin. "Up- and down-regulation of membrane receptors as possible mechanisms related to the antiulcer actions of milk in rat gastric mucosa." Bioscience Reports 7, no. 2 (February 1, 1987): 135–42. http://dx.doi.org/10.1007/bf01121877.

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The effects of a cow's milk diet on receptor activity and histamine metabolism in gastric glands and mucosa isolated from adult rats were examined. The milk diet was associated with (1) a decreased mobilization of H2 receptors by histamine and (2) an increased mobilization of PGE2 (prostaglandin E2) receptors in mucous cells (cytoprotective effect) and parietal cells (antiacid effect). These changes are not observed for the receptors reducing pentagastrin- and histamine-induced gastric acid secretion (pancreatic/enteroglucagons, somatostatin) and stimulating mucus, bicarbonate and pepsin secretions in the rat (secretin). Cimetidine produced a parallel displacement of the histamine dose-response curve, suggesting competitive inhibition between this classical H2 receptor antagonist and histamine in the two experimental groups. Prostaglandins and other components in milk such as EGF (epidermal growth factor) and somatostatin might therefore protect gastric mucosa by a differential control of PGE2 and histamine H2 receptor activity either directly (PGE2 in milk) or indirectly (inhibition of endogeneous histamine synthesis/release and stimulation of PGE-I synthesis/release).
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22

Chaudhry, Javed, Asma Inam, Khadija Javed, Abdullah Javed, Gulpash Saghir, and Najma Shoaib. "A Study of Empirical Use of Proton Pump Inhibitors in Indoor Patients." Pakistan Journal of Medical and Health Sciences 16, no. 8 (August 31, 2022): 113–15. http://dx.doi.org/10.53350/pjmhs22168113.

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Background: Proton pump inhibitors are amongst most widely used gastric protectants due to their effectiveness. However, there are concerns about their over utilization, patient safety and socioeconomic burden. Aim: To evaluate empirical use, risks and hazards associated with over- usage of Proton pump inhibitors (PPIs). Methodology: A descriptive cross-sectional study was conducted at a tertiary care hospital in Lahore from July to August 2021. Seventy five patients were randomly picked up from indoor wards of the hospital. Patient’s demographic data and frequency of PPIs usage was recorded. Route of administration, adverse effects and indications of proton pump inhibitors were also noted in percentages. Results: All patients were prescribed PPIs on their admission day. Among them, two patients were concomitantly taking H2 Receptor Blockers. Seventy eight (78 %) users were administered PPIs through intravenous route, while rest were given once daily oral formulation. Fourty two (42) % of patients were not prescribed PPIs according to AGA criteria. Moreover, 12% of our sample population suffered from different adverse effects like diarrhea, abdominal pain, bone pain and headache. The results of our study clearly indicated frequent use of PPIs in indoor patients as a prophylaxis of SRMD. Conclusion: Keeping in view the incorrect use of antiacids and their adverse effects including increased risk of enteric and hospital acquired infection, unnecessary use of PPIs in admitted patients should be monitored regularly. MeSH words: PPIs, SRMD, NSAIDs, AG
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23

Jin, Xiaofeng, Yanyan Niu, Wei Gu, and Jian Wang. "Effects of Antiacid Therapy on Granuloma after Transoral Type IV-VI Cordectomy in Patients with Early-Stage Glottic Cancer." BioMed Research International 2020 (August 10, 2020): 1–6. http://dx.doi.org/10.1155/2020/4178376.

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Анотація:
Objective. To investigate whether preventive administration of a proton pump inhibitor (PPI) can reduce the occurrence and development of traumatic granuloma (TG) following type IV-VI cordectomy. Methods. We retrospectively analyzed the status of postoperative granulomas in 37 patients who underwent type IV-VI cordectomy due to glottic cancer and determined whether postoperative administration of a PPI had any impact on granuloma formation and development. Results. The percentage and number of patients with granuloma in the PPI treatment group (experimental group) at the 1st, 2nd, 3rd, and 6th month following surgery were 81.25% (13/16), 25.00% (4/16), 18.75% (3/16), and 0.00% (0/16), respectively. The percentage and number of patients with granuloma in the no-PPI group (control group) were 95.24% (20/21), 71.43% (15/21), 52.38% (11/21), and 14.29% (3/21), respectively. The granuloma percentage of the PPI treatment group was lower than that of the control group at all postoperative time points assessed. The differences were not statistically significant at the 1st month (p=0.175) but were statistically significant at the 2nd and 3rd months after surgery (p=0.005, p=0.037). Conclusion. Preventive use of a PPI in patients after type IV-VI cordectomy can shorten the TG recovery duration and may reduce the severity of TG, but it cannot prevent TG from occurring. Our results should be confirmed by prospective randomized controlled trials with large sample sizes.
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24

Ruaro, Barbara, Riccardo Pozzan, Paola Confalonieri, Stefano Tavano, Michael Hughes, Marco Matucci Cerinic, Elisa Baratella, et al. "Gastroesophageal Reflux Disease in Idiopathic Pulmonary Fibrosis: Viewer or Actor? To Treat or Not to Treat?" Pharmaceuticals 15, no. 8 (August 22, 2022): 1033. http://dx.doi.org/10.3390/ph15081033.

