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Sample records for schultz gerd lutze

  1. GERD

    Science.gov (United States)

    ... carries food from your mouth to your stomach. Gastroesophageal reflux disease (GERD) happens when a muscle at the end of ... more than twice a week, you may have GERD. You can also have GERD without having heartburn. ...

  2. Reflux and GERD (in Children)

    Science.gov (United States)

    ... Pediatric Gastroenterology and Nutrition Nurses Print Share Reflux GERD Reflux occurs during or after a meal when ... tube connecting the mouth to the stomach). Reflux & GERD The Difference Between Reflux and GERD in Kids ...

  3. Reflux and GERD in Infants

    Science.gov (United States)

    ... Gastroenterology and Nutrition Nurses Print Share Reflux and GERD : Reflux and GERD in Infants Reflux and GERD in Infants It’s not uncommon for a baby ... happy, healthy childhood. Quick Facts about Reflux and GERD in Infants The majority of infants do not ...

  4. Johannes Heinrich Schultz and National Socialism.

    Science.gov (United States)

    Brunner, Jürgen; Schrempf, Matthias; Steger, Florian

    2008-01-01

    Johannes Heinrich Schultz (1884-1970) established the set of techniques known as "autogenic training." From 1936 until 1945 he worked as assistant director of the Göring Institute. His role during National Socialism has been underestimated in our opinion. We considered Schultz's academic publications and his "autobiography" from 1964. Schultz publicly advocated compulsory sterilization as well as the "annihilation of life unworthy of life" and developed a diagnostic scheme which distinguished between the neurotic/curable and the hereditary/ incurable. In fact, this classification was then employed to decide between life and death. In order to justify the "New German Psychotherapy" alongside eugenic psychiatry, Schultz carried out degrading and inhuman "treatments" of homosexual prisoners of concentration camps who were in mortal danger. This study was based on written documents. We were not able to interview contemporary witnesses. By advocating compulsory sterilization and the "annihilation of life unworthy of life" and by the abuse of homosexuals as research objects Schultz violated fundamental ethical principles of psychiatry.

  5. Pediatric GERD (Gastro-Esophageal Reflux Disease)

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You Pediatric GERD (Gastro-Esophageal Reflux Disease) Pediatric GERD (Gastro-Esophageal ... What symptoms are displayed by a child with GERD? While GER and EER in children often cause ...

  6. Acid Reflux (GER & GERD) in Infants

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  7. Winston-Lutz Test: A quantitative analysis

    International Nuclear Information System (INIS)

    Pereira, Aline Garcia; Nandi, Dorival Menegaz; Saraiva, Crystian Wilian Chagas

    2017-01-01

    Objective: Describe a method of quantitative analysis for the Winston-Lutz test. Materials and methods The research is a qualitative exploratory study. The materials used were: portal film; Winston- Lutz test tools and Omni Pro software. Sixteen portal films were used as samples and were analyzed by five different technicians to measure the deviation between the radiation isocenters and mechanic. Results: Among the results were identified two combinations with offset values greater than 1 mm. In addition, when compared the method developed with the previously studied, it was observed that the data obtained are very close, with the maximum percentage deviation of 32.5%, which demonstrates its efficacy in reducing dependence on the performer. Conclusion: The results show that the method is reproducible and practical, which constitutes one of the fundamental factors for its implementation. (author)

  8. Anfíbios Anuros da coleção Adolpho Lutz: III - Hyla claresignata Lutz & B. Lutz, 1939

    Directory of Open Access Journals (Sweden)

    Bertha Lutz

    1948-12-01

    Full Text Available Hyla claresignata Lutz & Lutz, 1939, is a large species apparently not closely allied to the other known Brazilian hylas. It is characterized by the very small tympanum; the head is short and the snout rounded; the legs are long, the hands and feet unusually large, the latter extensively webbbed. The specific name is derived from the insular, irregular, or roughly triangular, dark spots, with a light halo, found mostly in the dorso-lateral region and on the legs. It belongs to the rain-forest fauna of the Marítime Range. The adult is a bromeliad-dweller and the tadpole rhyacophilous. DESCRIPTION. Vomerine teeth in two separate, oblique, groups, behind the large choanae, parallel to the posterior half of their inner border. Tongue entire, short, very broad and hardly free behind. Snout short, rounded, with distinct canthus rostralis and gradually sloping loreal region. Eye very large and prominent, its horizontal diameter almost equal to the distance between its anterior corner and the tip of the snout. Tympanum very small, less than one third of the diameter of the eye, but distinct, partly covered by a short, heavy ridge. Lateral fingers less than one third webbed; fourth finger slightly longer than the second, just reaching the base of the disk of the third; subarticular tubercles well developed; an angular pollex rudiment, more noticeable in the males. Toes almost completely webbed, the edge of the web inserted at the base of the disk on the third and the fifth; an inner metatarsal tubercle. Skin smooth above, granular beneath, on the throat minutely so. No dermal appendage on the hell. Habit robust, head broader than long, body rather heavy, slightly narrowed in the postaxillary region. Legs long, the tibiotarsal articulation reaching beyond the tip of the snout when adpressed. Type (female: 61 mm. (Fig. 1. DIAGNOSIS of TADPOLE (by G. Orton. "A large specialized, mountain-stream tadpole, with wide head an elongated, flattened snout, greatly

  9. Sexual reproduction in Odontella regia (Schultze) Simonsen 1974 (Bacillariophyta)

    Digital Repository Service at National Institute of Oceanography (India)

    Hegde, S.; Narale, D.D.; Anil, A.C.

    The sequence of spermatogenesis and sperm cell count of Odontella regia (Schultze) Simonsen from Indian waters is reported. The sequence of events in the spermatogenesis producing 16 spermatogonia following four differentiating (depauperating...

  10. A Conversation with Howard Schultz CEO of Starbucks

    OpenAIRE

    Christopher Muller

    2014-01-01

    At the 12th annual European Food Service Summit in Zurich, Switzerland in September 2011, Professor Christopher Muller sat down with Howard Schultz, the CEO of Starbucks to discuss a wide range of topics. Their discussion touched on best management and business practices and the techniques that Schultz used to bring Starbucks back from the brink of bankruptcy to the international coffee corporation it is today.

  11. A Conversation with Howard Schultz CEO of Starbucks

    Directory of Open Access Journals (Sweden)

    Christopher Muller

    2014-04-01

    Full Text Available At the 12th annual European Food Service Summit in Zurich, Switzerland in September 2011, Professor Christopher Muller sat down with Howard Schultz, the CEO of Starbucks to discuss a wide range of topics. Their discussion touched on best management and business practices and the techniques that Schultz used to bring Starbucks back from the brink of bankruptcy to the international coffee corporation it is today.

  12. Winston-Lutz Test: A quantitative analysis; Teste de Winston-Lutz: uma analise quantitativa

    Energy Technology Data Exchange (ETDEWEB)

    Pereira, Aline Garcia; Nandi, Dorival Menegaz; Saraiva, Crystian Wilian Chagas, E-mail: dnandi@gmail.com [Universidade Federal de Santa Catarina (UFSC), Florianopolis (Brazil); Instituto Federal de Santa Catarina (IFSC), Florianopolis (Brazil); Hospital do Coracao, Sao Paulo, SP (Brazil)

    2017-11-01

    Objective: Describe a method of quantitative analysis for the Winston-Lutz test. Materials and methods The research is a qualitative exploratory study. The materials used were: portal film; Winston- Lutz test tools and Omni Pro software. Sixteen portal films were used as samples and were analyzed by five different technicians to measure the deviation between the radiation isocenters and mechanic. Results: Among the results were identified two combinations with offset values greater than 1 mm. In addition, when compared the method developed with the previously studied, it was observed that the data obtained are very close, with the maximum percentage deviation of 32.5%, which demonstrates its efficacy in reducing dependence on the performer. Conclusion: The results show that the method is reproducible and practical, which constitutes one of the fundamental factors for its implementation. (author)

  13. Have You Heard of GERD? (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Español Have You Heard of GERD? KidsHealth / For Kids / Have You Heard of GERD? What's in this ...

  14. Insights into the genetics of gastroesophageal reflux disease (GERD) and GERD-related disorders.

    Science.gov (United States)

    Böhmer, A C; Schumacher, J

    2017-02-01

    Gastroesophageal reflux disease (GERD) is associated with obesity and hiatal hernia, and often precedes the development of Barrett's esophagus (BE) and esophageal adenocarcinoma (EA). Epidemiological studies show that the global prevalence of GERD is increasing. GERD is a multifactorial disease with a complex genetic architecture. Genome-wide association studies (GWAS) have provided initial insights into the genetic background of GERD. The present review summarizes current knowledge of the genetics of GERD and a possible genetic overlap between GERD and BE and EA. The review discusses genes and cellular pathways that have been implicated through GWAS, and provides an outlook on how future molecular research will enhance understanding of GERD pathophysiology. © 2017 John Wiley & Sons Ltd.

  15. Laparoscopic Anti-Reflux (GERD) Surgery

    Science.gov (United States)

    ... and Humanitarian Efforts Login Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Surgery for “Heartburn” If you suffer from moderate to ...

  16. Gerd Neggo stipendiumi sai Rene Nõmmik

    Index Scriptorium Estoniae

    2012-01-01

    Eesti Tantsuhariduse Liit andis tänavuse Gerd Neggo nimelise tantsuõpetaja stipendiumi Rene Nõmmikule, kes on üks Fine 5 tantsuteatri ja kooli asutajatest ning Tallinna Ülikooli tantsukunsti õppejõud

  17. Vabariigi President õnnitles maailmameister Gerd Kanterit

    Index Scriptorium Estoniae

    2007-01-01

    President Toomas Hendrik Ilves helistas Gerd Kanterile, kes võitis Osakas kergejõustiku maailmameistrivõistlustel kettaheites kuldmedali. Riigipea õnnitles G. Kanterit maailmameistri tiitli puhul ja kutsus ta Eestisse saabumise järel Kadriorgu

  18. Estimation of the symptoms for GERD by GerdQ in the patients with rheumatic diseases.

    Science.gov (United States)

    Nozaki, Yuji; Kinoshita, Koji; Ri, Jinhai; Sakai, Kenji; Shiga, Toshihiko; Hino, Shoichi; Hirooka, Yasuaki; Sugiyama, Masahumi; Funauchi, Masanori; Matsumura, Itaru

    2016-01-01

    Gastroesophageal reflux disease (GERD) is one of the most common comorbidity in many diseases, but the frequency in rheumatic disease has not been well understood. We investigated the prevalence of GERD by GerdQ in 530 rheumatic patients [systematic lupus erythematosus (SLE; n = 120), rheumatoid arthritis (RA; n = 117), polymyalgia rheumatica (PMR; n = 40), dermatomyositis and polymyositis (PM/DM; n = 38), systemic scleroderma (SSc; n = 37), mixed connective tissue disease (MCTD; n = 18), Behçet disease (BD; n = 17), adult onset still disease (AOSD; n = 14), and other rheumatic diseases (n = 129)]. The mean GerdQ scores of patients was 6.2 ± 1.8, respectively, and no significant differences were observed between all patients. However, the GERD prevalence in SSc and BD was increased compared to that in SLE, RA, PMR, PM/DM, MCTD, and AOSD. In no medication of proton pump inhibitors (PPIs), a significant increase in the risk of GERD symptoms was 2.5 times compared with that in the medication of PPIs in all patients by multivariable regression analysis. On the other hand, there were no increased risks of GERD symptoms with corticosteroids. In rheumatic diseases, GerdQ would be the useful tool of diagnosis GERD, regardless whether the patients complain or not about gastrointestinal (GI) symptoms.

  19. GERD: Can Certain Medications Increase Severity?

    Science.gov (United States)

    ... increase severity? I've heard that some medications can aggravate the symptoms of GERD. Can you tell me more? Answers from Michael F. Picco, M.D. Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn ...

  20. Gas Environment Recoverable Detection (GERD) HMI

    CERN Document Server

    Sillat, Mari Liis

    2016-01-01

    Report on the work done during the summer student project. The goal was to produce HMI panels for the GERD smoke detection system. The required platform was WinCC OA and the running sensor data needed to be displayed, pump controls were needed and an alarm was required to be set for the smoke sensors upper limit range.

  1. Diagnostic tests in gastroesophageal reflux disease (GERD)

    International Nuclear Information System (INIS)

    Hani de Ardila, Albis

    2009-01-01

    The true prevalence of gastroesophageal reflux disease (GERD) is difficult to establish despite that an estimated 11% of the U.S. population experiencing heartburn daily or 30% every three days (1), perhaps due to that the disease can cause many symptoms, both typical and atypical as heartburn or chest pain, among others. Multiple techniques for measuring reflux have been used, and many authors (1-3) have asked why this situation, possibly because the techniques measure and quantify the basic pathophysiologic problem disease, the time of exposure of the esophagus distal to the gastric juice, because the measures are quantitatively related to the degree of esophageal mucosal injury, or because the episodes of exposure to gastric juice correlated with the patient's symptoms. As said Richter (4) m any times these studies are unnecessary because the history is sufficiently revealing to identify the presence of GERD. But the clinician must decide which test you choose to carry a diagnosis of a reliable, timely and cost-effective . But we cannot rely on the presence of symptoms to diagnosis, because we incur the overdiagnosis in a considerable number of individuals, the sensitivity set for the typical symptoms as heartburn is 68% and specificity was 63% (2), which leads us to conclude that atypical symptoms should be investigated as they may relate to functional dyspepsia rather than GERD. It is also clear that the severity and frequency of symptoms in any way correlates with the presence or absence of esophagitis, patients with erosive esophagitis are more severe disease and increased risk of developing complications. The persistent exposure of the esophagus to gastric juice does not cause mucosal injury in all individuals, therefore, it is possible to define the disease by the presence of mucosal injury, while endoscopy is able to define the mucosal injury caused by the reflux can also lead to false conclusions, such as those patients with symptoms of GERD who have no

  2. GERD: Diagnosing and treating the burn.

    Science.gov (United States)

    Alzubaidi, Mohammed; Gabbard, Scott

    2015-10-01

    Gastroesophageal reflux disease (GERD) is chronic, very common, and frequently encountered in internal medicine and subspecialty clinics. It is often diagnosed on clinical grounds, but specialized testing such as endoscopy and pH monitoring may be necessary in certain patients. Although proton pump inhibitors (PPIs) are the mainstay of treatment, clinicians should be aware of their short-term and long-term side effects. Copyright © 2015 Cleveland Clinic.

  3. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD.

    Science.gov (United States)

    Fass, Ronnie; Johnson, David A; Orr, William C; Han, Cong; Mody, Reema; Stern, Kathleen N; Pilmer, Betsy L; Perez, M Claudia

    2011-03-01

    Nocturnal heartburn and related sleep disturbances are common among patients with gastroesophageal reflux disease (GERD). This study evaluated the efficacy of dexlansoprazole MR 30 mg in relieving nocturnal heartburn and GERD-related sleep disturbances, improving work productivity, and decreasing nocturnal symptom severity in patients with symptomatic GERD. Patients (N=305) with frequent, moderate-to-very severe nocturnal heartburn and associated sleep disturbances were randomized 1:1 in a double-blind fashion to receive dexlansoprazole MR or placebo once daily for 4 weeks. The primary end point was the percentage of nights without heartburn. Secondary end points were the percentage of patients with relief of nocturnal heartburn and of GERD-related sleep disturbances over the last 7 days of treatment. At baseline and week 4/final visit, patients completed questionnaires that assessed sleep quality, work productivity, and the severity and impact of nocturnal GERD symptoms. Dexlansoprazole MR 30 mg (n=152) was superior to placebo (n=153) in median percentage of nights without heartburn (73.1 vs. 35.7%, respectively; Pheartburn and GERD-related sleep disturbances (47.5 vs. 19.6%, 69.7 vs. 47.9%, respectively; Pheartburn, in reducing GERD-related sleep disturbances and the consequent impairments in work productivity, and in improving sleep quality/quality of life.

  4. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD

    DEFF Research Database (Denmark)

    Galmiche, Jean-Paul; Hatlebakk, Jan; Attwood, Stephen

    2011-01-01

    Context Gastroesophageal reflux disease (GERD) is a chronic, relapsing disease with symptoms that have negative effects on daily life. Two treatment options are long-term medication or surgery. Objective To evaluate optimized esomeprazole therapy vs standardized laparoscopic antireflux surgery...

  5. Dyspepsia and gastroesophageal reflux disease (GERD): is there any correlation?

    Science.gov (United States)

    Simadibrata, Marcellus

    2009-10-01

    Dyspepsia is a syndrome characterized by symptoms and signs of upper gastrointestinal tract and the adjacent organs. It is estimated that 25% of the community have symptoms of dyspepsia syndrome. One-third of patients who visit general physician practices are patients with dyspepsia syndrome; and half of patients who visit gastroenterologists are also patients with dyspepsia syndrome. Dyspepsia syndrome and gastroesophageal reflux disease (GERD) are very prevalent in the community throughout the world.Gastroesophageal reflux disease (GERD) is more and more commonly found in daily medical practice. Until now,the natural history of disease on GERD and dyspepsia is hardly understood, even though many scientists studied both conditions and there are frequently overlapping. In an individual, GERD and dyspepsia may occur simultaneously and therefore they are hardly to be discriminated.The management of GERD is performed in keeping with Indonesia and Asia Pacific consensus, life-style modification and administering the acid suppression agents (Proton pump inhibitor (drug of choice), H2-receptor antagonist, etc),prokinetic agents (Cisapride, domperidone, etc). Life-style modification shall be performed as follows, i.e. sleep with 30-45 degree elevated head or upper chest, do not avoid sour beverages, chocolate, coffee or alcohol, avoid fat and various fried foods, sour food, less stress, stop smoking, small but frequent feeding, etc. There is a correlation between dyspepsia syndrome and gastroesophageal reflux disease(GERD), particularly between the functional dyspepsia and non-erosive gastroesophageal reflux (NERD). More appropriate definition is necessary to differentiate the dyspepsia syndrome and GERD. Further studies are needed to establish distinct definition and criteria between dyspepsia syndrome and GERD.

  6. Review of gastroesophageal reflux disease (GERD) in the diabetic patient.

    Science.gov (United States)

    Punjabi, Paawan; Hira, Angela; Prasad, Shanti; Wang, Xiangbing; Chokhavatia, Sita

    2015-09-01

    This article reviews the known pathophysiological mechanisms of comorbid gastroesophageal reflux disease (GERD) in the diabetic patient, discusses therapeutic options in care, and provides an approach to its evaluation and management. We searched for review articles published in the past 10 years through a PubMed search using the filters diabetes mellitus, GERD, pathophysiology, and management. The search only yielded a handful of articles, so we independently included relevant studies from these review articles along with related citations as suggested by PubMed. We found diabetic patients are more prone to developing GERD and may present with atypical manifestations. A number of mechanisms have been proposed to elucidate the connection between these two diseases. Studies involving treatment options for comorbid disease suggest conflicting drug-drug interactions. Currently, there are no published guidelines specifically for the evaluation and management of GERD in the diabetic patient. Although there are several proposed mechanisms for the higher prevalence of GERD in the diabetic patient, this complex interrelationship requires further research. Understanding the pathophysiology will help direct diagnostic evaluation. In our review, we propose a management algorithm for GERD in the diabetic patient. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  7. Geomorphic aspects of post-fire soil erosion - Schultz Fire 2010

    Science.gov (United States)

    Ann Youberg; Karen A. Koestner; Daniel G. Neary; Peter E. Koestner

    2011-01-01

    The summer of 2010 brought wildfires and near record monsoon rains to northern Arizona, USA, which generated debris flows and floods that caused extensive damage. The human-caused Schultz Fire on the Coconino National Forest northeast of Flagstaff was the largest wildfire in Arizona during 2010, burning 6,100 ha between June 20th and 30th. Ignited by an abandoned...

  8. Depositional characteristics of post-fire flooding following the Schultz Fire, San Francisco Peaks, Arizona

    Science.gov (United States)

    Karen A. Koestner; Mike D. Carroll; Daniel G. Neary; Peter E. Koestner; Ann Youberg

    2011-01-01

    During the summer of 2010 the northern Arizona mountain town of Flagstaff experienced three fires all blazing the same week in late-June, the height of the fire season for this region. By July 1st, all three were extinguished, but that was only the first phase of disturbance. The largest and most detrimental of these fires was the Schultz Fire. From June 20th to July...

  9. Post-fire rill and gully formation, Schultz Fire 2010, Arizona, USA

    Science.gov (United States)

    Daniel G. Neary; Karen A. Koestner; Ann Youberg; Peter E. Koestner

    2011-01-01

    The Schultz Fire burned 6,100 ha on the eastern slopes of the San Francisco Peaks, a dormant Middle Pliocene to Holocene aged stratovolcano in northern Arizona (Figure 1). The fire burned in the Coconino National Forest between June 20th and 30th, 2010, across moderate to very steep ponderosa pine and mixed conifer watersheds. About 40% of the fire area was classified...

  10. [Adolpho Lutz's collection of black flies (Diptera - Simuliidae), its history and importance].

    Science.gov (United States)

    Ribeiro do Amaral-Calvão, Ana Margarida; Maia-Herzog, Marilza

    2003-01-01

    This is part of a master's thesis currently being written under the auspices of the Post-Graduate Program in Animal Biology of the Federal University of Rio de Janeiro, with support from CAPES. It presents the species of black flies in Adolpho Lutz's collection, held at the Laboratory of Black Flies and Oncocercosis of the Department of Entomology of the Instituto Oswaldo Cruz. A pioneer in the study of these dipterons, Lutz described about 25 species from different places in Brazil. A vector of round worm, the black fly's importance to public health was recognized at the end of the 1920s.

  11. GERD questionnaire for diagnosis of gastroesophageal reflux disease in systemic sclerosis.

    Science.gov (United States)

    Chunlertrith, K; Noiprasit, A; Foocharoen, C; Mairiang, P; Sukeepaisarnjaroen, W; Sangchan, A; Sawadpanitch, K

    2014-01-01

    Gastroesophageal reflux disease (GERD) is clinically-identified in patients with systemic sclerosis (SSc). The GERD-questionnaire (GERD-Q) score is a sensitive, non-invasive, diagnostic screening tool for diagnosis of GERD in general patients, but it has been not investigated for use in SSc. Our aim was to evaluate the proper cut-off GERD-Q score, sensitivity and specificity for a diagnosis of GERD in SSc patients. A cross-sectional study using the GERD-Q was performed during May 2012-January 2013 on patients over 18 with the diffuse SSc subset. Both esophago-gastro-duodenoscopy (EGD) and 24-hr pH-monitoring (24hr-pH) were performed as the gold standard tests for both symptomatic and asymptomatic GERD. A total of 75 SSc patients completed the GERD-Q, EGD and 24hr-pH. We identified 22 males (29.3%), 53 females (70.7%) with a mean age of 54.2 years. The respective number of symptomatic and asymptomatic GERD was 69 and 6 cases. For a GERD diagnosis, a cut-off GERD-Q score of 4 provided the best balance between sensitivity and specificity (96.9% and 50%, respectively). Of 48 participants (69.6%) with symptomatic GERD (i.e. positive for both EGD and 24hr-pH), 65 (94.2%) were positive for either EGD or 24hr-pH, and 4 (5.8%) were negative for both EGD and 24hr-pH. A respective majority (83%) vs. one-third of the asymptomatic group had reflux as detected by 24hr-pH vs. A GERD-Q score of 4 or higher indicates a high sensitivity for a diagnosis of GERD in SSc. It can thus be used as a non-invasive screening tool for diagnosing GERD in cases where EGD and 24hr-pH are unavailable.

  12. Gerd Kanter alistas keerulised tuuled ja tugevad vastased / Peep Pahv

    Index Scriptorium Estoniae

    Pahv, Peep, 1970-

    2008-01-01

    Vt. ka Postimees : na russkom jazõke 17. märts, lk. 13. Maailmameister Gerd Kanter võitis viiendat korda Euroopa talvised karikavõistlused. Mihkel Kukk viskas oda 78.41 ning täitis Pekingi olümpia B-normi

  13. Advances in the physiological assessment and diagnosis of GERD

    NARCIS (Netherlands)

    Savarino, Edoardo; Bredenoord, Albert J.; Fox, Mark; Pandolfino, John E.; Roman, Sabine; Gyawali, C. Prakash

    2017-01-01

    GERD is a common condition worldwide. Key mechanisms of disease include abnormal oesophagogastric junction structure and function, and impaired oesophageal clearance. A therapeutic trial of acid-suppressive PPI therapy is often the initial management, with endoscopy performed in the setting of alarm

  14. Evelin Ilves ja Gerd Kanter kohtusid Viimsi kooli õpilastega

    Index Scriptorium Estoniae

    2011-01-01

    Proua Evelin Ilves ja olümpiavõitja Gerd Kanter kohtusid 19. mail 2011 Viimsi kooli õpilastega, et tunnustada Viimsi kooli 10. klassis õppivat noore sportlase preemia saajat, purjetajat Sten Christian Taali ning tänada kooli tema toetamise eest

  15. Long-term GERD management: The individualized approach

    NARCIS (Netherlands)

    Tytgat, Guido

    2006-01-01

    Gastroesophageal reflux disease (GERD) is a complex condition, and both mucosal lesions and symptoms are important parameters in evaluating disease severity and the impact of treatment. An individualized approach in which treatment is tailored to each patient is the appropriate strategy. Treatment

  16. Evolution, knowledge and Christian faith: Gerd Theissen and the ...

    African Journals Online (AJOL)

    Evolution, knowledge and Christian faith: Gerd Theissen and the credibility of theology. In this article the way in which Theissen uses the evolutionary paradigm as a comprehensive framework for interpreting not only central themes in theology but also the credibility of theology as such, is analysed from an epistemological ...

  17. Validation of the GerdQ questionnaire for the diagnosis of gastro-oesophageal reflux disease.

    Science.gov (United States)

    Jonasson, C; Wernersson, B; Hoff, D A L; Hatlebakk, J G

    2013-03-01

    The diagnosis of gastro-oesophageal reflux disease (GERD) remains a challenge as both invasive methods and symptom-based strategies have limitations. The symptom-based management of GERD in primary care may be further optimised with the use of a questionnaire. To assess the diagnostic validity of the GerdQ questionnaire in patients with symptoms suggestive of GERD. Patients with symptoms suggestive of GERD without alarm features, underwent upper endoscopy, and if normal, pH-metry. Patients were followed for 4 weeks and GerdQ was completed blinded to the investigator at both visits. Reflux oesophagitis or pathological acid exposure was used as diagnostic references for GERD. The diagnostic accuracy for GERD on symptom response to proton pump inhibitor (PPI) was assessed. Among the 169 patients, a GerdQ cutoff ≥9 gave the best balance with regard to sensitivity, 66% (95% CI: 58-74), and specificity, 64% (95% CI: 41-83), for GERD. The high prevalence of reflux oesophagitis (81%) resulted in a high proportion of true positives, but at the same time a high proportion of false-negatives. Consequently, GerdQ had a high positive predictive value, 92% (95% CI: 86-97), but a low negative predictive value, 22% (95% CI: 13-34), for GERD. Symptom resolution on PPI therapy had high sensitivity, 76% (95% CI: 66-84), but low specificity, 33% (95% CI: 17-53), for GERD. GerdQ is a useful complementary tool for the diagnosis of gastro-oesophageal reflux disease in primary care. The implementation of GerdQ could reduce the need for upper endoscopy and improve resource utilisation. Symptom resolution on proton pump inhibitor did not predict gastro-oesophageal reflux disease. © 2013 Blackwell Publishing Ltd.

  18. Taxonomic study and redescription of Culex (Melanoconion theobaldi (Lutz, 1904 (Diptera: Culicidae

    Directory of Open Access Journals (Sweden)

    Oswaldo Paulo Forattini

    1989-01-01

    Full Text Available Based on type examination, Culex (Melanoconion theobaldi (Lutz, 1904 is redescribed. The species Cx. (Mel. chrysonotum Dyar & Knab, 1908, was put back as synonym of theobaldi. Besides, examination of Cx. (Mel. chrysothorax (Newstead & Thomas, 1910 type, leads to retiring as synonym of theobaldi and considered it as "species inquirenda".

  19. Test Reviews: Euler, B. L. (2007). "Emotional Disturbance Decision Tree". Lutz, FL: Psychological Assessment Resources

    Science.gov (United States)

    Tansy, Michael

    2009-01-01

    The Emotional Disturbance Decision Tree (EDDT) is a teacher-completed norm-referenced rating scale published by Psychological Assessment Resources, Inc., in Lutz, Florida. The 156-item EDDT was developed for use as part of a broader assessment process to screen and assist in the identification of 5- to 18-year-old children for the special…

  20. A review of pharmacotherapy for treating gastroesophageal reflux disease (GERD).

    Science.gov (United States)

    Savarino, Edoardo; Zentilin, Patrizia; Marabotto, Elisa; Bodini, Giorgia; Della Coletta, Marco; Frazzoni, Marzio; de Bortoli, Nicola; Martinucci, Irene; Tolone, Salvatore; Pellegatta, Gaia; Savarino, Vincenzo

    2017-09-01

    Medical therapy of gastroesophageal reflux disease (GERD) is based on the use of proton pump inhibitors (PPIs) as first choice treatment. Despite their effectiveness, about 20-30% of patients report an inadequate response and alternative drugs are required. Areas covered: This review provides an overview of current pharmacotherapy for treating GERD by showing the results of PPIs, reflux inhibitors, antidepressants and mucosa protective medications. Expert opinion: Medical therapy of GERD does not definitely cure the disease, because even PPIs are not able to change the key factors responsible for it. However, they remain the mainstay of medical treatment, allowing us to alleviate symptoms, heal esophagitis and prevent complications in the majority of cases. Nevertheless, many patients do not respond, because acid does not play any pathogenetic role. Prokinetics and reflux inhibitors have the potential to control motor abnormalities, but the results of clinical trials are inconsistent. Antidepressant drugs are effective in specific subgroups of NERD patients with visceral hypersensitivity, but larger, controlled clinical studies are necessary. Protective drugs or medical devices have been recently adopted to reinforce mucosal resistance and preliminary trials have confirmed their efficacy either combined with or as add-on medication to PPIs in refractory patients.

  1. Analysis of community response to transportation noise a quarter century after Schultz (1978)

    Science.gov (United States)

    Fidell, Sanford

    2003-10-01

    Transportation noise is a vexing and intrinsically controversial problem that has plagued societies since the beginnings of urban civilization. A function relating cumulative noise exposure to the prevalence of noise-induced annoyance [T. J. Schultz, ``Synthesis of social surveys on noise annoyance,'' J. Acoust. Soc. Am. 64, 377-405 (1978)] is the foundation for contemporary analyses of transportation noise effects on communities. The expenditures of billions of dollars in airplane ticket and fuel taxes for the construction of an airport infrastructure and for the mitigation of noise impacts in the United States are governed by policies ostensibly supported by a successor to Schultz's original ``synthesis'' curve. Many have grown so comfortable with the last quarter century's paradigm for transportation noise assessment and regulation, however, that they have lost sight of its underpinnings and limitations. A review of the historical and modern states of the art identifies persistent unresolved problems in the prediction and explanation of community response to transportation noise that are not fully addressed by descriptive dosage-effect analysis.

  2. Estudio de la propagación sexual del arboloco Montanoa quadrangularis Schultz Bipontianus Asteraceae

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    William Escobar-Torres

    2010-04-01

    Full Text Available Sexual propagation of arboloco Montanoa quadrangularis Schultz Bipontianus (Asteraceae. Objective. To develop sexual propagationmethodologies for Montanoa quadrangularis Schultz Bipontianus (arboloco. Materials and methods. Seeds were harvested from treesgrown at the Chilaca environmental station (Geoambiente Ltda. located in Pacho, Cundinamarca, Colombia. The study was carried out intwo phases: firstly, substrate effect on germination responses was evaluated in seedbed conditions. Substrates evaluated were: local soil,local soil mixed with worm humus, and peat. Additionally, two spatial arrangements were assessed: seeds sown at random and at 0.5 cmin depth. Secondly, in nursery conditions the effect of the substrates local soil, local soil mixed with worm humus and peat, as well as theeffect of developmental stages of the plants (with 2, 4, and 6 leaves on their further growth and development were evaluated. Results. Inseedbed conditions, the germination capacity was highly influenced by peat substrate (83.67% whereas in local soil the germinationcapacity was 40.83%. In nursery conditions, 6-leaf plants grown in local soil mixed with worm humus showed the best responses onparameters such as plant total length (9.51 cm, leaf area (36.69 cm2, and total dry weight (0.10 g. Conclusions. The type of substrateused in seedbed conditions influenced the germination capacity of M. quadrangularis seeds. The substrate and the developmental stage ofthe plant had a significant influence on the growth and development of arboloco plants.

  3. Comparison of central and intraesophageal factors between gastroesophageal reflux disease (GERD) patients and those with GERD-related noncardiac chest pain.

    Science.gov (United States)

    Shapiro, M; Simantov, R; Yair, M; Leitman, M; Blatt, A; Scapa, E; Broide, E

    2012-01-01

    Gastroesophageal reflux disease (GERD) causes a wide range of symptoms. Some patients present with typical symptoms such as heartburn and regurgitation and others with atypical symptoms such as chest pain. The mechanism responsible for the varying clinical presentation of GERD is still not fully elucidated. The aim of this study was to prospectively evaluate differences in central and local intraesophageal factors between patients with typical GERD symptoms and those with noncardiac chest pain (NCCP). Patients presenting with typical and atypical symptoms suspicious of GERD underwent upper endoscopy and 24-hour pH monitoring with four sensors, each positioned at a different esophageal level. All patients completed GERD symptom, Hospital Anxiety and Depression Scale, and Symptom Stress Rating questionnaires. From January 2006 to December 2009, 50 patients were recruited, 29 with typical symptoms, and 21 with NCCP. Patients with proven GERD and NCCP had higher proximal extension of acid during reflux episodes than patients with typical symptoms. They were found to be older, had a shorter history of symptom onset, worse anxiety scores, and more endoscopic findings compatible with gastritis. Proximal extension of acid during the reflux episodes in patients with GERD presenting with NCCP may play a role in symptom generation. © 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  4. Comparison of Dorris-Gray and Schultz methods for the calculation of surface dispersive free energy by inverse gas chromatography.

    Science.gov (United States)

    Shi, Baoli; Wang, Yue; Jia, Lina

    2011-02-11

    Inverse gas chromatography (IGC) is an important technique for the characterization of surface properties of solid materials. A standard method of surface characterization is that the surface dispersive free energy of the solid stationary phase is firstly determined by using a series of linear alkane liquids as molecular probes, and then the acid-base parameters are calculated from the dispersive parameters. However, for the calculation of surface dispersive free energy, generally, two different methods are used, which are Dorris-Gray method and Schultz method. In this paper, the results calculated from Dorris-Gray method and Schultz method are compared through calculating their ratio with their basic equations and parameters. It can be concluded that the dispersive parameters calculated with Dorris-Gray method will always be larger than the data calculated with Schultz method. When the measuring temperature increases, the ratio increases large. Compared with the parameters in solvents handbook, it seems that the traditional surface free energy parameters of n-alkanes listed in the papers using Schultz method are not enough accurate, which can be proved with a published IGC experimental result. © 2010 Elsevier B.V. All rights reserved.

  5. Rock gabion, rip-rap, and culvert treatments: Successes and failures in post-fire erosion mitigation, Schultz Fire 2010

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    Daniel G. Neary; Karen A. Koestner

    2011-01-01

    Following the Schultz Fire in June of 2010, several erosion mitigation efforts were undertaken to reduce the impacts of post-fire flooding expected during the 2010 monsoon. One treatment consisted of the placement of large rock rip-rap on targeted fill slopes of a high elevation forest road that contains a buried pipeline supplying water to the city of Flagstaff....

  6. Toward a New, Musical Paradigm of Place: The Port River Symphonic of Chester Schultz

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    Robin, Ryan

    2014-05-01

    Full Text Available In privileging music as a focus for applied ecology, the goal of this essay is to deepen perspectives on the musical representation of land in an age of complex environmental challenge. As the metaphor driving public narration of environmental crises, the notion of Earth as our home—signified by the prefix “eco”—brings with it a critical expectation for the musical academy to retreat from bland talk about a “sense of place.” Based on the premise that damaged ecologies are a matter of concern to many people, Indigenous and Settler; and building on the late Val Plumwood’s theory of “shadow” or “denied” places (Australian Humanities Review 44, 2008, the author introduces Within Our Reach: A Symphony of the Port River Soundscapes by anti-elitist South Australian composer Chester Schultz (b. 1945. Inspired by the tradition of R. Murray Schafer’s performances for outdoor sites, Schultz predicated this niche symphony on the noise-polluting defoliation of Adelaide’s “wetland wonder,” the Old Port Reach. Presented as a series of narrative soundscapes, the symphony harnesses the power of music, including popular genres, to engender a sense of local “belonging” to the Port. In an ecological subtext an Indigenous Elder sings in the re-awakening language of the Kaurna people who, in 1890, were evicted from their “nourishing terrain” (terminology after Rose, 1996 by the CSR Sugar Refinery. Schultz’s ethical musical representation of local oral, natural and industrial history generates a benchmark opus for what shadow place composition might sound like in the modern global city.

  7. Correlation of endoscopic severity of gastroesophageal reflux disease (gerd) with body mass index (bmi)

    International Nuclear Information System (INIS)

    Zafar, S.; Haq, I.U.; Butt, A.R.; Shafiq, F.; Huda, G.; Mirza, G.; Rehman, A.U.

    2007-01-01

    To assess the correlation of endoscopic severity of Gastroesophageal Reflux Disease (GERD) with Body Mass Index (BMI). This study was conducted on 203 patients, who presented with upper GI symptoms. Patients who fulfilled the symptom criteria were referred for endoscopy. Classification of GERD was done according to LA Grading classification system. Body mass index (BMI) was calculated as Body Weight (BW) in kilograms (kg) divided by the square of the body height (BH) in meter (m2). Patient data was analyzed using SPSS 12 software. Statistical evaluation was done using non-parametric Wilcoxon's-sign Rank test. P-value <0.05 was considered to be statistically significant. Distribution of GERD was as follows: GERD-A subjects 65 (32%), GERD B subjects 72 (35.4%), GERD-C subjects 23 (11.3%), GERD-D subjects 10 (4.92%), while Non-Erosive Reflux Disease (NERD) was present in 33 subjects (16.2%). Mean BMI was 27+5.02SD (range of 18.2-38.3). BMI of patients having NERD was in normal range but patients who were having advanced disease i.e. Grade C-D were in obese range of BMI, while those who were having LA grade A-B were in overweight BMI range. When regrouped as mild GERD (grade A-B) and NERD versus severe GERD (grade C-D), there was a strong significant correlation between severity of GERD and BMI, as detected by Wilcoxon's signed Rank test (p=0.001). Higher BMI seems to be associated with higher degree of endoscopic GERD severity. (author)

  8. Transoral incision free fundoplication (TIF – A new paradigm in the surgical treatment of GERD

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    Elliot Goodman

    2010-07-01

    Full Text Available An estimated 10 billion dollars is spent treating gastro-oesophageal reflux disease (GERD in the USA every year. The present article reports a case of the safe and successful use of transoral incisionless fundoplication (TIF using the EsophyX™ device in the surgical treatment of GERD.

  9. Sobre as espécies do gênero Echinostoma Rudolphi, 1809 descritas por Adolpho Lutz em 1924 On the species of the genus Echinostoma Rudolphi, 1809, described by Adolpho Lutz in 1924

    Directory of Open Access Journals (Sweden)

    Anna Kohn

    1975-01-01

    Full Text Available Os autores redescrevem as espécies E. erraticum, E. exile, E. microrchis, E. neglectum, E. nephrocystis e E. parcespinosum, criadas por Lutz em 1924, apresentando figuras e quadros de medidas.In 1924, LUTZ in his work "Estudos sobre a evolução dos Endotrematodeos brazileiros", proposed six new species under the genus Echinostoma and described them although without offering many details. For this reason, it was not possible to achieve a complete knowledge of these species and as almost the whole material studied by LUTZ was encolosed in the Oswaldo Cruz Helminthological Collection, the authors revised it, presenting redescriptions of the species, as well as original camera lucida drawings, in order to facilitate further investigations on the matter.

  10. The Medicine and GERD of Immanuel Kant (1724-1804).

    Science.gov (United States)

    Figueiredo Filho, Gilberto Vilela

    2009-01-01

    We can place Kant as one of the pillars of contemporary medicine. Firstly, as an Illuminist, his work subordinates the collection of empirical data, which in medical science is constitutional to reason. This was the basis of a rational medical science. Secondly, he is the father of medical regulation, having set the philosophical control ground stone for physicians by the State. His work "Critique of Practical Reason" drafts all the future codes of ethics and bioethics. We will hereby study his relationship with medicine based on the text "The Conflict with the Faculty of Medicine" and other auxiliary texts.We can find in Kant's works the description of a series of symptoms that were related to a nonspecific dyspeptic syndrome that nowadays would be diagnosed as a strong indication that he suffered from gastroesophageal reflux disease (GERD).

  11. Lutz's spontaneous sedimentation technique and the paleoparasitological analysis of sambaqui (shell mound sediments

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    Morgana Camacho

    2013-04-01

    Full Text Available Parasite findings in sambaquis (shell mounds are scarce. Although the 121 shell mound samples were previously analysed in our laboratory, we only recently obtained the first positive results. In the sambaqui of Guapi, Rio de Janeiro, Brazil, paleoparasitological analysis was performed on sediment samples collected from various archaeological layers, including the superficial layer as a control. Eggs of Acanthocephala, Ascaridoidea and Heterakoidea were found in the archaeological layers. We applied various techniques and concluded that Lutz's spontaneous sedimentation technique is effective for concentrating parasite eggs in sambaqui soil for microscopic analysis.

  12. Lutz's spontaneous sedimentation technique and the paleoparasitological analysis of sambaqui (shell mound) sediments

    Science.gov (United States)

    Camacho, Morgana; Pessanha, Thaíla; Leles, Daniela; Dutra, Juliana MF; Silva, Rosângela; de Souza, Sheila Mendonça; Araujo, Adauto

    2013-01-01

    Parasite findings in sambaquis (shell mounds) are scarce. Although the 121 shell mound samples were previously analysed in our laboratory, we only recently obtained the first positive results. In the sambaqui of Guapi, Rio de Janeiro, Brazil, paleoparasitological analysis was performed on sediment samples collected from various archaeological layers, including the superficial layer as a control. Eggs of Acanthocephala, Ascaridoidea and Heterakoidea were found in the archaeological layers. We applied various techniques and concluded that Lutz's spontaneous sedimentation technique is effective for concentrating parasite eggs in sambaqui soil for microscopic analysis. PMID:23579793

  13. Validation of the GerdQ questionnaire for the management of gastro-oesophageal reflux disease in Japan

    Science.gov (United States)

    Matsuzaki, Juntaro; Okada, Sawako; Hirata, Kenro; Fukuhara, Seiichiro; Hibi, Toshifumi

    2013-01-01

    Background The GerdQ scoring system may be a useful tool for managing gastro-oesophageal reflux disease. However, GerdQ has not been fully validated in Asian countries. Objective To validate the Japanese version of GerdQ and to compare this version to the Carlsson-Dent questionnaire (CDQ) in both general and hospital-based populations. Methods The questionnaires, including the Japanese versions of GerdQ and CDQ, and questions designed to collect demographic information, were sent to a general population via the web, and to a hospital-based population via conventional mail. The optimal cutoff GerdQ score and the differences in the characteristics between GerdQ and CDQ were assessed. Results The answers from 863 web-responders and 303 conventional-mail responders were analysed. When a GerdQ cutoff score was set at 8, GerdQ significantly predicted the presence of reflux oesophagitis. Although the GerdQ scores were correlated with the CDQ scores, the concordance rates were poor. Multivariate analysis results indicated that, the additional use of over-the-counter medications was associated with GerdQ score ≥ 8, but not with CDQ score ≥ 6. Conclusions The GerdQ cutoff score of 8 was appropriate for the Japanese population. Compared with CDQ, GerdQ was more useful for evaluating treatment efficacy and detecting patients’ unmet medical needs. PMID:24917957

  14. GERD 2003 -- a consensus on the way ahead.

    Science.gov (United States)

    Moss, Steven F; Armstrong, David; Arnold, Rudi; Ferenci, Peter; Fock, Kwong M; Holtmann, Gerald; McCarthy, Denis M; Moraes-Filho, Joaquim P; Mutschler, Ernst; Playford, Raymond; Spechler, Stuart J; Stanghellini, Vincenzo; Modlin, Irvin M

    2003-01-01

    Gastroesophageal reflux disease (GERD) has in recent times become an important public health issue owing to the considerable health care resources utilized in its management, its deleterious effect on quality of life and the increasing prevalence of a relatively rare complication of reflux disease - esophageal adenocarcinoma. We review here the major current challenges in the field of reflux disease and its complications, and provide some approaches that may be useful in management. The issues to be faced include the very limited comprehension of the reasons behind the increasing prevalence of the disease, difficulties in correlating symptoms with objective data of pathological gastroesophageal reflux and the relatively unsophisticated tools we are employing to investigate the underlying pathophysiology. It is certain that the lack of well-defined and characterized methodologies to compare the effects of therapy require the development of more effective questionnaire-type analytic tools. In regard to treatment, there is little doubt that the widely prescribed proton pump inhibitors have dose-equivalent efficacy and are the most highly effective agents capable of suppressing acid, controlling many of the symptoms of GERD and healing erosions. Nevertheless, many patients continue to experience symptoms on withdrawal or at night. Pharmacological agents that can effectively increase lower esophageal sphincter pressure or promote motility are as yet unavailable. Although the introduction of laparoscopic techniques has resulted in a modest revival in surgical intervention using a variety of 'wrap-type' operations, the indications are few and the procedure is associated with a significant morbidity and even mortality especially if the expertise of the surgeon is an issue. Endoscopic techniques of regulating reflux are at this time experimental and not applicable to the general population. Intestinal metaplasia in the lower esophagus is probably very common. Whether and

  15. Rock gabion, rock armoring, and culvert treatments contributing to and reducing erosion during post-wildfire flooding - Schultz Fire 2010

    Science.gov (United States)

    Daniel G. Neary; Karen A. Koestner; Ann Youberg

    2011-01-01

    The Schultz Fire burned 6,100 ha on the eastern slopes of the San Francisco Peaks of the Coconino National Forest in north-central Arizona. The fire burned between June 20th and 30th, 2010, across moderate to very steep ponderosa pine and mixed conifer watersheds. One of the Burned Area Emergency Response treatments on Coconino National Forest lands consisted of the...