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Анотація:
Background: Idiopathic pulmonary fibrosis (IPF) is a rare and severe disease with a median survival of ∼3 years. Several risk factors have been identified, such as age, genetic predisposition, tobacco exposure, and gastro-oesophageal reflux disease (GERD). Prevalence of GERD in IPF is high and may affect 87% of patients, of whom only half (47%) report symptoms. Objective: The aim of this study is to review current evidence regarding the correlation between GERD and IPF and to evaluate the current studies regarding treatments for GERD-IPF. Methods: A review to identify research papers documenting an association between GERD and IPF was performed. Results: We identified several studies that have confirmed the association between GERD and IPF, with an increased acid exposure, risk of gastric aspiration and bile acids levels in these patients. Few studies focused their attention on GERD treatment, showing how antiacid therapy was not able to change IPF evolution. Conclusions: This review investigating the correlation between GERD and IPF has confirmed the hypothesized association. However, further large prospective studies are needed to corroborate and elucidate these findings with a focus on preventative and treatment strategies.
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25

Lobbes, Hervé, Stéphane Durupt, Sabine Mainbourg, Bruno Pereira, Raphaele Nove-Josserand, Isabelle Durieu, and Quitterie Reynaud. "Iron Deficiency in Cystic Fibrosis: A Cross-Sectional Single-Centre Study in a Referral Adult Centre." Nutrients 14, no. 3 (February 5, 2022): 673. http://dx.doi.org/10.3390/nu14030673.

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Анотація:
Iron deficiency (ID) diagnosis in cystic fibrosis (CF) is challenging because of frequent systemic inflammation. We aimed to determine the prevalence and risk factors of ID in adult patients with CF. We conducted a single-centre prospective study in a referral centre. ID was defined by transferrin saturation ≤16% or ferritin ≤20 (women) or 30 (men) μg/L, or ≤100 μg/L in the case of systemic inflammation. Apparent exacerbation was an exclusion criterion. We included 165 patients (78 women), mean age—31.1 ± 8.9 years. ID prevalence was 44.2%. ID was significantly associated with female gender (58.9% vs. 38%), lower age (29.4 ± 8.5 vs. 32.5 ± 9.1), lower body mass index (20.5 ± 2.2 vs. 21.3 ± 2.5), and Pseudomonas aeruginosa colonization (70.8% vs. 55.1%). Diabetes mellitus, antiacid drug use and low pulmonary function were more frequent in patients with ID with no statistical significance. The use of CFTR correctors was not associated with ID. In the multivariate analysis, ID was associated with female gender (OR 2.64, CI95% 1.31–5.31), age < 30 years (OR 2.30, CI95% 1.16–4.56), and P. aeruginosa (OR 2.09, CI95% 1.04–4.19).
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26

Menezes, Fernanda Souza de, Heitor Pons Leite, Juliana Fernandez, Silvana Gomes Benzecry, and Werther Brunow de Carvalho. "Hypophosphatemia in critically ill children." Revista do Hospital das Clínicas 59, no. 5 (2004): 306–11. http://dx.doi.org/10.1590/s0041-87812004000500015.

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The purpose of this paper is to review clinical studies on hypophosphatemia in pediatric intensive care unit patients with a view to verifying prevalence and risk factors associated with this disorder. We searched the computerized bibliographic databases Medline, Embase, Cochrane Library, and LILACS to identify eligible studies. Search terms included critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. The search period covered those clinical trials published from January 1990 to January 2004. Studies concerning endocrinological disorders, genetic syndromes, rickets, renal diseases, anorexia nervosa, alcohol abuse, and prematurity were not included in this review. Out of 27 studies retrieved, only 8 involved pediatric patients, and most of these were case reports. One clinical trial and one retrospective study were identified. The prevalence of hypophosphatemia exceeded 50%. The commonly associated factors in most patients with hypophosphatemia were refeeding syndrome, malnutrition, sepsis, trauma, and diuretic and steroid therapy. Given the high prevalence, clinical manifestations, and multiple risk factors, the early identification of this disorder in critically ill children is crucial for adequate replacement therapy and also to avoid complications.
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Teixeira, Joás Araújo, Amitis Vieira Costa e. Silva, Valdeci Elias dos Santos Júnior, Paulo Correia de Melo Júnior, Manuela Arnaud, Maria Goretti Lima, Miguel Angel Pelagio Flores, et al. "Effects of a New Nano-Silver Fluoride-Containing Dentifrice on Demineralization of Enamel andStreptococcus mutansAdhesion and Acidogenicity." International Journal of Dentistry 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/1351925.