  16. Functional Heartburn Overlaps With Irritable Bowel Syndrome More Often than GERD.

    Science.gov (United States)

    de Bortoli, Nicola; Frazzoni, Leonardo; Savarino, Edoardo V; Frazzoni, Marzio; Martinucci, Irene; Jania, Aleksandra; Tolone, Salvatore; Scagliarini, Michele; Bellini, Massimo; Marabotto, Elisa; Furnari, Manuele; Bodini, Giorgia; Russo, Salvatore; Bertani, Lorenzo; Natali, Veronica; Fuccio, Lorenzo; Savarino, Vincenzo; Blandizzi, Corrado; Marchi, Santino

    2016-12-01

    We aimed to evaluate the prevalence of irritable bowel syndrome (IBS) in patients with typical reflux symptoms as distinguished into gastroesophageal reflux disease (GERD), hypersensitive esophagus (HE), and functional heartburn (FH) by means of endoscopy and multichannel intraluminal impedance (MII)-pH monitoring. The secondary aim was to detect pathophysiological and clinical differences between different sub-groups of patients with heartburn. Patients underwent a structured interview based on questionnaires for GERD, IBS, anxiety, and depression. Off-therapy upper-gastrointestinal (GI) endoscopy and 24 h MII-pH monitoring were performed in all cases. In patients with IBS, fecal calprotectin was measured and colonoscopy was scheduled for values >100 mg/kg to exclude organic disease. Multivariate logistic regression analysis was performed to identify independent risk factors for FH. Of the 697 consecutive heartburn patients who entered the study, 454 (65%) had reflux-related heartburn (GERD+HE), whereas 243 (35%) had FH. IBS was found in 147/454 (33%) GERD/HE but in 187/243 (77%) FH patients (Pheartburn (GERD+HE). IBS overlaps more frequently with FH than with GERD and HE, suggesting common pathways and treatment. HE showed intermediate characteristic between GERD and FH.

  17. Anomaly manifestation of Lieb-Schultz-Mattis theorem and topological phases

    Science.gov (United States)

    Cho, Gil Young; Hsieh, Chang-Tse; Ryu, Shinsei

    2017-11-01

    The Lieb-Schultz-Mattis (LSM) theorem dictates that emergent low-energy states from a lattice model cannot be a trivial symmetric insulator if the filling per unit cell is not integral and if the lattice translation symmetry and particle number conservation are strictly imposed. In this paper, we compare the one-dimensional gapless states enforced by the LSM theorem and the boundaries of one-higher dimensional strong symmetry-protected topological (SPT) phases from the perspective of quantum anomalies. We first note that they can both be described by the same low-energy effective field theory with the same effective symmetry realizations on low-energy modes, wherein non-on-site lattice translation symmetry is encoded as if it were an internal symmetry. In spite of the identical form of the low-energy effective field theories, we show that the quantum anomalies of the theories play different roles in the two systems. In particular, we find that the chiral anomaly is equivalent to the LSM theorem, whereas there is another anomaly that is not related to the LSM theorem but is intrinsic to the SPT states. As an application, we extend the conventional LSM theorem to multiple-charge multiple-species problems and construct several exotic symmetric insulators. We also find that the (3+1)d chiral anomaly provides only the perturbative stability of the gaplessness local in the parameter space.

  18. Refractory heartburn: comparison of intercellular space diameter in documented GERD vs. functional heartburn.

    Science.gov (United States)

    Vela, Marcelo F; Craft, Brandon M; Sharma, Neeraj; Freeman, Janice; Hazen-Martin, Debra

    2011-05-01

    Refractory heartburn despite acid suppression may be explained by ongoing gastroesophageal reflux disease (GERD) or functional heartburn (FH), i.e., symptoms without evidence of GERD. Impedance-pH monitoring (impedance-pH) detects acid and nonacid reflux and is useful for evaluating acid-suppressed, refractory patients. Intercellular space diameter (ISD) of esophageal epithelium measured by transmission electron microscopy (TEM) is a marker of epithelial damage present in both erosive and nonerosive reflux disease. ISD has not been used to study refractory heartburn or FH. Our aim was to compare ISD in healthy controls and refractory heartburn patients with GERD and FH. In refractory heartburn patients (heartburn more than twice/week for at least 2 months despite proton pump inhibitor (PPI) b.i.d.), erosive esophagitis and/or abnormal impedance-pH (increased acid exposure or positive symptom index) defined GERD; normal esophagogastroduodenoscopy (EGD)/impedance-pH defined FH. Asymptomatic, healthy controls had normal EGD and pH-metry. Mean ISD in each subject, determined by blinded TEM of esophageal biopsies, was the average of 100 measurements (10 measurements in each of 10 micrographs). In all, 11 healthy controls, 11 FH, and 15 GERD patients were studied. Mean ISD was significantly higher in GERD compared with controls (0.87 vs. 0.32 μm, P=0.003) and FH (0.87 vs. 0.42 μm, P=0.012). Mean ISD was similar in FH and controls (0.42 vs. 0.32 μm, P=0.1). The proportion of patients with abnormal ISD was significantly higher for GERD compared with FH (60 vs. 9%, P=0.014). ISD is increased in refractory heartburn patients with GERD but not those with FH. Our findings suggest that measurement of ISD by TEM might be a useful tool to distinguish GERD from FH in patients with refractory heartburn.

  19. Frequency of different lifestyle modification measures among patients with GERD based on monthly income.

    Science.gov (United States)

    Chen, Philumena; Khan, Mahnoor Saeed; Naseem, Sajida

    2017-11-01

    A cross-sectional study was carried out at Shifa International Hospital Islamabad over a period of 6 months, to determine the frequency and compare the different lifestyle modifications among patients with Gastroesophageal Reflux Disease (GERD) of different monthly income groups. Two hundred patients of GERD were enrolled in the study and divided into two groups based on monthly income less than and more than Rs. 30,000 respectively. Data was analyzed using SPSS 21. Descriptive statistics were calculated. Chi-square test was applied keeping p-value modifications to reduce GERD symptoms and stop sole reliance on medications.

  20. Coleção de simuliídeos (Diptera - Simuliidae de Adolpho Lutz, sua história e importância Adolpho Lutz's collection of black flies (Diptera - Simuliidae, its history and importance

    Directory of Open Access Journals (Sweden)

    Ana Margarida Ribeiro do Amaral-Calvão

    2003-04-01

    Full Text Available O presente trabalho é parte de uma dissertação de mestrado em elaboração no curso de pós-graduação em biologia animal da Universidade Federal do Rio de Janeiro (UFRJ, apoiado pela CAPES. Nele, são apresentadas as espécies de simuliídeos que pertencem à coleção de Adolpho Lutz depositadas no Laboratório de Simuliídeos e Oncocercose do Departamento de Entomologia do Instituto Oswaldo Cruz (IOC. Pioneiro no estudo desses dípteros, Lutz descreveu cerca de 25 espécies de diferentes localidades do Brasil. Vetor da oncocercose, os simuliídeos tiveram sua importância médico-sanitária reconhecida em fins da década de 1920.This paper is part of a master's thesis currently being written under the auspices of the Post-Graduate Program in Animal Biology of the Federal University of Rio de Janeiro, with support from CAPES. It presents the species of black flies in Adolpho Lutz's collection, held at the Laboratory of Black Flies and Oncocercosis of the Department of Entomology of the Instituto Oswaldo Cruz. A pioneer in the study of these dipterons, Lutz described about 25 species from different places in Brazil. A vector of round worm, the black fly's importance to public health was recognized at the end of the 1920s.

  1. Response of Lutz, Sitka, and white spruce to attack by Dendroctonus rufipennis (Coleoptera: Scolytidae) and blue stain fungi

    Science.gov (United States)

    Richard A. Werner; Barbara L. Illman

    1994-01-01

    Mechanical wounding and wounding plus inoculation with a blue-stain fungus, Leptographium abietinum (Peck), associated with the spruce beetle, Dendroctonus rufipennis (Kirby), caused an induced reaction zone or lesion around the wound sites in Lutz spruce, Picea lutzii Little, Sitka spruce, P. sitchensis (Bong.) Carr., and white spruce, P. glauca (Moench) Voss, in...

  2. Mental Illness within Family Context: Visual Dialogues in Joshua Lutz's Photographic Essay "Hesitating Beauty"

    Science.gov (United States)

    Sile, Agnese

    2018-01-01

    The status of photography within medical arts or humanities is still insecure. Despite a growing number of published photographic essays that disclose illness experience of an individual and how illness affects close relatives, these works have received relatively little scholarly attention. Through analysis of Joshua Lutz's "Hesitating…

  3. Tiibeti toetajad petsid Gerd Kanterilt allkirja välja / Henrik Kalmet

    Index Scriptorium Estoniae

    Kalmet, Henrik

    2008-01-01

    Kettaheite maailmameister Gerd Kanteri allkiri seisis paljude teiste olümpialaste omade seas veebilehel "Sport for peace" ehk "Sport rahu eest" avaldatud pöördumise järel, mis oli mõeldud Hiina presidendile

  4. Motion – Helicobacter pylori Causes or Worsens GERD: Arguments against the Motion

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    Kenneth EL McColl

    2002-01-01

    Full Text Available Data from large epidemiological studies show that Helicobacter pylori is less prevalent in patients with gastroesophageal reflux disease (GERD than in control subjects. The more virulent cagA-positive strains of the organism are also less commonly seen in patients with erosive esophagitis and in those with Barrett's esophagus than in those with less severe forms of GERD. Although the relationship between H pylori and gastric physiology is complex, the organism has little effect on acid secretion in most North American or Western European subjects, and has a net suppressive effect, especially in elderly subjects, in other parts of the world. Thus, the organism has a potential protective effect against GERD, which is exacerbated by gastric acidity. H pylori has no proven effect on other gastric factors that might provoke reflux, including delayed gastric emptying or inappropriate relaxation of the gastric fundus. Two well-designed interventional studies have found that eradication of H pylori either provoked GERD or had no effect. A third smaller study, which seemed to demonstrate that persistent infection was associated with GERD, was flawed, in that the two treatment groups were not comparable. The evidence thus does not support the idea that H pylori infection provokes or aggravates GERD.

  5. Brain processing of visceral sensation upon esophageal chemical stimulation in different types of GERD

    International Nuclear Information System (INIS)

    Xu Shuchang; Zheng Fangfang; Zhao Xiaohu; Chen Ying; Kong Xuan; Wang Chen; Zhu Liren; Wang Zhiyong

    2010-01-01

    We designed to investigate the cortical response to esophageal acid exposure in different types of gastroesophageal reflux disease (GERD) by functional magnetic resonance imaging (fMRI). Fifteen healthy volunteers, 13 with reflux esophagitis (RE), 12 with non-erosive reflux disease with abnormal acid reflux (NERD+) and nine with non-erosive reflux disease with normal acid reflux (NERD-) received intraesophageal perfusion with isotonic saline followed by 0.1 N hydrochloric acid. Modified block-design model of fMRI scanning was performed simultaneously to the intraesophageal perfusion. The sensitized regions in different types of GERD were not completely identical but were more widely distributed compared to the sensitized regions in the healthy individuals. The activated intensity of the ACC was significantly higher in the healthy volunteers compared to the GERD patients (P < 0.001). Nevertheless, healthy volunteers exhibited a significantly lighter intensity in the right side of the DLPFC (P < 0.001) and a lower intensity in the left side of the insula than the GERD patients (P < 0.05). In conclusion, the underlying central mechanisms of esophageal visceral sensation in different types of GERD patients are quite different. The deactivation of the ACC, the activation of the right side of the DLPFC and the right side of the insula may play an important role in the occurrence of GERD.

  6. Motion – Helicobacter pylori Causes or Worsens GERD: Arguments for the Motion

    Directory of Open Access Journals (Sweden)

    Colm A O’Morain

    2002-01-01

    Full Text Available There are several reasons for eradicating Helicobacter pylori in patients with chronic gastroesophageal reflux disease (GERD. Perhaps the most compelling is the evidence that chronic acid suppression therapy can lead to the development of atrophic gastritis, a premalignant condition, in patients with H pylori infection. Epidemiological data that suggest that H pylori is less prevalent in GERD patients than in control subjects may be susceptible to publication bias, and confounding social and environmental factors may also be involved. Although it has been thought that eradication of the organism might lead to increased esophageal acid exposure, this has not been demonstrated in practice. Studies that appeared to show that GERD could be provoked by antimicrobial therapy of duodenal ulcers also have methodological weaknesses. Underlying GERD symptoms might be unmasked after withdrawal of acid-suppression therapy, for reasons that are unrelated to H pylori. In fact, eradication of the organism has been shown to decrease heartburn in patients with peptic ulcer disease. When H pylori is successfully eradicated in patients with GERD, relapse rates are not increased, and the disease- free interval seems to be prolonged. Eradication of the organism is a wise policy in patients who face long term acid-suppression therapy for GERD.

  7. Brain processing of visceral sensation upon esophageal chemical stimulation in different types of GERD

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    Xu Shuchang, E-mail: xschang@163.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Zheng Fangfang, E-mail: shaoxr228@sina.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Department of Gastroenterology, Nanhui Branch of Huashan Hospital, Fudan University, Shanghai 201300 (China); Zhao Xiaohu, E-mail: xhzhao999@263.ne [Imaging Department, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Chen Ying, E-mail: cyghost-ren@sohu.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Kong Xuan, E-mail: kongxuan83818@hotmail.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Wang Chen, E-mail: wangchen014271@163.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Zhu Liren, E-mail: zhuliren512@163.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China); Wang Zhiyong, E-mail: wzy19810820@163.co [Department of Gastroenterology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065 (China)

    2010-09-15

    We designed to investigate the cortical response to esophageal acid exposure in different types of gastroesophageal reflux disease (GERD) by functional magnetic resonance imaging (fMRI). Fifteen healthy volunteers, 13 with reflux esophagitis (RE), 12 with non-erosive reflux disease with abnormal acid reflux (NERD+) and nine with non-erosive reflux disease with normal acid reflux (NERD-) received intraesophageal perfusion with isotonic saline followed by 0.1 N hydrochloric acid. Modified block-design model of fMRI scanning was performed simultaneously to the intraesophageal perfusion. The sensitized regions in different types of GERD were not completely identical but were more widely distributed compared to the sensitized regions in the healthy individuals. The activated intensity of the ACC was significantly higher in the healthy volunteers compared to the GERD patients (P < 0.001). Nevertheless, healthy volunteers exhibited a significantly lighter intensity in the right side of the DLPFC (P < 0.001) and a lower intensity in the left side of the insula than the GERD patients (P < 0.05). In conclusion, the underlying central mechanisms of esophageal visceral sensation in different types of GERD patients are quite different. The deactivation of the ACC, the activation of the right side of the DLPFC and the right side of the insula may play an important role in the occurrence of GERD.

  8. Influence of larval and pupal products on the oviposition behavior of Aedes Fluviatilis (Lutz (Diptera: Culicidae

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    Rotraut A. G. B. Consoli

    1988-06-01

    Full Text Available Several larval and pupal products of Aedes fluviatilis (Lutz were tested for their influence on the oviposition behaviour of females of the same species. Significant (alfa = 0,05 atractiveness was shown by: larval water, previously containing 5 to 15 larvae/1,5 ml; larval water, preserved up to 38 days; evaporate and reconstructed larval water extracts up to 2 years after production and water filtered through fresh or dried ground larvae. hexanic larval water extracts and water filtered through fresh or dired ground pupae did not influence oviposition.Estudou-se a influência sobre o comportamento de oviposição das fêmeas de Aedes fluviatilis (Lutz de produtos derivados das formas imaturas da mesma espécie. As fêmeas foram atraídas significativamente (x=0,05 por ocasião da ovoposição por: água destilada que contivera 5 ou 15 larvas/1,5 ml, a mesma água (5 larvas/1,5 mlapós sua preservação por 38 dias; extratos evaporados e reconstituídos de água que conteve larvas, por até dois anos a sua produção, e filtrados de macerados frescos e secos de larvas. Extratos hexânicos de água que conteve larvas e filtrados de macerados descos e secos de pupas não atraíram a ovoposição das fêmeas.

  9. The diagnostic value of gastroesophageal reflux disease (GERD) symptoms and detection of pepsin and bile acids in bronchoalveolar lavage fluid and exhaled breath condensate for identifying lung transplantation patients with GERD-induced aspiration.

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    Reder, Nicholas P; Davis, Christopher S; Kovacs, Elizabeth J; Fisichella, P Marco

    2014-06-01

    Gastroesophageal reflux disease (GERD) is thought to lead to aspiration and bronchiolitis obliterans syndrome after lung transplantation. Unfortunately, the identification of patients with GERD who aspirate still lacks clear diagnostic indicators. The authors hypothesized that symptoms of GERD and detection of pepsin and bile acids in the bronchoalveolar lavage fluid (BAL) and exhaled breath condensate (EBC) are effective for identifying lung transplantation patients with GERD-induced aspiration. From November 2009 to November 2010, 85 lung transplantation patients undergoing surveillance bronchoscopy were prospectively enrolled. For these patients, self-reported symptoms of GERD were correlated with levels of pepsin and bile acids in BAL and EBC and with GERD status assessed by 24-h pH monitoring. The sensitivity and specificity of pepsin and bile acids in BAL and EBC also were compared with the presence of GERD in 24-h pH monitoring. The typical symptoms of GERD (heartburn and regurgitation) had modest sensitivity and specificity for detecting GERD and aspiration. The atypical symptoms of GERD (aspiration and bronchitis) showed better identification of aspiration as measured by detection of pepsin and bile acids in BAL. The sensitivity and specificity of pepsin in BAL compared with GERD by 24-h pH monitoring were respectively 60 and 45 %, whereas the sensitivity and specificity of bile acids in BAL were 67 and 80 %. These data indicate that the measurement of pepsin and bile acids in BAL can provide additional data for identifying lung transplantation patients at risk for GERD-induced aspiration compared with symptoms or 24-h pH monitoring alone. These results support a diagnostic role for detecting markers of aspiration in BAL, but this must be validated in larger studies.

  10. The effect of endoscopic fundoplication and proton pump inhibitors on baseline impedance and heartburn severity in GERD patients.

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    Rinsma, N F; Farré, R; Bouvy, N D; Masclee, A A M; Conchillo, J M

    2015-02-01

    Antireflux therapy may lead to recovery of impaired mucosal integrity in gastro-esophageal reflux disease (GERD) patients as reflected by an increase in baseline impedance. The study objective was to evaluate the effect of endoscopic fundoplication and proton pump inhibitor (PPI) PPI therapy on baseline impedance and heartburn severity in GERD patients. Forty-seven GERD patients randomized to endoscopic fundoplication (n = 32) or PPI therapy (n = 15), and 29 healthy controls were included. Before randomization and 6 months after treatment, baseline impedance was obtained during 24-h pH-impedance monitoring. Heartburn severity was evaluated using the GERD-HRQL questionnaire. Before treatment, baseline impedance in GERD patients was lower than in healthy controls (p heartburn severity indicates that other factors may contribute to heartburn perception in GERD. © 2014 John Wiley & Sons Ltd.

  11. Diagnosis and management of gastroesophageal reflux disease (GERD): an Indian perspective.

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    Poddar, Ujjal

    2013-01-08

    NEED AND PURPOSE: The scarcity of literature and lack of published guidelines on gastroesophageal reflux disease (GERD) from India, have necessitated this review. A literature search in PubMed was conducted with regard to epidemiology, clinical features, investigation and management of GERD in children. English language studies published full over the last 20 years were considered and relevant information was extracted. Nearly half of all healthy babies regurgitate at least once a day by 4 months of age and this subsides in 90% of them by 1 year. In contrast, GERD prevalence increases with age and by adolescence it is similar to adults (20%). While regurgitation in infancy does not need investigation or therapy, empirical proton pump inhibitor (PPI) for 4 weeks is justified in older children with classical GERD symptoms. There is no gold-standard investigation for GERD. A pH study with or without impedance is useful in extraesophageal manifestations and endoscopy in esophagitis. Proton pump inhibitors (PPI) play a pivotal role in the management of GERD and its long-term use has been shown to be safe in children. Antireflux surgery plays a minor role due to, its associated morbidity and high failure rate, especially in the high risk group who needs it most. Regurgitation in infancy need not be investigated unless there are warning features. Empirical PPI therapy is justified in older children and adolescents with typical reflux symptoms. pH study in extraesophageal manifestations and endoscopy for esophagitis are the investigations of choice. PPI is the mainstay of therapy in GERD.

  12. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy

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    Fill Malfertheiner Sara

    2012-09-01

    Full Text Available Abstract Background Symptoms of gastro-esophageal reflux disease (GERD in pregnancy are reported with a prevalence of 30–80%. The aim of this study was to assess the prevalence and severity of GERD symptoms during the course of pregnancy. Furthermore current practice in medical care for GERD during pregnancy was assessed. Methods We performed a prospective longitudinal cohort study on 510 pregnant women (mean age 28.12, SD 5.3. Investigations for reflux symptoms where based on the use of validated reflux-disease questionnaire (RDQ. Additional information was collected about the therapy. A group of non-pregnant women (mean age 24.56, SD 5.7 was included as controls. Frequency and severity of reflux symptoms were recorded in each trimester of pregnancy. Results The prevalence of GERD symptoms in pregnant women increased from the first trimester with 26.1 to 36.1% in the second trimester and to 51.2% in the third trimester of pregnancy. The prevalence of GERD symptoms in the control group was 9.3%. Pregnant women received medication for their GERD symptoms in 12.8% during the first, 9.1% during the second and 15.7% during the third trimester. Medications used >90% antacids, 0% PPI. Conclusion GERD symptoms occur more often in pregnant women than in non-pregnant and the frequency rises in the course of pregnancy. Medical therapy is used in a minority of cases and often with no adequate symptom relief.

  13. Estudo comparativo dos métodos coprológicos de Lutz, Kato-Katz e Faust modificado A comparative study of the coprologic methods of Lutz, Kato-Katz and the Faust modified

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    Adelú Chaves

    1979-12-01

    Full Text Available Foram estudados, comparativamente, em 500 pacientes, os métodos de exames de fezes de Lutz, Faust modificado e Kato-Katz para o diagnóstico parasitológico de fezes. O método de Kato-Katz proporcionou maiores índices de positividade do que as outras duas técnicas no diagnóstico de ancilostomideos, T. trichiurus e S. mansoni. Nenhuma diferença foi observada quanto ao diagnóstico de A. lumbricoides. Para o diagnóstico das protozooses não houve diferença significativa entre os métodos de Faust modificado e de Lutz. Baseado nos dados obtidos, eficiência, simplicidade e rapidez de execução recomenda-se a associação dos métodos de Kato-Katz e Faust modificado na rotina de diagnóstico parasitológico de fezes.A comparative study was of the Lutz, Faust (modified, and Kato-Katz stool examination methods for parasitological diagnosis using 500 patients. The Kato-Katz method provided higher rates of positivity than the other two techniques in the diagnosis of Ancylostomidae, T. trichiurus, and S. mansoni. No differences were observed in the diagnosis of A. lumbicoides. Nor was a statistically significant difference observed in the diagnosis of protozoosis when using the Lutz and modified Faust methods. The data obtained led to a recommendation for an association of Kato-Katz and modified Faust methods for routine parasitological diagnosis due to Us simplicity, rapidity, and efficiency.

  14. Breathing training on lower esophageal sphincter as a complementary treatment of gastroesophageal reflux disease (GERD): a systematic review.

    Science.gov (United States)

    Casale, M; Sabatino, L; Moffa, A; Capuano, F; Luccarelli, V; Vitali, M; Ribolsi, M; Cicala, M; Salvinelli, F

    2016-11-01

    Gastroesophageal reflux disease (GERD) represents one of the most common gastrointestinal disorders, but is still a challenge to cure. Proton pump inhibitors (PPIs) are currently the GERD's standard treatment, although not successful in all patients; some concerns have been raised regarding their long term consumption. Recently, some studies showed the benefits of inspiratory muscle training in increasing the lower esophageal sphincter pressure in patients affected by GERD, thereby reducing their symptoms. Relevant published studies were searched in Pubmed, Google Scholar, Ovid or Medical Subject Headings using the following keywords: "GERD" and physiotherapy", "GERD" and "exercise", "GERD" and "breathing", "GERD and "training". At the end of our selection process, four publications have been included for systematic review. All of them were prospective controlled studies, mainly based on the training of the diaphragm muscle. GERD symptoms, pH-manometry values and PPIs usage were assessed. Among the non-surgical, non-pharmacological treatment modalities, the breathing training on diaphragm could play an important role in selected patients to manage the symptoms of GERD.

  15. The incidence of oropharyngeal dysphagia in infants with GERD-like symptoms.

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    Fishbein, Mark; Branham, Christina; Fraker, Cheryl; Walbert, Laura; Cox, Sibyl; Scarborough, Donna

    2013-09-01

    Symptoms of infantile gastroesophageal reflux disease (GERD) may overlap with oropharyngeal dysphagia, but the evaluation and treatment of these conditions vary greatly. In this investigation, the incidence of oropharyngeal dysphagia in infants with GERD-like symptoms is determined. A retrospective chart review was performed on infants referred to a pediatric gastroenterology clinic for GERD-like symptoms. A feeding screen was performed in all infants. Standardized bedside swallow evaluation and modified barium swallow (MBS) studies were then performed when clinically indicated. A similarly aged cohort of normal participants also underwent a standard bedside swallow evaluation for group comparison. Study population included 67 infants. A swallow evaluation was recommended in 39 of 67 infants with abnormalities noted in all. Swallowing abnormalities were more frequent and clustered in infants with GERD-like symptoms vs controls. MBS was abnormal in 16 of 17 qualifying infants. Characteristics of at-risk infants included extreme prematurity, developmental delay, or symptoms refractory to antireflux medications. Oropharyngeal dysphagia is prominent in infants with GERD-like symptoms.

  16. Surgical management of gastroesophageal reflux disease (GERD) in children: A systematic review.

    Science.gov (United States)

    Jancelewicz, Tim; Lopez, Monica E; Downard, Cynthia D; Islam, Saleem; Baird, Robert; Rangel, Shawn J; Williams, Regan F; Arnold, Meghan A; Lal, Dave; Renaud, Elizabeth; Grabowski, Julia; Dasgupta, Roshni; Austin, Mary; Shelton, Julia; Cameron, Danielle; Goldin, Adam B

    2017-08-01

    The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to derive recommendations from the medical literature regarding the surgical treatment of pediatric gastroesophageal reflux disease (GERD). Five questions were addressed by searching the MEDLINE, Cochrane, Embase, Central, and National Guideline Clearinghouse databases using relevant search terms. Consensus recommendations were derived for each question based on the best available evidence. There was insufficient evidence to formulate recommendations for all questions. Fundoplication does not affect the rate of hospitalization for aspiration pneumonia, apnea, or reflux-related symptoms. Fundoplication is effective in reducing all parameters of esophageal acid exposure without altering esophageal motility. Laparoscopic fundoplication may be comparable to open fundoplication with regard to short-term clinical outcomes. Partial fundoplication and complete fundoplication are comparable in effectiveness for subjective control of GERD. Fundoplication may benefit GERD patients with asthma, but may not improve outcomes in patients with neurologic impairment or esophageal atresia. Overall GERD recurrence rates are likely below 20%. High-quality evidence is lacking regarding the surgical management of GERD in the pediatric population. Definitive conclusions regarding the effectiveness of fundoplication are limited by patient heterogeneity and lack of a standardized outcomes reporting framework. Systematic review of level 1-4 studies. Level 1-4 (mainly level 3-4). Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Effect of alginate in patients with GERD hiatal hernia matters.

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    Vardar, R; Keskin, M; Valitova, E; Bayrakci, B; Yildirim, E; Bor, S

    2017-10-01

    Alginate-based formulations are frequently used as add-on proton pump inhibitor (PPI) therapy to help control of heartburn and regurgitation. There are limited data regarding the mechanisms and effects of alginate-based formulations. We aimed to evaluate the effects of the sodium alginate intake and its likely temporal relations on intraesophageal reflux events by MII-pH in patients with and without hiatal hernia (HH). Fifty GERD patients (18 with HH, 32 without HH) with heartburn or regurgitation once a week or more common were included. After combined multichannel intraluminal impedance and pH-metry (MII-pH) had been performed, all patients were asked to eat the same standard meal (double cheeseburger, 1 banana, 100 g regular yoghurt, and 200 mL water with total energy value of 744 kcal: 37.6% of carbohydrates, 21.2% of proteins, and 41.2% of lipids) during two consecutive days. On separate random two consecutive days, all patients took 10 mL of sodium alginate (GA; Gaviscon Advance; Reckitt Benckiser Healthcare, Hull, UK) or 10 mL of water, 30 minutes after the refluxogenic meal. After eating refluxogenic meal, patients were examined ½ hour for basal conditions, 1 hour in upright, and 1 hour in supine positions. Alginate significantly decreased acid reflux after intake at the first hour in comparison to water in patients with HH (6.1 vs. 13.7, P = 0.004) and without HH (3.5 vs. 5.5, P = 0.001). Weakly acid reflux were increased at the first hour in patients with HH (3.4 vs. 1.3, P = 0.019) and without HH (1.7 vs. 5, P = 0.02) compared to water. There was no distinctive effect of alginate on the height of proximal migration of reflux events in patients with HH and without HH. Alginate decreases acid reflux events within a limited time period, especially at the first hour both in patients with and without HH. Alginate has no effect on the height of reflux events along the esophagus both in patients with and without HH. © The Authors 2017. Published by Oxford

  18. SU-E-CAMPUS-T-01: Automation of the Winston-Lutz Test for Stereotactic Radiosurgery

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    Litzenberg, D; Irrer, J; Kessler, M; Lam, K [University of Michigan, Ann Arbor, MI (United States); Keranen, W [Varian Medical Systems, Inc., Palo Alto, CA (United States)

    2014-06-15

    Purpose: To optimize clinical efficiency and shorten patient wait time by minimizing the time and effort required to perform the Winston-Lutz test before stereotactic radiosurgery (SRS) through automation of the delivery, analysis, and documentation of results. Methods: The radiation fields of the Winston-Lutz (WL) test were created in a “machine-QA patient” saved in ARIA for use before SRS cases. Images of the BRW target ball placed at mechanical isocenter are captured with the portal imager for each of four, 2cm×2cm, MLC-shaped beams. When the WL plan is delivered and closed, this event is detected by in-house software called EventNet which automates subsequent processes with the aid of the ARIA web services. Images are automatically retrieved from the ARIA database and analyzed to determine the offset of the target ball from radiation isocenter. The results are posted to a website and a composite summary image of the results is pushed back into ImageBrowser for review and authenticated documentation. Results: The total time to perform the test was reduced from 20-25 minutes to less than 4 minutes. The results were found to be more accurate and consistent than the previous method which used radiochromic film. The images were also analyzed with DoseLab for comparison. The difference between the film and automated WL results in the X and Y direction and the radius were (−0.17 +/− 0.28) mm, (0.21 +/− 0.20) mm and (−0.14 +/− 0.27) mm, respectively. The difference between the DoseLab and automated WL results were (−0.05 +/− 0.06) mm, (−0.01 +/− 0.02) mm and (0.01 +/− 0.07) mm, respectively. Conclusions: This process reduced patient wait times by 15–20 minutes making the treatment machine available to treat another patient. Accuracy and consistency of results were improved over the previous method and were comparable to other commercial solutions. Access to the ARIA web services is made possible through an Eclipse co-development agreement

  19. Features of reproduction in laboratory-reared Aedes fluviatilis (Lutz, 1904 (Diptera: Culicidae

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    Rotraut A. G. B. Cônsoli

    1983-03-01

    Full Text Available Observations were made on 100 female Aedes fluviatilis (Lutz maintained individually from the first blood meal onwards and allowed one blood meal during each oviposition cycle, 5% dextrose solution been supplied throughout life. The average length of live was 49.9 ± 17.8 days; the logarithm of the mortality rate increased proportionately to physiological age. The insects took an average of 7.3 ± 3.2 blood meals and produced a mean of 7.9 ± 3.7 clutches of eggs. There was a progressive decrease, proportional to advancing physiological age, in the mean numbers of eggs laid in successive oviposition cycles, in the intervals between blood feeding oviposition, and in the numbers of larvae that hatched. Delayed oviposition, transient sterility and a total loss of fertility were also recorded.De 100 fêmeas de Aedese fluviatilis (Lutz, 1904 individualmente observadas foram obtidos 45.475 ovos em um total de 790 posturas. As médias de desovas produzidas e de repastos sangüíneos ingeridos por fêmea, foram respectivamente 7,9 ± 3,7 e 7,3 ± 3,2 e a longevidade média foi de 49,9 ± 17,8 dias. Em análise de regressão linear, foi observado um progressivo decréscimo das médias de ovos por postura, larvas eclodidas e número de dias entre repasto sangüíneo e postura, proporcional ao aumento da idade fisiológica. Foram ainda observadas ocorrências de ingestão de sangue durante o desenvolvimento dos ovos, recusa de alimentação sangüínea entre desovas sucessivas, retenção espontânea de ovos por períodos apreciáveis, esterilidade transitória e esgotamento de fecundidade.

  20. Application of Robust Regression and Bootstrap in Poductivity Analysis of GERD Variable in EU27

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    Dagmar Blatná

    2014-06-01

    Full Text Available The GERD is one of Europe 2020 headline indicators being tracked within the Europe 2020 strategy. The headline indicator is the 3% target for the GERD to be reached within the EU by 2020. Eurostat defi nes “GERD” as total gross domestic expenditure on research and experimental development in a percentage of GDP. GERD depends on numerous factors of a general economic background, namely of employment, innovation and research, science and technology. The values of these indicators vary among the European countries, and consequently the occurrence of outliers can be anticipated in corresponding analyses. In such a case, a classical statistical approach – the least squares method – can be highly unreliable, the robust regression methods representing an acceptable and useful tool. The aim of the present paper is to demonstrate the advantages of robust regression and applicability of the bootstrap approach in regression based on both classical and robust methods.

  1. Hans-Peter Schultze, a great paleoichthyologist for whom work is synonymous with enjoyment

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    R. Cloutier

    2002-01-01

    Full Text Available In the summer of 1982, Hans-Peter Schultze and Gloria Arratia were invited to a small museum located on a fossiliferous site of the Devonian Escuminac Formation in Miguasha, Quebec, eastern Canada, Hans-Peter was to work with Marius Arsenault, the director of the Miguasha Museum, on the skull of the elpistostegalid Elpistostege watsoni, a species closely related to basal tetrapod. In addition, he went through the collections to describe and measure numerous juvenile specimens of the osteolepiform. Eusthenopteran foordi. As expected, there two projects turned out to be important contributions in lower vertebrate paleontology and systematics: one on the origin of tetrapods (1985, and the second one on growth patterns of a Late Devonian fish (1984. During his visit to Miguasha, Hans-Peter also spent time digging for fossils and drawing numerous specimens in the collection. In addition, in order to help the personnel of the museum to identify some of the Escuminac fished, he created an identification key based on the gross morphology of the scales. For a small group of undergraduate students, hired at the museum during the summer as naturalists, it was a unique opportunity to discuss paleontology with a leading researcher. We were amazed by his willingness to talk to us, even if then most of us only spoke French! For the first time, we were exposed to Hennigian methodology and its usage in vertebrate paleontology during and evening lecture that Hans-Peter prepared for us. His lecture was delightful; it was an intensive course in lower vertebrate anatomy, and an intellectual journey among the philosophers Karl Marx and Karl Popper, the entomologists Willy Hennig and Lars Brundin, and "The Band of Four" (Rosen et al., 1981. It was for most of us our first exposure to science, as it should be done. We were all impressed by his knowledge and above all by his simplicity and friendliness. Two years later I started my Ph.D. at The University of Kansas

  2. SU-F-T-547: Off-Isocenter Winston-Lutz Test for Stereotactic Radiosurgery/stereotactic Body Radiotherapy

    International Nuclear Information System (INIS)

    Gao, J; Liu, X

    2016-01-01

    Purpose: To perform a quantitative study to verify that the mechanical field center coincides with the radiation field center when both are off from the isocenter during the single-isocenter technique in linear accelerator-based SRS/SBRT procedure to treat multiple lesions. Methods: We developed an innovative method to measure this accuracy, called the off-isocenter Winston-Lutz test, and here we provide a practical clinical guideline to implement this technique. We used ImagePro V.6 to analyze images of a Winston-Lutz phantom obtained using a Varian 21EX linear accelerator with an electronic portal imaging device, set up as for single-isocenter SRS/SBRT for multiple lesions. We investigated asymmetry field centers that were 3 cm and 5 cm away from the isocenter, as well as performing the standard Winston-Lutz test. We used a special beam configuration to acquire images while avoiding collision, and we investigated both jaw and multileaf collimation. Results: For the jaw collimator setting, at 3 cm off-isocenter, the mechanical field deviated from the radiation field by about 2.5 mm; at 5 cm, the deviation was above 3 mm, up to 4.27 mm. For the multileaf collimator setting, at 3 cm off-isocenter, the deviation was below 1 mm; at 5 cm, the deviation was above 1 mm, up to 1.72 mm, which is 72% higher than the tolerance threshold. Conclusion: These results indicated that the further the asymmetry field center is from the machine isocenter, the larger the deviation of the mechanical field from the radiation field, and the distance between the center of the asymmetry field and the isocenter should not exceed 3 cm in of our clinic. We recommend that every clinic that uses linear accelerator, multileaf collimator-based SRS/SBRT perform the off-isocenter Winston-Lutz test in addition to the standard Winston-Lutz test and use their own deviation data to design the treatment plan.

  3. Adolpho Lutz: um esboço biográfico

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    Benchimol Jaime Larry

    2003-01-01

    Full Text Available Este artigo retrata as origens familares e a trajetória de Adolpho Lutz (1855-1940 até sua transferência para o Instituto Oswaldo Cruz (IOC, em 1908. Utiliza o cientista como fio condutor para a análise da instituição das medicinas pasteuriana e tropical no Brasil. Examina seus estudos superiores e de aperfeiçoamento na Europa germânica, suas atividades como clínico e como investigador de temas relacionados à helmintologia, parasitologia, veterinária e bacteriologia no interior de São Paulo, sua estada no leprosário de Molokai, no Havaí, e controvérsias médicas de que participou durante o período em que chefiou o Instituto Bacteriológico de São Paulo, especialmente aquelas concernentes ao cólera, às disenterias, à febre tifóide, à malária e à febre amarela.

  4. Lewandowsky and Lutz dysplasia: Report of two cases in a family

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    Bhawna Bhutoria

    2011-01-01

    Full Text Available Lewandowsky and Lutz dysplasia, also known as epidermodysplasia verruciformis (EV, is an inherited disorder in which there is widespread and persistent infection with human papilloma virus, defect in cell-mediated immunity and propensity for malignant transformation. Differential clinical and histopathologic evolutions of lesions in two cases of familial EV are compared and discussed in detail. Cases were followed up for 7 years. Detailed history, clinical features and investigations, including skin biopsy from different sites at different times, were examined. Generalized pityriasis versicolor like hypopigmented lesions in both the cases, together with variable pigmented nodular actinic keratosis like lesions on sun-exposed areas, were present. Multiple skin biopsies done from various sites on different occasions revealed features typical of EV along with lesions, i.e., actinic keratosis, Bowen′s disease, basal and squamous cell carcinoma, in the elder sibling. However, skin biopsy of the other sibling showed features of EV and seborrheic keratosis only till date. This study reveals that the disease progression is variable among two individuals of the same family. Malignant lesions were seen only on sun-exposed areas and may be associated with other skin lesions or infections such as angiokeratoma of Fordyce and tinea cruris, as seen in this report.

  5. Phylogeography and population diversity of Simulium hirtipupa Lutz (Diptera: Simuliidae based on mitochondrial COI sequences.

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    Vanderly Andrade-Souza

    Full Text Available High morphological homogeneity and cryptic speciation may cause the diversity within Simuliidae to be underestimated. Recent molecular studies on population genetics and phylogeography have contributed to reveal which factors influenced the diversity within this group. This study aimed at examining the genetic diversity of Simulium hirtipupa Lutz, 1910 in populations from the biomes Caatinga, Cerrado, and Atlantic Forest. In this study, we carried out phylogeographic and population genetic analyses using a fragment of the mitochondrial gene COI. The 19 populations studied were clustered into seven groups, most of which are associated with geography indicating certain genetic structure. The northern region of the state of Minas Gerais is most likely the center of origin of this species. The average intergroup genetic distance was 3.7%, indicating the presence of cryptic species. The species tree as well as the haplotype network recovered all groups forming two major groups: the first comprises groups Gr-Bahia (in which the São Francisco river has not acted as geographical barrier, Gr-Pernambuco, and Gr-Mato Grosso do Sul. The second included groups comprising populations of the states of Goiás, Tocantins, Minas Gerais, Bahia, São Paulo, and Espírito Santo. The mismatch distribution for groups was consistent with the model of demographic expansion, except for the Gr-Central-East_1 group. The diversification in this group occurred about 1.19 Mya during the Pleistocene, influenced by paleoclimatic oscillations during the Quaternary glacial cycles.

  6. The Validity and Reliability Test of the Indonesian Version of Gastroesophageal Reflux Disease Quality of Life (GERD-QOL) Questionnaire.

    Science.gov (United States)

    Siahaan, Laura A; Syam, Ari F; Simadibrata, Marcellus; Setiati, Siti

    2017-01-01

    to obtain a valid and reliable GERD-QOL questionnaire for Indonesian application. at the initial stage, the GERD-QOL questionnaire was first translated into Indonesian language and the translated questionnaire was subsequently translated back into the original language (back-to-back translation). The results were evaluated by the researcher team and therefore, an Indonesian version of GERD-QOL questionnaire was developed. Ninety-one patients who had been clinically diagnosed with GERD based on the Montreal criteria were interviewed using the Indonesian version of GERD-QOL questionnaire and the SF 36 questionnaire. The validity was evaluated using a method of construct validity and external validity, and reliability can be tested by the method of internal consistency and test retest. the Indonesian version of GERD-QOL questionnaire had a good internal consistency reliability with a Cronbach Alpha of 0.687-0.842 and a good test retest reliability with an intra-class correlation coefficient of 0.756-0.936; pGERD-QOL questionnaire has been proven valid and reliable to evaluate the quality of life of GERD patients.

  7. Comparison of Endoscopic Findings with Gastroesophageal Reflux Disease Questionnaires (GerdQ) and Reflux Disease Questionnaire (RDQ) for Gastroesophageal Reflux Disease in Medan

    OpenAIRE

    Siregar, Gontar Alamsyah; Halim, Sahat; Sitepu, Ricky Rivalino

    2015-01-01

    ABSTRACT Background: There are many questionnaires that have been developed to diagnose gastroesophageal reflux disease (GERD), i.e. reflux disease questionnaire (RDQ), and the recently developed, gastroesophageal reflux disease questionnaires (GerdQ). In this study, we tried to compare GerdQ and RDQ in terms of sensitivity and specificity to diagnose GERD and its relationship with endoscopic findings. Method: This study was a cross sectional analytical study. Subsequently, all the subj...

  8. Long-term management of GERD in the elderly with pantoprazole

    Directory of Open Access Journals (Sweden)

    Carlo Calabrese

    2007-04-01

    Full Text Available Carlo Calabrese, Anna Fabbri, Giulio Di FeboDepartment of Internal Medicine and Gastroenterology, University of Bologna, ItalyAbstract: The prevalence of gastroesophageal reflux disease (GERD increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.Keywords: GERD, long-term management, pantoprazole, safety, efficacy, tolerability

  9. Frequency of obstructive sleep apnea (OSA in patients with gastroesophageal reflux disease (GERD and the effect of nasal continuous positive airway pressure

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    Amany Shaker

    2016-10-01

    Conclusion: (1 A high risk for OSA development is more frequent in GERD patients especially NERD ones and who experience nighttime symptoms, (2 there is a mutual relationship between OSA and GERD reinforcing each other, and (3 CPAP therapy has a good role in the treatment of both OSA and GERD symptoms.

  10. Prevalence and predictors of columnar lined esophagus in gastroesophageal reflux disease (GERD) patients undergoing upper endoscopy.

    Science.gov (United States)

    Balasubramanian, Gokulakrishnan; Singh, Mandeep; Gupta, Neil; Gaddam, Srinivas; Giacchino, Maria; Wani, Sachin B; Moloney, Brian; Higbee, April D; Rastogi, Amit; Bansal, Ajay; Sharma, Prateek

    2012-11-01

    Chronic gastroesophageal reflux disease (GERD) is a risk factor for Barrett's esophagus (BE), the most important surrogate marker for the development of esophageal adenocarcinoma (EAC). The need to document the presence of intestinal metaplasia in esophageal biopsies from a columnar lined esophagus (CLE) to diagnose BE is debated. The objective of this study was to prospectively evaluate the prevalence and risk factors of CLE in a large cohort of GERD patients undergoing upper endoscopy. Consecutive patients presenting to the endoscopy unit at a tertiary referral center for their index upper endoscopy for evaluation of GERD symptoms were enrolled in this prospective cohort study. Patients were asked to complete a validated GERD questionnaire that documents the onset of GERD symptoms (heartburn and acid regurgitation) and grades the frequency and severity of symptoms experienced over the past year. Demographic information, body mass index, and use of aspirin/nonsteroidal antiinflammatory drugs were recorded. Endoscopic details including length of CLE, presence and size of hiatal hernia were noted. Patients with CLE (cases) were compared with those without CLE (controls) using Fischer's exact test and t-test. All factors that were statistically significant (PGERD symptoms were prospectively enrolled. On index endoscopy, the prevalence of CLE was 23.3%, whereas of CLE with documented intestinal metaplasia was 14.1%. On univariate analysis, male gender, Caucasian race, heartburn duration of >5 years, presence and size of hiatal hernia were significantly associated with the presence of CLE compared with controls (P5 years (odds ratio (OR): 1.50, 95% confidence interval (CI): 1.07-2.09, P=0.01), Caucasian race (OR: 2.40, 95% CI: 1.42-4.03, P=0.001), and hiatal hernia (OR: 2.07, 95% CI: 1.50-2.87, PGERD patients are diagnosed with this lesion. Enrolling all these patients in surveillance programs would have significant ramifications on health-care resources.

  11. Comparison between immunomagnetic separation, coupled with immunofluorescence, and the techniques of Faust et al. and of Lutz for the diagnosis of Giardia lamblia cysts in human feces

    Directory of Open Access Journals (Sweden)

    Souza Doris Sobral Marques

    2003-01-01

    Full Text Available In the present study, the performance of Immunomagnetic Separation technique, coupled with Immunofluorescence (IMS-IFA, was compared with the FAUST et al. and Lutz parasitological techniques for the detection of Giardia lamblia cysts in human feces. One hundred and twenty-seven samples were evaluated by the three techniques at the same time showing a rate of cyst detection of 27.5% by IMS-IFA and 15.7% by both Faust et al. and Lutz techniques. Data analysis showed a higher sensitivity of IMS-IFA for the detection of G. lamblia cysts in comparison with the techniques of FAUST et al. and Lutz. The use of this methodology as a routine procedure enables the processing of many samples simultaneously, in order to increase recovery rate of G. lamblia cysts and reduce the time of sample storage.

  12. Evidence of phenotypic plasticity of larvae of Simulium subpallidum Lutz in different streams from the Brazilian Cerrado

    Directory of Open Access Journals (Sweden)

    Ronaldo Figueiró

    2015-03-01

    Full Text Available In this paper, the overall morphological differences between populations of Simulium subpallidum Lutz, 1909 are studied. Several studies found in the literature point to a relationship between the labral fans and body size and the habitat where blackfly larvae occur. However, other characteristics potentially related to the microhabitat, such as abdominal hook circlet morphology, which is used for larvae to fix themselves in the substratum, and thoracic prolegs morphology, which help larvae move in the substratum, were analyzed in three different populations of S. subpallidum, one of which occupied a faster flow. The results suggest phenotypic plasticity in S. subpallidum and a tendency toward larger structures in faster flows.

  13. Bromeliaceae do Herbário do Dr. Adolpho Lutz: Encholirium Lutzii L. B. Smith n. sp

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    Lyman B. Smith

    1958-07-01

    Full Text Available Encholirium Lutzii is distinguished from the majority of species by its branched inflorescence. Only E. horridum L. B. Smith and rarely E. spectabile Martius exhibit this character, but have much larger flowers than E. Lutzii and stout floral axes. Also the wing of the seed in E. horridum is very long-caudate. We feel that it is particularly appropriate to dedicate this new species to Dr. Adolpho Lutz because of his great discoveries in the biological relationships of the Bromeliaceae.

  14. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication - results of 151 consecutive cases.

    Science.gov (United States)

    Wróblewski, Tadeusz; Kobryn, Konrad; Nowosad, Małgorzata; Krawczyk, Marek

    2016-01-01

    Gastroesophageal reflux disease (GERD) is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT). The best choice of management for advanced GERD is laparoscopic surgery. To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Between 2001 and 2012, 353 patients (211 female and 142 male), aged 17-76 years (mean 44), underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz procedure (WTP). The mean age of the group was 47.77 years (17-80 years). Forty-nine (32.45%) patients had severe symptoms, 93 (61.58%) had mild symptoms and 9 (5.96%) had a single mild but intolerable sign of GERD. Eighty-six (56.95%) patients had a Toupet fundoplication and 65 (43.04%) had a WTP. The follow-up period was 18-144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90-300 min) and 147 min (90-210 min), respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2-16 post-operative days (POD) = Toupet) vs. 4.7 days (2-9 POD = WTP). No reoperations were performed. No major surgical complications were identified. Wroblewski Tadeusz procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice.

  15. Mobile applications and patient education: Are currently available GERD mobile apps sufficient?

    Science.gov (United States)

    Bobian, Michael; Kandinov, Aron; El-Kashlan, Nour; Svider, Peter F; Folbe, Adam J; Mayerhoff, Ross; Eloy, Jean Anderson; Raza, S Naweed

    2017-08-01

    Despite the increasing role of mobile applications (apps) in patient education, there has been little inquiry evaluating the quality of these resources. Because poor health literacy has been associated with inferior health outcomes, evaluating the quality of patient education materials takes on great importance. Our objective was to employ validated readability tools for the evaluation of gastroesophageal reflux (GERD) mobile apps. GERD-specific apps found in the Apple App Store (Apple Inc., Cupertino CA) were evaluated using the Readability Studio Professional Version 2015 for Windows (Oleander Software, Ltd, Vandalia, OH). All text was evaluated using nine validated algorithms measuring readability including Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook grading, Gunning Fog index, Coleman-Liau, New Fog Count formula, Raygor Readability Estimate, FORCAST, Fry graph, and Flesch Reading Ease score. Average reading grade levels for individual GERD apps ranged from 9.6 to 12.9 (interquartile range 10.3-12). The average reading grade level for all apps analyzed was 11.1 ± 0.2 standard error of the mean (SEM), with an average Flesch Reading Ease score for all mobile apps analyzed of 51 ± 2.05 (SEM), falling into the "fairly difficult" category given by this measure. Raygor Readability estimates that most mobile apps have a reading grade level between 10 and 12, with the majority of this outcome due to long words. This analysis demonstrates the feasibility of assessing readability of mobile health apps. Our findings suggest significant gaps in potential comprehension between the apps analyzed and the average reader, diminishing the utility of these resources. We hope our findings influence future mobile health-related app development and thereby improve patient outcomes in GERD and other chronic diseases. NA. Laryngoscope, 127:1775-1779, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Predictors of heartburn resolution and erosive esophagitis in patients with GERD.

    Science.gov (United States)

    Orlando, Roy C; Monyak, John T; Silberg, Debra G

    2009-09-01

    The primary objective was to assess gastroesophageal reflux disease (GERD) symptom resolution rates with esomeprazole by erosive esophagitis (EE) status, and the secondary objective was to evaluate potential predictors of the presence of EE and heartburn resolution. Patients with GERD who have EE have higher reported symptom resolution rates than those with nonerosive reflux disease (NERD) when treated with proton pump inhibitors (PPIs). This open-label multicenter study included adults with GERD symptoms. Patients were stratified by EE status after endoscopy and received once-daily esomeprazole 40 mg for 4 weeks. Questionnaires determined symptom response rates, and baseline predictors of EE or heartburn resolution were evaluated. Potential predictors, including years with GERD, history of EE, and time to relief with antacids, were examined. Heartburn resolution rates at 4 weeks were higher for patients with EE than NERD (69% [124/179] vs. 48% [85/177]; p < 0.0001). Multivariate models had moderate predictive ability for EE (c-index, 0.76) and poor predictive ability (c-index, 0.57) for heartburn resolution. However, faster heartburn relief with antacid use, particularly within 15 min, was predictive of EE and heartburn resolution. Patients with EE have higher heartburn resolution rates than patients with NERD after treatment, although recall bias may be possible. Fast relief with antacid use is predictive of EE and heartburn resolution with a PPI and suggests that a history of antacid relief may provide corroborative evidence to empiric PPI therapy in determining whether patients with heartburn have acid reflux disease. ClinicalTrials.Gov IDENTIFIER: NCT00242736.

  17. Effect of itopride, a new prokinetic, in patients with mild GERD: a pilot study.

    Science.gov (United States)

    Kim, Yong Sung; Kim, Tae Hyeon; Choi, Chang Soo; Shon, Young Woo; Kim, Sang Wook; Seo, Geom Seog; Nah, Yong Ho; Choi, Myung Gyu; Choi, Suck Chei

    2005-07-21

    Itopride is a newly developed prokinetic agent, which enhances gastric motility through both antidopaminergic and anti-acetylcholinesterasic actions. The importance of esophageal motor dysfunction in the pathogenesis of gastro-esophageal reflux disease (GERD) makes it interesting to examine the effect of itopride on esophageal acid exposure. The effect of itopride on esophageal acid reflux variables for 24 h was studied in 26 patients with GERD symptoms, pre-entry total acid exposure time (pHitopride thrice a day (t.i.d.) for 30 d in random order, using an open label method. For evaluating the safety of itopride, blood biochemical laboratory test was performed and the serum prolactin level was also examined before and after treatment. Total symptom score was significantly decreased after treatment in 150- or 300-mg group. Itopride 300 mg was significantly effective than 150 mg on decreasing the total per cent time with pHitopride in both groups. Itopride 100 mg t.i.d. is effective on decreasing pathologic reflux in patient with GERD and therefore it has the potential to be effective in the treatment of this disease.

  18. Psychological factors influence the gastroesophageal reflux disease (GERD) and their effect on quality of life among firefighters in South Korea.

    Science.gov (United States)

    Jang, Seung-Ho; Ryu, Han-Seung; Choi, Suck-Chei; Lee, Sang-Yeol

    2016-10-01

    The purpose of this study was to examine psychosocial factors related to gastroesophageal reflux disease (GERD) and their effects on quality of life (QOL) in firefighters. Data were collected from 1217 firefighters in a Korean province. We measured psychological symptoms using the scale. In order to observe the influence of the high-risk group on occupational stress, we conduct logistic multiple linear regression. The correlation between psychological factors and QOL was also analyzed and performed a hierarchical regression analysis. GERD was observed in 32.2% of subjects. Subjects with GERD showed higher depressive symptom, anxiety and occupational stress scores, and lower self-esteem and QOL scores relative to those observed in GERD - negative subject. GERD risk was higher for the following occupational stress subcategories: job demand, lack of reward, interpersonal conflict, and occupational climate. The stepwise regression analysis showed that depressive symptoms, occupational stress, self-esteem, and anxiety were the best predictors of QOL. The results suggest that psychological and medical approaches should be combined in GERD assessment.

  19. Presence of the fire ant Solenopsis invicta (Westwood) (Hymenoptera: Formicidae) stimulates burrowiong behavior by larvae of the sandfly Lutzomyia longipalpis (Lutz & Neiva)(Diptera: Psychodidae)

    NARCIS (Netherlands)

    Harvey, J.A.; Hamilton, J.G.C.; Ward, R.D.

    2010-01-01

    The sandfly Lutzomyia longipalpis (Lutz & Neiva) vectors leishmaniasis in the neotropics. Although much is known about the biology of adult flies, little is known about interactions with its natural enemies. Here, we examined behavior of larvae of L4 L.longipalpis on a soil substrate when exposed to

  20. Development and validation of a simple and multifaceted instrument, GERD-TEST, for the clinical evaluation of gastroesophageal reflux and dyspeptic symptoms.

    Science.gov (United States)

    Nakada, Koji; Matsuhashi, Nobuyuki; Iwakiri, Katsuhiko; Oshio, Atsushi; Joh, Takashi; Higuchi, Kazuhide; Haruma, Ken

    2017-07-28

    To evaluate the psychometric properties of a newly developed questionnaire, known as the gastroesophageal reflux and dyspepsia therapeutic efficacy and satisfaction test (GERD-TEST), in patients with GERD. Japanese patients with predominant GERD symptoms recruited according to the Montreal definition were treated for 4 wk using a standard dose of proton pump inhibitor (PPI). The GERD-TEST and the Medical Outcome Study Short Form-8 Health Survey (SF-8) were administered at baseline and after 4 wk of treatment. The GERD-TEST contains three domains: the severity of GERD and functional dyspepsia (FD) symptoms (5 items), the level of dissatisfaction with daily life (DS) (4 items), and the therapeutic efficacy as assessed by the patients and medication compliance (4 items). A total of 290 patients were eligible at baseline; 198 of these patients completed 4 wk of PPI therapy. The internal consistency reliability as evaluated using the Cronbach's α values for the GERD, FD and DS subscales ranged from 0.75 to 0.82. The scores for the GERD, FD and DS items/subscales were significantly correlated with the physical and mental component summary scores of the SF-8. After 4 wk of PPI treatment, the scores for the GERD items/subscales were greatly reduced, ranging in value from 1.51 to 1.87 and with a large effect size ( P GERD items/subscales were observed between treatment responders and non-responders ( P GERD-TEST has a good reliability, a good convergent and concurrent validity, and is responsive to the effects of treatment. The GERD-TEST is a simple, easy to understand, and multifaceted PRO instrument applicable to both clinical trials and the primary care of GERD patients.

  1. Greater loss of productivity among Japanese workers with gastro-esophageal reflux disease (GERD) symptoms that persist vs resolve on medical therapy.

    Science.gov (United States)

    Suzuki, H; Matsuzaki, J; Masaoka, T; Inadomi, J M

    2014-06-01

    Gastro-esophageal reflux disease (GERD) impairs quality of life; however, the association between GERD and work productivity has not been well investigated in Japan. This study was designed to compare the impact of GERD on productivity between Japanese workers with GERD symptoms that persisted vs resolved on medical therapy. A cross-sectional Web-based survey was conducted in workers. The impact of GERD on work and daily productivity was evaluated using a Web-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD and a GERD symptom severity Questionnaire. Demographic information, clinical history, and satisfaction with GERD medication were also ascertained. A total of 20 000 subjects were invited to the survey. After the exclusion of patients with a history of gastrointestinal (GI) malignancy, peptic ulcer, upper GI surgery, and unemployment, 650 participants were included in the analysis. Participants with persistent GERD symptoms reported a significantly greater losses of work productivity (11.4 ± 13.4 h/week), absenteeism (0.7 ± 3.1 h/week), presenteeism (10.7 ± 12.6 h/week), costs (20 100 ± 26 800 JPY/week), and lower daily productivity (71.3% [95% confidence interval, 69.0-73.7]) than those whose symptoms were alleviated with medications. The level of dissatisfaction with GERD medications among participants with persistent GERD symptoms was significantly correlated with loss of work and daily productivity (p < 0.001). GERD places a significant burden on work and daily productivity despite medical therapy. Ineffective GERD therapy is associated with greater productivity loss. © 2014 John Wiley & Sons Ltd.

  2. The economic impact of GERD and PUD: examination of direct and indirect costs using a large integrated employer claims database.

    Science.gov (United States)

    Joish, Vijay N; Donaldson, Gary; Stockdale, William; Oderda, Gary M; Crawley, Joseph; Sasane, Rahul; Joshua-Gotlib, Sandra; Brixner, Diana I

    2005-04-01

    The objective of this study was to examine the relationship of work loss associated with gastro- the relationship of work loss associated with gastro- the relationship of work loss associated with gastro-esophageal reflux disease (GERD) and peptic ulcer disease (GERD) and peptic ulcer disease (PUD) in a large population of employed individuals in the United States (US) and quantify the individuals in the United States (US) and quantify the economic impact of these diseases to the employer. A proprietary database that contained work place absence, disability and workers' compensation data in addition to prescription drug and medical claims was used to answer the objectives. Employees with a medical claim with an ICD-9 code for GERD or PUD were identified from 1 January 1997 to 31 December 2000. A cohort of controls was identified for the same time period using the method of frequency matching on age, gender, industry type, occupational status, and employment status. Work absence rates and health care costs were compared between the groups after adjusting for demo graphic, and employment differences using analysis of covariance models. There were significantly lower (p rate of adjusted all-cause absenteeism and sickness-related absenteeism were observed between the disease groups versus the controls. In particular, controls had an average of 1.2 to 1.6 days and 0.4 to 0.6 lower all-cause and sickness-related absenteeism compared to the disease groups. The incremental economic impact projected to a hypothetical employed population was estimated to be $3441 for GERD, $1374 for PUD, and $4803 for GERD + PUD per employee per year compared to employees without these diseases. Direct medical cost and work absence in employees with GERD, PUD and GERD + PUD represent a significant burden to employees and employers.

  3. Sitophilus granarius L. (Coleoptera) Toxicity and Biological Activities of the Essential Oils of Tanacetum macrophyllum (Waldst. & Kit.) Schultz Bip.

    Science.gov (United States)

    Polatoğlu, Kaan; Karakoç, Ömer Cem; Demirci, Betül; Gören, Nezhun; Can Başer, Kemal Hüsnü

    2015-01-01

    Insecticides of the natural origin are an important alternative to the synthetic insecticides that are being employed for the preserving stored products. The volatiles obtained from T. cinerariifolium (=Pyrethrum cinerariifolium) is being used for many types of insecticidal applications; however there is a very little information on the insecticidal activity of the essential oils of other Tanacetum species. The main purpose of the present study is to determine the chemical composition of T. macrophyllum (Waldst. & Kit.) Schultz Bip. essential oils and evaluate their insecticidal activity against S. granarius as well as its other beneficial biological activities. Highest contact toxicity was observed in the leaf oil of (88.93%) against S. granarius. The flower oil showed considerable fumigant toxicity against L. minor at 10 mg/mL application concentration (61.86 %) when compared with other samples at the same concentration. The highest DPPH (2,2-Diphenyl-1-picrylhydrazyl) scavenging activity (47.7%) and phosphomolybdenum reducing activity was observed also for the flower oil of T. macrophyllum at 10 mg/mL concentration. The essential oils were analyzed by GC, GC/MS. The flower and leaf oils were characterized with γ-eudesmol 21.5%, (E)-sesquilavandulol 20.3%, copaborneol 8.5% and copaborneol 14.1%, 1,8-cineole 11%, bornyl acetate 9.6%, borneol 6.3% respectively. AHC analysis of the qualitative and quantitative data obtained from the essential oil composition of the T. macrophyllum essential oil from the present research and previous reports pointed out that two different chemotypes could be proposed with current findings which are p-methyl benzyl alcohol/ cadinene and eudesmane chemotypes.

  4. Comparison of voice quality in patients with GERD-related dysphonia or chronic cough.

    Science.gov (United States)

    Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Arcimowicz, Magdalena; Lachowska, Magdalena; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

    2014-01-01

    The aim was to compare a voice quality in patients with GERD-related dysphonia or chronic cough and to determine whether there is a relationship between the main symptom reported and voice quality. 249 consecutive patients diagnosed with GERD-related chronic cough or dysphonia were involved in this retrospective study and were divided into two main groups of men and women, and furthermore into groups of chronic cough and dysphonia. Laryngeal lesions were evaluated with videolaryngostroboscopy using Reflux Finding Score. Voice quality was assessed using GRBAS scale, sonograms, and multidimensional voice program (MDVP). All subjects were found to have vocal abnormalities both in subjective and objective voice analysis. Perceptual assessment of voice (GRBAS) did not reveal any differences between analyzed groups depending on the reported symptom. In MDVP analysis, the group of women with cough as the main symptom demonstrated significantly less abnormalities in VTI value. In men with cough as their main complaint, significantly less MDVP abnormalities were found in Jita, Jitt, RAP, PPQ, and sPPQ parameters. The comparison of voice perceptual assessment in patients with GERD-related dysphonia or chronic cough revealed no differences between analyzed groups. In objective voice analysis, the latter group presented lower degree of hoarseness in Yanagihara's scale. In objective MDVP analysis, the chronic cough group presented lower degree of abnormalities only in one of the noise related parameters in females and five frequency perturbation parameters in males. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  5. Proton pump inhibitor step-down therapy for GERD: A multi-center study in Japan

    Science.gov (United States)

    Tsuzuki, Takao; Okada, Hiroyuki; Kawahara, Yoshiro; Takenaka, Ryuta; Nasu, Junichiro; Ishioka, Hidehiko; Fujiwara, Akiko; Yoshinaga, Fumiya; Yamamoto, Kazuhide

    2011-01-01

    AIM: To investigate the predictors of success in step-down of proton pump inhibitor and to assess the quality of life (QOL). METHODS: Patients who had heartburn twice a week or more were treated with 20 mg omeprazole (OPZ) once daily for 8 wk as an initial therapy (study 1). Patients whose heartburn decreased to once a week or less at the end of the initial therapy were enrolled in study 2 and treated with 10 mg OPZ as maintenance therapy for an additional 6 mo (study 2). QOL was investigated using the gastrointestinal symptom rating scale (GSRS) before initial therapy, after both 4 and 8 wk of initial therapy, and at 1, 2, 3, and 6 mo after starting maintenance therapy. RESULTS: In study 1, 108 patients were analyzed. Their characteristics were as follows; median age: 63 (range: 20-88) years, sex: 46 women and 62 men. The success rate of the initial therapy was 76%. In the patients with successful initial therapy, abdominal pain, indigestion and reflux GSRS scores were improved. In study 2, 83 patients were analyzed. Seventy of 83 patients completed the study 2 protocol. In the per-protocol analysis, 80% of 70 patients were successful for step-down. On multivariate analysis of baseline demographic data and clinical information, no previous treatment for gastroesophageal reflux disease (GERD) [odds ratio (OR) 0.255, 95% CI: 0.06-0.98] and a lower indigestion score in GSRS at the beginning of step-down therapy (OR 0.214, 95% CI: 0.06-0.73) were found to be the predictors of successful step-down therapy. The improved GSRS scores by initial therapy were maintained through the step-down therapy. CONCLUSION: OPZ was effective for most GERD patients. However, those who have had previous treatment for GERD and experience dyspepsia before step-down require particular monitoring for relapse. PMID:21472108

  6. Delayed release dexlansoprazole in the treatment of GERD and erosive esophagitis

    Directory of Open Access Journals (Sweden)

    Eric T Wittbrodt

    2009-11-01

    Full Text Available Eric T Wittbrodt1, Charles Baum2, David A Peura31Takeda Pharmaceuticals North America, Inc., 2Takeda Pharmaceuticals International, Inc., Deerfield, IL, USA; 3University of Virginia, School of Medicine, Charlottesville, VA, USAAbstract: Although proton pump inhibitors (PPI have a record of remarkable effectiveness and safety in the management of gastroesophageal reflux disease (GERD, several treatment challenges with PPI have emerged. Dexlansoprazole MR is the (R-enantiomer of lansoprazole contained in a formulation that produces two distinct releases of drug and significantly extends the duration of active plasma concentrations and % time pH > 4 beyond that of conventional singlerelease PPI. Dexlansoprazole MR can be administered without regard to meals or the timing of meals in most patients. Dexlansoprazole MR 60 mg demonstrated similar efficacy for healing of erosive esophagitis at 8 weeks compared with lansoprazole 30 mg, and dexlansoprazole MR 30 mg was superior to placebo for maintenance of healed erosive esophagitis at 6 months with 99% of nights and 96% of days heartburn-free over 6 months in patients taking dexlansoprazole MR 30 mg. Superior relief of heartburn occurred in patients taking dexlansoprazole MR 30 mg (55% heartburn-free 24-hour periods vs placebo (14% for symptomatic nonerosive GERD. The safety profile of dexlansoprazole MR is similar to that of lansoprazole. The extended pharmacodynamic effects, added convenience, and efficacy and safety of dexlansoprazole MR offer a novel approach to gastric pH control in patients with acid-related disorders.Keywords: dexlansoprazole MR, gastroesophageal reflux disease, GERD, erosive esophagitis, TAK-390MR

  7. Heritability and genetic correlation between GERD symptoms severity, metabolic syndrome, and inflammation markers in families living in Mexico City

    Science.gov (United States)

    Reding-Bernal, Arturo; Sánchez-Pedraza, Valentin; Moreno-Macías, Hortensia; Sobrino-Cossio, Sergio; Tejero-Barrera, María Elizabeth; Burguete-García, Ana Isabel; León-Hernández, Mireya; Serratos-Canales, María Fabiola; Duggirala, Ravindranath; López-Alvarenga, Juan Carlos

    2017-01-01

    Objective The aim of this study was to estimate the heritability (h2) and genetic correlation (ρG) between GERD symptoms severity, metabolic syndrome components, and inflammation markers in Mexican families. Methods Cross-sectional study which included 32 extended families resident in Mexico City. GERD symptoms severity was assessed by the ReQuest in Practice questionnaire. Heritability and genetic correlation were determined using the Sequential Oligogenic Linkage Analysis Routines software. Results 585 subjects were included, the mean age was 42 (±16.7) years, 57% were women. The heritability of the severity of some GERD symptoms was h2 = 0.27, 0.27, 0.37, and 0.34 (p-value metabolic syndrome components ranged from 0.40 for fasting plasma glucose to 0.61 for body mass index and diabetes mellitus. The heritability for fibrinogen and C-reactive protein was 0.64 and 0.38, respectively. Statistically significant genetic correlations were found between acidity complaints and fasting plasma glucose (ρG = 0.40); sleep disturbances and fasting plasma glucose (ρG = 0.36); acidity complaints and diabetes mellitus (ρG = 0.49) and between total ReQuest score and fasting plasma glucose (ρG = 0.43). The rest of metabolic syndrome components did not correlate with GERD symptoms. Conclusion Genetic factors substantially explain the phenotypic variance of the severity of some GERD symptoms, metabolic syndrome components and inflammation markers. Observed genetic correlations suggest that these phenotypes share common genes. These findings suggest conducting further investigation, as the determination of a linkage analysis in order to identify regions of susceptibility for developing of GERD and metabolic syndrome. PMID:28582452

  8. Asthma symptoms improvement in moderate persistent asthma patients with gastroesophageal reflux disease (GERD: the role of proton-pump inhibitor

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    Agus D. Susanto

    2008-09-01

    Full Text Available This study aimed to evaluate effect of proton pump inhibitor (esomeprazole on asthma symptoms, use of inhaled bronchodilator and peak expiratory flow rate (PEFR in moderate persistent asthma with gastroesofageal refluks disease (GERD. This randomized single blind, controlled clinical trial study was conducted at Persahabatan Hospital, Jakarta from July 2004 until October 2005. Samples were moderate persistent asthma patients with GERD. GERD is diagnosed GERD symptoms and proof of oesophagitis from endoscopy and or histapatologic examination from oesophagus biopsy. Phase 1:2 week run-in period patient received inhaled budesonide 2x200 ug/day. Phase 2: patient randomised to receive inhaled budesonide 2 x 400 ug/day with esomeprazole 40 mg/day or without esomeprazole (control group for 8 weeks. Phase 3: 4 week wash out period, patient receive inhaled budesonide 2 x 200 ug/day. Diary cards were assessed at run-in periode, after treatment 4 weeks, 8 weeks and wash out. There were 32 patients (23 female and 9 male completed the study. Mean total asthma symptoms score daily were significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-2.29 vs -0.90; p < 0.05. Mean use of inhaled bronchodilator was significantly decreased on esomeprazole vs without esomeprazole after 8 weeks (-1.09 vs -0.42; p < 0.05. Morning and evening PEFR improved higher on esomeprazole than without esomeprazol but were not significantly difference. In conclusion, administration esomeprazole 40 mg daily improved asthma symptoms and lower the use of inhaled bronchodilator in moderate persistent asthma patients with GERD. (Med J Indones 2008; 17: 169-74Keywords: Asthma symptoms, inhaled bronchodilator, moderate persistent asthma, GERD, esomeprazole

  9. Proton pump inhibitor responders who are not confirmed as GERD patients with impedance and pH monitoring: who are they?

    NARCIS (Netherlands)

    de Bortoli, N.; Martinucci, I.; Savarino, E.; Bellini, M.; Bredenoord, A. J.; Franchi, R.; Bertani, L.; Furnari, M.; Savarino, V.; Blandizzi, C.; Marchi, S.

    2014-01-01

    A short-course of proton pump inhibitors (PPIs) is often used to confirm gastroesophageal reflux disease (GERD). However, some patients with PPI responsive heartburn do not seem to have evidence of GERD on impedance-pH monitoring (MII-pH). The aim of the study was to evaluate patients with reflux

  10. Evaluation of anti-GERD activity of gastro retentive drug delivery system of itopride hydrochloride.

    Science.gov (United States)

    Satapathy, Trilochan; Panda, Prasana K; Goyal, Amit K; Rath, Goutam

    2010-08-01

    The present work describes the formulation and evaluation of the gastroretentive system of Itopride hydrochloride. In this research, we have formulated floating hydrogel-based microspheres employing calcium carbonate (CaCO(3)) as a gas forming agent dispersed in alginate matrix. In vitro characterizations such as drug content, particle size, and drug release were carried out. GI motility was determined by administration of charcoal meal to rats. Results demonstrated that prepared microspheres were spherical in shape with smooth surface, good loading efficiency, and excellent buoyancy. The gastro retentive dosage form of itiopride demonstrated significant antacid, anti-ulcer, and anti-GERD activity after 12 hours in comparison with the conventional dosage form.

  11. Specific count model for investing the related factors of cost of GERD and functional dyspepsia

    Science.gov (United States)

    Abadi, Alireza; Chaibakhsh, Samira; Safaee, Azadeh; Moghimi-Dehkordi, Bijan

    2013-01-01

    Aim The purpose of this study is to analyze the cost of GERD and functional dyspepsia for investing its related factors. Background Gastro-oesophageal reflux disease GERD and dyspepsia are the most common symptoms of gastrointestinal disorders. Recent studies showed high prevalence and variety of clinical presentation of these two symptoms imposed enormous economic burden to the society. Cost data that related to economics burden have specific characteristics. So this kind of data needs to specific models. Poisson regression (PR) and negative binomial regression (NB) are the models that were used for analyzing cost data in this paper. Patients and methods This study designed as a cross-sectional household survey from May 2006 to December 2007 on a random sample of individual in the Tehran province, Iran to find the prevalence of gastrointestinal symptoms and disorders and its related factors. The Cost in each item was counted. PR and NB were carried out to the data respectively. Likelihood ratio test was performed for comparison between models. Also Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models. Results According to Likelihood ratio test and all three criterions that we used to compare performance of the models, NB was the best model for analyzing this cost data. Sex, age and insurance statues were being significant. Conclusion PR and NB models were carried out for this data and according the results improved fit of the NB model over PR, it clearly indicates that over-dispersion is involved due to unobserved heterogeneity and/or clustering. NB model in cost data more appropriate fit than PR. PMID:24834282

  12. Monitoramento da autenticidade de amostras de bebidas alcoólicas enviadas ao Instituto Adolfo Lutz em São Paulo Evaluation of authenticity of alcoholic beverage samples examined by the Instituto Adolfo Lutz (São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Leticia Araujo Farah NAGATO

    2001-01-01

    Full Text Available Este trabalho teve como objetivo verificar a autenticidade de bebidas alcoólicas (whisky, vodka, conhaque de gengibre, etc. enviadas para análise ao Instituto Adolfo Lutz no período de 1993 a agosto de 1999. Devido à presença no mercado nacional de bebidas alcoólicas clandestinas, principalmente aquelas com alto valor agregado, foi realizado o monitoramento através da análise de composição química destas bebidas. Normalmente estes produtos são elaborados com álcool, água, aroma e corante caramelo e que por falta de controle dessas matérias-primas, podem oferecer risco potencial à saúde humana pela presença de metanol. A técnica empregada na análise dos componentes secundários e metanol das amostras foi realizada através da cromatografia em fase gasosa com detector de ionização de chama. Observou-se que em 608 amostras de bebidas alcoólicas analisadas, 391 eram falsificadas e dentre estas 2 apresentaram teores de metanol acima do limite tolerado (200mg/100mL de álcool anidro pela legislação em vigor. Os resultados obtidos sugerem uma grande persistência em se produzir bebidas alcoólicas falsificadas. Desta forma, é muito importante estar sempre monitorando estes produtos e identificando os diferentes tipos de falsificações existentes no país.This work aimed at verifying the authenticity of alcoholic beverages (whisky, vodka, ginger spirit, etc. sent for analysis by the Instituto Adolfo Lutz, São Paulo from 1993 to August 1999. The chemical composition of these drinks was studied because of the presence of illicit alcoholic beverages on the national market, especially those with a high commercial value. These products are usually elaborated with alcohol, water, flavor and caramel coloring. Since there is no control over these raw materials, these drinks could offer a potential risk to human health because of the presence of methanol. The method employed in the analysis of congeners and methanol in alcoholic

  13. Presence of the fire ant Solenopsis invicta (Westwood) (Hymenoptera: Formicidae) stimulates burrowing behavior by larvae of the sandfly Lutzomyia longipalpis (Lutz and Neiva) (Diptera: Psychodidae)

    Energy Technology Data Exchange (ETDEWEB)

    Harvey, Jeffrey A. [Netherlands Institute of Ecology, Heteren (Netherlands). Dept. of Terrestrial Ecology; Hamilton, James G.C.; Ward, Richard D. [University of Keele, Staffordshire (United Kingdom). Centre for Applied Entomology and Parasitology. Dept. of Biological Sciences

    2010-01-15

    The sandfly Lutzomyia longipalpis (Lutz and Neiva) vectors leishmaniasis in the neotropics. Although much is known about the biology of adult flies, little is known about interactions with its natural enemies. Here, we examined behavior of larvae of L4 L. longipalpis on a soil substrate when exposed to the fire ant Solenopsis invicata (Westwood). When ants were absent, most larvae tended to remain at or close to the soil surface, but when ants were present the larvae burrowed into the soil. Sandflies seek refuges in the presence of generalist predators, thus rendering them immune to attack from many potential enemies. (author)

  14. Presence of the fire ant Solenopsis invicta (Westwood) (Hymenoptera: Formicidae) stimulates burrowing behavior by larvae of the sandfly Lutzomyia longipalpis (Lutz and Neiva) (Diptera: Psychodidae)

    International Nuclear Information System (INIS)

    Harvey, Jeffrey A.; Hamilton, James G.C.; Ward, Richard D.

    2010-01-01

    The sandfly Lutzomyia longipalpis (Lutz and Neiva) vectors leishmaniasis in the neotropics. Although much is known about the biology of adult flies, little is known about interactions with its natural enemies. Here, we examined behavior of larvae of L4 L. longipalpis on a soil substrate when exposed to the fire ant Solenopsis invicata (Westwood). When ants were absent, most larvae tended to remain at or close to the soil surface, but when ants were present the larvae burrowed into the soil. Sandflies seek refuges in the presence of generalist predators, thus rendering them immune to attack from many potential enemies. (author)

  15. Presence of the fire ant Solenopsis invicta (Westwood) (Hymenoptera: Formicidae) stimulates burrowing behavior by larvae of the sandfly Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae).

    Science.gov (United States)

    Harvey, Jeffrey A; Hamilton, James G C; Ward, Richard D

    2010-01-01

    The sandfly Lutzomyia longipalpis (Lutz & Neiva) vectors leishmaniasis in the neotropics. Although much is known about the biology of adult flies, little is known about interactions with its natural enemies. Here, we examined behavior of larvae of L4 L.longipalpis on a soil substrate when exposed to the fire ant Solenopsis invicata (Westwood). When ants were absent, most larvae tended to remain at or close to the soil surface, but when ants were present the larvae burrowed into the soil. Sandflies seek refuges in the presence of generalist predators, thus rendering them immune to attack from many potential enemies.

  16. Surgical treatment of GERD. Comperative study of WTP vs. Toupet fundoplication – results of 151 consecutive cases

    Directory of Open Access Journals (Sweden)

    Tadeusz Wróblewski

    2016-03-01

    Full Text Available Introduction: Gastroesophageal reflux disease (GERD is recognized as one of the most common disorders of the upper gastrointestinal tract (GIT. The best choice of management for advanced GERD is laparoscopic surgery. Aim : To compare and evaluate the results of surgical treatment of GERD patients operated on using two different techniques. Material and methods : Between 2001 and 2012, 353 patients (211 female and 142 male, aged 17–76 years (mean 44, underwent laparoscopic antireflux surgery. The study included patients who underwent a Toupet fundoplication or Wroblewski Tadeusz Procedure (WTP. Results: The mean age of the group was 47.77 years (17–80 years. Forty-nine (32.45% patients had severe symptoms, 93 (61.58% had mild symptoms and 9 (5.96% had a single mild but intolerable sign of GERD. Eighty-six (56.95% patients had a Toupet fundoplication and 65 (43.04% had a WTP. The follow-up period was 18–144 months. The average operating time for Toupet fundoplication and the WTP procedure was 164 min (90–300 min and 147 min (90–210 min, respectively. The perioperative mortality rate was 0.66%. The average post-operative hospitalization period was 5.4 days (2–16 post-operative days (POD = Toupet vs. 4.7 days (2–9 POD = WTP. No reoperations were performed. No major surgical complications were identified. Conclusions : Wroblewski Tadeusz Procedure due to a low percentage of post-operative complications, good quality of life of patients and a zero recurrence rate of hiatal hernia should be a method of choice.

  17. Review: Gerd Jüttemann (Hrsg. (2013. Die Entwicklung der Psyche in der Geschichte der Menschheit

    Directory of Open Access Journals (Sweden)

    Uwe Krebs

    2015-03-01

    Full Text Available Der Vorbereitungsband für die Reihe "Die Psychogenese der Menschheit" – ein Sammelband aus 32 Beiträgen, betitelt "Die Entwicklung der Psyche in der Geschichte der Menschheit" und 2013 herausgegeben von Gerd JÜTTEMANN – wird in dieser Besprechung in mehreren Schritten vorgestellt und bewertet. Zunächst wird kontextuell argumentiert, dass die bewährte, empirisch-experimentelle Methodologie der Psychologie zur Vernachlässigung weiterer Erkenntnisverfahren führte, die bei Themen wie dem hier zu besprechenden Werk allein verbleiben und die kurz angesprochen werden. Sodann wird das Werk im Überblick knapp dargestellt und die außergewöhnliche Heterogenität in Inhalten und Methoden betont. Die Besprechung einzelner Beiträge, die nach dem Gesichtspunkt großer Unterschiedlichkeit ausgewählt wurden, schließt sich an. Die abschließende Gesamtbewertung betont den lückenhaften Forschungsstand, die Notwendigkeit der allein verbleibenden qualitativen Methodik mit ihren verschiedenen Möglichkeiten und nennt Desiderata künftigen Vorgehens für diesen thematisch und methodisch interessanten Auftakt-Band, der insbesondere durch Dichte und Verschiedenheit der Beiträge beeindruckt. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1502219

  18. Comparison of the Carlsson-Dent and GERD-Q questionnaires for gastroesophageal reflux disease symptom detection in a general population.

    Science.gov (United States)

    Contreras-Omaña, R; Sánchez-Reyes, O; Ángeles-Granados, E

    Gastroesophageal reflux disease (GERD) is an extremely common pathology in the general population and one of the main reasons for consultation in gastroenterology. There are different instruments for detecting its symptoms, but few studies comparing one tool with another have been conducted in Mexico. To compare the effectiveness of the Carlsson-Dent questionnaire (CDQ) and the GERD-Q questionnaire (GQQ) in detecting GERD symptoms in a general population. A prospective, descriptive, cross-sectional study was conducted on 220 individuals in an open population within the time frame of May-June 2015. The subjects were evaluated through the self-assessment CDQ and GQQ. The positive scores from the CDQ (≥ 4) were compared with those of the GQQ (≥ 8), to determine which of the two instruments more easily detected patients with GERD symptoms. Fifty-seven percent of the patients were men and the mean patient age was 38.1 years. Fifty percent of the subjects presented with GERD symptoms with a positive score in at least one questionnaire; 45% had positive CDQ results and 23% had positive GQQ results. Fifty-seven percent of the patients with a positive CDQ score presented with overweight/obesity, as did 72% of the patients with a positive GQQ result. Finally, 20% of the individuals had positive results for reflux symptoms in both questionnaires. There was a prevalence of GERD symptoms in 50% of the individuals studied from a general population. The GQQ detected a greater number of GERD symptoms in patients that presented with overweight/obesity and the CDQ was considered easier for patients to understand and answer. It is striking that there was only 20% agreement between the two questionnaires, suggesting that they may be useful for identifying GERD symptoms in different populations. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  19. Partial versus complete fundoplication for the correction of pediatric GERD: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Peter Glen

    Full Text Available There is no consensus as to what extent of "wrap" is required in a fundoplication for correction of gastroesophageal reflux disease (GERD.To evaluate if a complete (360 degree or partial fundoplication gives better control of GERD.A systematic search of MEDLINE and Scopus identified interventional and observational studies of fundoplication in children. Screening identified those comparing techniques. The primary outcome was recurrence of GERD following surgery. Dysphagia and complications were secondary outcomes of interest. Meta-analysis was performed when appropriate. Study quality was assessed using the Cochrane Risk of Bias Tool.2289 abstracts were screened, yielding 2 randomized controlled trials (RCTs and 12 retrospective cohort studies. The RCTs were pooled. There was no difference in surgical success between partial and complete fundoplication, OR 1.33 [0.67,2.66]. In the 12 cohort studies, 3 (25% used an objective assessment of the surgery, one of which showed improved outcomes with complete fundoplication. Twenty-five different complications were reported; common were dysphagia and gas-bloat syndrome. Overall study quality was poor.The comparison of partial fundoplication with complete fundoplication warrants further study. The evidence does not demonstrate superiority of one technique. The lack of high quality RCTs and the methodological heterogeneity of observational studies limits a powerful meta-analysis.