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An experimental dentifrice containing nano-silver fluoride (NSF) and a sodium fluoride (NaF) toothpaste were testedin vitro, againstS. mutans, to evaluate the minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC), antiadherence, antiacid, enamel microhardness, and OCT. The microdilution technique was used to determine the MIC and MBC. Fragments of deciduous enamel were treated with dentifrice slurries, containing bacterial suspension and PBS-treated saliva. The quantification of the microorganisms that adhered to the enamel was determined after 24 hours of incubation, and media pH readings were performed after 2 hours and 24 hours. Deciduous teeth were evaluated for microhardness and OCT during 14 days of pH cycling. Data were statistically analyzed using Student’st-test, Mann–WhitneyUtest, ANOVA, and Tukey tests at 5% of significance. Dentifrices containing NSF presented a lower MIC and higher statistically significant results compared to NaF dentifrices with respect to preventing bacterial adhesion and pH decreases. NSF and NaF dentifrices showed the same ability to avoid enamel demineralization corroborated by the OCT images. The NSF formulation had a better antibacterial effect compared to NaF dentifrices and similar action on the demineralization of enamel indicating their potential effectiveness to prevent caries.
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Tanae, M. M., M. T. R. Lima-Landman, T. C. M. De Lima, C. Souccar, and A. J. Lapa. "Chemical standardization of the aqueous extract of Cecropia glaziovii Sneth endowed with antihypertensive, bronchodilator, antiacid secretion and antidepressant-like activities." Phytomedicine 14, no. 5 (May 2007): 309–13. http://dx.doi.org/10.1016/j.phymed.2007.03.002.

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29

Rizzo, Alessandro, Matteo Santoni, Veronica Mollica, Angela Dalia Ricci, Concetta Calabrò, Antonio Cusmai, Gennaro Gadaleta-Caldarola, Gennaro Palmiotti, and Francesco Massari. "The Impact of Concomitant Proton Pump Inhibitors on Immunotherapy Efficacy Among Patients with Urothelial Carcinoma: A Meta-Analysis." Journal of Personalized Medicine 12, no. 5 (May 20, 2022): 842. http://dx.doi.org/10.3390/jpm12050842.

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Background. Immune checkpoint inhibitors (ICIs) have recently represented a breakthrough in urothelial carcinoma (UC). Proton pump inhibitors (PPIs) are routinely used for extended time periods in UC patients, with these agents having potentially and frequently undervalued effects on ICIs efficacy. Methods. We performed a meta-analysis aimed at investigating the impact of concomitant PPI administration on progression-free survival (PFS) and overall survival (OS) among patients receiving immunotherapy for metastatic UC. Results. Two studies encompassing a total of 1015 patients were included. The pooled Hazard Ratios (HRs) for OS and PFS were 1.55 (95% CI, 1.31–1.84) and 1.43 (95% CI, 1.23–1.66), respectively, suggesting that the administration of PPIs was negatively associated with PFS and with OS in UC patients treated with ICIs. Conclusions. The current meta-analysis represents the first study to provide a systematic evaluation of the impact of concomitant PPI use in UC patients treated with ICIs. Further studies are warranted on this topic to clarify the relationship between gut microbiome, antiacid exposure, and cancer immunotherapy. In the current era of medical oncology, progress in this setting will require the collaboration of basic science and clinical research to optimize systemic treatment and to improve the outcomes of UC patients receiving ICIs.
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Di Pompo, Gemma, Katsuyuki Kusuzaki, Marco Ponzetti, Vito Leone, Nicola Baldini, and Sofia Avnet. "Radiodynamic Therapy with Acridine Orange Is an Effective Treatment for Bone Metastases." Biomedicines 10, no. 8 (August 5, 2022): 1904. http://dx.doi.org/10.3390/biomedicines10081904.

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Current multimodal treatment of bone metastases is partially effective and often associated with side effects, and novel therapeutic options are needed. Acridine orange is a photosensitizing molecule that accumulates in acidic compartments. After photo- or radiodynamic activation (AO-PDT or AO-RDT), acridine orange can induce lysosomal-mediated cell death, and we explored AO-RDT as an acid-targeted anticancer therapy for bone metastases. We used osteotropic carcinoma cells and human osteoclasts to assess the extracellular acidification and invasiveness of cancer cells, acridine orange uptake and lysosomal pH/stability, and the AO-RDT cytotoxicity in vitro. We then used a xenograft model of bone metastasis to compare AO-RDT to another antiacid therapeutic strategy (omeprazole). Carcinoma cells showed extracellular acidification activity and tumor-derived acidosis enhanced cancer invasiveness. Furthermore, cancer cells accumulated acridine orange more than osteoclasts and were more sensitive to lysosomal death. In vivo, omeprazole did not reduce osteolysis, whereas AO-RDT promoted cancer cell necrosis and inhibited tumor-induced bone resorption, without affecting osteoclasts. In conclusion, AO-RDT was selectively toxic only for carcinoma cells and effective to impair both tumor expansion in bone and tumor-associated osteolysis. We therefore suggest the use of AO-RDT, in combination with the standard antiresorptive therapies, to reduce disease burden in bone metastasis.
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Suto, Daisuke, Masashi Yoshida, Takaaki Otake, Yosuke Osawa, Kiichi Sato, Hidehiko Yamada, Takayuki Akita, Hironori Ohdaira, Yutaka Suzuki, and Yutaka Kohgo. "Anti-acid treatment for ulcerated early gastric cancer may be a treatment option avoiding unnecessary gastrectomy: a cohort study." Annals of Medicine & Surgery 85, no. 7 (June 5, 2023): 3269–72. http://dx.doi.org/10.1097/ms9.0000000000000874.

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Background: Diagnosing the invasion depth of ulcerated early gastric cancer is usually inaccurate, especially for endoscopists in primary care clinics who are often not experts in this area. In reality, many patients with open ulcers who can be treated with endoscopic submucosal dissection (ESD) are referred for surgery. Materials and methods: Twelve patients with ulcerated early gastric cancer who were treated with proton pump inhibitors, including vonoprazan, and underwent ESD were included in the study. Conventional endoscopic and narrow-band images were evaluated by five board-certified endoscopists (two physicians: A, B, and three gastrointestinal surgeons: C, D, and E). They assessed the invasion depth, and the results were compared with the pathologic diagnosis. Results: The accuracy of the invasion depth diagnosis was 38.3%. According to the pretreatment diagnosis of invasion depth, gastrectomy was recommended for 41.7% (5/12) of the cases. However, histological examination revealed that additional gastrectomy was required in only one case (8.3%). Thus, in four out of five patients unnecessary gastrectomy could be avoided. Post-ESD mild melena occurred in only one case, and there was no case of perforation. Conclusion: Antiacid treatment contributed to avoid unnecessary gastrectomy in four out of five patients for whom gastrectomy was indicated based on an inaccurate pretreatment diagnosis of the invasion depth.
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Ali, M., and Z. Zhou. "Elastotic Mass-Forming Lesion of the Omentum; A New Pathological Entity." American Journal of Clinical Pathology 158, Supplement_1 (November 1, 2022): S57. http://dx.doi.org/10.1093/ajcp/aqac126.113.

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Abstract Introduction/Objective Elastotic lesions are rare benign mass-forming entity. Although, few reports of mucosal and submucosal elastotic lesions have been previously described, localization of these lesions in the omentum is not previously described in the literature. Methods/Case Report We report a case of 60-year-old man with medical history of obesity, hypertension, diabetes mellitus, and a remote abdominal surgery in 1980s who presented to the emergency room complaining of abrupt severe constant epigastric pain that started few hours before. The pain was not relieved by antiacid or analgesic medications. CT of the abdomen showed multiple distended fluid-filled loops of small bowel in mid abdomen with infiltrative changes of mesentery. A diagnosis of small bowel obstruction was made, and patient proceed to have an exploratory laparotomy. During the procedure, extensive adhesions between small bowel and omentum and small bowel obstruction due to a phytobezoar were noted for which he underwent lysis of adhesion, excision of thickened omentum, and enterotomy for removal of significant food bezoar. Grossly, the omentum has multiple chalky tan-gray masses ranging between 1.2 and 1.0 cm in greatest dimension surrounded by indurated fatty tissue. Microscopically, multiple hypocellular foci are seen that are composed almost entirely of truncated elastic fibers, with sparse delicate bands of collagen and scattered prominent thick-walled vessels. Elastic stain highlights these elastic fibers while trichrome stains the elastic fibers pale gray in contrast to the bright blue color of the collagen fibers. Mucicarmine, and Congo red are negative. Patient tolerated the procedure well however, postoperatively he had local wound infection leading to prolonged skin dehiscence. Results (if a Case Study enter NA) NA. Conclusion Elastotic mass-forming lesions in the omentum is a new entity that has not been described before in this location that can clinically manifest with signs and symptoms of bowel obstruction. We suggested the name of elastomatosis omentum.
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Мratskova, Galina, and Rumen Deliev. "THERAPEUTIC OPPORTUNITIES OF NON-SURGICAL TREATMENT IN PATIENTS WITH URINARY INCONTINENCE." Knowledge International Journal 32, no. 2 (July 26, 2019): 261–66. http://dx.doi.org/10.35120/kij3202261m.