  20. Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD.

    Science.gov (United States)

    Mukaisho, Ken-ichi; Hagiwara, Tadashi; Nakayama, Takahisa; Hattori, Takanori; Sugihara, Hiroyuki

    2014-09-14

    The long-term use of proton pump inhibitors (PPIs) exacerbates corpus atrophic gastritis in patients with Helicobacter pylori (H. pylori) infection. To identify a potential mechanism for this change, we discuss interactions between pH, bile acids, and H. pylori. Duodenogastric reflux, which includes bile, occurs in healthy individuals, and bile reflux is increased in patients with gastroesophageal reflux disease (GERD). Diluted human plasma and bile acids have been found to be significant chemoattractants and chemorepellents, respectively, for the bacillus H. pylori. Although only taurine conjugates, with a pKa of 1.8-1.9, are soluble in an acidic environment, glycine conjugates, with a pKa of 4.3-5.2, as well as taurine-conjugated bile acids are soluble in the presence of PPI therapy. Thus, the soluble bile acid concentrations in the gastric contents of patients with GERD after continuous PPI therapy are considerably higher than that in those with intact acid production. In the distal stomach, the high concentration of soluble bile acids is likely to act as a bactericide or chemorepellent for H. pylori. In contrast, the mucous layer in the proximal stomach has an optimal bile concentration that forms chemotactic gradients with plasma components required to direct H. pylori to the epithelial surface. H. pylori may then colonize in the stomach body rather than in the pyloric antrum, which may explain the occurrence of corpus-predominant gastritis after PPI therapy in H. pylori-positive patients with GERD.

  1. A causal relationship between cough and gastroesophageal reflux disease (GERD) has been established: a pro/con debate.

    Science.gov (United States)

    Kahrilas, Peter J; Smith, Jaclyn A; Dicpinigaitis, Peter V

    2014-02-01

    Along with upper airway cough syndrome (formerly, postnasal drip syndrome) and eosinophilic airway inflammation (asthma, nonasthmatic eosinophilic bronchitis), gastroesophageal reflux disease (GERD) is generally considered among the most common etiologies of chronic cough. Indeed, cough management guidelines published by numerous respiratory societies worldwide recommend evaluation and treatment of GERD as an integral component of the diagnostic/therapeutic algorithm for the management of chronic cough. However, a significant number of patients with chronic cough presumed due to GERD do not report improvement despite aggressive acid-suppressive therapy. Some of these refractory cases may be due to the recently appreciated entity of nonacid or weakly acidic reflux. Further contributing to the controversy are recent studies that demonstrate that patients with chronic cough do not have excessive reflux events relative to healthy volunteers. Although a temporal relationship between cough and reflux events has been suggested by studies utilizing impedance-pH monitoring of reflux events and objective cough recording, consensus is lacking in terms of whether this temporal relationship proves a causal link between reflux and cough. The fourth American Cough Conference (New York, June 2013) provided an ideal forum for the debate of this issue between two internationally recognized experts in the field of reflux and chronic cough.

  2. The Frequency of Heartburn (GERD and Its Related Factors in the Students of Hamadan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    A.R. Khalilian

    2013-10-01

    Full Text Available Introduction & Objective: Gastro-esophageal acid reflux disease (GERD is the most common disease of the digestive system in the world and Iran. The main Symptom of GERD is heart-burn. GERD reduces the quality of life and leads to esophageal adenocarcinoma. The aim of this study was to determine the prevalence of heartburn in students of Hamadan University of Medical Sciences. Materials & Methods: This study was a cross-sectional descriptive study on 388 randomly se-lected students. They had the inclusion criteria. The survey tool included questionnaire (demographic questions and symptoms of heartburn and acid regurgitation. Data were ana-lyzed with descriptive statistics. Chi square and t- tests were used to examine the relation-ships between variables. Results: Out of the 388 students, 270 (69.6% reported symptoms of heartburn. The relation-ship of BMI, sex, marital status, body mass index, ethnicity of individuals, fruits and fresh vegetables, and most food with heartburn was not significant (P> 0.05but the relationship was significant with age, smoking and smoking hookah, the college, semester, tea consump-tion and pickles, spices, smoked and canned foods, soft drinks and high-fat (P <0.05. Conclusion: A lot of people in this study had heartburn. But they were not concerned about its cause and suitable treatment. (Sci J Hamadan Univ Med Sci 2013; 20 (3:232-239

  3. Dental Erosion in Patients with Gastroesophageal Reflux Disease (GERD) in a Sample of Patients Referred to the Motahari Clinic, Shiraz, Iran.

    Science.gov (United States)

    Alavi, G; Alavi, Aa; Saberfiroozi, M; Sarbazi, Ah; Motamedi, M; Hamedani, Sh

    2014-03-01

    Systematic reviews of the literature show that the dental erosion is associated with the gastroesophageal reflux disease (GERD).The prevalence of the problem may not be exclusively similar in different countries. The purpose of this study was to investigate the association of gastro-esophageal reflux disease (GERD) with dental erosion in a sample of Iranian population regarding the standing difference in the Iranian oral hygiene and diet. Material s and Method: 140 patients with the average age of 30 to 50 years old comprised the study group. The participants were already eligible for the endoscopic examination, diagnosed by their gastroenterologist. All patients completed a detailed questionnaire regarding the medical and dental situations. After completing the questionnaire and before endoscopy, dental examination was performed by two blinded dentists.The endoscopy was then performed by a gastroenterologist and the patients were divided into three groups of healthy, suspected to GERD, and positive GERD. Data were collected and analyzed by Chi- Square test. The cross tabulation test was performed to compare the qualitative variants and discover the correlations. The statistical significance was adopted as: p dental erosion in GERD patients (22.6%) was found to be higher than the suspected (5.3%) and the healthy (7%) individuals. This study declared the GERD patients are at higher risk of developing dental erosion compared to the healthy individuals in a sample of Iranian population.

  4. Characteristics of refractory gastroesophageal reflux disease (GERD) symptoms -is switching proton pump inhibitors based on the patient's CYP2C19 genotype an effective management strategy?

    Science.gov (United States)

    Takeuchi, Toshihisa; Oota, Kazuhiro; Harada, Satoshi; Edogawa, Shoko; Kojima, Yuichi; Sanomura, Makoto; Sakaguchi, Masahiro; Hayashi, Katsuyoshi; Hongoh, Yasushi; Itabashi, Tsukasa; Kitae, Hidehiro; Hoshimoto, Masahiro; Takeuchi, Nozomi; Higuchi, Kazuhide

    2015-01-01

    We investigated factors related to proton pump inhibitor (PPI) -refractory gastroesophageal reflux disease (GERD) symptoms, particularly with respect to acid, the CYP2C19 genotype and psychological aspects. Patients with an Frequency Scale for the Symptoms of GERD (FSSG) score of ≥8 after the initial treatment were switched to therapy with rabeprazole at a dose of 20 mg once daily for eight weeks. We investigated the rate of improvement in PPI-refractory GERD symptoms, background factors, the Hospital Anxiety and Depression Scale (HADS) score and the CYP2C19 genotype. Patients Sixty patients endoscopically diagnosed with reflux esophagitis within the past six months who had received omeprazole at a dose of 20 mg once daily for eight weeks or longer were enrolled. In 71.6% of the patients, the FSSG score decreased to GERD symptoms. Significant factors related to omeprazole-refractory GERD symptoms included a longer disease duration (p=0.0004) and higher HADS score (p=0.01). Among the omeprazole-refractory cases, only 23.5% of the patients showed symptom improvement after switching to rabeprazole. There were no significant differences in the average scores for FSSG (p=0.089) or HADS (p=0.182), before or after the drug change. A total of 92% of the rabeprazole poor responders were homo/hetero extensive metabolizers for the CYP2C19 genotype. Our findings suggest that switching the PPI from omeprazole (20 mg once daily) to rabeprazole (20 mg once daily) is not a significant effective therapeutic strategy for improving PPI-refractory GERD symptoms, taking into consideration possible psychometric factors and patients who require stronger acid suppression than that achieved with a double dose of PPIs for PPI-refractory GERD symptoms.

  5. Accounting for the effect of GERD symptoms on patients' health-related quality of life: supporting optimal disease management by primary care physicians.

    Science.gov (United States)

    Flook, N W; Wiklund, I

    2007-12-01

    To review, from a primary care physician (PCP) perspective, the use of patient-reported outcome (PRO) instruments for assessment of gastro-oesophageal reflux disease (GERD) symptoms, their impact on health-related quality of life (HRQL) and the effectiveness of therapy. While generic and disease-specific PRO instruments have been used in the assessment of GERD, the latter can be considered to be more appropriate as they focus only on problems relevant to the disease in question (and therefore tend to be more responsive to change). Such instruments include the Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire and the Gastrointestinal Symptom Rating Scale and the Reflux Disease Questionnaire (RDQ). Their use indicates that GERD symptoms are troublesome and significantly reduce patients' HRQL, and that effective treatment of GERD improves HRQL. The GERD Impact Scale (GIS) questionnaire, primarily developed for use within primary care, can also help to determine the impact of symptoms on patients' everyday lives and, in turn, the benefit of appropriately targeted therapy. Notably, these PRO instruments were developed from focus groups of GERD patients, and only aspects rated of highest importance are used in the final instruments. Consequently, PCPs can feel confident that these questionnaires encompass the most relevant points that they are likely to ask in terms of how symptoms affect patients' everyday lives. Primary care physicians are encouraged to make wider use of PRO instruments within routine practice to improve communication with their GERD patients that, in turn, could lead to improved clinical outcomes and greater patient satisfaction.

  6. Assessment of Social Information Processing in early childhood: development and initial validation of the Schultz Test of Emotion Processing-Preliminary Version.

    Science.gov (United States)

    Schultz, David; Ambike, Archana; Logie, Sean Kevin; Bohner, Katherine E; Stapleton, Laura M; Vanderwalde, Holly; Min, Christopher B; Betkowski, Jennifer A

    2010-07-01

    Crick and Dodge's (Psychological Bulletin 115:74-101, 1994) social information processing model has proven very useful in guiding research focused on aggressive and peer-rejected children's social-cognitive functioning. Its application to early childhood, however, has been much more limited. The present study responds to this gap by developing and validating a video-based assessment tool appropriate for early childhood, the Schultz Test of Emotion Processing-Preliminary Version (STEP-P). One hundred twenty-five Head Start preschool children participated in the study. More socially competent children more frequently attributed sadness to the victims of provocation and labeled aggressive behaviors as both morally unacceptable and less likely to lead to positive outcomes. More socially competent girls labeled others' emotions more accurately. More disruptive children more frequently produced physically aggressive solutions to social provocations, and more disruptive boys less frequently interpreted social provocations as accidental. The STEP-P holds promise as an assessment tool that assesses knowledge structures related to the SIP model in early childhood.

  7. Randomised clinical trial: the clinical efficacy and safety of an alginate-antacid (Gaviscon Double Action) versus placebo, for decreasing upper gastrointestinal symptoms in symptomatic gastroesophageal reflux disease (GERD) in China.

    Science.gov (United States)

    Sun, J; Yang, C; Zhao, H; Zheng, P; Wilkinson, J; Ng, B; Yuan, Y

    2015-10-01

    There is a paucity of large-scale studies evaluating the clinical benefit of the Gaviscon Double Action (DA) alginate-antacid formulation for treating gastroesophageal reflux disease (GERD) symptoms. Randomised double-blind placebo-controlled parallel-group study to evaluate efficacy and safety of Gaviscon DA in reducing heartburn, regurgitation and dyspepsia symptoms in individuals with mild-to-moderate GERD in China. Participants with symptomatic GERD (n = 1107) were randomised to receive Gaviscon DA or placebo (two tablets four times daily) for seven consecutive days. The primary endpoint compared the change in Reflux Disease Questionnaire (RDQ) score for the GERD (heartburn + regurgitation) dimension between Gaviscon DA and placebo. Secondary endpoints compared the change in RDQ scores for individual heartburn, regurgitation and dyspepsia dimensions, overall treatment evaluation (OTE) scores and incidence of adverse events (AEs). Mean RDQ GERD scores: 2.51 for Gaviscon DA and 2.50 for placebo at baseline; 1.25 for Gaviscon DA and 1.46 for placebo post treatment. Gaviscon DA was statistically superior to placebo in reducing GERD and dyspepsia RDQ scores [least-squares mean (LSM) difference: GERD -0.21, P GERD symptoms was observed both in those with non-erosive and those with erosive reflux disease (LSM difference -0.14 [P = 0.038] and -0.29 [P GERD. ClinicalTrials.gov: NCT01869491. © 2015 The Authors. Alimentary Pharmacology & Therapeutics Published by John Wiley & Sons Ltd.

  8. Biology of the first generation of a laboratory colony of Nyssomyia intermedia (Lutz & Neiva, 1912 and Nyssomyia neivai (Pinto, 1926 (Diptera: Psychodidae

    Directory of Open Access Journals (Sweden)

    José Dilermando Andrade Filho

    2004-10-01

    Full Text Available The phlebotomine sand flies Nyssomyia intermedia (Lutz & Neiva, 1912 and Nyssomyia neivai (Pinto, 1926 are very close and may be involved in the transmission of Leishmania spp. Ross, 1903 in Brazil. The biology of the first laboratory-reared generations of these species, descended from insects captured in Além Paraíba (N. intermedia and Corinto (N. neivai in the Brazilian state of Minas Gerais, is described here. The captured females were fed on hamsters and maintained individually in rearing pots. Laboratory temperature and relative humidity were maintained at 25-26ºC and 80% respectively. The productivity of the first generation of N. intermedia was greater than that of N. neivai, and its development time clearly shorter, particularly for the second and third larval instars.

  9. Biology of the first generation of a laboratory colony of Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) (Diptera: Psychodidae).

    Science.gov (United States)

    Andrade Filho, José Dilermando; Galati, Eunice A Bianchi; Falcão, Alda Lima

    2004-10-01

    The phlebotomine sand flies Nyssomyia intermedia (Lutz & Neiva, 1912) and Nyssomyia neivai (Pinto, 1926) are very close and may be involved in the transmission of Leishmania spp. Ross, 1903 in Brazil. The biology of the first laboratory-reared generations of these species, descended from insects captured in Além Paraíba (N. intermedia) and Corinto (N. neivai) in the Brazilian state of Minas Gerais, is described here. The captured females were fed on hamsters and maintained individually in rearing pots. Laboratory temperature and relative humidity were maintained at 25-26 masculineC and 80% respectively. The productivity of the first generation of N. intermedia was greater than that of N. neivai, and its development time clearly shorter, particularly for the second and third larval instars.

  10. Prevalence of gallstones in 1,229 patients submitted to surgical laparoscopic treatment of GERD and esophageal achalasia: associated cholecystectomy was a safe procedure.

    Science.gov (United States)

    Sallum, Rubens Antonio Aissar; Padrão, Eduardo Messias Hirano; Szachnowicz, Sergio; Seguro, Francisco C B C; Bianchi, Edno Tales; Cecconello, Ivan

    2015-01-01

    Association between esophageal achalasia/ gastroesophageal reflux disease (GERD) and cholelithiasis is not clear. Epidemiological data are controversial due to different methodologies applied, the regional differences and the number of patients involved. Results of concomitant cholecistectomy associated to surgical treatment of both diseases regarding safety is poorly understood. To analyze the prevalence of cholelithiasis in patients with esophageal achalasia and gastroesophageal reflux submitted to cardiomyotomy or fundoplication. Also, to evaluate the safety of concomitant cholecistectomy. Retrospective analysis of 1410 patients operated from 2000 to 2013. They were divided into two groups: patients with GERD submitted to laparocopic hiatoplasty plus Nissen fundoplication and patients with esophageal achalasia to laparoscopic cardiomyotomy plus partial fundoplication. It was collected epidemiological data, specific diagnosis and subgroups, the presence or absence of gallstones, surgical procedure, operative and clinical complications and mortality. All groups/subgroups were compared. From 1,229 patients with GERD or esophageal achalasia, submitted to laparoscopic cardiomyotomy or fundoplication, 138 (11.43%) had cholelitiasis, occurring more in females (2.38:1) with mean age of 50,27 years old. In 604 patients with GERD, 79 (13,08%) had cholelitiasis. Lower prevalence occurred in Barrett's esophagus patients 7/105 (6.67%) (p=0.037). In 625 with esophageal achalasia, 59 (9.44%) had cholelitiasis, with no difference between chagasic and idiopathic forms (p=0.677). Complications of patients with or without cholecystectomy were similar in fundoplication and cardiomyotomy (p=0.78 and p=1.00).There was no mortality or complications related to cholecystectomy in this series. Prevalence of cholelithiasis was higher in patients submitted to fundoplication (GERD). Patients with chagasic or idiopatic forms of achalasia had the same prevalence of cholelithiasis. Gallstones

  11. Ocorrência de Taenia sp. na população atendida no laboratório central do Instituto Adolfo Lutz, São Paulo, SP, Brasil (1960/1989 Occurrence of Taenia sp. in the population attended in the central laboratory of "Instituto Adolfo Lutz", São Paulo, SP, Brazil (1960/1989

    Directory of Open Access Journals (Sweden)

    Rosa Maria Donini Souza Dias

    1991-04-01

    Full Text Available Foram examinados retrospectivamente os relatórios mensais e anuais da Seção de Enteroparasitoses do Laboratório Central do Instituto Adolfo Lutz, São Paulo, SP, do período de 1960 a 1989, perfazendo uma série histórica de 30 anos, com 1.519.730 exames protoparasitológicos e 355 identificações de proglotes de Taenia. Pelo método da sedimentação espontânea foram diagnosticados 7.663 (0,5% casos de presença de ovos de Taenia sp. nas fezes. Das 355 proglotes enviadas para identificação, 311 (87,60% estavam em condições de serem especificadas, e dessas, 273 (87,80% eram proglotes de Taenia saginata e 38 (12,22% de T. solium.Monthly and yearly reports of the Seção de Enteroparasitoses of the Instituto Adolfo Lutz (São Paulo, SP, Brazil from 1960 to 1989 with 1,519,730 parasitological stool examinations were studied. There were also 355 identifications of Taenia sp. proglottids. Using HOFFMAN, PONS & JANER's method, 7,663 (0.5% cases of taeniasis were diagnosed, and 311 (87.60% of the 355 proglottids were on easy terms to be specified, 273 (87.80% of them were from Taenia saginata.

  12. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring

    Science.gov (United States)

    Zhang, Chao; Wu, Jimin; Hu, Zhiwei; Yan, Chao; Gao, Xiang; Liang, Weitao; Liu, Diangang; Li, Fei; Wang, Zhonggao

    2016-01-01

    Background/Aims Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD). Although the role of multichannel intraluminal impedance–pH (MII-pH) monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes. Methods We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations. Results Of the 195 patients, 96 (49.2%) exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3) than patients without respiratory symptoms (64.7±24.4, p = 0.044) based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3) than the non-respiratory symptomatic group (28.3±17.9, p = 0.013). One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms) or LTF (n = 65, 35 with respiratory symptoms) completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05). However, LTF significantly reduced the recurrence (re-operation) rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006). Conclusions MII-pH monitoring effectively detected respiratory

  13. Diagnosis and Anti-Reflux Therapy for GERD with Respiratory Symptoms: A Study Using Multichannel Intraluminal Impedance-pH Monitoring.

    Directory of Open Access Journals (Sweden)

    Chao Zhang

    Full Text Available Respiratory symptoms are often associated with gastroesophageal reflux disease (GERD. Although the role of multichannel intraluminal impedance-pH (MII-pH monitoring in GERD is clear, little is known regarding the characteristics of patients with respiratory symptoms based on MII-pH monitoring and anti-reflux therapy. We evaluated a cohort of GERD patients to identify the MII-pH parameters of GERD-related respiratory symptoms and to assess the anti-reflux therapy outcomes.We undertook a prospective study of patients who were referred for GERD evaluation from January 2011 to January 2012. One hundred ninety-five patients underwent MII-pH monitoring and esophageal manometry, and one hundred sixty-five patients underwent invasive anti-reflux therapy that included laparoscopic Toupet fundoplication (LTF and the Stretta procedure. The patient characteristics and MII-pH parameters were analyzed, and the symptom scores were assessed at baseline and at 1- and 3-year follow-up evaluations.Of the 195 patients, 96 (49.2% exhibited respiratory symptoms and significantly more reflux episodes (70.7±29.3 than patients without respiratory symptoms (64.7±24.4, p = 0.044 based on the MII-pH monitoring results. Moreover, the group of patients with respiratory symptoms exhibited more proximal reflux episodes (35.2±21.3 than the non-respiratory symptomatic group (28.3±17.9, p = 0.013. One hundred twenty-five patients following the Stretta procedure (n = 60, 31 with respiratory symptoms or LTF (n = 65, 35 with respiratory symptoms completed the designated 3-year follow-up period and were included in the final analysis. The symptom scores after anti-reflux therapy all decreased relative to the corresponding baseline values (p0.05. However, LTF significantly reduced the recurrence (re-operation rate compared with the Stretta procedure (0 vs. 19.4%, p = 0.006.MII-pH monitoring effectively detected respiratory-related predictive parameters, including total

  14. Environment-friendly building. Energy efficiency - thermal comfort - materials. Publication on the occasion of the 60th birthday of Gerd Hauser; Umweltbewusstes Bauen. Energieeffizienz - Behaglichkeit - Materialien. Festschrift zum 60. Geburtstag von Gerd Hauser

    Energy Technology Data Exchange (ETDEWEB)

    Maas, A. (ed.)

    2008-07-01

    In honour of the 60th birthday of Professor Gerd Hauser, ''father of the Energy Passport'' in this festival script 38 contributions are compiled in recognition of his work. These articles present the whole thematics of heat- and energy transfer in the building sector. The broad spectra is arranged into the sections energy efficiency, thermal comfort and materials. Constructive problems on sun protection, computer-simulated models of indoor climate, energetic sanitation of monuments taking into account preservative aspects, problems of sound emission from traffic as the constructional physical evaluation of materials in the building envelope. Furtheron the actual discussion on energy saving construction is reflected due to perspective and strategies of climate policy in Germany. The spectrum of the contribution from research and practice shows clearly, that construction physics has developed since last decades from a niche position to a comprehensive branche. (orig./GL) [German] Aus Anlass des 60. Geburtstages von Professor Gerd Hauser, dem Vater des Energiepasses, sind in dieser Festschrift in Anerkennung seines Werkes 38 Beitraege zusammengestellt. Diese stellen die gesamte Thematik der Waerme- und Energieuebertragung im Gebaeudebereich vor. Das breite Spektrum ist in die Abschnitte Energieeffizienz, Behaglichkeit und Materialien gegliedert. Behandelt werden beispielsweise baukonstruktive Fragestellungen beim Sonnenschutz, Computer simulierte Raumklimamodelle, denkmalpflegerische Aspekte bei der energetischen Sanierung, Probleme der Schalluebertragung im Verkehr sowie die bauphysikalische Bewertung von Materialien der Gebaeudehuelle. Darueber hinaus wird die aktuelle Diskussion zum Energiesparenden Bauen im Hinblick auf die Perspektiven und Strategien der Klimapolitik in Deutschland wiedergegeben. Die Bandbreite der Beitraege aus Forschung und Praxis zeigen anschaulich, dass sich die Bauphysik in den letzten Jahrzehnten aus einer

  15. Long-term outcome of microscopic esophagitis in chronic GERD patients treated with esomeprazole or laparoscopic antireflux surgery in the LOTUS trial

    DEFF Research Database (Denmark)

    Fiocca, Roberto; Mastracci, Luca; Engström, Cecilia

    2010-01-01

    OBJECTIVES: Gastroesophageal reflux disease (GERD)-associated changes in esophageal histology have been reported mainly after short-term medical antireflux therapy, and few individual lesions have been examined. We report detailed histological findings from the LOTUS study, at baseline and at 1...

  16. An alginate-antacid formulation (Gaviscon Double Action Liquid) can eliminate or displace the postprandial 'acid pocket' in symptomatic GERD patients.

    Science.gov (United States)

    Kwiatek, M A; Roman, S; Fareeduddin, A; Pandolfino, J E; Kahrilas, P J

    2011-07-01

    Recently, an 'acid pocket' has been described in the proximal stomach, particularly evident postprandially in GERD patients, when heartburn is common. By creating a low density gel 'raft' that floats on top of gastric contents, alginate-antacid formulations may neutralise the 'acid pocket'. To assess the ability of a commercial high-concentration alginate-antacid formulation to neutralize and/or displace the acid pocket in GERD patients. The 'acid pocket' was studied in ten symptomatic GERD patients. Measurements were made using concurrent stepwise pH pull-throughs, high resolution manometry and fluoroscopy in a semi-recumbent posture. Each subject was studied in three conditions: fasted, 20 min after consuming a high-fat meal and 20 min later after a 20 mL oral dose of an alginate-antacid formulation (Gaviscon Double Action Liquid, Reckitt Benckiser Healthcare, Hull, UK). The relative position of pH transition points (pH >4) to the EGJ high-pressure zone was analysed. Most patients (8/10) exhibited an acidified segment extending from the proximal stomach into the EGJ when fasted that persisted postprandially. Gaviscon neutralised the acidified segment in six of the eight subjects shifting the pH transition point significantly away from the EGJ. The length and pressure of the EGJ high-pressure zone were minimally affected. Gaviscon can eliminate or displace the 'acid pocket' in GERD patients. Considering that EGJ length was unchanged throughout, this effect was likely attributable to the alginate 'raft' displacing gastric contents away from the EGJ. These findings suggest the alginate-antacid formulation to be an appropriately targeted postprandial GERD therapy. © 2011 Blackwell Publishing Ltd.

  17. Temira Pachmuss 75 / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2003-01-01

    24. dets. 2002 USA-s oma juubelit tähistanud rahvusvaheliselt tuntud baltisaksa päritolu kirjandusteadlase ja professori eluteest, õpingutest ning uurimistöödest, mille huvikeskmeks on põhiliselt Dostojevski ja välisvene kirjandus, sealhulgas vene kirjandus Eestis ja Soomes

  18. Lovesongs and period gene polymorphisms indicate Lutzomyia cruzi (Mangabeira, 1938) as a sibling species of the Lutzomyia longipalpis (Lutz and Neiva, 1912) complex.

    Science.gov (United States)

    Vigoder, Felipe M; Araki, Alejandra S; Bauzer, Luiz G S R; Souza, Nataly A; Brazil, Reginaldo P; Peixoto, Alexandre A

    2010-08-01

    The sand fly Lutzomyia cruzi (Mangabeira, 1938) is implicated as a vector of American visceral leishmaniasis (AVL) in some areas of Brazil. Lutzomyia cruzi is closely related to Lutzomyia longipalpis s.l. (Lutz and Neiva, 1912) the main Latin American vector of AVL and a species complex. Although females of the two species are identical, the males can be distinguished by differences in the genitalia. Nevertheless, pheromone analysis shows that Lu. cruzi males produce 9-methyl-germacrene-B, which has also been found in a number of Latin American populations of Lu. longipalpis s.l. In addition, analysis of microsatellite loci shows that the level of divergence between Lu. cruzi and Lu. longipalpis s.l. is similar to that observed among the Lu. longipalpis s.l. sibling species. Here we present the lovesongs of Lu. cruzi males which are similar to the Burst-type songs produced by one of the Lu. longipalpis s.l. sibling species. We also present data on the molecular polymorphisms of the period gene of Lu. cruzi that indicate this species as another sibling within the Lu. longipalpis complex. The results highlight the importance of an integrative approach to understand the patterns of genetic and phenotypic divergence among very closely related vector species. Copyright 2010. Published by Elsevier B.V.

  19. Genetic differentiation in natural populations of Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae) with different phenotypic spot patterns on tergites in males.

    Science.gov (United States)

    Silva, M H; Nascimento, M D S B; Leonardo, F S; Rebêlo, J M M; Pereira, S R F

    2011-01-01

    Entomological surveys in the state of Maranhão have recorded morphologically distinct populations of Lutzomyia longipalpis (Lutz & Neiva). Some populations have one pair of spots (1S) on the fourth tergite, while others have two pairs (2S) on the third and fourth tergites of males. In the present study we investigated the degree of genetic polymorphism among four populations in the municipalities of Caxias, Codó and Raposa, in the state of Maranhão, Brazil, by using RAPD (Random Amplified Polymorphic DNA) markers. A total of 35 loci were identified, of which 30 were polymorphic. The highest polymorphism was observed with primer OPA 4, which produced 11 different profiles. Genetic diversity was assessed using grouping methods that produced a dendrogram in which the genotypes could be clearly separated into two main clades according to the number of spots on the male abdominal tergites. One cluster contained the populations from Caxias and Codó, and the other was formed by the populations from Raposa and Codó. The results of our RAPD analysis showed a clear separation between the populations with one and two pairs of spots. The epidemiologic significance of this genetic differentiation should be investigated in future studies.

  20. Book review: “From Ethnomathematics to art-design matrices and cyclic matrices” – Paulus Gerdes – Ed. UNESP, 2010

    Directory of Open Access Journals (Sweden)

    2010-08-01

    Full Text Available In this review, we present the ethnomathematics investigations undertaken in the last three decades by Paulus Gerdes, a Mozambique mathematics educator. The author presents a variety of discussions with several examples that explains the relationship of mathematics to human activities. We present, among other things, the cyclic matrices and its interrelationships with the African cultural contexts, undoing the erroneous impression that mathematics can be seen disconnected from the feature, which makes the individuals in their socio-cultural environments. Gerdes shows us that there's mathematics in different cultures and this helps us to realize the beauty of the symmetries and patterns, in addition to allowing depth between mathematics and human actions in the art.

  1. Study for every other day administration of vonoprazan in maintenance treatment of erosive GERD: study protocol for a multicentre randomised cross-over study.

    Science.gov (United States)

    Kato, Mototsugu; Ito, Noriko; Demura, Mamiko; Kubo, Kimitoshi; Mabe, Katsuhiro; Harada, Naohiko

    2018-01-01

    The first drug selected for treatment of gastro-oesophageal reflux disease (GERD) and prevention of the recurrence is a proton pump inhibitor (PPI), but recently, a potassium-competitive acid blocker (P-CAB) was put on the market in Japan. Its onset of effect is faster than PPI, and it takes more than 2 days to recover acid secretion after the withdrawal period. Therefore, unlike PPI, the usefulness of every other day administration or discontinuous administration is expected. This study is a prospective, multicentre, open-label, two-period randomised cross-over study to compare the efficacy and safety of PPI every other day administration and P-CAB every other day administration in 120 patients who receive erosive GERD maintenance therapy with PPI. Patients will be randomly allocated to receive 4 weeks P-CAB or PPI followed by 4 weeks cross over, where those on P-CAB will receive PPI and vice versa. The primary endpoint is proportion of asymptomatic patients. Secondary endpoints are suppressive effect of GERD symptoms, proportion of asymptomatic patients at each time point, safety and cost-saving effect of P-CAB every other day administration, compliance with every other day administration, and proportion of asymptomatic patients at the first month of study drug administration. This study was approved by the National Hospital Organization Central Review Board for Clinical Trials (5 December 2017). If P-CAB every other day administration is established as one of GERD maintenance therapies, there is merit in both medical cost reduction and the safety to alleviate elevation in serum gastrin. UMIN000034701.

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

    Science.gov (United States)

    Sivalingam, Maneesha; Sitaram, Swetha; Hasenstab, Kathryn A; Wei, Lai; Woodley, Frederick W; Jadcherla, Sudarshan R

    2017-08-01

    To 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 symptom 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 esophageal sensitivity, acid neutralization delays, or clearance mechanism delays may accentuate multi-systemic troublesome symptoms.

  3. Comparison of health care resource utilization and costs among patients with GERD on once-daily or twice-daily proton pump inhibitor therapy

    Directory of Open Access Journals (Sweden)

    Mody R

    2013-04-01

    Full Text Available Reema Mody,1 Debra Eisenberg,2 Likun Hou,2 Siddhesh Kamat,2 Joseph Singer,2 Lauren B Gerson3 1Takeda Pharmaceuticals International Inc, Deerfield, IL, 2HealthCore Inc, Wilmington, DE, 3Stanford University School of Medicine, Stanford, CA, USA Background: The purpose of this study was to assess differences in health care resource utilization and costs associated with once-daily and twice-daily proton pump inhibitor (PPI therapy. Most patients with gastroesophageal reflux disease (GERD achieve symptom control on once-daily PPI therapy, but approximately 20%–30% require twice-daily dosing. Methods: Patients were ≥18 years of age with at least one medical claim for GERD and at least two PPI claims from HealthCore's Integrated Research Database (HIRDSM during 2004–2009. Patients were continuously eligible for 12 months before and after the index date (date of first PPI claim. Based on PPI dosing throughout the post-index period (quantity of medication dispensed/number of days supply, patients were classified as once-daily (dose ≤ 1.5 pills per day or twice-daily (≥1.5 PPI users. Results: The study cohort included 248,386 patients with GERD (mean age 52.8 ± 13.93 years, 56% females of whom 90% were once-daily and 10% were twice-daily PPI users. The Deyo-Charlson Comorbidity Index for once-daily and twice-daily PPI users was 0.70 ± 1.37 and 0.89 ± 1.54, respectively (P < 0.05. More once-daily patients had claims for Barrett's esophagus (5% versus 2%, P < 0.0001 than twice-daily patients. Post-index, higher proportions of twice-daily patients had at least one GERD-related inpatient visit (7% versus 5%, outpatient visit (60% versus 49%, and office visit (48% versus 38% versus once-daily patients (P < 0.0001. Mean total GERD-related health care costs were $2065 ± $6636 versus $3749 ± $11,081 for once-daily and twice-daily PPI users, respectively (P < 0.0001. Conclusion: Patients receiving twice-daily PPI therapy were likely to have more

  4. The effects of concomitant GERD, dyspepsia, and rhinosinusitis on asthma symptoms and FeNO in asthmatic patients taking controller medications

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    Ishizuka T

    2014-09-01

    Full Text Available Tamotsu Ishizuka,1,2 Takeshi Hisada,2 Yosuke Kamide,2 Haruka Aoki,2 Kaori Seki,2 Chisato Honjo,1 Hiroyuki Sakai,1 Maiko Kadowaki,1 Yukihiro Umeda,1 Miwa Morikawa,1 Masaki Anzai,1 Shingo Ameshima,1 Takeshi Ishizaki,1 Kunio Dobashi,2 Masanobu Yamada,2 Motoyasu Kusano3 1Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, 2Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3Department of Endoscopy and Endoscopic Surgery, Gunma University Hospital, Maebashi, Japan Background: Losing the sense of smell, which suggests eosinophilic rhinosinusitis, is a subjective symptom, sometimes reported in asthmatic patients taking controller medication. Upper abdominal symptoms, suggesting gastroesophageal reflux disease (GERD or functional dyspepsia, occur also in these patients. However, the relationship between these symptoms, concomitant with asthma, and the intensity of eosinophilic airway inflammation remains obscure. Objective: To assess the symptoms of asthma and rhinosinusitis, and to examine the relationship between the symptoms and bronchial inflammation, a new questionnaire, the G scale, was developed. To investigate the effects of GERD, dyspepsia, and rhinosinusitis on asthma symptoms and bronchial inflammation, the symptoms of asthma and rhinosinusitis obtained by the G scale, upper abdominal symptoms obtained by the modified F scale, a questionnaire for GERD and dyspepsia, and fractional exhaled nitric oxide (FeNO were analyzed. Methods: A prospective, observational study was performed in four hospitals in Gunma prefecture, and a retrospective analysis was done using data obtained from five hospitals in Gunma prefecture and Fukui prefecture, Japan. A total of 252 patients diagnosed as having asthma participated in the prospective study. Results: The frequency of daytime phlegm or losing the sense of smell had a positive correlation with FeNO levels in asthmatic

  5. Value of the Gastroesophageal Reflux Disease Questionnaire (GerdQ) in predicting the proton pump inhibitor response in coronary artery disease patients with gastroesophageal reflux-related chest pain.

    Science.gov (United States)

    He, S; Liu, Y; Chen, Y; Tang, Y; Xu, J; Tang, C

    2016-05-01

    Chest pain experienced by patients with coronary artery disease can be partly due to gastroesophageal reflux-induced chest pain (GERP). Empirical proton pump inhibitor (PPI) therapy has been recommended as an initial clinical approach for treating GERP. However, PPI use may lead to some health problems. The Gastroesophageal Reflux Disease Questionnaire (GerdQ) may represent a noninvasive and cost-effective approach for avoiding PPI misuse and for identifying the appropriate patients for the PPI trial test. The aim of this pilot study was to prospectively evaluate the association between GerdQ scores and PPI response in patients with coronary artery disease (CAD) and GERP to determine whether the GerdQ predicts the PPI response in patients with CAD and GERP and to further validate the clinical application value of the GerdQ. A total of 154 consecutive patients with potential GERP were recruited to complete a GerdQ with subsequent PPI therapy. Based on the PPI trial result, patients were divided into a PPI-positive response group and a PPI-negative response group. The difference in the GerdQ scores between the two groups was assessed. The receiver operating characteristic (ROC) curve of GerdQ score was drawn according to the PPI response as the gold standard. The ability of GerdQ to predict the PPI response was assessed. A total of 96 patients completed the entire study; 62 patients (64.6%) were assigned to the PPI-positive response group, and 34 patients (35.4%) to the PPI-negative response group. The GerdQ score of the PPI-positive response group (8.11 ± 3.315) was significantly higher than that of the PPI-negative response group (4.41 ± 2.743), and the difference was statistically significant (t = 5.863, P = 0.000). The ROC curve was drawn according to a PPI response assessment result with a score above 2 as the gold standard. The area under curve was 0.806. When the critical value of GerdQ score was 7.5, Youden index was up to 0.514, the diagnostic sensitivity

  6. A randomized controlled trial of laparoscopic Nissen fundoplication versus proton pump inhibitors for the treatment of patients with chronic gastroesophageal reflux disease (GERD): 3-year outcomes.

    Science.gov (United States)

    Anvari, Mehran; Allen, Christopher; Marshall, John; Armstrong, David; Goeree, Ron; Ungar, Wendy; Goldsmith, Charles

    2011-08-01

    A randomized controlled trial (RCT) investigated patients with gastroesophageal reflux disease (GERD) who were stable and symptomatically controlled with long-term medical therapy to compare ongoing optimized medical therapy with laparoscopic Nissen fundoplication (LNF). Of the 180 patients eligible for randomization, 104 gave informed consent, and 3 withdrew from the study immediately after randomization. The patients randomized to medical therapy received optimized treatment with proton pump inhibitors (PPIs) using a standardized management protocol based on best evidence and published guidelines. The surgical patients underwent LNF by one of four surgeons using a previously published technique. The patients underwent symptom evaluation using the GERD symptom scale (GERSS) and the global visual analog scale (VAS) for overall symptom control. They had 24-h esophageal pH monitoring at baseline and after 3 years. The medical patients were evaluated receiving PPI, and the surgical patients were evaluated not receiving PPI. For the 3-year follow-up assessment, 93 patients were available. At 3 years, surgery was associated with more heartburn-free days, showing a mean difference of -1.35 days per week (p = 0.0077) and a lower VAS score (p = 0.0093) than medical management. Surgical patients reported improved quality of life on the general health subscore of the Medical Outcomes Survey Short Form 36 (SF-36) at 3 years, with a mean difference of -12.19 (p = 0.0124). The groups did not differ significantly in terms of GERSS or acid exposure on 24-h esophageal pH monitoring at 3 years. There were six treatment failures (11.8%) in the surgical group and eight treatment failures (16%) in the medical group by 3 years. For patients whose GERD symptoms are stable and controlled with PPI, continuing medical therapy and laparoscopic antireflux surgery are equally effective, although surgery may result in better symptom control and quality of life.

  7. Inhaled Beta Agonist Bronchodilator Does Not Affect Trans-diaphragmatic Pressure Gradient but Decreases Lower Esophageal Sphincter Retention Pressure in Patients with Chronic Obstructive Pulmonary Disease (COPD) and Gastroesophageal Reflux Disease (GERD).

    Science.gov (United States)

    Del Grande, Leonardo M; Herbella, Fernando A M; Bigatao, Amilcar M; Jardim, Jose R; Patti, Marco G

    2016-10-01

    Chronic obstructive pulmonary disease (COPD) patients have a high incidence of gastroesophageal reflux disease (GERD) whose pathophysiology seems to be linked to an increased trans-diaphragmatic pressure gradient and not to a defective esophagogastric barrier. Inhaled beta agonist bronchodilators are a common therapy used by patients with COPD. This drug knowingly not only leads to a decrease in the lower esophageal sphincter (LES) resting pressure, favoring GERD, but also may improve ventilatory parameters, therefore preventing GERD. This study aims to evaluate the effect of inhaled beta agonist bronchodilators on the trans-diaphragmatic pressure gradient and the esophagogastric barrier. We studied 21 patients (mean age 67 years, 57 % males) with COPD and GERD. All patients underwent high-resolution manometry and esophageal pH monitoring. Abdominal and thoracic pressure, trans-diaphragmatic pressure gradient (abdominal-thoracic pressure), and the LES retention pressure (LES basal pressure-transdiaphragmatic gradient) were measured before and 5 min after inhaling beta agonist bronchodilators. The administration of inhaled beta agonist bronchodilators leads to the following: (a) a simultaneous increase in abdominal and thoracic pressure not affecting the trans-diaphragmatic pressure gradient and (b) a decrease in the LES resting pressure with a reduction of the LES retention pressure. In conclusion, inhaled beta agonist bronchodilators not only increase the thoracic pressure but also lead to an increased abdominal pressure favoring GERD by affecting the esophagogastric barrier.

  8. [GERD: endoscopic antireflux therapies].

    Science.gov (United States)

    Caca, K

    2006-08-02

    A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.

  9. The diet of Scinax angrensis (Lutz tadpoles in an area of the Atlantic Forest (Mangaratiba, Rio de Janeiro (Amphibia, Anura, Hylidae Dieta de girinos de Scinax angrensis (Lutz na Floresta Atlântica (Mangaratiba, Rio deJaneiro (Amphibia, Anura, Hylidae

    Directory of Open Access Journals (Sweden)

    Izidro F. de Sousa Filho

    2007-12-01

    Full Text Available Scinax angrensis (Lutz, 1973 is an endemic species, which occurs in low altitude hillside forests, distributed from the municipalities of Mangaratiba to Parati in the south of the state of Rio de Janeiro, Brazil. The aim of this study was to compare the morphology of S. angrensis tadpoles in two different stages of development, and verify their feeding spectrum. The mouth morphology of the two stages studied (27 and 37 appeared similar, with a difference in the size of the oral opening as well as an increase in the dimensions of the body. The examined species presented a trophic spectrum comprised of algae, protozoan, rotifers, microcrustaceans, nematodes, vegetation and invertebrate remains, fungus hyphae, and sand grains. Significant differences were found between dimensions of the two stages, but not between diets, although a differentiated preference with regards to planktonic items has been verified. The results suggest that the partitioning of feeding resources is not only related to morphology and occupation of different microhabitats but also to the feeding behaviour of tadpoles. The relevance of important food items to the natural diet of S. angrensis tadpoles, especially the diatoms and filamentous algae, reveal the importance of the periphytic community to the conservation of this species in the Atlantic Forest.Scinax angrensis (Lutz, 1973 é uma espécie endêmica ocorrendo em florestas de encosta de baixa altitude, no sul do Estado do Rio de Janeiro, Brasil. O objetivo do presente estudo foi o de comparar a morfologia e verificar o espectro alimentar de girinos de S. angrensis de dois estágios diferenciados de desenvolvimento. A morfologia bucal dos dois estágios (27 e 37 apresentou-se similar, havendo diferença de tamanho da abertura oral, bem como aumento das dimensões do corpo e da cauda. A espécie examinada apresentou um espectro trófico integrado por algas, protozoários, rotíferos, microcrustáceos, nematódeos, restos

  10. Multicenter, randomized, double-blind study comparing 20 and 40 mg of pantoprazole for symptom relief in adolescents (12 to 16 years of age) with gastroesophageal reflux disease (GERD)

    Science.gov (United States)

    An age-appropriate questionnaire (GASP-Q) was used to assess the frequency and severity of the gastroesophageal reflux disease (GERD) symptoms: abdominal/belly pain, chest pain/heartburn, pain after eating, nausea, burping/belching, vomiting/regurgitation, choking when eating, and difficulty swallow...

  11. Volume, distribution and acidity of gastric secretion on and off proton pump inhibitor treatment: a randomized double-blind controlled study in patients with gastro-esophageal reflux disease (GERD) and healthy subjects.

    Science.gov (United States)

    Steingoetter, Andreas; Sauter, Matthias; Curcic, Jelena; Liu, Dian; Menne, Dieter; Fried, Michael; Fox, Mark; Schwizer, Werner

    2015-09-02

    Postprandial accumulation of gastric secretions in the proximal stomach above the meal adjacent to the esophagogastric junction (EGJ), referred to as the 'acid pocket', has been proposed as a pathophysiological factor in gastro-esophageal reflux disease (GERD) and as a target for GERD treatment. This study assessed the effect of proton pump inhibitor (PPI) therapy on the volume, distribution and acidity of gastric secretions in GERD and healthy subjects (HS). A randomized, double blind, cross-over study in 12 HS and 12 GERD patients pre-treated with 40 mg pantoprazole (PPI) or placebo b.i.d. was performed. Postprandial secretion volume (SV), formation of a secretion layer and contact between the layer and the EGJ were quantified by Magnetic Resonance Imaging (MRI). Multi-channel pH-monitoring assessed intragastric pH. A distinct layer of undiluted acid secretion was present on top of gastric contents in almost all participants on and off high-dose acid suppression. PPI reduced SV (193 ml to 100 ml, in HS, 227 ml to 94 ml in GERD; p < 0.01) and thickness of the acid layer (26 mm to 7 mm, 36 mm to 9 mm respectively, p < 0.01). No differences in secretion volume or layer thickness were observed between groups; however, off treatment, contact time between the secretion layer and EGJ was 2.6 times longer in GERD compared to HS (p = 0.012). This was not the case on PPI. MRI can visualize and quantify the volume and distribution dynamics of gastric secretions that form a layer in the proximal stomach after ingestion of a liquid meal. The secretion volume and the secretion layer on top of gastric contents is similar in GERD patients and HS; however contact between the layer of undiluted secretion and the EGJ is prolonged in patients. High dose PPI reduced secretion volume by about 50% and reduced contact time between secretion and EGJ towards normal levels. NCT01212614.

  12. Phlébotomes de Bolivie: VII. Répartition des deux morphotypes du phlébotome lutzomyia longipalpis (Lutz et Neiva, 1912 (Diptera: Psychodidae dans le piémont andin de Bolivie

    Directory of Open Access Journals (Sweden)

    Francois Le Pont

    1989-09-01

    Full Text Available Deux morphotypes de Lytzomyia longipalpis (Lutz et Neiva, 1912 ont été décrits au Brésil, l'un avec une seule paire de taches tergales, l'autre avec deux paires de taches. Ce caractère est propre aux mâles. En Bolivie, la forme à une tache existe seule dans le foyer de leishmaniose viscérale des Yungas (alt. 1000-2000 m dans l'envirionnement péridomicilliaire; c'est le vecteur confirmé de cette maladie. Le second morphotype à deux taches a été récemment découvert sous le porche de grottes dans le région de Cochabamba (alt. 2700 m; il était absent dans et autour des habitations de cette région, où la leishmaniose vicérale est inconnue. Les deux morphotypes de Lu. longipalpis ont, en Bolivie, une distribution allopatrique, et leurs écologies respectives sont très différentes.

  13. Frisby v. Schultz, 27 June 1988.

    Science.gov (United States)

    1988-01-01

    The plaintiffs, anti-abortion protesters, challenged a Brookfield Wisconsin ordinance making it "unlawful for any person to engage in picketing before or about the residence or dwelling of any individual" and declaring that the primary purpose of the ban is to "protec[t] and preserv[e] the home" through assurance "that members of the community enjoy in their homes . . . a feeling of well-being, tranquillity, and privacy." They claimed that the ordinance violated their First Amendment rights of free speech. The Court reversed lower court rulings finding the ordinance unconstitutional. It held that the ban on picketing did not ban all picketing in residential areas, but, rather, only "focused picketing" taking place solely in front of a specific residence, and that the ordinance left ample means of alternative channels of communication. It concluded that the ordinance served a significant government interest of protecting residential privacy and that there was no constitutional right to force speech into the home of an unwilling listener. In 1988, US courts reached the following decisions with respect to the activities of anti-abortion protesters: 1) action charging anti-abortionists with conspiracy under federal laws is allowed (Portland Feminist Women's Health Center vs. Advocates for Life, US District Court, D. Oregon, 28 June 1988 [712 F.Supp. 165]); 2) action charging anti-abortionists with conspiracy under federal laws not allowed, but action charging anti-abortionists with violation of racketeering laws allowed (Feminist Women's Health Center vs. Roberts, US District Court, W.D. Washington, 11 March 1988 [1988 US Dist. Lexis 16325]); 3) action charging anti-abortionists with violation of racketeering laws allowed (Northeast Women's Center, Inc. vs. McMonagle, US District Court, E.D. Pennsylvania, 31 March 1988 [689 F.Supp. 465]); and 4) action charging anti-abortionists with conspiracy under federal laws and with violation of racketeering laws is allowed (Roe vs. Operation Rescue, US District Court for the Eastern District of Pennsylvania, 19 December 1988 [1988 US District Lexis 14484]). full text

  14. Hobuste hääled : Gerd Heuschmanni kõnekad väljaastumised hobuste eest / Birgit Popp ; saksa keelest tõlkisid Merike Udrik ja Agnes Raudam ; kommenteerinud Marlen Vassil

    Index Scriptorium Estoniae

    Popp, Birgit

    2009-01-01

    Gerd Heuschmanni poolt väljaantud raamatust Finger in der Wunde ja selle ingliskeelsest tõlkest Tug of War : Classical versus "Modern" Dressage ning kakskeelsest filmist Stimmen der Pferde = If Horses Could Speak. Kõigis neis teostes käsiteltaksehobuse pingevaba kehahoiaku kujundamise ja hobusõbraliku koolituse vajalikkust ning ratsahobustele vigastuste ning kannatuste põhjustamist hobuse anatoomia vähese tundmise ja juba väljakujunenud treeningmeetodite järgimise tulemusel kasutatavast valest ratsutamistiilist

  15. Development and gamma scintigraphy evaluation of gastro retentive calcium ion-based oral formulation: an innovative approach for the management of gastro-esophageal reflux disease (GERD).

    Science.gov (United States)

    Sharma, Braj Gaurav; Khanna, Kushagra; Kumar, Neeraj; Nishad, Dhruv K; Basu, Mitra; Bhatnagar, Aseem

    2017-11-01

    Calcium chloride is an essential calcium channel agonist which plays an important role in the contraction of muscles by triggering calcium channel. First time hypothesized about its role in the treatment of GER (gastro-esophageal reflux) and vomiting disorder due to its local action. There are two objectives covered in this study as first, the development and optimization of floating formulation of calcium chloride and another objective was to evaluate optimized formulation through gamma scintigraphy in human subjects. Gastro retentive formulation of calcium chloride was prepared by direct compression method. Thirteen tablet formulations were designed with the help of sodium chloride, HPMC-K4M, and carbopol-934 along with effervescing agent sodium bicarbonate and citric acid. Formulation (F8) fitted best for Korsmeyer-Peppas equation with an R 2 value of 0.993. The optimized formulation was radiolabelled with 99m Tc-99 m pertechnetate for its evaluation by gamma scintigraphy. Gastric retention (6 h) was evaluated by gamma scintigraphy in healthy human subjects and efficacy of present formulation confirmed in GER positive human subjects. Gamma scintigraphy results indicated its usefulness in order to manage GERD. Stability studies of the developed formulation were carried out as per ICH guidelines for region IV and found out to be stable for 24 months.

  16. Baxter'i Balti riike halvustavad plakatid / Uno Schultz ; foto: Emil Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2007-01-01

    rahvusvahelise meditsiinifirma Baxter Rootsi osakonna, Stockholmi äärelinnas Kistas asuva Baxter Medical AB tegevusest puugihammustuste kaudu levivate haiguste vastase kaitsepookimise propageerimisel

  17. Cardiac mucosa at the gastro-oesophageal junction: indicator of gastro-oesophageal reflux disease? Data from a prospective central European multicentre study on histological and endoscopic diagnosis of oesophagitis (histoGERD trial).

    Science.gov (United States)

    Langner, Cord; Schneider, Nora I; Plieschnegger, Wolfgang; Schmack, Bertram; Bordel, Hartmut; Höfler, Bernd; Eherer, Andreas J; Wolf, Eva-Maria; Rehak, Peter; Vieth, Michael

    2014-07-01

    The origin and significance of cardiac mucosa at the gastro-oesophageal junction are controversial. In the prospective Central European multicentre histoGERD trial, we aimed to assess the prevalence of cardiac mucosa, characterized by the presence of glands composed of mucous cells without parietal cells, and to relate its presence to features related to gastro-oesophageal reflux disease (GORD). One thousand and seventy-one individuals (576 females and 495 males; median age 53 years) were available for analysis. Overall, in biopsy specimens systematically taken from above and below the gastro-oesophageal junction, cardiac mucosa was observed in 713 (66.6%) individuals. Its presence was associated with patients' symptoms and/or complaints (P = 0.0025), histological changes of the squamous epithelium (P gastro-oesophageal junction. Its association with reflux symptoms, histological changes indicating GORD and the endoscopic diagnosis of oesophagitis suggests that injury and repair related to GORD contribute to its development and/or expansion. © 2014 John Wiley & Sons Ltd.

  18. Early ontogenesis of the angelfish, Pterophyllum scalare Schultze, 1823 (Cichlidae

    Directory of Open Access Journals (Sweden)

    Agata Korzelecka-Orkisz

    2012-09-01

    Full Text Available This study describes the egg membrane structures of angelfish (Pterophyllum scalare, morpho-physiological changes during angelfish embryogenesis from activation to hatching under optimal conditions (28°C; pH 6.8, the developing larvae and fry, the effect of alkaline pH on the early developmental stages of the species, the relationship between food item size and fry survival. Egg membranes (thin, transparent, 1.67-2.18 µm thick are covered by a sticky substance. The amber-coloured angelfish eggs were oval in shape, with average diameters of 1.436 and 1.171 mm, i.e., a mean volume of 1.033 ± 0.095 mm³. The survival rate of embryos and larvae kept in water with an elevated, slightly alkaline pH was very low: as few as 2% of the embryos survived, while in the batch kept in optimal water conditions very few eggs died. The first larvae hatched after 1288 h of embryonic development. The newly hatched larvae measured on average 2.60 ± 0.093 mm and had large (0.64 ± 0.077 mm³ yolk sacs. They attached themselves to the substrate with a secretion of thin, viscous threads, which was released from glands situated on the top of the head. The glands vanished on day 5. The 1-day-old larvae showed the first pigment cells on the body and the eyes of the 2-day-olds were already fully pigmented. Between day 4 and 5 of larval life, the larvae began feeding on live food. The 23-day-old fry looked like a miniature versions of the adults. Mortality of the angelfish larvae during their first days after hatching was higher in those fed brine shrimp (Artemia salina nauplii than those fed protozoans and rotifers.En este trabajo se ha descrito la estructura de las túnicas ovulares del escalar o pez ángel (Pterophyllum scalare, las modificaciones morfo-fisiológicas que transcurren durante la embriogénesis del escalar desde el momento de activización para el desove en condiciones ambientales óptimas (28ºC y pH 6,8 y, se han caracterizado las larvas y los alevines desarrollándose. Adicionalmente, se ha estudiado el efecto del pH básico del agua sobre los primeros estadios de desarrollo y la dependencia entre la cantidad de alimento y la supervivencia de los alevines. Las túnicas ovulares del escalar son finas (1,67-2,18 mm, transparentes, cubiertas de una sustancia viscosa. Los huevos de color ámbar tienen forma ovalada de diámetros medios 1,436 y 1,171 mm y de un volumen medio de 1,033 ± 0,095mm³. El porcentaje de supervivencia de embriones y de larvas en agua con pH aumentado, ligeramente básico, fue muy bajo, ya que sólo el 2% de los embriones sobrevivió, mientras que en agua de parámetros óptimos sólo algunos huevos palidecieron. Las larvas recién salidas del huevo medían 2,60 ± 0,093 mm por término medio y poseían grandes (0,64 ± 0,077 mm³ sacos vitelinos. Se han adherido al substrato mediante una secreción en forma de filamentos finos y viscosos. Esta secreción se ha desprendido de las glándulas ubicadas en la cumbre de la cabeza. Las glándulas desaparecieron al 5º día de vida de las larvas. Las larvas de un día poseían ya las primeras células pigmentarias en el cuerpo, los ojos de las larvas de dos días estaban pigmentadas plenamente. Entre el 4º y 5º día de vida las larvas empezaron a tomar alimento. Las larvas de 23 días se parecían a una versión miniaturizada de los adultos. La mortalidad de las larvas del escalar alimentadas durante los primeros días a partir del desove con larvas de artemia salina (Artemia salina fue mayor que la de las alimentadas con protozoarios y rotíferos.

  19. Tšernobõli katastroof oma silmaga / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2000-01-01

    Rootsi ajakirjaniku kohtumisest rakverelasega, kes 1986. aastal Tšernobõli aatomielektrijaama neljanda ploki plahvatuse tagajärgi likvideerima saadeti : Lisa: Tšernobõli saadetud meeste jaotus maakonniti ; Eestit ümbritsevad tuumaelektrijaamad

  20. Uurimistöö-kompvek sugupuu-uurijale / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2002-01-01

    rets. rmt.: Maldonado, Sigrid Renate. Estonian experience and roots: ethnic Estonian genealogy with historical perspective, social influences and possible family history resources. Fort Wayne (USA) : AS WAS Publishing, 1996. 120 p.

  1. Gastroesophageal Reflux Disease (GERD) (and Asthma)

    Science.gov (United States)

    ... examines the inside of the esophagus) • Ambulatory acid (pH) test (monitors the amount of acid in the ... H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid production and ...

  2. Gastroesophageal Reflux Disease (GERD) (For Teens)

    Science.gov (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... permanent damage of the esophagus and sometimes even cancer. What Causes ... X-rays. A gastric emptying scan can help show whether a person’s ...

  3. Acid Reflux (GER and GERD) in Adults

    Science.gov (United States)

    ... Treatment Eating, Diet, & Nutrition Clinical Trials Peptic Ulcers (Stomach Ulcers) Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Proctitis Definition & Facts Symptoms & ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, ...

  4. Acid Reflux (GER & GERD) in Children & Teens

    Science.gov (United States)

    ... the National Institutes of Health (NIH) conduct and support basic and clinical research into many digestive disorders. Related News NIAID scientists identify cause, possible treatment for life-threatening gut condition Jun 29, 2017 An enzyme ...

  5. Non-complicated cholelithiasis associated with GERD: Results of combined laparoscopic surgery in low risk patients Colelitiasis no complicada asociada con ERGE: Resultados de la cirugía laparoscópica combinada en pacientes con bajo riesgo quirúrgico

    Directory of Open Access Journals (Sweden)

    F. Pozo

    2004-04-01

    Full Text Available Objectives: the aim of this study was to evaluate the efficacy of combined laparoscopic surgery for non-complicated cholelithiasis and gastroesophageal reflux disease (GERD in patients with low surgical risk. Methods: a total of 680 cholecystectomies performed by means of laparoscopic surgery were retrospectively studied from February 1991 to February 2002. A total of 442 patients that fulfilled the inclusion criteria were divided into two groups: group A: non-complicated cholelithiasis (cholecystectomy alone, consisting of a total of 362 patients, and group B: non-complicated cholelithiasis and GERD (cholecystectomy and Toupet’s fundoplication in all cases in 80 patients. Demographic and clinical data, intraoperatory incidences, and post-surgical complications were prospectively collected and compared for all patients. The results of reflux surgery (group B were evaluated at 6 months by means of 24-hour pH-metry. Results: in spite of the fact that the group undergoing combined surgery consisted of patients with greater weight and older age (p Objetivos: el objetivo del presente estudio fue la valoración de la eficacia de la cirugía laparoscópica combinada de la colelitiasis no complicada y de la enfermedad por reflujo gastroesofágico (ERGE en pacientes con bajo riesgo quirúrgico. Métodos: desde febrero de 1991 a febrero de 2002 se realizaron 680 colecistectomías mediante cirugía laparoscópica, cumpliendo criterios de inclusión para el presente estudio un total de 442 pacientes que fueron divididos en dos grupos: grupo A: colelitiasis no complicada (colecistectomía sola con un total de 362 pacientes y grupo B: colelitiasis no complicada y ERGE (colecistectomía y reparación hiatal con funduplicatura tipo Toupet en 80 pacientes. En todos los pacientes se recogieron de forma prospectiva y se compararon datos demográficos y clínicos, incidencias peroperatorias y complicaciones post-intervención. Los resultados de la cirugía del

  6. Presença de refluxo em pacientes com sintomas típicos de doença do refluxo gastroesofágico Factors related to the presence of reflux in patients with typical symptoms of gastroesophageal reflux disease (GERD

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Corsi

    2007-04-01

    Full Text Available OBJETIVO: Analisar os aspectos clínicos, ultra-sonográficos, endoscópicos, manométricos e os dados de pHmetria prolongada do esôfago nos pacientes com sintomas típicos de doença do refluxo gastroesofágico (DRGE. MÉTODOS: Foram estudados, em 251 pacientes com sintomas típicos da doença do refluxo gastroesofágico, os aspectos clínicos, o IMC, os dados ultra-sonográficos, endoscópicos, manométricos e de pHmetria do esôfago. RESULTADOS: Eram mulheres 172 pacientes (68,5%. A média de idade foi de 51,8 anos. A ultra-sonografia diagnosticou colelitíase em 23 doentes e colecistectomia prévia em 21 pacientes. A hérnia hiatal (HH estava presente em 177 pacientes (71%, com tamanho médio de 3 cm. A esofagite erosiva foi encontrada em 168 pacientes (66,9% e o esôfago de Barrett em 23 casos (9,2%. A associação de HH com EE foi observada em 131 pacientes (52,3%. Apenas 37 pacientes (14,7% não apresentavam HH ou EE. Quanto à manometria, o valor médio da extensão do esfíncter inferior do esôfago (EIE foi 2,6 cm, sendo que 132 pacientes (52,6% apresentaram EIE curto. A pressão média do EIE foi 18,9 mmHg e 46 doentes (18,3% apresentaram pressão abaixo de 14 mmHg. À pHmetria prolongada do esôfago, a média do número de refluxos foi 42,9 e a porcentagem de tempo ácido total média foi 8,4%. Em 175 pacientes (69,7%, o índice de DeMeester mostrou-se elevado. CONCLUSÃO: Nos pacientes com sintomas típicos da DRGE, os fatores que influenciaram a presença do refluxo patológico, comprovada pela pHmetria do esôfago, foram: a idade mais avançada, a presença de hérnia hiatal com esofagite erosiva; a extensão menor, a pressão basal diminuída e o menor vetor volume do EIE.OBJECTIVE: To analyze clinical, abdominal ultrasound, upper digestive endoscopic, esophageal manometric and prolonged esophageal pH-monitoring findings in patients with typical symptoms of GERD. METHODS: The study included a total of 251 patients with typical

  7. Parent's Take Home Guide to GERD (Gastroesophogeal Reflux Disease)

    Science.gov (United States)

    ... or recurrent pneumonia •Hoarseness •Asthma If you have concerns, speak to your healthcare provider. SICK AND TIRED OF BEING SICK (13+ years) Reflux and your Teen Gastroesophageal Reflux (GER) occurs during or after a ...

  8. IPO. Mäng suure orkestriga / Tiiu Pedaja, Gerd Laub

    Index Scriptorium Estoniae

    Pedaja, Tiiu

    2006-01-01

    Aktsiate avaliku pakkumise ehk IPO korraldamisest. Lisad: Millal on õige aeg?; Milline ettevõte sobib avalikuks pakkumiseks?; Milline avalik pakkumine on edukas?; Kuidas IPO-l aktsiaid jaotatakse? Skeemid: Aktsia hinna kujunemine avaliku pakkumise käigus; Järelturu aktsiahinda mõjutavad tegurid

  9. The ABCs of GERD | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  10. Security implications of EU enlargement / Gerd Föhrenbach

    Index Scriptorium Estoniae

    Föhrenbach, Gerd

    2001-01-01

    Autor vaatleb julgeolekuprobleeme, mis võivad ilmneda Euroopa Liidu laienemisel, kui sinna kuuluks kuni 33 liiget. Vaja on reformida EL institutsioone, luua ühtne julgeolekustrateegia ning välis- ja julgeolekupoliitika

  11. Kohaliku omavalitsuse võimalused ettevõtluse arendamisel / Gert Schultz

    Index Scriptorium Estoniae

    Schultz, Gert

    2003-01-01

    Autor on seisukohal, et omavalitsus, kes on huvitatud elanikkonnale kvaliteetse teenuse pakkumisest ning laiemas mõttes elukeskkonna parandamisest, peab oma peamiseks prioriteediks pidama ettevõtlust ning eeskätt just väikeettevõtluse arendamist oma territooriumil. Tabel

  12. Randic and Schultz molecular topological indices and their correlation with some X-ray absorption parameters

    International Nuclear Information System (INIS)

    Khatri, Sunil; Kekre, Pravin A; Mishra, Ashutosh

    2016-01-01

    The properties of a molecular system are affected by the topology of molecule. Therefore many studies have been made where the various physic-chemical properties are correlated with the topological indices. These studies have shown a very good correlation demonstrating the utility of the graph theoretical approach. It is, therefore, very natural to expect that the various physical properties obtained by the X-ray absorption spectra may also show correlation with the topological indices. Some complexes were used to establish correlation between topological indices and some X-ray absorption parameters like chemical shift. The chemical shift is on the higher energy side of the metal edge in these complexes. The result obtained in these studies shows that the topological indices of organic molecule acting as a legands can be used for estimating edge shift theoretically. (paper)

  13. Eestlaste matusepaik Rootsis Frösö saarel / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2008-01-01

    Frösö kiriku taga surnuaias, valgete ristide ja hauakivide all puhkavad: Elmar Aunpuu, Aarne Meri, Heino Albo, Hindrek Lipp, Kalju Mälk, Heinrich Koppel, Sulev Paju, Eugenius Gorski, Edgar Toompuu, Helmut Lillevars, Venda Oskar, Walentin Riis

  14. The Schultz MIDI Benchmarking Toolbox for MIDI interfaces, percussion pads, and sound cards

    NARCIS (Netherlands)

    Schultz, Benjamin G

    2018-01-01

    The Musical Instrument Digital Interface (MIDI) was readily adopted for auditory sensorimotor synchronization experiments. These experiments typically use MIDI percussion pads to collect responses, a MIDI-USB converter (or MIDI-PCI interface) to record responses on a PC and manipulate feedback, and

  15. Growth and reproductive performance by different feed types in fresh water angelfish (Pterophyllum scalare Schultze, 1823

    Directory of Open Access Journals (Sweden)

    Milad Kasiri

    2012-09-01

    Full Text Available It is well established that reproduction is sensitive to the state of energy reserves, and that there is a balance between energy homeostasis and fertility. In this view, this study examined the effects of different diets on growth and reproductive performance of fresh water angelfish. Twenty four pairs of angelfish (weighing 3.58 ± 0.24 g were fed with four types of diets including live earth worm (LEW, dried Tubifex (DT, dried Gammarus (DG and prepared granulated feed (PGF, twice a day for 90 days. Reproductive parameters were measured between days 60 and 90. The significant increase in the gonadosomatic index (GSI, fecundity and hatchability brought about by the LEW were demonstrated by the higher number of spawned eggs and hatched larvae. The best growth observed significantly in PGF, and length of larvae was enhanced in this group, consequently. The numbers of dead and deformed fry were lower in the fish fed with PGF and LEW, but there was no significant difference among experimental groups. This study showed that breeders benefit from inclusion of prepared granulated feed and living earth worm during their growth and reproductive stages, and simultaneous using of them for achieving better results is suggested.

  16. Eestlaste ristid Frösö kiriku juures / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2005-01-01

    12. sajandi lõpus Frösö saarele ehitatud samanimeline kirik on Rootsis populaarne laulatuskirik. Kiriku taha surnuaeda on maetud eestlased: Aunpuu, Elmar, Meri, Aarne, Albo, Heino, Lipp, Hindrek, Mälk, Kalju, Koppel, Heinrich, Paju, Sulev, Gorski, Eugenius, Toompuu, Edgar, Lillevars, Helmut, Oskar, Venda, Riis, Walentin

  17. REPRODUCTIVE BIOLOGY OF THE VENEZUELA ROUND STINGRAY UROTRYGON VENEZUELAE SCHULTZ FROM THE COLOMBIAN CARIBBEAN

    Directory of Open Access Journals (Sweden)

    KELLY ACEVEDO

    2015-06-01

    Full Text Available As for most batoid species, little is known about the basic biology of the Venezuela round stingray Urotrygon venezuelae (Urotrygonidae. This study presents information about the reproductive biology of the species, including fecundity, embryonic development stage, relationship between maternal size and fecundity, gonadosomatic (GSI and hepatosomatic (HSI indices, sex ratios, maturity size and size at birth. With all this information, a preliminary reproductive cycle is proposed. A total of 269 specimens were caught with beach seine in Salguero beach, Colombian Caribbean Sea, between August 2005 and October 2006. We propose for U. venezuelae a biological cycle with three reproductive peaks: November-December, March-April and August. Size at sexual maturity was calculated in 176 mm (total length for females and 227 mm for males; fecundity ranged between one and six embryos per female. We found that cloacal diameter and liver weight were better predictors for fecundity than total length for U. venezuelae.

  18. Antibacterial activity and the variation of Tanacetum parthenium (L.) Schultz Bip. essential oils from Turkey.

    Science.gov (United States)

    Polatoglu, Kaan; Demirci, Fatih; Demirci, Betül; Gören, Nezhun; Başer, Kemal Hüsnü Can

    2010-01-01

    Water-distilled essential oils from herbal parts of Tanacetum parthenium from two different localities in Turkey were analyzed by GC and GC/MS. The essential oil of T. parthenium collected from Davutpasa-Istanbul location were characterized with camphor 49%, trans-chrysanthenyl acetate 22.1% and camphene 9.4%. Second plant sample is collected from the remote east end of the country Savşat-Ardahan location. The essential oil from this location was characterized with camphor 60.8% and camphene 6.8%. Unlike the former this sample contains trans-chrysanthenyl acetate in trace amount and cis- chrysanthenyl acetate in very small amount (0.6%) which is not present in the first sample. Antibacterial activity of the oils were evaluated for five Gram (+) and five Gram (-) bacteria by using a broth microdilution assay. The highest activity was observed on Bacillus subtilis, Staphylococcus aureus and methicillin-resistant S.aureus however when compared with positive control oils showed higher MIC values. The oil of Istanbul-sample showed highest activity on B. subtilis (125 microg/mL) and methicillin-resistant S. aureus (125 microg/mL) which is two fold concentration when compared with the positive control chloramphenicol (62.5 microg/mL). The oil of Ardahan sample showed the highest activity on S. aureus (125 microg/mL) which is likewise two fold concentration of the positive control chloramphenicol (62.5 microg/mL). DPPH scavenging activity was 59.3% of the oil from Davutpasa at 15 mg/mL concentration. When compared to positive control alpha-tocopherol (94.6%) Savşat oil (28.2%) showed low and Davutpasa oil showed medium DPPH scavenging activity. All of the oils showed toxicity to Vibrio fischeri in the TLC-bioluminescence assay.

  19. 76 FR 78695 - Barry M. Schultz, M.D.; Decision and Order

    Science.gov (United States)

    2011-12-19

    ... process via the state hearing, and accordingly, under the facts of this case, has no constitutional right... not so narrowly tailored as to adhere to Florida Law and to protect his due process rights.'' [Id. at... process ``by allowing him to petition this Tribunal for either an abeyance of the Administration's...

  20. Pärleid vanapaberi hulgast : kohtumisi inimeste ja vanaraamatuga / Uno Schultz

    Index Scriptorium Estoniae

    Schultz, Uno, 1956-

    2010-01-01

    Bibliofiil Uno Schultzi vanaraamatute kogu kujunemisest ning inimestest, kellega haruldaste raamatute leidmisel kohtutud, sh Kyra Robertist, Voldemar Millerist, Trivimi Vellistest, Oskar Kuningast, Helene Kulpast, Erik Tederist jt.

  1. Depositional characteristics and sediment availability resulting from the post-Schultz Fire floods of 2010

    Science.gov (United States)

    Karen A. Koestner; Mike D. Carroll; Daniel G. Neary; Peter E. Koestner; Ann Youberg

    2011-01-01

    Wildfire is a major land management concern due to direct impacts of fire on forest resources, and potentially negative effects on landscape processes by increasing rates of runoff, erosion, downstream sedimentation, and overall site degradation (DeBano et al. 1998, Neary et al. 2005, Robichaud et al. 2010). In the United States the number of fires has been increasing...

  2. Een onderzoek over de waarde van de Schultz-Dale techniek in de immuno-pathologie

    NARCIS (Netherlands)

    Jansz, Anton

    1960-01-01

    Dit proefschrift geeft in hoofdstuk I een overzicht over problemen in de immuno-pathologie. waarbij vooral aandacht wordt geschonken aan de auto-immunologische ziekteprocessen. Een beter inzicht hierin kan verkregen worden door dierexperimenteel en door serologisch onderzoek. Het laatste vooral

  3. Die Politik der EZB an den Grenzen ihres Mandats? / Lutz Lammers

    Index Scriptorium Estoniae

    Lammers, Lutz

    2015-01-01

    Riigi võlakirjade ostmisega seotud rahanduspoliitikast. Saksamaa põhiseaduskohtu seisukohast Euroopa Keskpanga väljakuulutatud OMT-programmi kohta, mis võimaldab keskpangal piiramatult võlakirju osta. Riigi võlakirjade ostmisest järelturgudel

  4. Test Reviews: Loranger, A. W. (2001). "OMNI Personality Inventory." Lutz, FL: Psychological Assessment Resources

    Science.gov (United States)

    Guess, Pamela

    2006-01-01

    The OMNI Personality Inventory (OMNI) is a self-report questionnaire designed for use with adolescents and adults between 18 and 74 years of age. The questionnaire is not based on a particular theory, consistent with current trends in test development, according to the author. An abbreviated form of the OMNI, the OMNI-IV Personality Disorder…

  5. Baseline susceptibility to alpha-cypermethrin in Lutzomyia longipalpis (Lutz & Neiva, 1912) from Lapinha Cave (Brazil).

    Science.gov (United States)

    Pessoa, Grasielle Caldas Davila; Lopes, Josiane Valadão; Rocha, Marília Fonseca; Pinheiro, Letícia C; Rosa, Aline Cristine Luiz; Michalsky, Érika Monteiro; Dias, Edelberto Santos

    2015-09-17

    Given the increase in cases of visceral leishmaniasis in recent years, associated with the socio-economic impact of this disease, as well as the wide distribution of Lutzomyia longipalpis in Brazil and the likelihood that this vector may develop resistance to insecticides used for control, the Ministry of Health considers as crucial the creation of a network in order to study and monitor the resistance of this vector to insecticides used for control. In this sense, this study aimed: 1) to characterize the susceptibility of L. longipalpis from Lapinha Cave (Lagoa Santa, MG - Brazil) to Alfateck SC200 in field bioassays, and 2) to define the susceptibility baseline to alpha-cypermethrin in laboratory bioassays, checking the possibility of using it as susceptibility reference lineage (SRL). The field bioassays revealed that the tested population was highly susceptible to alpha-cypermethrin in all time periods with high mortality (~100 %) in all treated surfaces before six months after spraying. In the laboratory bioassays, the studied population presented LD50, LD95 and LD99 to 0.78013, 10.5580 and 31.067 mg/m(2), respectively. The slope was 1.454121. The studied population of L. longipalpis was considered as adequate for SRL according criterion recommended by Pan-American Health Organization and has proven susceptibility to tested insecticide in the field. One cannot rule out the possibility of finding populations of L. longipalpis more susceptible to alpha-cypermethrin; therefore, further research is necessary on other populations with potential use as a SRL.

  6. Roosna-Alliku mõisa häärber / Karl Kolopka, Nele Rohtla, Johann Schultz

    Index Scriptorium Estoniae

    Kolopka, Karl

    2004-01-01

    12 ill.; peahoone ehitati Johann Schultzi kavandite järgi, siseinterjööri ilmestava Louis XVI stiilis stukitöö tegi Karl Kolopka, häärber restaureeriti Nele Rohtla (OÜ Mõisaprojekt) suunamisel

  7. Orobanche flava Mart. ex F.W. Schultz (Orobanchaceae: en la Península Ibérica

    Directory of Open Access Journals (Sweden)

    Pujadas Salvá, Antonio J.

    2003-12-01

    Full Text Available Orobanche flava is reported in the N of the Iberian Península. Its diversity and distribution is analyzed for the península: var. flava in the Pyrenees and var. albicans Rhiner in the Cantabrian Mountain chain. Lectotypification of O. flava var. albicans Rhiner [ZT] is proposed. To facilítate the identification of O. flava we emphasize its differential morphological characters and an original icon is contributed.Se indica la presencia de Orobanche flava en el N de la Península Ibérica. Se analiza su diversidad y su distribución en el territorio: var. flava en el Pirineo y var. albicans Rhiner en la Cordillera Cantábrica. Se propone el lectótipo de O. flava var. albicans Rhiner [ZT]. Para facilitar la identificación de O. flava destacamos sus caracteres morfológicos diferenciales y aportamos un icono original.

  8. The Insecticidal Activity of Tanacetum parthenium (L.) Schultz Bip. Extracts Obtained by Supercritical Fluid Extraction and Hydrodistillation

    Czech Academy of Sciences Publication Activity Database

    Pavela, R.; Sajfrtová, Marie; Sovová, Helena; Bárnet, M.; Karban, Jindřich

    2010-01-01

    Roč. 31, č. 3 (2010), s. 449-454 ISSN 0926-6690 R&D Projects: GA MŠk 2B06049 Institutional research plan: CEZ:AV0Z40720504 Keywords : botanical insecticides * spodoptera littoralis * tanacetum parthenium Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 2.507, year: 2010

  9. Fonte alimentar sangüínea e a peridomiciliação de Lutzomyia longipalpis (Lutz & Neiva, 1912 (Psychodidae, Phlebotominae Blood feeding sources and peridomiciliation of Lutzomyia longipalpis (Lutz & Neiva, 1912 (Psychodidae, Phlebotominae

    Directory of Open Access Journals (Sweden)

    Flávio de Oliveira Passos Dias

    2003-10-01

    Full Text Available Estudou-se por meio da reação da precipitina, o conteúdo estomacal de Lutzomyia longipalpis nos ambientes intradomiciliar e peridoméstico, no Município de Raposa, Maranhão, área de transmissão de leishmaniose visceral ou "calazar". De 2.240 fêmeas capturadas, 547 (24,4% estavam alimentadas com sangue de vertebrados nas proporções que seguem: ave (87,9%; roedor (47,2%; humano (42,4%, cão (27,6%; mucura (26,6% e eqüino (22,5%. A investigação levada a efeito em 120 habitações confirmou a galinha como o animal doméstico mais comum no ambiente peridoméstico (28,3%, seguido pelo cão (21,7%, gato (17,5%, jumento (13,3%, pombo (7,5%, coelho (3,3% e pato (3,3%; enquanto o cavalo, marreco e porco representaram, cada um, 1,7%. Entre os animais sinantrópicos, a mucura foi a mais citada naquele ambiente (39,3%, seguida pelo rato (37,9%, morcego (14,3% guaxinim (3,6%, raposa (2,1%, cobra (1,4% e sapo (1,4%. A presença no peridomicílio de animais domésticos e sinantrópicos e o encontro de flebótomos alimentados, ao mesmo tempo, com sangue humano, de mucura e de canídeos, corroboram a hipótese de que a transmissão do calazar esteja ocorrendo realmente no ambiente antrópico, no Município de Raposa.A precipitin test was employed to study the alimentary tract content of Lutzomyia longipalpis in the intra- and peridomiciliary environments in the municipality of Raposa, Maranhão State, a transmission area for visceral leishmaniasis or kala azar. Out of 2,240 female sandflies captured, 547 (24.4% had fed on vertebrate blood, with the following proportions: avian (87.9%; rodent (47.2%; human (42.4%; canine (27.6%; opossum (26.6%; and equine (22.5%. Based on a survey of 120 human dwellings, chickens were found to be the most common domestic animals in the peridomicile (28.3%, followed by dogs (21.7%, cats (17.5%, donkeys (13.3%, pigeons (7.5%, rabbits (3.3%, ducks (3.3%, and horses, mallards, and pigs (1.7% each. Synanthropic animals included opossums (39.3%, followed by rats (37.9%, bats (14.3%, raccoons (3.6%, foxes (2.1%, snakes (1.4%, and frogs (1.4%. The peridomiciliary presence of domestic and synanthropic animals as well as sandflies that had fed on human, opossum, and canid blood supports the hypothesis that kala azar transmission has been taking place in the anthropic environment in the municipality of Raposa.

  10. Implementation of an automated assessment system of the Winston-Lutz test based on the transformed generalized Hough; Implementacion de un sistema de evaluacion automatizada del test de Winston-Lutz basado en la transformada generalizada de Hough

    Energy Technology Data Exchange (ETDEWEB)

    Martin-Viera Cueto, J. A.; Moreno Saiz, C.; Benitez Villegas, E. M.; Fernandez Canadillas, M. J.; Caballero Lucena, E.; Cantero Carrillo, M.

    2013-07-01

    It has implemented a software tool based on the generalized Hough transform to automate the evaluation of test WL This method provides a quantitative evaluation of the test. It also eliminates the subjectivity of the evaluator which is an uncertainty of 0.3 mm. (Author)

  11. Estudo da competência vetorial de Lutzomyia intermedia (Lutz & Neiva, 1912 para Leishmania (Viannia braziliensis, Vianna, 1911 Study of the vectorial competence of Lutzomyia intermedia (Lutz & Neiva, 1912 to Leishmania (Viannia braziliensis, Vianna, 1911

    Directory of Open Access Journals (Sweden)

    Antonio Carlos da Silva

    2001-04-01

    Full Text Available Estudou-se a competência vetorial de Lutzomyia intermedia (Diptera: Psychodidae do Vale do Ribeira (SP para estirpes de Leishmania (Viannia braziliensis (Kinetoplastida: Trypanosomatidae, mediante pesquisa de infectividade natural; exposições de fêmeas silvestres e colonizadas (F1 às lesões de hamsters experimentalmente infectados e testes de transmissão via picada. A infectividade natural e os testes de transmissão revelaram-se negativos e, nas exposições, foram obtidas positividades de 74% (123+/166 dissecados e 70% (115+/164 dissecados para fêmeas silvestres e colonizadas respectivamente, e o desenvolvimento das formas evolutivas compatíveis com o modelo Peripilaria. A suscetibilidade às estirpes testadas associada aos indicadores epidemiológicos concorrem para a suspeita do papel vetorial de Lutzomyia intermedia na região estudada.This paper investigated the vectorial competence of Lutzomyia intermedia (Diptera: Psychodidae in Vale do Ribeira (SP to strains of Leishmania (Viannia braziliensis (Kinetoplastida: Trypanosomatidae, by means of a search for natural infection; exposure of wild and colonized females (F1 to the lesions of experimentally infected hamsters and transmission tests by bite. The natural infection and the transmission tests were negative. In the exposures of Lu. intermedia to infected lesions we found rates of 74% (123+/166 dissected and 70% (115+/164 dissected for the wild and colonized females respectively. The development of the parasites was compatible with the development model of Peripilaria. The susceptibility of the tested strains associated with the epidemiological indicators contribute to the vectorial role suspicion of Lutzomyia intermedia in the studied region.

  12. Sôbre o encontro de Lutzomyia longipalpis (Lutz & Neiva, 1912 no Estado de São Paulo, Brasil Lutzomyia longipalpis (Lutz & Neiva, 1912 detected in the State of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Oswaldo Paulo Forattini

    1970-06-01

    Full Text Available Relata-se o encontro de Lutzomyia longipalpis na localidade denominada Bairro do Arado, município de Salto de Pirapora, Estado de São Paulo, Brasil. Trata-se do primeiro registro concreto da presença dessa espécie em território paulista. Sugere-se a necessidade de investigar o significado epidemiológico dêsse achado.Lutzomyia longipalpis was found at the rural area named "Bairro do Arado", Salto de Pirapora County, São Paulo State, Brazil. This vector of visceral leihmaniasis is by the first time, surely recorded in the São Paulo State. The specimens were found in a chicken house built on rocks for observing the possibility of Triatoma arthurneivai colonization in artificial ecotopes. This suggests that the sandfly breeding places will possibly be found between or under the stones harbouring that triatomid bug. The necessity of epidemiological studies related to this found is emphasized.

  13. Estabelecimento de colonia, em laboratório, de Lutzomyia intermedia Lutz & Neiva, 1912 (Diptera, Psychodidae, Phlebotominae Establishment of colony, in laboratory, of Lutzomyia intermedia Lutz & Neiva, 1912 (Diptera, Psychodidae, Phlebotominae

    Directory of Open Access Journals (Sweden)

    Elizabeth F. Rangel

    1985-06-01

    Full Text Available Para a utilização em infecções experimentais e xenodiagnósticos de infecções naturais por leishmânias dermotrópicas do Rio de Janeiro, estabelecemos, em laboratório, uma colônia de Lutzomyia intermedia apresentando aqui a metodologia seguida, juntamente com dados relativos ao rendimento e duração de cada fase evolutiva nas quatro primeiras gerações.A laboratory colony of the sandfly Lutzomyia intermedia was established (at present in its seventh generation in order to provide specimens for experimental infection and for experimental xenodiagnosis of natural infections due to cutaneous leishmanias in Rio de Janeiro. Date are presented on the methodology and on the yield and duration of each stage of development, during the first four generations.

  14. Prevalence of GERD in Ado-Ekiti, Nigeria | Ajayi | Nigerian Journal ...

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2013) >. Log in or Register to get access to full text downloads.

  15. Laparo-assisted jejunostomy in neurological patients with chronic malnutrition and GERD

    Directory of Open Access Journals (Sweden)

    C. Esposito

    2013-06-01

    Full Text Available Background: Feeding difficulties and gastroesophageal reflux (GER are major problems in severely neurologically impaired children. Many patients are managed with a simple gastrostomy, with or without fundoplication. Unfortunately, fundoplication and gastrostomy are not devoid of complications, indicating the need for other options in the management of these patients. Methods: Between January 2002 and June 2010, ten patients (age range,18 months–14 years have been treated by creating a jejunostomy with the laparoscopic-assisted procedure. The procedure was performed using 2-3 trocars. The technique consists of identifying the first jeujnal loop, grasping it 20–30 cm away from the Treitz ligament, and exteriorizing it to the trocar orifice under visual guide. The jejunostomy was created outside the abdominal cavity during open surgery. At the end of the jejunostomy, the correct position of the intestinal loops was evaluated via laparoscopy. Results: Surgery lasted 40 min on average, the laparoscopic portion about 10 min. Hospital stay was 3 or 7 days for all patients. At the longest follow-up (8 years, all patients had experienced a significant weight gain. One patient died 1 year after the procedure of unknown causes. As for the other complications: 4/10 patients experienced peristomal heritema, 2/10 device’s dislocation and 1 patient a peristomal granuloma.Conclusions: Laparoscopic-assisted jejunostomy is a safe and effective procedure to adopt in neurologically impaired children with feeding problems and GER. We advocate the use of this procedure in neurologically impaired patients with feeding problems and reflux due to its overall practicability and because there is minimal surgical trauma. The improvement in the quality of life of these children after the jejunostomy seems to be the major advantage of this procedure. However the management of jejunostomy can be difficult for parents above all in the first postoperative months.