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Urinary Incontinence (UI) is a significant medical and social problem which affects both sexes. It can lead to a reduction in social contacts and physical activity, associated with poor self-assessment of the health status, impairment of emotional and mental well-being, reduction of sexual relations and depressive symptomatology. It is a significant reason for lower quality of life. In women, urinary incontinence is more common than in men. There are a number of reasons why urinary incontinence may occur: after surgery in small pelvis, pregnancy, vaginal delivery, hysterectomy, menopause, extreme obesity, chronic cough, constipation, some medications (muscle relaxants, sedative, antihypertensive agents, ACE inhibitors, antiacids) and others. Age factors leads to increased rate of incontinence, which has a large social and financial impact. It reflects the quality of life and it is a significant financial problem, both personal and for the health insurance system.The purpose of this review article is to investigate the therapeutic opportunities of non-surgical and physiotherapeutic treatment of patients with urinary incontinence.The treatment of urinary incontinence is strictly individual and depends on the type of incontinence, its severity and the reasons for its occurrence. It can be conservative and operative. The disease often does not progress over time and the conservative therapy is well tolerated, effective and safe. Non-surgical and physiotherapeutic treatment (behavioral therapy, the reduction of body mass, bladder training, lifestyle change, kinesitherapy for the pelvic floor muscles, biofeedback therapy, electrostimulation of skeletal pelvic floor muscles (ES), vaginal cones, mechanical devices, medication therapy, Botulinum toxin therapy) is the first choice and is preferred by most patients and it is well tolerated and effective. The application of physiotherapeutic methods of treatment requires the preparation of an individual rehabilitation program, which must be consistent with rehabilitation potential of the patient. The principles of gradual increase in the type and number of repetitions in therapeutic exercises, the continuity of kinesitherapy and the appropriate combination with electrostimulation procedures of the pelvic floor muscles are applied. It is considered, that the strengthening of the pelvic floor muscles is achieved through three levels of action: increasedg compression on the urethra, suppor of the bladder neck and improvement of the coordination of contractions of m. transversus abdominis and pelvic floor muscles. For electrostimulation, devices allowing percutaneous, intravaginal or intrarectal stimulation, usually with biphasic current, and low frequency and optimal intensity allowing painless contraction, are used.Conclusion: The urinary incontinence (UI) is highly prevalent and causes significant levels of morbidity, especially in women. The treatment for urinary incontinence is strictly individual and depends on the type of incontinence, the severity and the reasons for its occurrence. A stepwise approach treatment is recommended. The disease often does not progress over time, the conservative therapy is well tolerated, effective and safe.
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"Infection à Clostridium difficile : faut-il arrêter les antiacides ?" Médecine et Maladies Infectieuses 42, no. 7 (July 2012): 331. http://dx.doi.org/10.1016/j.medmal.2012.01.011.

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"Relationship between antiischemic and antiacidic effects of high-energy phosphates." Journal of Molecular and Cellular Cardiology 24 (August 1992): S90. http://dx.doi.org/10.1016/0022-2828(92)91761-s.

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36

Wang MD, Tong. "Potassium-Competitive Acid Blocker: Novel Class of AntiAcid Drug." Current Trends in Gastroenterology and Hepatology 2, no. 2 (March 14, 2019). http://dx.doi.org/10.32474/ctgh.2019.02.000131.

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37

Badillo, M., J. Denis-Robichaud, S. Buczinski, and M. Veillette. "Effects of Oral Administration of Magnesium Sulfate on Bovine Rumen pH, Rumen Protozoa and Serum Magnesium." American Association of Bovine Practitioners Conference Proceedings, September 22, 2011, 185. http://dx.doi.org/10.21423/aabppro20114060.

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Magnesium oxide (MgO) is usually used in bovine practice for its laxative and antiacid properties. However, side effects of its use are an increase in rumen pH, a change in numbers of protozoa and higher peripheral Mg levels, all of which may slow down the recovery process of the animal. Magnesium sulfate (MgS04) offers an interesting alternative to MgO as laxative treatment. The association of magnesium with a weaker base such as the sulfate group may alleviate harmful side effects on rumen pH and protozoa. The aim of the present study was to evaluate the effect of orally administered magnesium sulfate on rumen pH, rumen protozoa, and serum magnesium in cattle. In addition, fecal consistency scores will be used to monitor the laxative effect of magnesium sulfate.
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"IMPLICAŢII ALE ANTIBIOTERAPIEI ÎN INFECŢIA CU CLOSTRIDIUM DIFFICILE LA PACIENŢI SPITALIZAŢI ÎN JUDEŢUL DOLJ (ROMÂNIA)." Romanian Journal of Infectious Diseases 20, no. 2 (June 30, 2017): 99–103. http://dx.doi.org/10.37897/rjid.2017.2.7.

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Obiective. Lucrarea urmăreşte rolul tratamentului antibiotic şi al factorilor favorizanţi independenţi de antibioterapie identificaţi în apariţia infecţiei cu Clostridium difficile (ICD) la cazurile spitalizate în judeţul Dolj. Material şi metodă. Au fost analizate 2 loturi de pacienţi: lotul ICD AB (178 cazuri de ICD care au primit tratament antibiotic) şi lotul ICD non AB (36 cazuri ICD care nu au primit tratament antibiotic) înregistrate în intervalul iulie 2014 – decembrie 2016. Rezultate. Antibioterapia a constituit un factor de risc semnificativ, înregistrat la 83,2% dintre cazuri. Clasele de antibiotice asociate cu apariţia ICD au fost cefalosporinele (73,5% din cazuri), chinolonele (24,2%), penicilinele (13,4%), tuberculostaticele (6,1%), carbapenemele (5,6%). Cazurile au provenit din secţii de chirurgie generală (25,2%), pneumoftiziologie (16,8%), terapie intensivă (13,5%), neurologie (12,1%), nefrologie (6,1%), ortopedie (6,1%), cardiologie (4,2%), chirurgie plastică (4,2%), urologie (3,7%). ICD non AB a înregistrat comparativ cu ICD AB un procent mai crescut în secţiile de terapie intensivă (30,6% versus10,1%). Analiza comparativă a caracteristicilor pacienţilor cu ICD AB şi ICD non AB nu a evidenţiat diferenţe semnificative legate de vârstă, sex, intervalul între internare şi debutul simptomelor, chirurgia digestivă recentă sau administrarea medicaţiei antiacide. Concluzii. Antibioterapia este un factor de risc important pentru ICD, frecvent implicate fiind cefalosporinele şi chinolonele. În apariţia ICD la pacienţii fără expunere la antibiotice, un rol semnificativ au avut internarea în unitatea de terapie intensivă şi severitatea afecţiunilor subiacente.
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Owot, Jacob Canwat, Caleb Tuhumwire, Christine Tumuhimbise, Florence Tusiime, Byaruhanga Emmanuel, Boniface A. E. Lumori, and Samson Okello. "Diagnostic performance of fecal Helicobacter pylori antigen test in Uganda." BMC Gastroenterology 22, no. 1 (December 14, 2022). http://dx.doi.org/10.1186/s12876-022-02551-z.

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AbstractWe evaluated the diagnostic performance of a qualitative stool antigen test (SAT) in individuals with dyspepsia in rural Uganda using the polymerase chain reaction-based 16S ribosomal RNA assay (16S rRNA) for nucleotide sequences for two common H. pylori-associated genes as the reference standard. We enrolled 150 adults with dyspepsia with no self-reported use of antibiotic and/or antiacid medication medications within a fortnight. We performed blinded SAT on fecal specimens and 16S rRNA tests on gastric specimens. Using nonlinear mixed models, SAT had a sensitivity of 85⋅1% (95%CI 76⋅54%, 93⋅6%), and specificity of 97⋅6% (95%CI 94⋅3, 100). Twelve individuals with dyspepsia need to be tested to correctly diagnose 10 with H. pylori infection using SAT. The SAT is a robust diagnostic test to improve the diagnosis of H. pylori infection in people with dyspepsia in resource-limited settings.
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Guo, Bin, Ming He, Jidong Zhao, Minting Ma, and Zhanjie Gao. "Distal-continual colon interposition for esophageal reconstruction after esophagectomy: Two case reports." Frontiers in Surgery 10 (January 30, 2023). http://dx.doi.org/10.3389/fsurg.2023.1098583.

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BackgroundColon interposition is a complex and time-consuming procedure requiring at least three or four digestive anastomoses. However, the long-term functional outcomes are promising, with an acceptable operative risk.Case presentationHerein, two cases of esophageal carcinoma that received esophagus reconstruction using the distal continual colon interposition technique have been described. The transverse colon was lifted to the thoracic cavity for the end-to-side anastomosis with the esophagus, and a closure device was used to close the colon instead of severing and isolating the distal end. The duration of the operation was 140 and 150 min, respectively. The blood supply of the colon was maintained during the intervention. The tension-free anastomosis was performed without severe complications, and oral food intake was resumed on postoperative day 6. Neither anastomotic stenosis, antiacid or heartburn, dysphagia, or emptying obstacles nor complaints of diarrhea, bloating, or malodor were reported during the follow-up period.ConclusionsThe modified distal-continual colon interposition technique may have the advantages of a short operation time and potential prevention of serious complications caused by the torsion of mesocolon vessels.
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Puig-Moltó, María, Blanca Lumbreras, and Elsa López-Pintor. "Prevalence and risk factors of upper gastrointestinal symptoms in community pharmacies in Spain: a cross-sectional study." Frontiers in Pharmacology 14 (June 13, 2023). http://dx.doi.org/10.3389/fphar.2023.1162370.