  16. Gastroesophageal reflux symptoms not responding to proton pump inhibitor: GERD, NERD, NARD, esophageal hypersensitivity or dyspepsia?

    Science.gov (United States)

    Bashashati, Mohammad; Hejazi, Reza A; Andrews, Christopher N; Storr, Martin A

    2014-01-01

    Gastroesophageal reflux (GER) is a common gastrointestinal process that can generate symptoms of heartburn and chest pain. Proton pump inhibitors (PPIs) are the gold standard for the treatment of GER; however, a substantial group of GER patients fail to respond to PPIs. In the past, it was believed that acid reflux into the esophagus causes all, or at least the majority, of symptoms attributed to GER, with both erosive esophagitis and nonerosive outcomes. However, with modern testing techniques it has been shown that, in addition to acid reflux, the reflux of nonacid gastric and duodenal contents into the esophagus may also induce GER symptoms. It remains unknown how weakly acidic or alkaline refluxate with a pH similar to a normal diet induces GER symptoms. Esophageal hypersensitivity or functional dyspepsia with superimposed heartburn may be other mechanisms of symptom generation, often completely unrelated to GER. Detailed studies investigating the pathophysiology of esophageal hypersensitivity are not conclusive, and definitions of the various disease states may overlap and are often confusing. The authors aim to clarify the pathophysiology, definition, diagnostic techniques and medical treatment of patients with heartburn symptoms who fail PPI therapy. PMID:24719900

  17. Quality of life of patients undergoing surgery by videolaparoscopy for GERD treatment.

    Science.gov (United States)

    Andrade, Francisco José Cavalcante; de Almeida, Eliete Rodrigues; dos Santos, Maria Teresa Botti Rodrigues; Soares-Filho, Eurípedes; Lopes, João Batista; Veras e Silva, Roberto Cavalcante

    2012-01-01

    Gastroesophageal reflux disease is a chronic disease of high prevalence in Western countries, with negative effects on quality of life. Surgery is indicated for patients with intolerance to continuous medication, prolonged treatment or control, or in complicated forms of the disease. To evaluate the quality of life of patients undergoing surgery by videolaparoscopy for gastroesophageal reflux disease treatment. Sample comprised 43 patients of both genders (mean age = 51.4 years). For quality of life evaluation was made using the questionnaire Gastroesophageal Reflux Disease Health Related Quality of Life, translated and validated into Portuguese. Data were analyzed by Epi Info version 3.5.1, using Duncan test and Pearson's correlation coefficient, with 5% for null hypothesis (p ≤ 0.05). Over 50% of participants showed good quality of life (scores quality of life and high level of satisfaction with their postoperative condition.

  18. Motility abnormalities in esophageal body in GERD: are they truly related to reflux?

    Science.gov (United States)

    Ciriza de los Ríos, C; García Menéndez, L; Díez Hernández, A; Fernández Eroles, A L; Vega Fernández, A; Enguix Armada, A

    2005-03-01

    Esophageal motility abnormalities have been observed in patients with gastroesophageal reflux disease. The aim of the present study was to determine if esophageal motor disorders in patients with a positive response to the omeprazole test are related to the existence of reflux or they are concomitant findings. A 24-hour pH monitoring and a stationary manometry were performed on 128 patients: 49 of them had normal manometry, 31 hypotensive lower esophageal sphincter, 29 motor disorder in esophageal body, and 19 hypotensive lower esophageal sphincter and motor disorder in esophageal body. We found an association between the presence of abnormal reflux and motor disorder in esophageal body (chi test; P esophageal motility was the disorder most strongly related to reflux, whereas the hypercontractile disorders were not clearly attributed to it. Esophageal manometric abnormalities should be considered cautiously before considering a motor disorder as a consequence of abnormal reflux.

  19. GERD related micro-aspiration in chronic mustard-induced pulmonary disorder

    Directory of Open Access Journals (Sweden)

    Rasoul Aliannejad

    2012-01-01

    Full Text Available Background and Aim: Bronchiolitis obliterans (BO is the main pulmonary involvement resulting from sulfur mustard (SM gas exposure that was used against Iranian civilians and military forces during the Iran-Iraq war. The present study aimed to investigate the prevalence of gastro-esophageal reflux (GER and gastric micro-aspiration in SM gas injured patients with chronic pulmonary diseases and recurrent episodes of exacerbations. Materials and Methods: This cross-sectional study was done at Baqiyatallah University of Medical Sciences, Tehran, Iran. Gastric micro-aspiration and GER were assessed in the enrolled patients by assessing bile acids, pepsin and trypsin in their bronchoalveolar lavage fluid. Results: Our result showed that bile acids were found to be high in 21.4% patients, and low in 53.6% of patients. Only in 16% patients, no bile was detected in the BALF. Trypsin and pepsin were detected in BAL fluid of all patients. Conclusion: Most of BO patients after exposure to SM suffer GER, while none the etiologic factors of GER in post lung transplant BO are present. It would be hypothesized that GER per se could be considered as an aggregative factor for exacerbations in patients. Further studies will provide more advances to better understanding of pathophysiological mechanism regarding GER and BO and treatment.

  20. Evaluating outcomes of endoscopic full-thickness plication for gastroesophageal reflux disease (GERD) with impedance monitoring.

    Science.gov (United States)

    von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

    2010-05-01

    Endoscopic full-thickness plication allows transmural suturing at the gastroesophageal junction to recreate the antireflux barrier. Multichannel intraluminal impedance monitoring (MII) can be used to detect nonacid or weakly acidic reflux, acidic swallows, and esophageal clearance time. This study used MII to evaluate the outcome of endoscopic full-thickness plication. In this study, 12 subsequent patients requiring maintenance proton pump inhibitor therapy underwent endoscopic full-thickness plication for treatment of gastroesophageal reflux disease. With patients off medication, MII was performed before and 6-months after endoscopic full-thickness plication. The total median number of reflux episodes was significantly reduced from 105 to 64 (p = 0.016). The median number of acid reflux episodes decreased from 73 to 43 (p = 0.016). Nonacid reflux episodes decreased from 23 to 21 (p = 0.306). The median bolus clearance time was 12 s before treatment and 11 s at 6 months (p = 0.798). The median acid exposure time was reduced from 6.8% to 3.4% (p = 0.008), and the DeMeester scores were reduced from 19 to 12 (p = 0.008). Endoscopic full-thickness plication significantly reduced total reflux episodes, acid reflux episodes, and total reflux exposure time. The DeMeester scores and total acid exposure time for the distal esophagus were significantly improved. No significant changes in nonacid reflux episodes and median bolus clearance time were encountered.

  1. Sobre a ocorrência da Lutzomyia longipalpis (Lutz & Neiva, 1912 na Ilha Grande, Estado do Rio de Janeiro, Brasil

    Directory of Open Access Journals (Sweden)

    Nelson A. de Araújo Filho

    1980-12-01

    Full Text Available Os autores descrevem peta primeira vez a presença de Lutzomyia longipalpis na Praia Vermelha, praia localizada na Ilha Grande, litoral do Estado do Rio de Janeiro e acentuam a importância epidemiológica do achado.

  2. Biologia de Lutzomyia intermedia (Lutz & Neiva, 1912 e Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera, Psychodidae em condições experimentais: II. Influência de fatores ambientais no comportamento das formas imaturas e adultas Biology of Lutzomyia intermedia (Lutz & Neiva, 1912 and Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera, Psychodidae in experimental conditions: II. Influence of environmental factors in the behavior of immature stages and adults

    Directory of Open Access Journals (Sweden)

    Elizabeth F. Rangel

    1987-09-01

    Full Text Available Com o objetivo de ampliar os conheciemntos sobre a biologia de Lutzomyia intermedia e Lutzomya longipalpis, mantidos em colônias autônomas no laboratório, apresentamos dados referentes a alterações em seu comportamento determinadas por influência de fatores ambientais. L. longipalpis foi mais fácil de criar, mais produtiva e mais resitente ás variações das condições ambientais; suga a qualquer hora do dia, enquanto que L. intermedia prefere fazê-lo ao crepúsculo e à noite, quando também ocorrem masi freqüentemente as desovas e as ecdises dos adultos das duas espécies. As fases imaturas de ambas as espécies resistem à imersão na água por até 1 hora e a baixa temperatura de 5ºC por até 6 horas.Proceeding on our studies on the biology of Lutzomyia intermedia and Lutzomyia longipalpis in closed colonies in the laboratory, we here present our observations on changes in their behavior caused by environmental conditions. L. longipaldis was easier to breed, more productive and more resistant to environmental changes; it feeds at any time of the day or night, while L. intermedia prefers to do it at sunset and at night, the preferencial time for oviposition and ecdysis of adults of both species. The immature stages of both species resisted to immersion in water for up to 1 hour and low temperature (5ºC for 1 to 6 hours.

  3. Effects of a fire on a population of treefrogs (Scinax cf. alter, Lutz) in a restinga habitat in southern Brazil.

    Science.gov (United States)

    Rocha, C F D; Ariani, C V; Menezes, V A; Vrcibradic, D

    2008-08-01

    The area of the Dunas da Joaquina, in Santa Catarina island, contains one of the most important remnants of restinga habitat in Santa Catarina State, southern Brazil. In December 2003, a fire occurred in a portion of this area, affecting most of the vegetation, including the bromeliad community. In this study, the density of individuals and the diet composition of the bromelicolous treefrog Scinax cf. alter were compared between the area affected by the fire and an adjacent unburned area. One-hundred-and-fifty-eight ground bromeliads (Vriesea friburguensis) were dissected and searched for the presence of treefrogs among their leaves. We found 30 frogs in 29.5% (23/78) of the bromeliads from the unburned site, with a mean of 1.3 frogs per rosette, and 15 frogs in 12.5% (10/80) of the bromeliads from the burned site, with a mean of 1.6 frogs per rosette. Eight (27%) of the frogs from the unburned site and eleven (73%) of those from the burned site had empty stomachs. Frogs from the burned site also contained less prey per stomach than those from the unburned site. The data suggest that the fire has negatively affected the local population of Scinax cf. alter, though it is possible that the population can recover.

  4. Identification of the sex pheromone of Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae from Asunción, Paraguay

    Directory of Open Access Journals (Sweden)

    Caballero Norath

    2009-11-01

    Full Text Available Abstract The sand fly Lutzomyia longipalpis is the main vector of Leishmania (L. infantum (Nicolle, the causative agent of American visceral leishmaniasis (AVL in the New World. Male Lu. longipalpis have secretory glands which produce sex pheromones in either abdominal tergites 4 or 3 and 4. These glands are sites of sex pheromone production and each pheromone type may represent true sibling species. In Latin America, apart from Lu. pseudolongipalpis Arrivillaga and Feliciangeli from Venezuela, populations of Lu. longipalpis s.l. can be identified by their male-produced sex pheromones: (S-9-methylgermacrene-B, 3-methyl-α-himachalene and the two cembrenes, 1 and 2. In this study, we present the results of a coupled gas chromatography - mass spectrometry analysis of the pheromones of males Lu. longipalpis captured in an endemic area of visceral leishmaniasis in Asunción, Paraguay. Our results show that Lu. longipalpis from this site produce (S-9-methylgermacrene-B which has also been found in Lu. longipalpis from different areas of Brazil, Colombia and Central America.

  5. Occurrence of Lutzomyia longipalpis Lutz & Neiva 1912 and Cerdocyon thous Linnaeus 1977, in a visceral leishmaniasis endemic area in Brazil.

    Science.gov (United States)

    Araujo Soares, Maria Regiane; Lopes Antunes, Jadson Emanuel; de Mendonça, Ivete Lopes; Lima, Rogério Nora; Nery Costa, Carlos Henrique

    2017-10-01

    Cerdocyon thous presents a wide geographic distribution in Brazil and its role as a possible Leishmania infantum reservoir in a visceral leishmaniasis (VL) transmission cycle regardless of dogs (Canis familiaris) has been discussed. From this perspective, this work describes the occurrence and use of the habitat by Cerdocyon thous in a Lutzomyia longipalpis occurrence area Teresina (Piaui - Brazil), VL endemic region. Three specimens of C. thous were monitored with the use of radio telemetry and trails and footprints, seeking to find possible natural dens in order to collect the sanflies from the site. Luminous CDC and Damasceno traps were simultaneously installed at the visited sites, where two specimens of L. longipalpis and one L. termitophila were captured. The identification of the dens and trails, allows us to infer that the dens are not used only by the C. thous. Finding the VL vector in natural C. thous natural dens, reinforces the hypothesis of transmission of Le. infantum in the outskirts of the large urban centers, in a cycle that independs from dogs. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Identification of the sex pheromone of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae) from Asunción, Paraguay

    Science.gov (United States)

    Brazil, Reginaldo P; Caballero, Norath Natalia; Hamilton, James Gordon C

    2009-01-01

    The sand fly Lutzomyia longipalpis is the main vector of Leishmania (L.) infantum (Nicolle), the causative agent of American visceral leishmaniasis (AVL) in the New World. Male Lu. longipalpis have secretory glands which produce sex pheromones in either abdominal tergites 4 or 3 and 4. These glands are sites of sex pheromone production and each pheromone type may represent true sibling species. In Latin America, apart from Lu. pseudolongipalpis Arrivillaga and Feliciangeli from Venezuela, populations of Lu. longipalpis s.l. can be identified by their male-produced sex pheromones: (S)-9-methylgermacrene-B, 3-methyl-α-himachalene and the two cembrenes, 1 and 2. In this study, we present the results of a coupled gas chromatography - mass spectrometry analysis of the pheromones of males Lu. longipalpis captured in an endemic area of visceral leishmaniasis in Asunción, Paraguay. Our results show that Lu. longipalpis from this site produce (S)-9-methylgermacrene-B which has also been found in Lu. longipalpis from different areas of Brazil, Colombia and Central America. PMID:19883505

  7. Tribute to P.L. Lutz: cardiac performance and cardiovascular regulation during anoxia/Hypoxia in freshwwater turtles

    DEFF Research Database (Denmark)

    Overgaard, J.; Gesser, Hans; Wang, Tobias

    2007-01-01

    Freshwater turtles overwintering in ice-covered ponds in North America may be exposed to prolonged anoxia, and survive this hostile environment by metabolic depression. Here, we review their cardiovascular function and regulation, with particular emphasis on the factors limiting cardiac performance....... The pronounced anoxia tolerance of the turtle heart is based on the ability to match energy consumption with the low anaerobic ATP production during anoxia. Together with a well-developed temporal and spatial energy buffering by creatine kinase, this allows for cellular energy charge to remain high during anoxia....... Furthermore, the turtle heart is well adapted to handle the adverse effects of free phosphate arising when phosphocreatine stores are used. Anoxia causes tenfold reductions in heart rate and blood flows that match the metabolic depression, and blood pressure is largely maintained through increased systemic...

  8. Report of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in a cutaneous-leishmaniasis-endemic area of Panama.

    Science.gov (United States)

    Valderrama, Anayansi; Tavares, Mara Garcia; Andrade Filho, José Dilermando

    2011-12-01

    Lutzomyia longipalpis is the primary vector of the parasite responsible for visceral leishmaniasis in the Americas. In the present study, Lu. longipalpis was found in a domiciliary area in Limón, a district in Capira, a region in which cutaneous leishmaniasis is endemic in Panama. Previously, this species has been found in a humid forest in this same region. Finding Lu. longipalpis in domiciliary areas indicates that this species may be adapting to new habitats and that it may play a role in the transmission of leishmaniasis in Panama.

  9. The first record of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in the State of Paraná, Brazil.

    Science.gov (United States)

    Santos, Demilson Rodrigues Dos; Ferreira, Adão Celestino; Bisetto Junior, Alceu

    2012-10-01

    We report the first find of Lutzomyia longipalpis in the State of Paraná, Brazil. The specimens were captured in the urban area of the municipality of Foz do Iguaçu, with Falcão light traps, in domiciliary and peridomiciliary areas of 61 properties, on two consecutive nights from 18:00 to 06:00hs in March 2012. We captured 40 specimens of Lu. longipalpis and 54 specimens of other sandfly species. This find expands knowledge of the geographical distribution of this sandfly in Brazil.

  10. Sex pheromone and period gene characterization of Lutzomyia longipalpis sensu lato (Lutz & Neiva) (Diptera: Psychodidae) from Posadas, Argentina.

    Science.gov (United States)

    Salomón, Oscar D; Araki, Alejandra S; Hamilton, James Gc; Acardi, Soraya A; Peixoto, Alexandre A

    2010-11-01

    Lutzomyia longipalpis s.l. is the primary vector of Leishmania (L.) infantum in the New World. In this study, male Lutzomyia longipalpis specimens from Posadas, Argentina were characterized for two polymorphic markers: the male sex pheromone and the period (per) gene. The male sex pheromone was identified as (S)-9-methylgermacrene-B, the same compound produced by Lu. longipalpis from Paraguay and many populations from Brazil. The analysis of per gene sequences revealed that the population from Argentina is significantly differentiated from previously studied Brazilian populations. Marker studies could contribute to the understanding of the distribution and spread of urban American visceral leishmaniasis, thus aiding in the design of regional surveillance and control strategies.

  11. Genetic variation among natural and laboratory colony populations of Lutzomyia longipalpis (Lutz & Neiva, 1912)(Diptera: Psychodidae) from Colombia.

    Science.gov (United States)

    Lanzaro, G C; Alexander, B; Mutebi, J P; Montoya-Lerma, J; Warburg, A

    1998-01-01

    Genetic diversity among three field populations of Lutzomyia longipalpis in Colombia was studied using isozyme analysis. Study sites were as much as 598 km apart and included populations separated by the eastern Cordillera of the Andes. Genetic variability among populations, estimated by heterozygosity, was within values typical for insects in general (8.1%). Heterozygosity for field populations were compared with a laboratory colony from Colombia (Melgar colony) and were only slightly lower. These results suggest that establishment and long term maintenance of the Melgar colony has had little effect on the level of isozyme variability it carries. Genetic divergences between populations was evaluated using estimates of genetic distance. Genetic divergence among the three field populations was low (D = 0.021), suggesting they represent local populations within a single species. Genetic distance between field populations and the Melgar colony was also low (D = 0.016), suggesting that this colony population does not depart significantly from natural populations. Finally, comparisons were made between Colombian populations and colonies from Brazil and Costa Rica. Genetic distance values were high between Colombian and both Brazil and Costa Rica colony populations (D = 0.199 and 0.098 respectively) providing additional support for our earlier report that populations from the three countries represent distinct species.

  12. Identification of the sex pheromone of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae) from Asunción, Paraguay.

    Science.gov (United States)

    Brazil, Reginaldo P; Caballero, Norath Natalia; Hamilton, James Gordon C

    2009-11-02

    The sand fly Lutzomyia longipalpis is the main vector of Leishmania (L.) infantum (Nicolle), the causative agent of American visceral leishmaniasis (AVL) in the New World. Male Lu. longipalpis have secretory glands which produce sex pheromones in either abdominal tergites 4 or 3 and 4. These glands are sites of sex pheromone production and each pheromone type may represent true sibling species. In Latin America, apart from Lu. pseudolongipalpis Arrivillaga and Feliciangeli from Venezuela, populations of Lu. longipalpis s.l. can be identified by their male-produced sex pheromones: (S)-9-methylgermacrene-B, 3-methyl-alpha-himachalene and the two cembrenes, 1 and 2.In this study, we present the results of a coupled gas chromatography - mass spectrometry analysis of the pheromones of males Lu. longipalpis captured in an endemic area of visceral leishmaniasis in Asunción, Paraguay. Our results show that Lu. longipalpis from this site produce (S)-9-methylgermacrene-B which has also been found in Lu. longipalpis from different areas of Brazil, Colombia and Central America.

  13. Genetic Variation among Natural and Laboratory Colony Populations of Lutzomyia longipalpis (Lutz & Neiva, 1912(Diptera:Psychodidae from Colombia

    Directory of Open Access Journals (Sweden)

    Lanzaro Gregory C

    1998-01-01

    Full Text Available Genetic diversity among three field populations of Lutzomyia longipalpis in Colombia was studied using isozyme analysis. Study sites were as much as 598 km apart and included populations separated by the eastern Cordillera of the Andes. Genetic variability among populations, estimated by heterozygosity, was within values typical for insects in general (8.1%. Heterozygosity for field populations were compared with a laboratory colony from Colombia (Melgar colony and were only slightly lower. These results suggest that establishment and long term maintenance of the Melgar colony has had little effect on the level of isozyme variability it carries. Genetic divergences between populations was evaluated using estimates of genetic distance. Genetic divergence among the three field populations was low (D=0.021, suggesting they represent local populations within a single species. Genetic distance between field populations and the Melgar colony was also low (D=0.016, suggesting that this colony population does not depart significantly from natural populations. Finally, comparisons were made between Colombian populations and colonies from Brazil and Costa Rica. Genetic distance values were high between Colombian and both Brazil and Costa Rica colony populations (D=0.199 and 0.098 respectively providing additional support for our earlier report that populations from the three countries represent distinct species

  14. Effects of Mikania glomerata Spreng. and Mikania laevigata Schultz Bip. ex Baker (Asteraceae) extracts on pulmonary inflammation and oxidative stress caused by acute coal dust exposure

    Energy Technology Data Exchange (ETDEWEB)

    Freitas, T.P.; Silveira, P.C.; Rocha, L.G.; Rezin, G.T.; Rocha, J.; Citadini-Zanette, V.; Romao, P.T.; Dal-Pizzol, F.; Pinho, R.A.; Andrade, V.M.; Streck, E.L. [University Extremo Catarinense, Criciuma (Brazil)

    2008-12-15

    Several studies have reported biological effects of Mikania glomerata and Mikania laevigata, used in Brazilian folk medicine for respiratory diseases. Pneumoconiosis is characterized by pulmonary inflammation caused by coal dust exposure. In this work, we evaluated the effect of pretreatment with M. glomerata and M. laevigata extracts (MGE and MLE, respectively) (100 mg/kg, s.c.) on inflammatory and oxidative stress parameters in lung of rats subjected to a single coal dust intratracheal instillation. Rats were pretreated for 2 weeks with saline solution, MGE, or MLE. On day 15, the animals were anesthetized, and gross mineral coal dust or saline solutions were administered directly in the lung by intratracheal instillation. Fifteen days after coal dust instillation, the animals were killed. Bronchoalveolar lavage (BAL) was obtained; total cell count and lactate dehydrogenase (LDH) activity were determined. In the lung, myeloperoxidase activity, thiobarbituric acid-reactive substances (TBARS) level, and protein carbonyl and sulfhydryl contents were evaluated. In BAL of treated animals, we verified an increased total cell count and LDH activity. MGE and MLE prevented the increase in cell count, but only MLE prevented the increase in LDH. Myeloperoxidase and TBARS levels were not affected, protein carbonylation was increased, and the protein thiol levels were decreased by acute coal dust intratracheal administration. The findings also suggest that both extracts present an important protective effect on the oxidation of thiol groups. Moreover, pretreatment with MGE and MLE also diminished lung inflammatory infiltration induced by coal dust, as assessed by histopathologic analyses.

  15. Overcoming the Irrational Land Use in Africa and Other Regions of the World - A Critique to the Myths of Nobel Laureate Schultz and Nominee Hirschman

    OpenAIRE

    Zhou, Jian-Ming

    2009-01-01

    Paper presented at the UNU-WIDER (United Nations University – World Institute for Development Economics Research) Project Conference on African Development: Myths and Realities Accra, Ghana, 10-11 December 2009

  16. Assessment of Social Information Processing in Early Childhood: Development and Initial Validation of the Schultz Test of Emotion Processing--Preliminary Version

    Science.gov (United States)

    Schultz, David; Ambike, Archana; Logie, Sean Kevin; Bohner, Katherine E.; Stapleton, Laura M.; VanderWalde, Holly; Min, Christopher B.; Betkowski, Jennifer A.

    2010-01-01

    Crick and Dodge's (Psychological Bulletin 115:74-101, 1994) social information processing model has proven very useful in guiding research focused on aggressive and peer-rejected children's social-cognitive functioning. Its application to early childhood, however, has been much more limited. The present study responds to this gap by developing and…

  17. Essential oil composition and antibacterial activity of Tanacetum argenteum (Lam.) Willd. ssp. argenteum and T. densum (Lab.) Schultz Bip. ssp. amani heywood from Turkey.

    Science.gov (United States)

    Polatoğlu, Kaan; Demirci, Fatih; Demirci, Betül; Gören, Nezhun; Başer, Kemal Hüsnü Can

    2010-01-01

    Water-distilled essential oils from aerial parts of Tanacetum argenteum ssp. argenteum and T. densum ssp. amani from Turkey were analyzed by GC and GC/MS. The essential oil of T. argenteum ssp. argenteum was characterized with alpha-pinene 36.7%, beta-pinene 27.5% and 1,8-cineole 9.8%. T. densum ssp. amani was characterized with beta-pinene 27.2%, 1,8-cineole 13.1%, alpha-pinene 9.7% and p-cymene 8.9%. Antibacterial activity of the oils were evaluated for five Gram-positive and five Gram-negative bacteria by using a broth microdilution assay. The highest inhibitory activity was observed against Bacillus cereus for T. argenteum ssp. argenteum oil (125 microg/mL) when compared with positive control chloramphenicol it showed the same inhibition potency. However, the same oil showed lower inhibitory activity against B. subtilis when compared. The oil of T. densum ssp. amani did not show significant activity against the tested microorganisms. DPPH radical scavenging activity of the T. argenteum ssp. argenteum oil was investigated for 15 and 10 mg/mL concentrations. However, the oil did not show significant activity when compared to positive control alpha-tocopherol. Both oils showed toxicity to Vibrio fischeri in the TLC-bioluminescence assay.

  18. Okologie als Frage der Zeit: Eine Antwort auf Helmut Heid und Gerd-Jan Krol (The Concept of Time in Environmental Education: A Replique to Helmut Heid and Gerd-Jan Krol).

    Science.gov (United States)

    Reheis, Fritz

    1997-01-01

    Responds to arguments that environmental education must be backed up by a theory of society. Sketches a paradigm that would be broad enough to cover all object areas relevant to a well-grounded pedagogy of environment, and links the basic idea of ecology with insights on scales and rhythms of time. (DSK)

  19. An inverse relationship between CagA+ strains of Helicobacter pylori infection and risk of erosive GERD

    International Nuclear Information System (INIS)

    Somi, Mohammad H.; Fattahi, E.; Fouladi, Rohollah F.; Karimi, M.; Bonyadi, R.; Baballou, Z.

    2008-01-01

    The aim of this study is investigating the association of Helicobacter pylori (H. pylori) infection and its cytogenetic-associated gene A (cag A) strain with reflux esophagitis. In a case-control setting (May 2005-2006), patients with reflux esophagitis (case group) were compared with age and gender matched people suffering from symptoms of gastroesophageal reflux disease with normal upper gastrointestinal endoscopic findings (control group) in Imam Khomeini Hospital, Tabriz, Iran. The rates of H. pylori and its cagA positive infections were separately compared between the 2 groups and the subgroups with different severity of reflux esophagitis. Ninety-two and 93 patients were enrolled in the case and control groups. The rate of H.pylori infection was significantly lower in case group (81.5%versus 87.10%, p=0.29, odd ratio 0.654, 95% confidence interval [CI] 0.293 to 1.495). The CagA positive infections were found significantly more frequent in the control group (59.1% versus 40.2%, p=0.01, odd ratio 0.465, 95% CI 0.258 to 0.836). There was no significant difference between the severity subgroups of the disease for H. pylori (p=0.30) or cagA positive infection rates (p=0.40). The cagA positive strains might have a protective effect against reflux esophagitis. (author)

  20. Effect of lateral positioning on gastroesophageal reflux (GER) and underlying mechanisms in GER disease (GERD) patients and healthy controls

    NARCIS (Netherlands)

    Loots, C.; Smits, M.; Omari, T.; Bennink, R.; Benninga, M.; van Wijk, M.

    2013-01-01

    Background Posture has been shown to influence the number of transient lower esophageal sphincter relaxation (TLESRs) and gastroesophageal reflux (GER), however, the physiology explaining the influence of right lateral position (RLP), and left lateral position (LLP) is not clear. The aim of this

  1. Is GERD a Factor in Osteonecrosis of the Jaw? Evidence of Pathology Linked to G6PD Deficiency and Sulfomucins

    Directory of Open Access Journals (Sweden)

    Stephanie Seneff

    2016-01-01

    Full Text Available Osteonecrosis of the jaw (ONJ, a rare side effect of bisphosphonate therapy, is a debilitating disorder with a poorly understood etiology. FDA’s Adverse Event Reporting System (FAERS provides the opportunity to investigate this disease. Our goals were to analyze FAERS data to discover possible relationships between ONJ and specific conditions and drugs and then to consult the scientific literature to deduce biological explanations. Our methodology revealed a very strong association between gastroesophageal reflux and bisphosphonate-induced ONJ, suggesting acidosis as a key factor. Overgrowth of acidophilic species, particularly Streptococcus mutans, in the oral microbiome in the context of insufficient acid buffering due to impaired salivary glands maintains the low pH that sustains damage to the mucosa. Significant associations between ONJ and adrenal insufficiency, vitamin C deficiency, and Sjögren’s syndrome were found. Glucose 6 phosphate dehydrogenase (G6PD deficiency can explain much of the pathology. An inability to maintain vitamin C and other antioxidants in the reduced form leads to vascular oxidative damage and impaired adrenal function. Thus, pathogen-induced acidosis, hypoxia, and insufficient antioxidant defenses together induce ONJ. G6PD deficiency and adrenal insufficiency are underlying factors. Impaired supply of adrenal-derived sulfated sterols such as DHEA sulfate may drive the disease process.

  2. Combined esophageal intraluminal impedance, pH and skin conductance monitoring to detect discomfort in GERD infants.

    Directory of Open Access Journals (Sweden)

    Francesco Cresi

    Full Text Available BACKGROUND: The clinical significance of weakly acidic reflux in infants is unclear. Skin conductance is a novel not-invasive method to evaluate discomfort. The aim of our study was to evaluate reflux-induced discomfort in infants with gastroesophageal reflux disease using simultaneously combined skin conductance and esophageal multichannel intraluminal impedance and pH monitoring. METHODOLOGY/PRINCIPAL FINDINGS: Infants with gastroesophageal reflux symptoms were investigated for almost 20 hours divided into 120-second intervals. Temporal relationships between refluxes and discomfort were evaluated calculating the symptom association probability. Twelve infants aged 17-45 days were studied. Out of 194.38 hours of adequate artifact-free MII/pH and skin conductance monitoring, 584 reflux events were observed; 35.78% were positive for stress, of which 16.27% were acid and 83.73% weakly acidic. A significant association between refluxes and discomfort (p<0.05 was present in all infants. The intervals with reflux events showed increased skin conductance values compared to reflux-free intervals (p<0.001; SC values were similar for acid and weakly acidic reflux events. CONCLUSION/SIGNFICANCE: Discomfort was significantly associated with reflux events and did not differ between weakly acidic and acid refluxes. Our results may raise concerns about the over-prescription use of antacid drugs in the management of gastroesophageal reflux symptoms in infancy.

  3. Photosynthetic pigments content, photosynthesis rate and chloroplast structure in young plants of Mikania laevigata Schultz Bip. ex Baker grown under colored netsTeores de pigmentos fotossintéticos, taxa de fotossíntese e estrutura de cloroplastos de plantas jovens de Mikania laevigata Schultz Bip. ex Baker cultivadas sob malhas coloridas

    Directory of Open Access Journals (Sweden)

    Anacleto Ranulfo dos Santos

    2011-12-01

    Full Text Available Guaco (Mikania laevigata is a medicinal plant used to treat fever, rheumatism, flu and respiratory tract diseases. Understanding the physiology of this species and its responses to environmental conditions has become necessary to improving the cultivation methods. In this context, this work aimed to access the effects of shading by using colored nets in on photosynthetic pigment concentration, photosynthetic rate and ultrastructure of chloroplasts of Mikania laevigata. The plants were cultivated during four months under nets with 50% shading in blue, red and gray color nets and under full sunlight (0%. The plants grown under full sunlight had decreased contents of a and b chlorophyll, and of carotenoids, while those grown under blue nets shown higher concentrations of a and b chlorophyll. The lowest density of chloroplasts was found in plants cultivated under full sunlight. Elongated chloroplasts were noticed in treatments with 50% shading. Regarding the potential rate of photosynthesis no significant change was observed among the plants grown under red, blue and gray nets, which leads to the conclusion that the spectrum transmitted by different coloured nets did not affect guaco photosynthetic apparatus.O guaco (Mikania laevigata é uma planta medicinal, usada para o tratamento de febre, reumatismo, gripe e doenças do trato respiratório. O entendimento do comportamento fisiológico dessa espécie e as suas respostas às condições do ambiente tornam-se necessários ao aperfeiçoamento dos métodos de cultivo. Nesse contexto, o presente trabalho teve como objetivo avaliar os efeitos do sombreamento com uso de malhas coloridas na concentração de pigmentos fotossintéticos, na taxa de fotossíntese e na ultra-estrutura de cloroplastos de plantas de Mikania laevigata. As plantas foram cultivadas por quatro meses sob malhas de 50% de sombreamento nas cores azul, vermelha e cinza e a pleno sol (0%. As plantas mantidas a pleno sol tiveram os menores teores de clorofila a e b e o menor teor de carotenóides, enquanto aquelas cultivadas sob malha azul tiveram a maior concentração de clorofilas a e b. A menor densidade de cloroplastos foi encontrada nas plantas cultivadas a pleno sol. Nos tratamentos com 50% de sombreamento, foram verificados cloroplastos mais alongados. Com relação à taxa de fotossíntese potencial, não foi observada nenhuma diferença significativa entre plantas crescidas sob as malhas vermelha, cinza e azul, fato que leva a acreditar que o espectro diferenciado transmitido pelas malhas coloridas não interferiu no aparelho fotossintético do guaco.

  4. Ecology, reproductive biology and conservation of Picris willkommii (Schultz Bip.) Nyman (Asteraceae): an endemic, protected species from therophytic grasslands of South-Western Iberian Peninsula; Ecologia, biologia reproductiva y conservacion de Picris willkommii (Schultz Bip.) Nyman (Asteraceae): endemismo protegido integrado en pastos terofiticos del suroeste de la Peninsula Iberica

    Energy Technology Data Exchange (ETDEWEB)

    Monteagudo Sanchez-Movellan, F. J.; Butler Sierra, I.; Bastida Milian, F.

    2009-07-01

    Current knowledge of the biology of Picris willkommii and his grade of threat, seem not to be sufficient to ensure long term persistence of this plant species endemic to the South-Western Iberian Peninsula. In Spain, main populations of the species are narrowly restricted to therophytic grasslands around the town of Ayamonte, by the Guadiana river drainage. Results of the present study indicate that P. willkommii behaves as a very versatile, colonizing species in most of the habitats of their natural range, where it appears to be well suited to the cyclic disturbance dynamics imposed by local, traditional land uses, i.e. extensive rain-fed agriculture. Moreover, it is easy to grow under controlled conditions. Results could be helpful for conservation and population recovery purposes, as recent changes in land use, shifting from agricultural traditional systems to urban expansion or alternative agricultural systems, pose at risk P. willkommii populations due to habitat loss. (Author) 35 refs.

  5. The retained capacity of Lutzomya longipalpis (Lutz & Neiva to transmit Leishmania chagasi (Cunha & Chagas after eight years (64 generations in a closed laboratory colony

    Directory of Open Access Journals (Sweden)

    M. de N. A. Gonçalves

    1985-09-01

    Full Text Available A closed Lutzomyia longipalpis colony, from Ceará has been used to transmit Leishmania chagasi isolated from a fox in Pará state. The last time this colony was successfully used in similar transmission experiments was eight years (64 generations ago indicating that this colony of Lu. longipalpis has fully maintained its vectorial capacity in spite of such a long period of maintainance in the laboratory.Lutzomyia longipalpis foi alimentado através de membrana com uma suspensão de macerado de fígado e baço em sangue desfibrinado de coelho. Este material foi originário de um hamster infectado com Leishmania chagasi, realimentado em hamsters limpos, transmitindo os parasitos em duas ocasiões. Esta mesma colônia de Lu. longipalpis, do Ceará, foi usada para a primeira transmissão há oito anos e 64 gerações atrás e não teve a capacidade vetorial diminuída.

  6. Dero (Allodero lutzi Michaelsen, 1926 (Oligochaeta: Naididae associated with Scinax fuscovarius (Lutz, 1925 (Anura: Hylidae from Semi-deciduous Atlantic Rain Forest, southern Brazil

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    FH. Oda

    Full Text Available Amphibians are hosts for a wide variety of ecto- and endoparasites, such as protozoans and parasitic worms. Naididae is a family of Oligochaeta whose species live on a wide range of substrates, including mollusks, aquatic macrophytes, sponges, mosses, liverworts, and filamentous algae. However, some species are known as endoparasitic from vertebrates, such as Dero (Allodero lutzi, which is parasitic of the urinary tracts of frogs, but also have a free-living stage. Specimens in the parasitic stage lack dorsal setae, branchial fossa, and gills. Here we report the occurrence of D. (A. lutzi associated with anuran Scinax fuscovarius from Semi-deciduous Atlantic Rain Forest in southern Brazil. The study took place at the Caiuá Ecological Station, Diamante do Norte, Paraná, southern Brazil. Seven specimens of S. fuscovarius were examined for parasites but only one was infected. Parasites occurred in ureters and urinary bladder. Previous records of this D. (A. lutzi include the Brazilian States of Santa Catarina, São Paulo, Rio de Janeiro, and Minas Gerais, as well as Cuba and North America. This is a new locality record for this species in Brazil. Reports of Dero (Allodero lutzi are rare, due to difficulty of observation, and such events are restricted only the fortuitous cases. It is important to emphasize the necessity of future studies, which are fundamental to the understanding of biological and ecological aspects of this species.

  7. New species of Myxosporea from frogs and resurrection of the genus Cystodiscus Lutz, 1889 for species with myxospores in gallbladders of amphibians

    Czech Academy of Sciences Publication Activity Database

    Hartigan, A.; Fiala, Ivan; Dyková, Iva; Rose, K.; Phalen, D. N.; Šlapeta, J.

    2012-01-01

    Roč. 139, č. 4 (2012), s. 478-496 ISSN 0031-1820 R&D Projects: GA AV ČR KJB600960701 Grant - others:GA ČR(CZ) GP204/09/P519 Program:GP Institutional support: RVO:60077344 Keywords : Cystodiscus axonis * Cystodiscus australis * new species * Myxidium * Myxosporea * amphibians * frogs * tadpoles * brain * liver * disease * phylogeny Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.355, year: 2012

  8. Temporada e turno de vocalização de Leptodactylus natalensis Lutz, 1930 (Amphibia, Anura na mata atlântica de Pernambuco, Brasil

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    Fabiana Oliveira de Amorim

    2009-01-01

    Full Text Available A atividade de vocalização de uma população de Leptodactylus natalensis foi monitorada em uma poça temporária entre novembro/2002 e outubro/2004. A poça está situada em um fragmento de Mata Atlântica conhecido como Refúgio Ecológico Charles Darwin, município de Igarassu, Estado de Pernambuco. Os animais apresentaram-se ativos na maioria dos meses, apresentando picos na estação seca. A atividade de vocalização foi registrada durante o dia e a noite. Houve influência negativa e significativa entre a atividade vocal e a temperatura. O número de indivíduos vocalizando não foi significantemente afetado pela precipitação pluviométrica, mas o foi pelo número de fêmeas no ambiente. Verificou-se uma grande plasticidade na atividade de vocalização de L. natalensis durante a temporada e turno.Vocalizations of a population of Leptodactylus natalensis were monitored in a temporary pond from November 2002 to October 2004. This pond is located in a fragment of Atlantic rainforest belonging to the private Ecologic Refuge Charles Darwin, in the city of Igarassu, state of Pernambuco, Brazil. Individuals were active during most of the studied months, with peaks of activity during dry season. Vocal activity was recorded both in day and nighttime. There was a significant negative effect of temperature on vocal activity. The number of individuals vocalizing was not affected significantly by rainfall, but it was by the number of females on the environment. A great plasticity of vocal activities of L. natalensis was verified, both in season and turn.

  9. Test Review: Reynolds, C. R., & Kamphaus, R. W. (2003). "RIAS--Reynolds Intellectual Assessment Scales." Lutz, FL--Psychological Assessment Resources, Inc.

    Science.gov (United States)

    Dombrowski, Stefan C.; Mrazik, Martin

    2008-01-01

    In this article, the authors review the Reynolds Intellectual Assessment Scales (RIAS; Reynolds & Kamphaus, 2003), an individually administered test of intelligence for use with individuals between the ages of 3 and 94. The RIAS represents the newest intelligence test on the marketplace and incorporates the most current intelligence test theory…

  10. Programa de controle de surto de escorpião Tityus serrulatus, Lutz e Mello 1922, no município de Aparecida, SP (Scorpiones, Buthidae

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    Elieth Floret Spirandeli Cruz

    1995-06-01

    Full Text Available Os autores propuseram para o município de Aparecida, vale do Rio Paraíba, SP, região endêmica do Tityus serrulatus, um programa de controle do escorpionismo. Foram estudados a presença de focos do escorpião no campo e na cidade, as alterações ambientais periféricas à zona urbana e os novos ambientes de procriação e dispersão destes artrópodes. Além disso, foram avaliados os problemas básicos de infra-estrutura, tais como o acondicionamento e a coleta do lixo urbano público e domiciliar, o saneamento básico (esgotos e galerias pluviais e a situação dos terrenos baldios e as construções da zona urbana. Após estudo epidemiológico, foram propostas medidas educativas, que constaram da confecção e distribuição de folhetos, de mutirões de limpeza, de visitas domiciliares e do engajamento de professores e alunos da rede de ensino pública e privada na campanha. Nos locais onde existiam focos de alto risco, em especial nas pré-escolas, foi proposto o emprego do controle químico. Dentro das normas sanitárias vigentes para a zona urbana, foi proposto ainda, o uso de predadores naturais no combate. Os autores concluem que as ações devem ser integradas e continuadas de forma ininterrupta por vários anos e propõem ação conjunta com a campanha da dengue. A instituição de uma semana por ano dedicada ao estudo do escorpionismo nas escolas dos municípios onde ocorre o problema seria uma medida educativa que viria contribuir sobremaneira para a prevenção dos acidentes e controle do escorpionismo.A scorpion control program was proposed for the town of Aparecida (SP, an endemic region of Tityus serrulatus. Clusters of scorpions in urban and rural areas, environmental degradation of the town's outskirts and new scorpion procreation and dispersal habitats were studied. In addition, infrastructure problems such as the disposal and collection of residential and municipal refuse, sanitation (sewage and storm sewer, condition of vacant lots and constructions in the urban area were evaluated. After an epidemiological study, educational measures such as the distribution of pamphlets, cleaning group work, visits to residences and cooperation from High School teachers and students were also suggested. Chemical control was indicated in high-risk sites, especially those of nearschool buildings. Furthermore, the use of natural predators was also mentioned within the present sanitation regulations for urban areas. The authors assert that these procedures must be integrated and continued aninterrruptedly for several years. They also suggest a collaborative work with those responsible for the dengue erradication program, as well as the institution of the "scorpion study week", which would greatly contribute to the education of the population, to preventive programs and to scorpion control.

  11. Espécies novas do Herbário do Dr. Adolpho Lutz: Melastomataceae Tibouchina Lutzii Brade n.sp

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    A. C. Brade

    1955-12-01

    Full Text Available A posição desta espécie é após Tibouchina floribunda Cogn. No hábito assemelha-se a Tibouchina Schwackei Cogn. mas distingue-se bem desta pelo revestimento diferente e a côr alva da página inferior da folha.