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Background: Frequently, the community pharmacies are the only points of consultation for upper-gastrointestinal symptomology. However, the heterogeneity of symptoms often limits the correct management of the patient. The study aim is to describe the epidemiological and clinical characteristics of patients with upper-gastrointestinal symptoms who ask for advice in community pharmacies.Methods: A cross-sectional study was performed in 134 Spanish pharmacies (June-October 2022) and we included 1,360 patients. We collected sociodemographic, clinical variables and current medication data. The pharmacist evaluated the gastrointestinal symptoms through the application of the GERD Impact Scale (GIS questionnaire). Patients were classified into three groups according to their symptoms: epigastric, retrosternal and overlapping symptoms.Results: Median age was 49 years (interquartile range 36–62 years) and 59.3% were women. Most patients reported overlapping symptoms (738%, 54.3%), 433 (31.8%) retrosternal and 189 (13.9%) epigastric symptoms. Patients with overlapping symptoms were more likely to associated consumption of foods and/or drinks and symptoms and showed lower scores on the GIS scale (median 26, IQR 20-30) than those with epigastric (median 32, IQR 29-33) and retrosternal (median 32, IQR 28-34) symptoms (p &lt; 0.001). Patients in treatment with a combination of alginates and antiacids were more likely to think that it better alleviated their symptoms in all the patients included (p = 0.012).Conclusion: More than half of the patients showed overlapping symptoms and were more likely to associate their symptoms with dietary habits and having poorer scores in the GIS scale. Clinical awareness of such overlapping condition would help optimize the management of patients with upper gastrointestinal symptoms in practice.
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Isnard, Stéphane, Léna Royston, Susan C. Scott, Tsoarello Mabanga, John Lin, Brandon Fombuena, Simeng Bu, et al. "Translocation of bacterial LPS is associated with self-reported cognitive abilities in men living with HIV receiving antiretroviral therapy." AIDS Research and Therapy 20, no. 1 (May 18, 2023). http://dx.doi.org/10.1186/s12981-023-00525-z.

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Abstract Background Gut damage allows translocation of bacterial lipopolysaccharide (LPS) and fungal β-D-glucan (BDG) into the blood. This microbial translocation contributes to systemic inflammation and risk of non-AIDS comorbidities in people living with HIV, including those receiving antiretroviral therapy (ART). We assessed whether markers of gut damage and microbial translocation were associated with cognition in ART-treated PLWH. Methods Eighty ART-treated men living with HIV from the Positive Brain Health Now Canadian cohort were included. Brief cognitive ability measure (B-CAM) and 20-item patient deficit questionnaire (PDQ) were administered to all participants. Three groups were selected based on their B-CAM levels. We excluded participants who received proton pump inhibitors or antiacids in the past 3 months. Cannabis users were also excluded. Plasma levels of intestinal fatty acid binding protein (I-FABP), regenerating islet-derived protein 3 α (REG3α), and lipopolysaccharides (LPS = were quantified by ELISA, while 1–3-β-D-glucan BDG) levels were assessed using the Fungitell assay. Univariable, multivariable, and splines analyses were performed. Results Plasma levels of I-FABP, REG3α, LPS and BDG were not different between groups of low, intermediate and high B-CAM levels. However, LPS and REG3α levels were higher in participants with PDQ higher than the median. Multivariable analyses showed that LPS association with PDQ, but not B-CAM, was independent of age and level of education. I-FABP, REG3α, and BDG levels were not associated with B-CAM nor PDQ levels in multivariable analyses. Conclusion In this well characterized cohort of ART-treated men living with HIV, bacterial but not fungal translocation was associated with presence of cognitive difficulties. These results need replication in larger samples.
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Garcia-Gutiérrez, Susana, Cristobal Esteban-Aizpiri, Iratxe Lafuente, Irantzu Barrio, Raul Quiros, Jose Maria Quintana, Ane Uranga, et al. "Machine learning-based model for prediction of clinical deterioration in hospitalized patients by COVID 19." Scientific Reports 12, no. 1 (May 2, 2022). http://dx.doi.org/10.1038/s41598-022-09771-z.

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AbstractDespite the publication of great number of tools to aid decisions in COVID-19 patients, there is a lack of good instruments to predict clinical deterioration. COVID19-Osakidetza is a prospective cohort study recruiting COVID-19 patients. We collected information from baseline to discharge on: sociodemographic characteristics, comorbidities and associated medications, vital signs, treatment received and lab test results. Outcome was need for intensive ventilatory support (with at least standard high-flow oxygen face mask with a reservoir bag for at least 6 h and need for more intensive therapy afterwards or Optiflow high-flow nasal cannula or noninvasive or invasive mechanical ventilation) and/or admission to a critical care unit and/or death during hospitalization. We developed a Catboost model summarizing the findings using Shapley Additive Explanations. Performance of the model was assessed using area under the receiver operating characteristic and prediction recall curves (AUROC and AUPRC respectively) and calibrated using the Hosmer–Lemeshow test. Overall, 1568 patients were included in the derivation cohort and 956 in the (external) validation cohort. The percentages of patients who reached the composite endpoint were 23.3% vs 20% respectively. The strongest predictors of clinical deterioration were arterial blood oxygen pressure, followed by age, levels of several markers of inflammation (procalcitonin, LDH, CRP) and alterations in blood count and coagulation. Some medications, namely, ATC AO2 (antiacids) and N05 (neuroleptics) were also among the group of main predictors, together with C03 (diuretics). In the validation set, the CatBoost AUROC was 0.79, AUPRC 0.21 and Hosmer–Lemeshow test statistic 0.36. We present a machine learning-based prediction model with excellent performance properties to implement in EHRs. Our main goal was to predict progression to a score of 5 or higher on the WHO Clinical Progression Scale before patients required mechanical ventilation. Future steps are to externally validate the model in other settings and in a cohort from a different period and to apply the algorithm in clinical practice.Registration: ClinicalTrials.gov Identifier: NCT04463706.
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Samejima, Yoshitomo, Shohei Yoshimura, Yuichi Okata, Hiroya Sakaguchi, Hirofumi Abe, Shinwa Tanaka, Yuzo Kodama, and Yuko Bitoh. "Peroral endoscopic myotomy in pediatric patients with achalasia up to 12 years of age: a pilot study in a single center experience in Japan." European Journal of Pediatric Surgery, August 18, 2023. http://dx.doi.org/10.1055/a-2156-5099.

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Introduction Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic procedure for achalasia; its indication has expanded from adults to children. We aimed to evaluate the postoperative efficacy and anti-reflex status of POEM in young children with achalasia aged ≤12 years. Materials and Methods Pediatric patients with achalasia aged ≤18 years who underwent POEM in our hospital between 2016 and 2021 were included and divided into two age groups: group A (≤12 years) and group B (13–18 years). The success rate (Eckardt score ≤3), endoscopic reflux findings, and antiacid use at 1 year postoperatively were compared between the groups. Results Ten patients (four boys and six girls; Chicago classification type I: 5, type II: 4, and unclassified: 1) were included. Mean age and preoperative Eckardt scores in groups A (n=4) and B (n=6) were 9.2±3.0 vs. 15.6±0.6 years (p=0.001) and 5.5±3.9 vs. 7.2±3.7 (p=0.509), respectively, and mean operative time and myotomy length were 51.3±16.6 vs. 52.5±13.2 minutes (p=0.898) and 10.8±4.6 vs. 9.8±3.2 cm (p=0.720), respectively. The 1-year success rate was 100% in both groups. Mild esophagitis (Los Angeles classification B) was endoscopically found in one patient in each group (16.7% vs. 25.0%, p=0.714), and anti-acid use was required in three patients (group A, two; group B, one; 50.0% vs. 16.7%, p=0.500). Conclusions The success rate of POEM within 1 year in young children with achalasia aged ≤12 years was equal to that in adolescent patients. However, young children tended to require anti-acids 1 year postoperatively; therefore, long-term follow-up is necessary.
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Eriksson, Sven E., Ping Zheng, Inanc S. Sarici, Xinxin Shen, Blair A. Jobe, and Shahin Ayazi. "The impact of delayed gastric emptying as measured by gastric emptying scintigraphy on the outcome of magnetic sphincter augmentation." Surgical Endoscopy, June 16, 2023. http://dx.doi.org/10.1007/s00464-023-10190-y.

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Abstract Introduction The impact of delayed gastric emptying (DGE) on the outcome of anti-reflux surgery (ARS) is controversial. There is concern that poor gastric emptying diminishes outcomes. Magnetic sphincter augmentation (MSA) may have a comparatively mild impact on gastric physiology, but the relationship between DGE and MSA outcomes is unknown. This study aims to evaluate the relationship between objective DGE and MSA outcomes over time. Methods Patients who completed gastric emptying scintigraphy (GES) prior to MSA between 2013 and 2021 were included. DGE was defined as a 4 h retention > 10% or half emptying time > 90 min on GES. Outcomes were compared between DGE and normal gastric emptying (NGE) groups at 6 months, 1 and 2 years. Sub-analysis of patients with severe (> 35%) DGE and correlation analysis between 4-h retention and symptom and acid-normalization were performed. Results The study population consisted of 26 (19.8%) patients with DGE and 105 with NGE. DGE was associated with more 90-days readmissions (18.5 vs 2.9%, p = 0.009). At 6 months patients with DGE had higher median (IQR) GERD-HRQL total [17.0(10–29) vs 5.5(3–16), p = 0.0013], heartburn [1(1–3) vs 0(0–1), p = 0.0010) and gas-bloat [4(2–5) vs 2(1–3), p = 0.033] scores. Outcomes at 1 and 2 years follow-up were comparable (p > 0.05). From 6 months to 1-year the gas-bloat score decreased from 4(2–5) to 3(1–3), p = 0.041. Total and heartburn scores decreased, but not significantly. Severe DGE (n = 4) patients had lower antiacid medication freedom at 6 months (75 vs 87%, p = 0.014) and 1-year (50 vs 92%, p = 0.046). There were non-significant trends for higher GERD-HRQL scores, dissatisfaction, and removal rates in severe DGE at 6 months and 1-year. There was a weak correlation between 4-h retention and 6-month GERD-HRQL total score [R = 0.253, 95%CI (0.09–0.41), p = 0.039], but not acid-normalization (p > 0.05). Conclusion Outcomes after MSA are diminished early on in patients with mild-to-moderate DGE, but comparable by 1 year and durable at 2 years. Severe DGE outcomes may be suboptimal. Graphical abstract
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