  12. Studies on the Feeding Habits of Lutzomyia (Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae: Phlebotominae Populations from Endemic Areas of American Visceral Leishmaniasis in Northeastern Brazil

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    Margarete Martins dos Santos Afonso

    2012-01-01

    Full Text Available The aim of this study was to identify potential blood feeding sources of L. (L. longipalpis specimens from populations in Northeastern Brazil, endemic areas of American Visceral Leishmaniasis (AVL and its correlation with the transmission of L. (L. i. chagasi. The ELISA technique was applied using bird, dog, goat, opossum, equine, feline, human, sheep, and rodent antisera to analyze 609 females, resulting in an overall positivity of 60%. In all municipalities, females showed higher positivity for bird followed by dog antiserum and sand fly specimens were also positive for equine, feline, human, sheep, goat, opossum, and rodent antisera. The finding for 17 combinations of two or three types of blood in some females corroborates the opportunistic habit of this sand fly species. The results demonstrating the association between L. (L. longipalpis and opossum suggest the need for further evaluation of the real role of this synanthropic mammal in the eco-epidemiology of AVL.

  13. Prevalência da microbiota no trato digestivo de fêmeas de Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae provenientes do campo

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    Oliveira Sandra Maria Pereira de

    2000-01-01

    Full Text Available No presente trabalho foram dissecados o trato digestivo de 245 fêmeas de Lutzomyia longipalpis originários da Gruta da Lapinha, Município de Lagoa Santa, MG, formando 7 grupos de 35 flebotomíneos. Das 8 espécies de bactérias isoladas houve uma predominância de bactérias Gram negativas (BGN pertencentes ao grupo de não fermentadoras de açúcar das seguintes espécies: Acinetobacter lowffii, Stenotrophomonas maltophhilia, Pseudomonas putida e Flavimonas orizihabitans. No grupo das fermentadoras tivemos: Enterobacter cloacae e Klebsiella ozaenae. No grupo dos Gram positivos foram identificados Bacillus thuringiensis e Staphylococcus spp.

  14. PRIMEIRA OCORRÊNCIA DE Lutzomyia (Lutzomyia) longipalpis LUTZ & NEIVA, 1912 (DIPTERA: PSYCHODIDAE: PHLEBOTOMINAE) NO ESTADO DO AMAPÁ, BRASIL.

    OpenAIRE

    Allan Kardec Ribeiro Galardo; Clicia Denis Galardo; Aderbal Amanajás Santana; José Claudio Cortes Mendes; Francisco Redivaldo Almeida de Souza; Jorge Pereira Duarte; José Ferreira Saraiva; Luiz Carlos Leite Pinna; Raimundo Wilson Carvalho; Ana Paula Sales de Andrade Correa; Ana Cristina da Silva Ferreira Lima

    2013-01-01

    Relata-se a primeira ocorrência de Lutzomyia longipalpis, o mais importante vetor biológico do agente causador da Leishmaniose Visceral Americana (LVA), no município de Ferreira Gomes, estado do Amapá, Brasil e por tratar-se de uma espécie com grande importância epidemiológica, os autores alertam as autoridades locais.   Palavras-chave: Amapá, Ferreira Gomes, Lutzomyia longipalpis, Leishmaniose Visceral Americana.   DOI: http://dx.doi.org/10.18561/2179-5746/biotaamazonia.v3n2p179-...

  15. The first report of the main vector of visceral leishmaniasis in America, Lutzomyia longipalpis (Lutz & Neiva) (Diptera: Psychodidae: Phlebotominae), in the state of Rio Grande do Sul, Brazil.

    Science.gov (United States)

    Souza, Getúlio Dornelles; Santos, Edmilson dos; Andrade Filho, José Dilermando

    2009-12-01

    Visceral leishmaniasis (VL) is a widespread zoonosis in Brazil and, up to now, there has been no record of the main vector of its agent, Lutzomyia longipalpis, in the Southern Region. Due to the diagnosis of VL in a dog in October 2008 in the city of São Borja, in the southernmost Brazilian state of Rio Grande do Sul, a collection of phlebotomines was undertaken to detect the presence of the vector Lu. longipalpis. The captures were carried out with CDC light traps on three consecutive nights in 2008. A total of 39 specimens of Lu. longipalpis were captured, thereby increasing the knowledge of the geographical distribution of this important vector.

  16. Distribuição espacial de Lutzomyia longipalpis (Lutz & Neiva, 1912) e Lutzomyia cruzi (Mangabeira, 1938) no estado de Mato Grosso

    OpenAIRE

    Missawa, Nanci Akemi; Lima, Giovana Belem Moreira

    2006-01-01

    A leishmaniose visceral é considerada atualmente uma doença emergente e reemergente, em zonas rurais e urbanas, tanto em área domiciliar quanto peridomiciliar. Este trabalho teve como objetivo verificar a distribuição espacial de Lutzomyia longipalpis e Lutzomyia cruzi no Estado de Mato Grosso. Os dados de 1996 a 2004 foram obtidos junto ao Laboratório de Entomologia, cujas capturas foram realizadas com armadilha de luz CDC. Foram pesquisados 68 dos 139 municípios do estado. Lutzomyia longipa...

  17. Variability and genetic differentiation among Anopheles (Ano. intermedius Chagas, 1908 and Anopheles (Ano. mattogrossensis Lutz & Neiva, 1911 (Diptera: Culicidae from the Brazilian Amazon

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    Joselita Maria Mendes dos Santos

    2005-10-01

    Full Text Available Anopheles (Anopheles intermedius and Anopheles (Ano. mattogrossensis are Brazilian anopheline species belonging to the scarcely studied Anopheles subgenus. Few studies have been done on the genetic differentiation of these species. Both species have been found infected by Plasmodium and are sympatric with other anopheline species from the Nyssorhynchus subgenus. Eighteen enzymatic loci were analyzed in larval specimens of An. intermedius and An. mattogrossensis aiming to estimate the variability and genetic differentiation between these species. An. mattogrossensis population showed higher genetic variability (P = 44.4 and Ho = 0.081 ± 0.031 than that of An. intermedius (P = 33.3 and Ho = 0.048 ± 0.021. Most analyzed loci showed genotypic frequencies according to Hardy-Weinberg equilibrium, except for LAP1 and LAP2 in An. intermedius, and EST1 and PGM loci in An. mattogrossensis. The genetic distance between these species (D = 0.683 was consistent with the inter-specific values reported for Anopheles subgenus. We verified that the polymorphism and heterozygosity percentile values found in both species and compared to those in the literature, showed no relation between the level of isozyme variability and geographical distribution. The low variability found in these two species is probably more related to the niche they occupy than to their geographic distribution.

  18. Spatial population dynamics and temporal analysis of the distribution of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in the city of Clorinda, Formosa, Argentina.

    Science.gov (United States)

    Gómez-Bravo, Andrea; German, Alba; Abril, Marcelo; Scavuzzo, Marcelo; Salomón, Oscar D

    2017-07-25

    Lutzomyia longipalpis, the vector for the causal agent of visceral leishmaniasis (VL), has extended its distribution in the southern cone in the Americas. The first urban record of Lu. longipalpis in Argentina was from the City of Clorinda in 2004. The aim of this study was to analyse the monthly distribution and abundance of Lu. longipalpis and to evaluate its association with environmental and climatic variables in Clorinda City, Province of Formosa. Phlebotominae sampling was performed using CDC light mini-traps that were placed in different sites of the city between January 2012 and December 2013. Environmental variables including the normalised difference vegetation index, normalized difference water index, land surface temperature and precipitation were evaluated using a spatiotemporal model. A total of 4996 phlebotomine sandflies were captured during the study period, and eight species were reported: Lu. longipalpis, Migonemyia migonei, Nyssomyia whitmani, Ny. neivai, Brumptomyia guimaraesi, Evandromyia cortelezzii/sallesi, Psathyromyia bigeniculata and Expapillata firmatoi. This is the first urban record of Ex. firmatoi in Argentina. Lutzomyia longipalpis was the most abundant species between 2012 and 2013, and it appeared in all the sampled sites. Moreover, the model applied showed that ground humidity and temperature were significantly associated with the abundance of Lu. longipalpis. This longitudinal approach at city scale allows for modelling that explains more than 60% of the temporal variability of the abundance of Lu. longipalpis based exclusively on satellite obtained data. The results support the hypothesis of steady 'hot spots' of abundance with time, while other sites could change its abundance due to eventual microenvironment changes. The Lu. longipalpis abundance driving factors are breeding site-related variables, highlighting the importance both for modelling and surveillance to use lag data.

  19. [Expansion of the distribution of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae) in the department of Caldas: Increased risk of visceral leishmaniasis].

    Science.gov (United States)

    Acosta, Luz Adriana; Mondragón-Shem, Karina; Vergara, Daniela; Vélez-Mira, Andrés; Cadena, Horacio; Carrillo-Bonilla, Lina

    2013-01-01

    Diverse taxonomical and molecular studies suggest that Lutzomyia longipalpis , main vector of visceral leishmaniasis in Latin America, is a complex of species widely distributed throughout the continent and adapted to different habitats. To carry out entomological surveillance in the area of influence of the Miel I Hydroelectric Plant. Adhesive traps were used in a transect covering an area of approximately 400 km for the capture of insects, which were then identified using the Young and Duncan taxonomical key. This study reports the presence of Lutzomyia longipalpis in the municipalities of Norcasia at an altitude of 392 masl, and in Marquetalia at 1,387 masl. We suggest that the increase in the geographical and altitudinal distribution could be related to the existence of the Lu. longipalpis species complex, or to environmental factors, such as the rise in temperature due to global climate changes, which create the establishment of Lu. longipalpis , generating a new epidemiological risk for new visceral leishmaniasis foci in the country.

  20. Gastroesophageal reflux disease - children

    Science.gov (United States)

    Peptic esophagitis - children; Reflux esophagitis - children; GERD - children; Heartburn - chronic - children; Dyspepsia - GERD - children ... GERD. Certain factors can lead to GERD in children, including: Birth defects, such as hiatal hernia , a ...

  1. Novos registros de Lutzomyia longipalpis (Lutz & Neiva, 1912(Diptera: Psychodidae na região Centro-Leste do estado de São Paulo, Brasil New records of Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae in the Central East Region of São Paulo State, Brazil

    Directory of Open Access Journals (Sweden)

    André Antonio Cutolo

    2009-03-01

    Full Text Available A incidência das leishmanioses tegumentar (LTA e visceral (LVA americanas, especialmente essa última, em hospedeiros caninos e humanos, encontra-se em expansão no Estado de São Paulo. Na vigilância epidemiológica dessas endemias, torna-se fundamental o conhecimento da distribuição e ecologia das diferentes espécies de flebotomíneos. Assim, a divulgação de novos registros de seus vetores é fundamental para apontar novas áreas de risco para a transmissão dessas doenças. Neste estudo, realizaram-se capturas de flebotomíneos em ambiente de mata, em diferentes localidades dos municípios de Ipeúna, Itirapina e Analândia, entre agosto e setembro de 2007. Foram capturados 248 flebotomíneos de nove espécies diferentes, em Ipeúna, seis e sete espécimes de duas espécies distintas coletados respectivamente em Itirapina e Analândia. A espécie mais abundante em Ipeúna foi Pintomyia pessoai (37,5%, seguida de P. fischeri (33,06% e Migonemyia migonei (16,53%. Essas três espécies são consideradas importantes vetores de LTA no território paulista. O registro de Lutzomyia longipalpis pela primeira vez em Ipeúna e Analândia e a confirmação de sua presença em Itirapina indicam risco de essabelecimento da LVA na área e a necessidade de mais estudos locais sobre sua ecologia, sobretudo em relação à ocupação de ambientes antrópicos.Cutaneous (LTA and Visceral (LVA American Leishmaniasis incidences are increasing in human and canine hosts, especially LVA, which is expanding its range through São Paulo State. Distribution and ecology knowledge of different sand fly species is essential for leishmaniasis epidemiology vigilance. The communication of new findings of its vectors is mandatory for risk determination for transmission of these illnesses. On this study sand flies were trapped in bushed areas, in different localities at rural areas of Ipeúna, Itirapina and Analândia counties, between August and September 2007. A total of 248 specimens of nine different species were sampled in Ipeúna, six and seven specimens of two different species were trapped in Itirapina and Analândia, respectively. The most abundant species in Ipeúna was Pintomyia pessoai (37.5%, followed by Pintomyia fischeri (33.06% and Migonemyia migonei (16.53%, all three species are considered vectors of LTA in São Paulo State. Lutzomyia longipalpis was found in Ipeúna and Analândia for the first time and its presence confirmed in Itirapina, indicating a risk of LVA essablishment in the area and the need for further local studies on its ecology, especially regarding its occupation of the anthropic environment.

  2. Distribuição espacial de Lutzomyia longipalpis (Lutz & Neiva, 1912) e Lutzomyia cruzi (Mangabeira, 1938) no estado de Mato Grosso Spatial distribution of Lutzomyia longipalpis (Lutz & Neiva, 1912) and Lutzomyia cruzi (Mangabeira, 1938) in the State of Mato Grosso

    OpenAIRE

    Nanci Akemi Missawa; Giovana Belem Moreira Lima

    2006-01-01

    A leishmaniose visceral é considerada atualmente uma doença emergente e reemergente, em zonas rurais e urbanas, tanto em área domiciliar quanto peridomiciliar. Este trabalho teve como objetivo verificar a distribuição espacial de Lutzomyia longipalpis e Lutzomyia cruzi no Estado de Mato Grosso. Os dados de 1996 a 2004 foram obtidos junto ao Laboratório de Entomologia, cujas capturas foram realizadas com armadilha de luz CDC. Foram pesquisados 68 dos 139 municípios do estado. Lutzomyia longipa...

  3. Primeiro encontro de Lutzomyia longipalpis (Lutz & Neiva, 1912 na área urbana de Uberlândia, MG, concomitante com o relato de primeiro caso autóctone de leishmaniose visceral humana First finding of Lutzomyia longipalpis (Lutz & Neiva, 1912 in the urban area of Uberlândia, MG, concomitant with the first reported autochthonous case of human visceral leishmaniasis

    Directory of Open Access Journals (Sweden)

    Márcia Beatriz Cardoso de Paula

    2008-06-01

    Full Text Available Relata-se a primeira ocorrência do vetor da leishmaniose visceral, Lutzomyia longipalpis, na área urbana de Uberlândia, estado de Minas Gerais e o primeiro caso de leishmaniose visceral humana autóctone no município, notificado ao Centro de Controle de Zoonoses, por meio da Vigilância Epidemiológica da Secretaria Municipal de Saúde. Discute-se a importância deste encontro na transmissão da doença nessa área.The first occurrence of the vector for visceral leishmaniasis, Lutzomyia longipalpis, in the urban area of Uberlândia, State of Minas Gerais, and the first autochthonous case of human visceral leishmaniasis recorded in the same locality are reported. These were notified to the Zoonosis Control Center, through the Epidemiological Surveillance sector of the Municipal Health Department. The importance of these findings regarding transmission of the disease in this area is discussed.

  4. Crisis Communication (Handbooks of Communication Science Vol. 23)

    DEFF Research Database (Denmark)

    Johansen, Winni

    Vol. 23 - The Handbook of Communication Science General editors: Peter J. Schultz and Paul Cobley......Vol. 23 - The Handbook of Communication Science General editors: Peter J. Schultz and Paul Cobley...

  5. Prevalence and demographic determinants of gastroesophageal reflux disease (GERD) in the Turkish general population: a population-based cross-sectional study.

    Science.gov (United States)

    Mungan, Zeynel

    2012-08-01

    We aimed to establish the prevalence and demographic determinants of gastroesophageal reflux disease in the Turkish general population using the Turkish version of the gastroesophageal reflux disease questionnaire. A total of 8143 volunteers (mean age: 38.5 (13.3) years; 52.3% males) were included in this cross-sectional questionnaire study conducted via face-to-face administration of the questionnaire forms including items on sociodemographic features, past history of gastric disorders, gastroesophageal reflux disease, the influence of reflux symptoms on patients' lives, physician visits, diagnostic tests, and reflux medications. A past history of gastric symptoms was reported in half of the population. More female participants (p<0.001) had a past history of gastric symptoms that yielded a previous diagnosis of gastroesophageal reflux disease in 19.1% of the population. The likelihood of gastroesophageal reflux disease was low in the majority (75.3%) of the subjects evaluated. Gastroesophageal reflux disease with an inconveniencing or disrupting impact on the patient's life was present in 17.9% and 6.8% of the population. Total gastroesophageal reflux disease-questionnaire scores and reflux prevalence were higher in older age groups (p<0.001). Females were more likely to have gastroesophageal reflux disease prevalence based on reflux symptoms. The impact of gastroesophageal reflux disease on sleep and psychological/emotional well-being was more pronounced in older and female patients, whereas the impact on eating/drinking behaviors and physical-social activities was more marked among females independent of their age (p<0.001). Reflux prevalence was higher in subjects from East Anatolia, Central Anatolia, Mediterranean, and Black Sea regions of Turkey (p<0.001 for each). Prevalence and demographic determinants of gastroesophageal reflux disease are compatible with the profile of the disease in the other Western populations, with a predilection for females and older individuals.

  6. Evolução motora incomum na doença do refluxo gastroesofágico Unusual motor disorder on GERD

    Directory of Open Access Journals (Sweden)

    Antônio Moreira Mendes-Filho

    2010-09-01

    Full Text Available INTRODUÇÃO: Demonstra-se que os distúrbios motores esofágicos como o espasmo esofageano difuso podem progredir para acalásia. Também é conhecida a associação entre a doença do refluxo gastroesofágico e alguns destes distúrbios. RELATO DO CASO: Paciente com queixa de dor torácica, disfagia e perda de peso há dois meses. A primeira endoscopia digestiva alta sugeriu apenas dismotilidade esofágica. Posteriormente, realizou manometria esofágica que evidenciou alterações em corpo compatíveis com espasmo esofageano difuso, sem alterações no esfíncter esofageano inferior. Na oportunidade iniciou o tratamento com pantoprazol e nifedipina que se estendeu por oito meses; no entanto manteve-se sintomática. Após suspender medicação por 10 dias, realizou pH-metria esofageana prolongada constatando-se refluxo gastroesofágico patológico combinado e refluxo proximal, sendo submetida ao tratamento com esomeprazol e mantida a nifedipina. Após dois meses, com a persistência dos sintomas, realizou-se nova endoscopia que evidenciou estase alimentar e manometria esofágica com aperistalse completa de corpo. Neste momento, optou-se por cardiomiotomia a Heller com fundoplicatura laparoscópica. A endoscopia do terceiro mês do pós-operatório evidenciou fundoplicatura bem ajustada ao aparelho. No seguimento a médio prazo ela permanece assintomática. CONCLUSÃO: Existe correlação entre os distúrbios motores esofágicos e a doença do refluxo gastroesofágico, e o tratamento cirúrgico para corrigir a acalásia e o refluxo gastroesofágico ao mesmo tempo, pode ser indicado em casos selecionados.BACKGROUND: It is shown that esophageal motor disorders, such as diffuse esophageal spasm, may progress to achalasia. It is also known a link between gastroesophageal reflux disease and some of these motor disorders. CASE REPORT: Patient complaining of chest pain, dysphagia and weight loss for two months. The first endoscopy suggested only motility disorders. Esophageal manometry was done and showed changes in body compatible with diffuse esophageal spasm, without changes in lower esophageal sphincter. Treatment with pantoprazole and nifedipine for eight months was done, but the patient remained symptomatic. After stopping medication for 10 days, an esophageal pH-metry was realized and showed gastro-esophageal reflux. She was submitted to treatment with esomeprazole and nifedipine. After two months, with persistence of the symptoms, a new endoscopy showed food stasis, and esophageal manometry body esophageal aperistalsis. At this point, surgical treatment (Heller cardiomyotomy with fundoplication was done. Endoscopy of the third postoperative month showed fundoplication well adjusted to the endoscope. In follow-up, patient remained asymptomatic. CONCLUSION: There is a correlation between esophageal motor disorders and gastroesophageal reflux disease, and surgical treatment to correct achalasia and gastroesophageal reflux at the same time, may be indicated in selected cases.

  7. Effect of proton-pump inhibitor treatment on symptoms and quality of life in GERD patients depends on the symptom-reflux association

    NARCIS (Netherlands)

    Aanen, Marissa C.; Weusten, Bas L. A. M.; Numans, Mattijs E.; de Wit, Niek J.; Samsom, Melvin; Smout, Andre J. P. M.

    2008-01-01

    Backgound: Gastroesophageal reflux disease patients demonstrate various pathophysiologic backgrounds. Therefore, a heterogeneous response to proton-pump inhibitor (PPI) treatment can be expected. We investigated the effect of short-term PPI treatment on symptoms and quality of life (QOL) in primary

  8. Partial response to proton pump inhibitor therapy for GERD: observational study of patient characteristics, burden of disease, and costs in the USA

    OpenAIRE

    St?lhammar, Nils-Olov; Spiegel, Brennan M; Granstedt L?fman, Helena; Karlsson, Maria; Wahlqvist, Peter; N?sdal, J?rgen; Nelson, M Todd; Despi?gel, Nicolas

    2012-01-01

    Nils-Olov Stålhammar,1 Brennan M Spiegel,2,3 Helena Granstedt Löfman,1 Maria Karlsson,1 Peter Wahlqvist,1 Jørgen Næsdal,4 M Todd Nelson,5 Nicolas Despiégel61Payer Evidence, AstraZeneca R&D, Mölndal, Sweden; 2Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 3David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 4Medical Department, AstraZeneca R&D, Mölndal, Sweden; 5Late Phase...

  9. Gastroesophageal reflux disease

    Science.gov (United States)

    Peptic esophagitis; Reflux esophagitis; GERD; Heartburn - chronic; Dyspepsia - GERD ... into the esophagus. This is called reflux or gastroesophageal reflux. Reflux may cause symptoms. Harsh stomach acids can ...

  10. Ampliación de la distribución de Lutzomyia longipalpis (Lutz & Neiva, 1912 (Diptera: Psychodidae en el departamento de Caldas: potencial aumento del riesgo de leishmaniasis visceral

    Directory of Open Access Journals (Sweden)

    Luz Adriana Acosta

    2013-06-01

    Full Text Available Introducción. Diversos estudios a nivel taxonómico y molecular sugieren que Lutzomyia longipalpis, principal vector de la leishmaniasis visceral en Latinoamérica, es un complejo de especies con ampliadistribución a lo largo del continente y con adaptaciones a diferentes hábitats. Objetivo. Realizar vigilancia entomológica en el área de influencia de la hidroeléctrica Miel I. Materiales y métodos. Se utilizaron trampas adhesivas en una intersección de 400 km, aproximadamente, para la captura de insectos, los cuales fueron identificados con la clave taxonómica de Youngy Duncan. Resultados. En este estudio se reporta la presencia de Lu. longipalpis en los municipios de Norcasia a una altitud de 392 msnm y en Marquetalia a 1.387 msnm; es el primer reporte a esta altura para esta especie en Colombia. Conclusiones. Se sugiere que la ampliación de la distribución geográfica y altitudinal de Lu. longipalpis en el país podría estar relacionada con la existencia del complejo de especies Lu. longipalpis, o a factores ambientales como el aumento de temperatura debido al cambio climático global que viene sucediendo en las últimas décadas. Esta última hipótesis sugeriría que se están creando nuevos hábitats propiciospara el establecimiento de Lu. longipalpis, lo cual genera un nuevo riesgo epidemiológico de posiblesnuevos focos de leishmaniasis visceral en el país.   doi: http://dx.doi.org/10.7705/biomedica.v33i2.762

  11. Descripción y comparación del condrocráneo en larvas de Hyla raniceps (Cope, 1862, Scinax granulatus (Peters, 1871 y Scinax squalirostris (A. Lutz, 1925 (Anura: Hylidae

    Directory of Open Access Journals (Sweden)

    Alcalde, Leandro

    2003-09-01

    Full Text Available Se describe el condrocráneo en larvas de 3 especies de hílidos neotropicales, Hyla raniceps, Scinax granulatus y S. squalirostris, las cuales presentan larvas de charca, tipo IV, con desarrollo exotrófico, nectónicas (Scinax spp. o bentónicas (H. raniceps. Los datos obtenidos fueron comparados con la información conocida acerca de Hyla andina, H. arborea, H. cinerea, H. geographica, H. lanciformis, H. microcephala, H. nana, H. pulchella, H. rosenbergi, Scinax acuminatus, S. fuscovarius, S. nasicus y S. ruber. Las especies de Scinax se diferencian de las de Hyla, en forma independiente del tipo ecológico que presentan sus larvas, por la presencia de un proceso lateral al cóndilo articular del ceratohial (ausente en Hyla spp.. No ha sido posible dilucidar si este proceso es una sinapomorfía de Scinax o de las especies que componen el clado rubra. Diecisiete caracteres varían entre especies independientemente del ambiente y la dieta de las larvas: cinco de ellos son del neurocráneo, cinco del arco mandibular y siete del hiobranquium. El grado de desarrollo del proceso anterohial lateral del ceratohial muestra asociación con el mecanismo de alimentación de las larvas. Tres caracteres soportan grupos de especies en el género Hyla. Hyla lanciformis e H. raniceps (grupo albopuntacta presentan la comisura cuadrado craneal con la mitad del ancho que presenta el proceso muscular en su base y la pars reuniens con forma de "V". Hyla geographica (grupo geographica presenta la pars reuniens de forma cuadrada. Hyla nana (grupo microcephala carece de seno hipobranquial posterior y proceso cuadrado etmoidal. El grupo rostrata del género Scinax está soportado por la presencia de una conexión sindesmótica entre cuerpo y ala del cartílago suprarrostral. La existencia de diferencias en las estructuras del condrocráneo relacionadas con la dieta en aquellas larvas que presentan el mismo mecanismo de alimentación micrófago, indican que este tipo de alimentación puede ocurrir mediante una serie de estructuras y no por una única morfología en particular. The larval chondrocranium of 3 species of neotropical hylids, Hyla raniceps, Scinax granulatus and S. squalirostris is described, which present pond type, type IV, with exotrophic development, nektonic (Scinax spp. or benthic (H. raniceps tadpoles. The obtained data were compared with known information about Hyla andina, H. arborea, H. cinerea, H. geographica, H. lanciformis, H. microcephala, H. nana, H. pulchella, H. rosenbergi, Scinax acuminatus, S. fuscovarius, S. nasicus and S. ruber. The species of Scinax are differentiated from those of Hyla independently of the ecological type of their tadpoles by the presence of a process lateral to the ceratohyal?s condilus articularis (which is absent in Hyla spp.. The question about if this process is a sinapomorphy either for Scinax or the species that compound the rubra clade, could not be dilucidated. Seventeen characters vary among species independently of the environment and the diet of tadpoles: five of them are from the neurocranium, five from the mandibular arch and seven from the hiobranquium. The grade of development of the anterolateral process of the ceratohyale shows association with the feeding mechanism of tadpoles. Three characters support species groups on genus Hyla. Hyla lanciformis and H. raniceps (albopuntacta group have the commissura quadrato-cranialis anterior a half of wide compared with the wide of the processus muscularis quadrati at its base, and a V-shaped pars reuniens. Hyla geographica (geographica group presents a square-shaped pars reuniens. In Hyla nana (microcephala group, the sinus posterior hypobranchialis and the processus quadrato-ethmoidale are missing. The rostrata group from genus Scinax appears supported by the presence of a sindesmotic connection between corpus and ala of the cartilago suprarostrale. The existence of differences in the chondrocranial structures related whit diet in tadpoles that present the same microphagous feeding mechanism, indicates that this type of diet occurs by a series of structures and do not with a single particular morphology.

  12. Observations on the feeding habits of Lutzomyia longipalpis (Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) in Campo Grande, an endemic area of visceral leishmaniasis in Mato Grosso do Sul, Brazil.

    Science.gov (United States)

    de Oliveira, Alessandra Gutierrez; Marassá, Ana Maria; Consales, Cleide Aschenbrenner; Dorval, Maria Elizabeth Cavalheiros; Fernandes, Carlos Eurico; de Oliveira, Gilliard Rezende; Brazil, Reginaldo Peçanha; Galati, Eunice Aparecida Bianchi

    2008-09-01

    Sand flies were captured weekly with CDC light traps from December 2003 to November 2005 in three areas of Campo Grande, in the Brazilian state of Mato Grosso do Sul. These areas incorporated two patches of remnant forest and five houses. The blood meals of engorged female sand flies were identified using the avidin-biotin system of immunoenzymatic ELISA capture. Most (327/355) of the females analysed were Lutzomyia longipalpis, of which 66.4% reacted with human blood, 64.8% with that of birds and 8.9% with that of dogs. Females that had taken human blood predominated in the residential areas and two forest patches. The following combinations of blood were also detected for L. longipalpis in some of the samples analysed: bird+human (43.4%), bird+human+dog (6.1%). The combination bird+human+dog+pig was also found for Nyssomyia whitmani. Dogs and pigs appear to have little attractiveness for L. longipalpis. The results obtained demonstrate the eclecticism and high anthropophily of L. longipalpis and raise new questions with regard to the importance of dogs in VL epidemiology and the possible role of man as a source of infection for sand flies.

  13. Analysis of sandflies (Diptera: Psychodidae) in Barra do Garças, State of Mato Grosso, Brazil, and the influence of environmental variables on the vector density of Lutzomyia longipalpis (Lutz & Neiva, 1912).

    Science.gov (United States)

    Queiroz, Mirian Francisca Martins; Varjão, Jane Ramos; Moraes, Sinara Cristina de; Salcedo, Gladys Elena

    2012-06-01

    Leishmaniasis is an infectious and parasitic zoonotic, non-contagious, vector-borne disease caused by protozoa of the genus Leishmania. In Brazil, the major vector of Leishmania (Leishmania) infantum chagasi (Cunha & Chagas, 1934) is Lutzomyia longipalpis. Barra do Garças, State of Mato Grosso, was designated as a priority area by the Brazilian Ministry of Health for american visceral leishmaniasis, and it is important to identify the vector species present in this municipality. Our objective was to raise sandflies and study the influence of environmental variables on the vector density of Lutzomyia longipalpis. We performed entomological monitoring in 3 districts using Centers for Disease Control and Prevention (CDC) light traps and recorded human cases of american visceral leishmaniasis in the city. We calculated the relative frequency and richness of sandflies and applied a transfer function model to the vector density correlate with relative humidity. The sandfly population was composed of 2 genera and 27 species, totaling 8,097 individuals. Monitoring identified Lutzomyia longipalpis (44%), followed by Lutzomyia lenti (18.9%), Lutzomyia whitmani (13.9%), Lutzomyia carmelinoi (9.1%), Lutzomyia evandroi (5.1%), Lutzomyia termitophila (3.3%), Lutzomyia sordellii (1.9%), and 20 other species (Lutzomyia longipalpis showed occurrence peaks during the rainy season; there was a temporal correlation with humidity, but not with frequency or temperature. The presence of Lutzomyia longipalpis in the urban area of Barra do Garças underscores the changing disease profile, which was previously restricted to the wild environment.

  14. Identificação do sangue ingerido por Lutzomyia (Lutzomyia) longipalpis (Lutz & Neiva, 1912) e Lutzomyia (Lutzomyia) almerioi (Galati & Nunes, 1999) pela técnica imunoenzimática do ELISA de captura, no sistema avidina-biotina

    OpenAIRE

    Marassá,Ana Maria; Consales,Cleide Aschenbrenner; Galati,Eunice Aparecida Bianchi; Nunes,Vânia Lúcia Brandão

    2006-01-01

    Lutzomyia longipalpis e Lutzomyia almerioi, espécies integrantes da fauna flebotomínea da Serra da Bodoquena, no Estado de Mato Grosso do Sul, têm sido objeto de estudo devido às suas elevadas abundâncias no Assentamento Guaicurus, foco de leishmaniose tegumentar humana e visceral canina. Em pesquisas que vem sendo realizadas neste acampamento para a identificação de vetores destas parasitoses, foram capturados no período de 2002 a 2004, com armadilhas automáticas luminosas, instaladas em amb...

  15. Fuel cells science and engineering. Materials, processes, systems and technology. Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Stolten, Detlef; Emonts, Bernd (eds.) [Forschungszentrum Juelich GmbH (DE). Inst. fuer Energieforschung (IEF), Brennstoffzellen (IEF-3)

    2012-07-01

    The second volume is divided in four parts and 19 chapters. It is structured as follows: PART V: Modeling and Simulation. Chapter 23: Messages from Analytical Modeling of Fuel Cells (Andrei Kulikovsky); 24: Stochastic Modeling of Fuel-Cell Components (Ralf Thiedmann, Gerd Gaiselmann, Werner Lehnert and Volker Schmidt); 25: Computational Fluid Dynamic Simulation Using Supercomputer Calculation Capacity (Ralf Peters and Florian Scharf); 26 Modeling Solid Oxide Fuel Cells from the Macroscale to the Nanoscale (Emily M. Ryan and Mohammad A. Khaleel); 27: Numerical Modeling of the Thermomechanically Induced Stress in Solid Oxide Fuel Cells (Murat Peksen); 28: Modeling of Molten Carbonate Fuel Cells (Peter Heidebrecht, Silvia Piewek and Kai Sundmacher); Chapter 29: High-Temperature Polymer Electrolyte Fuel-Cell Modeling (Uwe Reimer); Chapter 30: Modeling of Polymer Electrolyte Membrane Fuel-Cell Components (Yun Wang and Ken S. Chen); 31: Modeling of Polymer Electrolyte Membrane Fuel Cells and Stacks (Yun Wang and Ken S. Chen). PART VI: Balance of Plant Design and Components. Chapter 32: Principles of Systems Engineering (Ludger Blum, Ralf Peters and Remzi Can Samsun); 33: System Technology for Solid Oxide Fuel Cells (Nguyen Q. Minh); 34: Desulfurization for Fuel-Cell Systems (Joachim Pasel and Ralf Peters); 35: Design Criteria and Components for Fuel Cell Powertrains (Lutz Eckstein and Bruno Gnoerich); 36: Hybridization for Fuel Cells (Joerg Wilhelm). PART VII: Systems Verification and Market Introduction. Chapter 37: Off-Grid Power Supply and Premium Power Generation (Kerry-Ann Adamson); 38: Demonstration Projects and Market Introduction (Kristin Deason). PART VIII: Knowledge Distribution and Public Awareness. Chapter 39: A Sustainable Framework for International Collaboration: the IEA HIA and Its Strategic Plan for 2009-2015 (Mary-Rose de Valladares); 40: Overview of Fuel Cell and Hydrogen Organizations and Initiatives Worldwide (Bernd Emonts) 41: Contributions for

  16. Unmet Needs in the Treatment of Gastroesophageal Reflux Disease

    Science.gov (United States)

    Dickman, Ram; Maradey-Romero, Carla; Gingold-Belfer, Rachel; Fass, Ronnie

    2015-01-01

    Gastroesophageal reflux disease (GERD) is a highly prevalent gastrointestinal disorder. Proton pump inhibitors have profoundly revolutionized the treatment of GERD. However, several areas of unmet need persist despite marked improvements in the therapeutic management of GERD. These include the advanced grades of erosive esophagitis, nonerosive reflux disease, maintenance treatment of erosive esophagitis, refractory GERD, postprandial heartburn, atypical and extraesophageal manifestations of GERD, Barrett’s esophagus, chronic protein pump inhibitor treatment, and post-bariatric surgery GERD. Consequently, any future development of novel therapeutic modalities for GERD (medical, endoscopic, or surgical), would likely focus on the aforementioned areas of unmet need. PMID:26130628

  17. Chronic Obstructive Pulmonary Disease Exacerbations Are Influenced by Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Bigatao, Amilcar M; Herbella, Fernando A M; Del Grande, Leonardo M; Nascimento, Oliver A; Jardim, Jose R; Patti, Marco G

    2018-01-01

    Gastroesophageal reflux disease (GERD) is associated with different pulmonary diseases, including chronic obstructive pulmonary disease (COPD). Whether GERD is contributory to COPD severity remains unclear. This study aims to evaluate the contribution of GERD to the clinical manifestation of COPD based on ventilatory parameters and yearly clinical exacerbations. We studied 48 patients (56% females, age 66 years) with COPD. All patients underwent high-resolution manometry and esophageal pH monitoring. The patients were separated into two groups according to the presence of GERD. GERD was present in 21 (44%) patients. GERD + and GERD - groups did not differ in regard to gender, age, and body mass index. Pulmonary parameters were not different in the absence or presence of GERD. The number of yearly exacerbations was higher in patients GERD+. The severity of GERD (as measured by DeMeester score) correlated with the number of exacerbations. Our results show the following: 1) GERD does not influence pulmonary parameters and 2) GERD is associated with a higher number of annual clinical exacerbations. We believe GERD must be objectively tested in patients with COPD because the prevalence of GERD in these patients is underestimated when only symptoms are considered. GERD treatment might decrease the frequency of episodes of exacerbation.

  18. Qualidade de vida do paciente submetido à cirurgia videolaparoscópica para tratamento para doença do refluxo gastroesofágico Quality of life of patients undergoing surgery by videolaparoscopy for GERD treatment

    Directory of Open Access Journals (Sweden)

    Francisco José Cavalcante Andrade

    2012-09-01

    Full Text Available RACIONAL: A doença do refluxo gastroesofágico é afecção crônica de elevada prevalência nos países ocidentais e com efeitos negativos sobre a qualidade de vida. O tratamento cirúrgico é indicado para pacientes que necessitam usar medicamentos ininterruptamente, intolerantes ao controle clínico prolongado e nas formas complicadas da doença. OBJETIVO: Avaliar a qualidade de vida de indivíduos submetidos à correção cirúrgica por videolaparoscopia, para tratamento da doença do refluxo gastroesofágico. MÉTODOS: Foram avaliados 43 pacientes com idade média de 51,4 anos, de ambos os gêneros nos últimos dez anos, utilizando-se o questionário Escala de Qualidade de Vida Relacionada à Saúde para doença do refluxo gastroesofágico (1996, traduzido e validado para a língua portuguesa. Os dados foram analisados pelo programa estatístico Epi Info versão 3.5.1, com auxilio do teste de Duncan e do coeficiente de correlação de Pearson, fixando-se o valor de 5% para a hipótese de nulidade (pBACKGROUND: Gastroesophageal reflux disease is a chronic disease of high prevalence in Western countries, with negative effects on quality of life. Surgery is indicated for patients with intolerance to continuous medication, prolonged treatment or control, or in complicated forms of the disease. AIM: To evaluate the quality of life of patients undergoing surgery by videolaparoscopy for gastroesophageal reflux disease treatment. METHODS: Sample comprised 43 patients of both genders (mean age = 51.4 years. For quality of life evaluation was made using the questionnaire Gastroesophageal Reflux Disease Health Related Quality of Life, translated and validated into Portuguese. Data were analyzed by Epi Info version 3.5.1, using Duncan test and Pearson's correlation coefficient, with 5% for null hypothesis (p < 0.05. RESULTS: Over 50% of participants showed good quality of life (scores <5 of the questionnaire, more than 90% indicated satisfaction with their health. A significant positive correlation between most variables related to heartburn and the time after surgery was observed (p < 0.05. CONCLUSION: Patients presented good quality of life and high level of satisfaction with their postoperative condition.

  19. Comparación de los cuestionarios Carlsson-Dent y GERD-Q para detección de síntomas de enfermedad por reflujo gastroesofágico en población general

    Directory of Open Access Journals (Sweden)

    R. Contreras-Omaña

    2017-01-01

    Conclusiones: Hubo una prevalencia del 50% con síntomas de ERGE en población general. El GQQ detectó un mayor número de síntomas de ERGE en pacientes con obesidad/sobrepeso. El CDQ fue calificado como más fácil de comprender y contestar por los pacientes. Es importante mencionar que solo hubo una concordancia del 20% entre ambos cuestionarios, lo que indica que tal vez sean de utilidad para identificar síntomas de ERGE en poblaciones distintas.

  20. Sequence analyses reveal that a TPR-DP module, surrounded by recombinable flanking introns, could be at the origin of eukaryotic Hop and Hip TPR-DP domains and prokaryotic GerD proteins.

    Science.gov (United States)

    Hernández Torres, Jorge; Papandreou, Nikolaos; Chomilier, Jacques

    2009-05-01

    The co-chaperone Hop [heat shock protein (HSP) organising protein] is known to bind both Hsp70 and Hsp90. Hop comprises three repeats of a tetratricopeptide repeat (TPR) domain, each consisting of three TPR motifs. The first and last TPR domains are followed by a domain containing several dipeptide (DP) repeats called the DP domain. These analyses suggest that the hop genes result from successive recombination events of an ancestral TPR-DP module. From a hydrophobic cluster analysis of homologous Hop protein sequences derived from gene families, we can postulate that shifts in the open reading frames are at the origin of the present sequences. Moreover, these shifts can be related to the presence or absence of biological function. We propose to extend the family of Hop co-chaperons into the kingdom of bacteria, as several structurally related genes have been identified by hydrophobic cluster analysis. We also provide evidence of common structural characteristics between hop and hip genes, suggesting a shared precursor of ancestral TPR-DP domains.

  1. Sequence analyses reveal that a TPR–DP module, surrounded by recombinable flanking introns, could be at the origin of eukaryotic Hop and Hip TPR–DP domains and prokaryotic GerD proteins

    Science.gov (United States)

    Papandreou, Nikolaos; Chomilier, Jacques

    2008-01-01

    The co-chaperone Hop [heat shock protein (HSP) organising protein] is known to bind both Hsp70 and Hsp90. Hop comprises three repeats of a tetratricopeptide repeat (TPR) domain, each consisting of three TPR motifs. The first and last TPR domains are followed by a domain containing several dipeptide (DP) repeats called the DP domain. These analyses suggest that the hop genes result from successive recombination events of an ancestral TPR–DP module. From a hydrophobic cluster analysis of homologous Hop protein sequences derived from gene families, we can postulate that shifts in the open reading frames are at the origin of the present sequences. Moreover, these shifts can be related to the presence or absence of biological function. We propose to extend the family of Hop co-chaperons into the kingdom of bacteria, as several structurally related genes have been identified by hydrophobic cluster analysis. We also provide evidence of common structural characteristics between hop and hip genes, suggesting a shared precursor of ancestral TPR–DP domains. Electronic supplementary material The online version of this article (doi:10.1007/s12192-008-0083-8) contains supplementary material, which is available to authorized users. PMID:18987995

  2. Anthropology with Activism: Settling Its Value

    Science.gov (United States)

    Hull, Glynda A.

    2014-01-01

    This response to Katherine Schultz's Presidential Address to the Council on Anthropology and Education explores the themes of temporality and reflexivity in activist scholarship, with Schultz's research as prime example. The need to take action to address a crisis, juxtaposed to the counter need to take time for scholarly reflection and…

  3. Vene võim hävitas Kopli kalmistu / Robert Nerman

    Index Scriptorium Estoniae

    Nerman, Robert, 1946-2015

    2004-01-01

    Tallinna Kopli kalmistu ajaloost ja arhitektuuriajaloolisest väärtusest. Kabelite asendiplaani koostas 1774. a. arhitekt Johann Schultz. Tõenäoliselt kavandas Johann Schultz ka osa arvukatest kabelitest. Õigeusukalmistule rajati paekivist kabel arhitekt Aleksandr Vladovski projekti järgi

  4. Implementing Integrated Multicultural Instructional Design in Management Education

    Science.gov (United States)

    Schultz, Jennifer L.; Higbee, Jeanne L.

    2011-01-01

    This purpose of this paper is to summarize the principles of integrated multicultural instructional design (IMID; Higbee, Goff, & Schultz, in press; Higbee, Schultz, & Goff, 2010) and present specific strategies for incorporating IMID in management education. The primary goal of IMID is to promote the integration of multicultural content…

  5. Report of the International Ice Patrol Service in the North Atlantic Ocean. Season of 1979.

    Science.gov (United States)

    1979-01-01

    used is ( Scobie and Schultz, 1976) and it is basically these the sum of a mean value and a wind driven compo- updated currents which were used during...direction REFERENCES and U (east-west) and V (north-south) components Scobie , R. W. and R. H. Schultz (1976). Oceanography of on a printout and plots

  6. Report of the International Ice Patrol Services in the North Atlantic Ocean, Season of 1985

    Science.gov (United States)

    1987-03-17

    drift to a hydroahic surveys ( Scobie AscresuleIPmt ofthis re lyconna e constant 90-150km drift error In and Schultz, 1976). It is on a grid schedule,l...D.G., 1980. On Predicting Iceberg Drift, Cold Regions Science and Technology, Vol 1 (3/4): 273-282. Scobie , R.W., and R.H. Schultz, 1976. Oceanographyof

  7. Anti-reflux surgery - children

    Science.gov (United States)

    ... stomach). Problems with these muscles can lead to gastroesophageal reflux disease (GERD). This surgery can also be done during a ... Anti-reflux surgery is usually done to treat GERD in children only after medicines have not worked ...

  8. Fundoplication in neurologically impaired children: Nissen or Thal?

    African Journals Online (AJOL)

    for management of GERD in neurologically impaired children. Materials and .... GERD pH analysis software, and accordingly, the patients were classified as having ... video processor model; Asahi Optical Co., Tokyo, Japan) and a standard ...

  9. Crohn's Disease

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  10. Zollinger-Ellison Syndrome

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  11. Gas in the Digestive Tract

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  12. Abdominal Adhesions

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  13. Celiac Disease

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  14. Menetrier's Disease

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  15. Appendicitis

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  16. Constipation in Children

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  17. Whipple's Disease

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  18. Hemorrhoids

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  19. Inguinal Hernia

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  20. Chronic Diarrhea in Children

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  1. Lactose Intolerance

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  2. Barrett's Esophagus

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  3. Gastroparesis

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  4. Proctitis

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  5. Pancreatitis

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  6. Dermatitis Herpetiformis

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  7. Cyclic Vomiting Syndrome

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  8. Gallstones

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  9. Diarrhea

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  10. Indigestion

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  11. Gastrointestinal (GI) Bleeding

    Science.gov (United States)

    ... Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Children & Teens Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Acid Reflux (GER & GERD) in Infants Definition & ...

  12. H2 blockers

    Science.gov (United States)

    Peptic ulcer disease - H2 blockers; PUD - H2 blockers; Gastroesophageal reflux - H2 blockers; GERD - H2 blockers ... H2 blockers are used to: Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD). This is a ...

  13. Foods Inducing Typical Gastroesophageal Reflux Disease Symptoms in Korea

    OpenAIRE

    Choe, Jung Wan; Joo, Moon Kyung; Kim, Hyo Jung; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Park, Jong-Jae; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young-Tae

    2017-01-01

    Background/Aims Several specific foods are known to precipitate gastroesophageal reflux disease (GERD) symptoms and GERD patients are usually advised to avoid such foods. However, foods consumed daily are quite variable according to regions, cultures, etc. This study was done to elucidate the food items which induce typical GERD symptoms in Korean patients. Methods One hundred and twenty-six Korean patients with weekly typical GERD symptoms were asked to mark all food items that induced typic...

  14. Gastroesophageal reflux in pediatrics; (patho)physiology and new insights in diagnostics and treatment

    NARCIS (Netherlands)

    Loots, C. M.; Benninga, M. A.; Omari, T. I.

    2012-01-01

    GER is the passage of gastric contents into the esophagus and is referred to as GER disease (GERD) when GER causes troublesome symptoms and/or complications. GERD in infants and children is sometimes difficult to diagnose and even more difficult to treat. The diagnosis of GERD is hampered by the

  15. Congenital Diaphragmatic Hernia: Long-term Risk of Gastroesophageal Reflux Disease

    NARCIS (Netherlands)

    Peetsold, Marieke G.; Kneepkens, C. M. F. Frank; Heij, Hugo A.; Ijsselstijn, Hanneke; Tibboel, Dick; Gemke, Reinoud J. B. J.

    2010-01-01

    Objectives: Gastroesophageal reflux disease (GERD) is a well-recognized consequence of congenital diaphragmatic hernia (CDH). Results of studies examining predictive factors for early and late GERD are inconclusive. The aim of this study was to assess the incidence of early ( <2 years) and late GERD

  16. Predisposing Role of Immunologic determinants in the Etiology of Barrett’s Esophagus

    NARCIS (Netherlands)

    L.M.G. Moons (Leon)

    2008-01-01

    textabstractGastroesophageal reflux disease (GERD) is defined as the presence of symptoms or lesions that can be attributed to reflux of gastric contents into the esophagus. In the Western world, GERD represent one of the most common gastrointestinal problems [1,2]. Cardinal manifestations of GERD

  17. Gastroesophageal reflux disease in Iran: SEPAHAN systematic review no. 2

    Directory of Open Access Journals (Sweden)

    Mohammadreza Fazel

    2012-01-01

    Conclusions: Due to the differences between studies, such as characteristics of the sampled population and the diagnostic criteria, the reported prevalence of GERD was remarkably different in the reviewed studies. Nonetheless, because of the high prevalence of GERD in Iran, conducting large-scale epidemiological studies should be considered to determine factors associated with the prevalence of GERD to prevent and control it.

  18. Gastroesophageal reflux disease and eosinophilic esophagitis in infants and children. A study of esophageal pH, multiple intraluminal impedance and endoscopic ultrasound

    DEFF Research Database (Denmark)

    Dalby, Kasper; Nielsen, Rasmus; Kruse-Andersen, Søren

    2010-01-01

    Eosinophilic esophagitis (EE) and gastroesophageal reflux disease (GERD) in childhood share aspects of symptomatology. In order to characterize EE and GERD in infants and children with symptoms of GERD we performed a prospective investigation including prolonged esophageal pH measurement, multiple...

  19. (R)-(3-amino-2-fluoropropyl) phosphinic acid (AZD3355), a novel GABAB receptor agonist, inhibits transient lower esophageal sphincter relaxation through a peripheral mode of action

    DEFF Research Database (Denmark)

    Lehmann, Anders; Antonsson, Madeleine; Holmberg, Ann Aurell

    2009-01-01

    Gastroesophageal reflux disease (GERD) affects >10% of the Western population. Conventionally, GERD is treated by reducing gastric acid secretion, which is effective in most patients but inadequate in a significant minority. We describe a new therapeutic approach for GERD, based on inhibition...

  20. Dental approach to erosive tooth wear in gastroesophageal reflux ...

    African Journals Online (AJOL)

    Background: The duration of gastro-esophageal reflux disease (GERD), the frequency of reflux, the pH and type of acid, and the quality and quantity of saliva affect the severity of dental erosion due to GERD. Objective: To summarize the diagnostic protocol and treatment of dental erosion due to GERD. Methods: A Medline ...

  1. Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Iwakura, Narika; Fujiwara, Yasuhiro; Shiba, Masatsugu; Ochi, Masahiro; Fukuda, Takashi; Tanigawa, Tetsuya; Yamagami, Hirokazu; Tominaga, Kazunari; Watanabe, Toshio; Arakawa, Tetsuo

    2016-01-01

    Objective Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances; however, the detailed differences in the characteristics of sleep disturbances between GERD and non-GERD patients are unknown. The aim of the present study was to analyze the clinical characteristics as well as health-related quality of life in GERD and non-GERD patients with sleep disturbances. Methods Three hundred and fifty patients, including 124 patients with GERD and 226 patients without GERD, completed a self-administered questionnaire that evaluated clinical information. The Pittsburg Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and 8-item Short-Form Health Survey (SF-8) were also used. Sleep disturbance was considered to be present if the PSQI was >5.5. Results The prevalence of sleep disturbances was significantly higher in the GERD patients (66/124, 53.9%) than in the non-GERD patients (89/226, 39.3%). Depression and anxiety were significantly more common in the subjects with sleep disturbances than in those without sleep disturbances, although there were no differences between the GERD and non-GERD patients. Among the subjects with sleep disturbances, daytime sleepiness was more common in the GERD patients than in the non-GERD patients. The subjects with sleep disturbances had a poorer health-related quality of life. The physical components of quality of life were impaired, particularly in the GERD patients with sleep disturbances. Conclusion GERD patients with sleep disturbances commonly experience daytime sleepiness and an impaired health-related quality of life, especially in terms of physical components.

  2. Test Review: Wilkinson, G. S., & Robertson, G. J. (2006). Wide Range Achievement Test--Fourth Edition. Lutz, FL: Psychological Assessment Resources. WRAT4 Introductory Kit (Includes Manual, 25 Test/Response Forms [Blue and Green], and Accompanying Test Materials): $243.00

    Science.gov (United States)

    Dell, Cindy Ann; Harrold, Barbara; Dell, Thomas

    2008-01-01

    The Wide Range Achievement Test-Fourth Edition (WRAT4) is designed to provide "a quick, simple, psychometrically sound assessment of academic skills". The test was first published in 1946 by Joseph F. Jastak, with the purpose of augmenting the cognitive performance measures of the Wechsler-Bellevue Scales, developed by David Wechsler.…

  3. Presentation and Epidemiology of Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Richter, Joel E; Rubenstein, Joel H

    2018-01-01

    Gastroesophageal reflux disease (GERD) is the most prevalent gastrointestinal disorder in the United States, and leads to substantial morbidity, though associated mortality is rare. The prevalence of GERD symptoms appeared to increase until 1999. Risk factors for complications of GERD include advanced age, male sex, white race, abdominal obesity, and tobacco use. Most patients with GERD present with heartburn and effortless regurgitation. Coexistent dysphagia is considered an alarm symptom, prompting evaluation. There is substantial overlap between symptoms of GERD and those of eosinophilic esophagitis, functional dyspepsia, and gastroparesis, posing a challenge for patient management. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Changes in Ghrelin-Related Factors in Gastroesophageal Reflux Disease in Rats

    Directory of Open Access Journals (Sweden)

    Miwa Nahata

    2013-01-01

    Full Text Available To examine gastrointestinal hormone profiles and functional changes in gastroesophageal reflux disease (GERD, blood levels of the orexigenic hormone ghrelin were measured in rats with experimentally induced GERD. During the experiment, plasma acyl ghrelin levels in GERD rats were higher than those in sham-operated rats, although food intake was reduced in GERD rats. Although plasma levels of the appetite-suppressing hormone leptin were significantly decreased in GERD rats, no changes were observed in cholecystokinin levels. Repeated administration of rat ghrelin to GERD rats had no effect on the reduction in body weight or food intake. Therefore, these results suggest that aberrantly increased secretion of peripheral ghrelin and decreased ghrelin responsiveness may occur in GERD rats. Neuropeptide Y and agouti-related peptide mRNA expression in the hypothalamus of GERD rats was significantly increased, whereas proopiomelanocortin mRNA expression was significantly decreased compared to that in sham-operated rats. However, melanin-concentrating hormone (MCH and prepro-orexin mRNA expression in the hypothalamus of GERD rats was similar to that in sham-operated rats. These results suggest that although GERD rats have higher plasma ghrelin levels, ghrelin signaling in GERD rats may be suppressed due to reduced MCH and/or orexin synthesis in the hypothalamus.

  5. The Characteristics of Postprandial Proximal Gastric Acid Pocket in Gastroesophageal Reflux Disease

    Science.gov (United States)

    Wu, Jing; Liu, Dong; Feng, Cheng; Luo, Yumei; Nian, Yuanyuan; Wang, Xueqin; Zhang, Jun

    2018-01-01

    Background Postprandial proximal gastric acid pocket (PPGAP) plays important roles in gastroesophageal reflux disease (GERD). In this study, we analyzed the characteristics of PPGAP in GERD. Material/Methods There were 17 normal participants and 20 GERD patients who completed a gastroesophageal reflux disease questionnaire (GerdQ) and underwent a gastroscopy, a high-resolution manometry, an esophageal 24-hour pH monitoring, and a station pull-through pH monitoring to assess their symptomatic degree, endoscopic change, acid exposure, and PPGAP. Results PPGAP was present in all participants. Compared with normal participants, the PPGAP in GERD patients was significantly different, thus the disappearing time was significantly later (pGERD patients was positively correlated with GerdQ score (pGERD patients was positively correlated with the DeMeester score (pGERD patients was negatively correlated with the DeMeester score (pGERD patients had characteristics of long time period, long length, and high acidity. Its length was positively correlated with subjective symptomatic degree. Its period, length, and acidity were positively correlated with the objective acid exposure. PPGAP seems to be the originator of acid reflux events and plays important roles in GERD. PMID:29309401

  6. Racial and geographic issues in gastroesophageal reflux disease.

    Science.gov (United States)

    Sharma, Prateek; Wani, Sachin; Romero, Yvonne; Johnson, David; Hamilton, Frank

    2008-11-01

    Gastroesophageal reflux disease (GERD) is a common chronic disorder that is associated with a huge economic burden in the western countries and significantly decreased quality of life. This review focuses on the various multicultural issues in the epidemiology, pathophysiology, diagnosis, and treatment of GERD. The prevalence of GERD appears to be highest in North America and Europe, whereas epidemiologic data from the Indian subcontinent, Africa, South America, and the Middle East are sparse. A limited number of studies have elucidated ethnic differences in GERD in multiracial populations. African Americans and Asians appear to be at a lower risk for the development of complicated GERD including Barrett's esophagus (BE). Whether the pathophysiology of GERD differs among different populations remains to be answered satisfactorily. It appears that most of the factors involved in the pathogenesis of GERD, as described in western populations, are present in Asians but at a lower scale. The current recommendations for the management of GERD by the American College of Gastroenterology may not meet the need for different ethnic groups or for different geographic regions. Recognition of language barriers in understanding the common terms used to describe reflux symptoms should be borne in mind while treating GERD patients with different ethnic backgrounds. In addition, a universally accepted definition for treatment success in GERD patients is lacking. Given the negative impact on health-related quality of life, significant cost ramifications, and increased risk for BE and esophageal adenocarcinoma, the study of multicultural issues in GERD should be considered.

  7. Gastroesophageal reflux disease and risk for bipolar disorder: a nationwide population-based study.

    Science.gov (United States)

    Lin, Wan-Shan; Hu, Li-Yu; Liu, Chia-Jen; Hsu, Chih-Chao; Shen, Cheng-Che; Wang, Yen-Po; Hu, Yu-Wen; Tsai, Chia-Fen; Yeh, Chiu-Mei; Chen, Pan-Ming; Su, Tung-Ping; Chen, Tzeng-Ji; Lu, Ti

    2014-01-01

    Studies have shown that chronic inflammation may play a vital role in the pathophysiology of both gastroesophageal reflux disease (GERD) and bipolar disorder. Among patients with GERD, the risk of bipolar disorder has not been well characterized. We explored the relationship between GERD and the subsequent development of bipolar disorder, and examined the risk factors for bipolar disorder in patients with GERD. We identified patients who were diagnosed with GERD in the Taiwan National Health Insurance Research Database. A comparison cohort without GERD was matched according to age, sex, and comorbidities. The occurrence of bipolar disorder was evaluated in both cohorts based on diagnosis and the prescription of medications. The GERD cohort consisted of 21,674 patients, and the comparison cohort consisted of 21,674 matched control patients without GERD. The incidence of bipolar disorder (incidence rate ratio [IRR] 2.29, 95% confidence interval [CI] 1.58-3.36, Pdisorder (HR 4.89, 95% CI 3.06-7.84, P = .004) were independent risk factors for the development of bipolar disorder among GERD patients. GERD may increase the risk of developing bipolar disorder. Based on our data, we suggest that attention should be focused on female patients younger than 60 years, and patients with alcohol use disorder, following a GERD diagnosis.

  8. Gastroesophageal reflux disease: recent advances and its association with sleep.

    Science.gov (United States)

    Oh, Jung Hwan

    2016-09-01

    Gastroesophageal reflux disease (GERD) is prevalent in Asia as well as in Western countries. Sleep disturbance and breathing disorders during sleep are becoming increasingly prevalent, and they are commonly associated with GERD. The relationship between GERD and obstructive sleep apnea (OSA) is still questionable, and it has expanded to include Barrett's esophagus. Nocturnal gastroesophageal reflux (nGER) symptoms might be clinically important in the explanation of this association. The therapy for reflux symptoms has resulted in improved subjective sleep parameters and enhanced sleep quality, thus supporting a direct relationship between GERD and sleep disturbance. This review discusses the epidemiology of sleep disturbances in GERD patients; the causative relationship between GERD and OSA, even though it remains an area of controversy; and the possible role of nGER in sleep problems. It also provides an update on the current state of knowledge linking GERD and sleep. © 2016 New York Academy of Sciences.

  9. Report of the International Ice Patrol in the North Atlantic. Bulletin Number 76

    Science.gov (United States)

    1990-01-01

    lIP’s iceberg predictions. Ice were updated by Scobie dynamic height, resulting in a and Schultz (1976). Figure low estimate of the current Page 78 I...0. - 9 *460 460 440 1. 4 40 I42*N 9 .’I...........1 442*N 53OW 510 490 470 450W Figure C-2. Mean Dynamic Topography Relative to 1000 db ( Scobie and...Schultz, 1976). Paqle 79 MI magnitude. Scobie and PREVIOUS CHANGES TO Kassler and Shuhy I Schultz (1976) substantially THE 1979 CURRENT FILE also

  10. Prevalence and Risk Factors of Gastroesophageal Reflux Disease in Patients with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Jun Ouk Ha

    2016-06-01

    Full Text Available BackgroundGastrointestinal symptoms are common in patients with type 2 diabetes mellitus (T2DM. The prevalence of gastroesophageal reflux disease (GERD in Korea appears to be increasing. Some studies have shown that T2DM is a risk factor for symptomatic GERD. However, this possibility is still debated, and the pathogenesis of GERD in T2DM is not yet fully understood. The aim of this study was to analyze the prevalence and risk factors (including autonomic neuropathy of GERD in patients with T2DM.MethodsThis cross-sectional case-control study enrolled T2DM patients (n=258 and healthy controls (n=184. All participants underwent physical examinations and laboratory tests. We evaluated medical records and long-term diabetes complications, including peripheral and autonomic neuropathy in patients with T2DM. Esophagogastroduodenoscopy was performed in all patients. The Los Angeles (LA classification was used to grade GERD. GERD was defined as LA grade A (or higher or minimal change with GERD symptoms. GERD symptoms were examined using a frequency scale. Data were expressed as mean±standard error. Independent t-tests or chi-square tests were used to make comparisons between groups.ResultsThe prevalence of GERD (32.6% vs. 35.9%, P=0.266 and GERD symptoms (58.8% vs. 59.2%, P=0.503 was not significantly different between T2DM patients and controls. We found no significant differences between T2DM patients with GERD and T2DM patients without GERD with respect to diabetic complications, including autonomic neuropathy, peripheral neuropathy, duration of DM, and glucose control.ConclusionThe prevalence of GERD in patients with T2DM showed no difference from that of controls. GERD was also not associated with peripheral and cardiovascular autonomic neuropathy, age, or duration of DM in patients with T2DM.

  11. Prevalence of dental erosion among people with gastroesophageal reflux disease in China.

    Science.gov (United States)

    Li, Wenhao; Liu, Jingming; Chen, Su; Wang, Yao; Zhang, Zhenting

    2017-01-01

    Gastroesophageal reflux disease (GERD) is typically diagnosed based on symptoms of regurgitation and heartburn, although it may also manifest as asthma-like symptoms, laryngitis, or dental erosion. The purpose of this prospective, cross-sectional study was to assess the prevalence of dental erosion in people with GERD and to evaluate the association between GERD and dental erosion. The presence, severity, and pattern of dental erosion was assessed in 51 participants with GERD and 50 participants without GERD using the Smith and Knight tooth wear index. Medical, dietary, and dental histories were collected by questionnaire. Factors potentially related to dental erosion, including GERD, were evaluated by logistic regression. Dental erosion was observed in 31 (60.8%) participants with GERD and 14 (28%) participants without GERD. Bivariate analysis revealed that participants with GERD were more likely to experience dental erosion (crude odds ratio [cOR]: 2.74; 95% CI: 1.19, 6.32) than participants without GERD. Multivariate analysis also revealed that participants with GERD had a higher risk of dental erosion (adjusted odds ratio [aOR]: 3.97; 95% CI: 1.45, 10.89). Consumption of grains and legumes, the most frequently consumed foods in China, did not correlate with dental erosion. However, carbonated beverage consumption was significantly associated with GERD and dental erosion (aOR: 3.34; 95% CI: 1.01, 11.04; P=.04). GERD was positively correlated with dental erosion. Carbonated beverage consumption can increase the risk of both GERD and dental erosion. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. Nickel sensitization in patients with gastro-esophageal reflux disease.

    Science.gov (United States)

    Stanghellini, Vincenzo; Tosetti, Cesare; Benedetto, Edoardo; Condoluci, Mario; De Bastiani, Rudi; Cogliandro, Rosanna; Mastronuzzi, Tecla; De Polo, Manuela; Di Mita, Francesco; Napoli, Luigi; Ubaldi, Enzo; Nebiacolombo, Cristina; Cottone, Carmelo; Grattagliano, Ignazio; Zamparella, Maria; Baldi, Elisabetta; Sanna, Guido

    2016-04-01

    Gastro-esophageal reflux disease (GERD) leads to frequent medical visits, and available therapies fail in up to 40% of patients. Food allergies may be involved in GERD pathogenesis; however, allergens other than food have received little attention. Nickel allergy is common in the general population and some high-nickel foods are associated with GERD. However, the potential relationship between nickel allergy and GERD remains unaddressed. This study aimed to evaluate the prevalence of nickel sensitization in patients with and without GERD and to compare clinical and demographic features. This prospective, multicenter study included 210 adult GERD patients and 140 patients without GERD who presented at the general practitioner. All GERD patients had undergone treatment with proton pump inhibitors and upper digestive endoscopy within the previous five years. Demographic and clinical data were collected by questionnaire and patients underwent a nickel patch allergy test. Patients with and without GERD presented similar characteristics, with the exception of nickel sensitization, which was significantly more prevalent among GERD patients than controls (39.5% vs. 16.4%; p = 0.001). Nickel-positive GERD patients were more frequently female (90.4% vs. 65.4%, p = 0.003) and asthmatic (18.1% vs. 4.7%; p = 0.038), compared to nickel-negative GERD patients. At six-month follow-up, most of the patients, with or without nickel sensitization, reported improved symptoms without differences in drug prescription. Nickel sensitization is particularly prevalent in GERD patients seen in general practice. Whether allergies other than food allergy play a role in GERD remains to be elucidated.

  13. Samaja bolshaja stroiploshtshadka v Estonii / Konstantin Morenko

    Index Scriptorium Estoniae

    Morenko, Konstantin

    2004-01-01

    Tallinna linnavalitsus korraldas ümarlaua linna rannaalade hetkeseisu ja arenguvõimaluste hindamiseks, mille töös osalesid ka Euroopa tuntud linnaplaneerimise konsultandid. Arvamust avaldavad Peep Aaviksoo, Lutz Schleich, Giorgio Risicaris ja Stefan Boltz

  14. "Keset filmi" Kiasmas

    Index Scriptorium Estoniae

    2004-01-01

    Soome kunstniku Tellervo Kalleineni filmiprojektist "In the middle of a movie'". Eestist esinesid projektis Taavi Eelmaa, Tarrvi Laamann, Silva Lutz, Anders Melts, Anneli Remme, Siiri Salem, Martin Palm, Kaja Prikk, Peeter Ristsoo, filmisid Peeter Maimik ja Marianne Kõrver

  15. ALICE A Large Ion Collider Experiment at CERN LHC : global layout

    CERN Multimedia

    Stephane Maridor

    2006-01-01

    from left to right: Pierluigi Bellutti (ITC); Andrea Zanotti President of ITC; Luciano Bosisio (Trieste University); Mario Zen,Director of ITC ; Maurizio Boscardin (ITC); Jean-Robert Lutz, ITS-SSD Project leader (IPHC Strasbourg).

  16. ALICE industrial award ceremony in Bologna at Santa Cristina

    CERN Multimedia

    2006-01-01

    from left to right:Pierluigi Bellutti (ITC); Andrea Zanotti President of ITC; Luciano Bosisio (Trieste University); Mario Zen,Director of ITC ; Maurizio Boscardin (ITC); Jean-Robert Lutz, ITS-SSD Project leader (IPHC Strasbourg).

  17. Aed pakub istet / Ele Praks

    Index Scriptorium Estoniae

    Praks, Ele

    2004-01-01

    Tutvustatakse maailmas moes olevat aiamööblit, mille disaineriteks noored belglased, Melbourneþi disainiüliõpilane Sherlya, Barcelonast pärit Joan Casas i Ortinez, Richard Schultz, Philippe Starck ja Skandinaavia disainerid

  18. Evaluation of cytotoxicity and oxidative stress induced by alcoholic ...

    African Journals Online (AJOL)

    Maqsood

    (Duke et al., 1992), sinapic acid and sinapin (Schultz and. Gmelin, 1952), and ... serum glutamic pyruvate transaminase (SGPT) were within normal levels ..... like asthma, skin disease and diabetes (Gill and Macleod, 1980; Maier et al., 1998).

  19. Constitutional reform as process

    OpenAIRE

    Schultze, Rainer-Olaf (Prof.)

    2000-01-01

    Constitutional reform as process. - In: The politics of constitutional reform in North America / Rainer-Olaf Schultze ... (eds.). - Opladen : Leske + Budrich, 2000. - S. 11-31. - (Politikwissenschaftliche paperbacks ; 30)

  20. Bootstrapping in language resource generation

    CSIR Research Space (South Africa)

    Davel, MH

    2003-11-01

    Full Text Available by Schultz [1]. Bootstrapping approaches are applicable to various lan- guage resource development tasks, specifically where an au- tomated mechanism can be defined to convert between vari- ous representations of the data considered. In the above ex...

  1. Prevalence of Gastroesophageal Reflux Disease in Type II Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Huihui Sun

    2014-01-01

    Full Text Available Background/Aims. Patients with type II diabetes mellitus (DM were known to have higher prevalence of gastroesophageal reflux disease (GERD in the Western countries, but data on the impact of GERD on DM patients in our country are scarce. The aim of this study was to evaluate the prevalence of GERD in type II DM patients in Shanghai, China, and to explore its possible risk factors. Methods. 775 type II DM cases were randomly collected. Reflux Disease Questionnaire (RDQ was used to check the presence of GERD. Patients’ characteristics, laboratory data, face-to-face interview, nerve conduction study, and needle electromyogram (EMG test were analyzed. Results. 16% patients were found with typical GERD symptoms. Pathophysiological factors such as peripheral neuropathy, metabolism syndrome, and obesity were found to have no significant differences between GERD and non-GERD type II DM patients in the present study. Conclusion. The prevalence of GERD in type II DM patients is higher than that in adult inhabitants in Shanghai, China. No difference in pathophysiological factors, such as peripheral neuropathy, and metabolism syndrome was found in DM-GERD patients, suggesting that further study and efforts are needed to explore deeper the potential risk factors for the high prevalence rate of GERD in DM patients.

  2. The prevalence of sexual behavior disorders in patients with treated and untreated gastroesophageal reflux disease.

    Science.gov (United States)

    Iovino, Paola; Pascariello, Annalisa; Limongelli, Paolo; Tremolaterra, Fabrizio; Consalvo, Danilo; Sabbatini, Francesco; Amato, Giuseppe; Ciacci, Carolina

    2007-07-01

    Gastroesophageal reflux disease (GERD) is a chronic disease. Sexual behavior is often altered in chronic illness. The aim of this study was to evaluate sexual behavior in patients affected with GERD before and after medical or surgical treatment in comparison to healthy controls (HC). Upper GI endoscopy and 24-h ambulatory pH testing were performed to confirm GERD in symptomatic patients. GERD patients completed an anonymous questionnaire on sexual life before and after medical or surgical treatment. Compared with HC, untreated patients with GERD showed more frequent difficulty in attaining orgasm and painful intercourse. GERD patients after surgical treatment had significantly more difficulty in attaining orgasm, while after continuous medical treatment GERD patients compared with HC had significantly more difficulty in attaining orgasm, higher painful intercourse, lower sexual desire, and perceived more frequently that the partner was unhelpful. When compared with untreated conditions, GERD patients after surgical treatment had a significant improvement in attaining orgasm and in painful intercourse but a significant decrease in sexual desire, a lower satisfaction with their sexual life, and a higher prevalence of an unhelpful partner, whereas GERD patients after medical treatment had a decrease in all indices of sexual behavior. Untreated GERD is associated with disorders in sexual behavior. Compared with HC, only the surgical group partially improved after treatment.

  3. Prevalence of Attention Deficit Hyperactivity Disorder in Pediatrics Patients Newly Diagnosed with Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Mohammad Effatpanah

    2017-09-01

    Full Text Available Background: Gastroesophageal reflux disease (GERD is associated with a number of comorbidities in pediatrics. However, its association with attention deficit hyperactivity disorder (ADHD has not been reported. The aim of the present study was to investigate the prevalence of ADHD in pediatric patients newly diagnosed with GERD. Materials and Methods: Sixty newly-diagnosed treatment naive GERD patients and sixty healthy controls aging between 5 to 12 years referring to the Children and Adolescent’s medical center, Tehran, Iran were recruited in a case-control study during the year 2015. Then patients were evaluated for ADHD by a psychiatrist according to the DSM-IV criteria. The revised Conners' Parent Rating Scale (CPRS-R was used for assessment of the symptoms of ADHD. To screen for psychiatry disorders other than ADHD, the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL questionnaire was used. Logistic regression analysis was used for modeling the association between GERD and ADHD in the study sample. Results: The mean age of GERD patients was 5.77±2.27 and for non-GERD controls was 6.03±2.52 (P= 0.543. Thirty-three out of 60 (55% GERD patients and 37 out of 60(61.66% non-GERD controls were male (P: 0.579. Prevalence of ADHD was 33.60 (55% in GERD patients and 10.60 (16.66% in non-GERD (P

  4. Review article: gastro-oesophageal reflux disease in asthma and chronic obstructive pulmonary disease.

    Science.gov (United States)

    Broers, C; Tack, J; Pauwels, A

    2018-01-01

    When gastro-oesophageal reflux is causing symptoms or lesions in the oesophagus, this is referred to as gastro-oesophageal reflux disease (GERD). GERD can manifest itself through typical symptoms (heartburn, regurgitation) or may lead to extra-oesophageal symptoms. Extra-oesophageal manifestations of GERD gained increasing attention over the last decade, especially respiratory disorders, because of the prevalent co-occurrence with GERD. The role of GERD in the pathogenesis of respiratory disorders has become a topic of intense discussion. To provide an overview of the current knowledge on the role of GERD in asthma and chronic obstructive pulmonary disease (COPD). PubMed was searched for relevant articles using the keywords: GERD, asthma, COPD, prevalence, treatment. Case reports were excluded, only English language articles were considered. Estimates for the prevalence of GERD in asthma range from 30% to 90%, compared to an average of 24% in controls. In COPD patients, the prevalence of GERD ranges from 19% to 78% compared to an average of 18% in controls. These data indicate an increased prevalence of GERD in patients with asthma and COPD, although causality is not established and GERD treatment yielded inconsistent effects. Literature supports GERD as a risk factor for COPD-exacerbations and a predictor of the 'frequent-exacerbator'-phenotype. Despite the high prevalence of GERD in asthma and COPD, a causal link is lacking. The results of anti-reflux therapy on pulmonary outcome are inconsistent and contradictory. Future studies will need to identify subgroups of asthmatics and COPD patients that may benefit from anti-reflux therapy (nocturnal or silent reflux). © 2017 John Wiley & Sons Ltd.

  5. Overdiagnosis of gastro-esophageal reflux disease and underdiagnosis of functional dyspepsia in a USA community.

    Science.gov (United States)

    Pleyer, C; Bittner, H; Locke, G R; Choung, R S; Zinsmeister, A R; Schleck, C D; Herrick, L M; Talley, N J

    2014-08-01

    There is symptom overlap between gastro-esophageal reflux disease (GERD) and functional dyspepsia (FD). We aimed to test the hypothesis that FD cases are now more likely mislabeled as GERD. In subjects from Olmsted County, MN seen at Mayo Clinic: (i) Investigation of GERD and FD diagnosis rates between 1985 and 2009. (ii) Assessment of survey-based upper gastrointestinal symptoms between 1988 and 2009. (iii) Analysis of patients reporting GERD and/or FD symptoms and subsequently receiving a consistent diagnosis of GERD and/or FD during a medical encounter. (iv) Assess the association between PPI use and GERD and/or FD symptoms and between actual diagnoses received. (i) Yearly GERD diagnosis rates rose between 1985 and 2009 (325-1866 per 100 000). FD diagnosis rates rose from 45 in 1985, to 964 in 1999 but decreased to 452 per 100 000 in 2009. (ii) Reported GERD symptoms did not significantly change between three survey waves in the years 1988-2009 (p = 0.052), whereas FD symptoms slightly increased (p = 0.01). (iii) 62.9% of subjects reporting GERD symptoms received a GERD diagnosis, however only 12.5% of subjects reporting FD symptoms received a FD diagnosis. (iv) PPI use was associated with documented GERD diagnosis (p < 0.001), however there was no significant association between GERD symptoms and PPI use (p = 0.078). We have found evidence supporting a systematic bias away from diagnosing FD, favoring a GERD diagnosis. © 2014 John Wiley & Sons Ltd.

  6. Ja mul oli veel nii palju öelda! / Marju Kõivupuu

    Index Scriptorium Estoniae

    Kõivupuu, Marju, 1960-

    2006-01-01

    Ka järgmistest raamatutest: Schultz-Bertram, Georg Julius. Balti idealisti kirjad emale / tlk. Ilmar Vene. Tartu : Ilmamaa, 2003 ; Dr. Bertram. Tartu tudengid viiskümmend aastat tagasi / saksa keelest Viktor Sepp. Tallinn : Perioodika, 1999. (Loomingu Raamatukogu ; 17) ; Pärnik, Ylo M. Dr Georg Julius von Schultz-Bertram. Tartu : Ilmamaa, 2006 ; Dr. Bertram. Kolm Tartu balli / tlk. Viktor Sepp. Tallinn : Perioodika, 1990. (Loomingu Raamatukogu ; 26)

  7. Accounting for the Poor

    OpenAIRE

    Robert M. Townsend

    2013-01-01

    Economists and other social scientists have long tried to understand the nature of poverty and how poor people make decisions. For example, T.W. Schultz, a Nobel Laureate, former professor of economics at the University of Chicago, and former president of the American Economic Association, spent his career working in development and agricultural economics. In his 1980 Nobel Prize acceptance speech, Schultz suggests that there is some accounting for the behavior of the poor in agriculture. "Fa...

  8. Lewis Y Antigen as a Target for Breast Cancer Therapy

    Science.gov (United States)

    1996-09-01

    United States of America 1992;89(12):5398-402. 23. Oldenburg KR, Loganathan D, Goldstein IJ, Schultz PG, Gallop MA. Peptide ligands for a sugar- binding...chain (Figure 3). respectively. Sequence alignment (Figure 3) indicates that the Both of these antibodies have been elucidated by X- ray anti-Y...the National Academy of Sciences of the United States of America 1992;89(12):5398-402. 42. Oldenburg KR, Loganathan D, Goldstein IJ, Schultz PG

  9. Sympatholysis

    DEFF Research Database (Denmark)

    Gliemann, Lasse; Carter, Howard Henry

    2018-01-01

    This Journal Club article highlights an article by Hearon Jr. et al. To read this article, visit https://doi.org/10.1113/JP274532. Edited by: Harold Schultz & Kathleen Morgan......This Journal Club article highlights an article by Hearon Jr. et al. To read this article, visit https://doi.org/10.1113/JP274532. Edited by: Harold Schultz & Kathleen Morgan...

  10. The Role of Using Social Media in the Performance of Manufacturers in Industrial Marketing (Case Study: Industries in western Iran)

    OpenAIRE

    Abolfazl Tajzadeh Namin; Abedin Pouya

    2016-01-01

    Social media are always considered as an important source for industrial marketing research. The aim of this study was to investigate the impact of social media on the manufacturers’ performance in western Iran. For this purpose, the impact of using social media on variables, includingmanufacturers’ personal goals ( Bulletin et al., 2011), The benefits of research media (Homburg et al., 2010; Schultz, 2012), support of producers from each (Schultz et al., 2012), manufacturers’ characteristic...

  11. Gastroesophageal reflux disease and non-digestive tract diseases.

    Science.gov (United States)

    Chen, Ying

    2015-05-01

    Over the past decade, incidence of gastroesophageal reflux disease (GERD) showed an increasing trend resulting from factors, including lifestyle and dietary habits; however, both etiology and pathological mechanisms remain controversial. GERD occurs as a result of a variety of mechanisms and there is no single factor. Symptoms of GERD are often non-typical, with a likelihood of being overlooked by non-gastroenterology professionals. Therefore, improving GERD awareness in non-gastroenterology practitioners, along with early diagnosis and treatment, provide potential benefit to clinicians and patients alike. Increasing evidence suggests GERD has specific connections with a variety of non-digestive tract conditions, may contribute an aggravating compounding effect on other diseases, prolong hospitalization, and increase subsequent medical costs. This review considers and emphasizes the association between GERD and non-digestive tract conditions, including atrial fibrillation, chronic obstructive pulmonary disease, primary pulmonary fibrosis and energy metabolism related to diet.

  12. Expression of Proteinase-activated Receptor-2 in the Esophageal Mucosa of Gastroesophageal Reflux Disease Patients: A Histomorphologic and Immunohistochemical Study.

    Science.gov (United States)

    Abd El-Rehim, Dalia M; Fath El-Bab, Hanaa K; Kamal, Enas M

    2015-10-01

    Data are limited regarding the role of proteinase-activated receptor-2 (PAR-2) in the esophageal mucosa in gastroesophageal reflux disease (GERD) patients. Our aim was to study PAR-2 expression and its relationship with different GERD-related clinical and pathologic parameters. Histomorphologic alterations in eosophageal mucosa in nonerosive reflux disease (NERD) and erosive reflux disease (ERD) were also, evaluated. Endoscopic biopsies of the esophageal mucosa were obtained from 94 GERD patients and 20 participants for histopathologic analysis and PAR-2 immunohistochemical staining. The present study demonstrated significantly higher PAR-2 expression in GERD patients compared with control, whereas no significant differences were seen between NERD and ERD groups. PAR-2 expression significantly correlated with histologic score (r=0.572, Pstudy provides evidence for the major role of PAR-2 in the pathogenesis of GERD and GERD-associated mucosal alterations.

  13. Clinical trial: esomeprazole for moderate-to-severe nighttime heartburn and gastro-oesophageal reflux disease-related sleep disturbances.

    Science.gov (United States)

    Johnson, D; Crawley, J A; Hwang, C; Brown, K

    2010-07-01

    Nighttime heartburn, common among patients with gastro-oesophageal reflux disease (GERD), is associated with substantial clinical effects. GERD-related sleep disturbances are underappreciated and undertreated. To evaluate the efficacy of esomeprazole on GERD-related nighttime heartburn and associated sleep disturbances. In this multicentre, randomized, double-blind, placebo-controlled study, patients with moderate-to-severe nighttime heartburn and GERD-related sleep disturbances (endoscopies not required) received esomeprazole 20 mg or placebo each morning for 4 weeks. Heartburn symptoms and GERD-related sleep disturbances were evaluated using the validated Pittsburgh Sleep Quality Index and validated Work Productivity and Activity Impairment Questionnaire. The analysis included 262 patients (esomeprazole, n = 137; placebo, n = 125). Significantly more patients receiving esomeprazole achieved nighttime heartburn relief (primary end point) than those receiving placebo (34.3% vs. 10.4%; P heartburn and GERD-related sleep disturbances, improving heartburn symptoms, sleep quality, work productivity and functionality.

  14. The effects of sleeve gastectomy on gastro-esophageal reflux and gastro-esophageal motility.

    Science.gov (United States)

    Hayat, Jamal O; Wan, Andrew

    2014-05-01

    Sleeve gastrectomy is an increasingly performed bariatric procedure associated with low morbidity and good short to medium term effects on weight loss and comorbid conditions. Studies assessing the prevalence of post-operative gastro-esophageal reflux disease (GERD), show sleeve gastrectomy may provoke de novo GERD symptoms or worsening of pre-existing GERD. Pathophysiological mechanisms of GERD after sleeve gastrectomy include a hypotensive lower esophageal sphincter, increased gastro-esophageal pressure gradient and intra-thoracic migration of the remnant stomach. A reduction in the compliance of the gastric remnant may provoke an increase in transient lower esophageal sphincter relaxations. Time-resolved MRI suggests relative gastric stasis in the proximal remnant and increased emptying from the antrum. A lack of standardisation of technique, along with heterogeneity of studies assessing GERD may explain the wide variability in reported results. Simultaneous and careful repair of an associated hiatus hernia may result in a reduction in the prevalence of post-operative GERD.

  15. Direct restorative treatment of dental erosion caused by gastroesophageal reflux disease associated with bruxism: a case report

    OpenAIRE

    Vidal, Cristina de Mattos Pimenta [UNESP; Catelan, Anderson [UNESP; Briso, André Luiz Fraga [UNESP; Santos, Paulo Henrique dos [UNESP

    2011-01-01

    Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder in which stomach acids are chronically regurgitated into the esophagus and oral cavity. Continual exposure of the teeth to these acids can cause severe tooth wear. Dentists are often the first healthcare professionals to diagnose dental erosion in patients with GERD. This article presents a case report of a 27-year-old male smoker with tooth wear and dentin sensitivity caused by GERD associated with bruxism. After diagnosis...

  16. The Prevalence and Clinical Features of Non-responsive Gastroesophageal Reflux Disease to Practical Proton Pump Inhibitor Dose in Korea: A Multicenter Study.

    Science.gov (United States)

    Park, Hong Jun; Park, Soo Heon; Shim, Ki Nam; Kim, Yong Sung; Kim, Hyun Jin; Han, Jae Pil; Kim, Yong Sik; Bang, Byoung Wook; Kim, Gwang Ha; Baik, Gwang Ho; Kim, Hyung Hun; Park, Seon Young; Kim, Sung Soo

    2016-07-25

    In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD. A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks. A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively). In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness.

  17. Does national expenditure on research and development influence stroke outcomes?

    Science.gov (United States)

    Kim, Young Dae; Jung, Yo Han; Norrving, Bo; Ovbiagele, Bruce; Saposnik, Gustavo

    2017-10-01

    Background Expenditure on research and development is a macroeconomic indicator representative of national investment. International organizations use this indicator to compare international research and development activities. Aim We investigated whether differences in expenditures on research and development at the country level may influence the incidence of stroke and stroke mortality. Methods We compared stroke metrics with absolute amount of gross domestic expenditure on R&D (GERD) per-capita adjusted for purchasing power parity (aGERD) and relative amount of GERD as percent of gross domestic product (rGERD). Sources included official data from the UNESCO, the World Health Organization, the World Bank, and population-based studies. We used correlation analysis and multivariable linear regression modeling. Results Overall, data on stroke mortality rate and GERD were available from 66 countries for two periods (2002 and 2008). Age-standardized stroke mortality rate was associated with aGERD (r = -0.708 in 2002 and r = -0.730 in 2008) or rGERD (r = -0.545 in 2002 and r = -0.657 in 2008) (all p < 0.001). Multivariable analysis showed a lower aGERD and rGERD were independently and inversely associated with higher stroke mortality (all p < 0.05). The estimated prevalence of hypertension, diabetes, or obesity was higher in countries with lower aGERD. The analysis of 27 population-based studies showed consistent inverse associations between aGERD or rGERD and incident risk of stroke and 30-day case fatality. Conclusions There is higher stroke mortality among countries with lower expenditures in research and development. While this study does not prove causality, it suggests a potential area to focus efforts to improve global stroke outcomes.

  18. Risk of pneumonia in patients with gastroesophageal reflux disease: A population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Wan-Tseng Hsu

    Full Text Available The prevalence of gastroesophagel reflux disease (GERD has steadily increased. However, the association between GERD itself and the risk of pneumonia remains unclear. This study aimed to investigate the association between GERD and long-term risk of pneumonia and to identify the major risk factors for pneumonia in GERD patients.Using the Taiwan National Health Insurance Research Database, we identified patients who were newly diagnosed with GERD and treated with proton pump inhibitors (PPIs from January 1, 2004 through December 31, 2010. Two groups comprising 15,715 GERD cases and 15,715 non-GERD matched controls were generated using propensity score matching, thereby making the differences in basic demographics, concomitant medication use, and comorbidities between the two groups inconsiderable.Cumulative incidence of pneumonia was significantly higher in the patients with GERD than that in the non-GERD matched controls, with an adjusted HR of 1.48 (95% confidence interval [CI] = 1.31-1.67; P < 0.001 within 6-year follow-ups. Multivariate stratified analyses revealed similar results in many subgroups, with a highest risk in individuals younger than 40 years of age (HR = 2.17, 95% CI = 1.48-3.19. Crucially, patients with GERD using PPIs longer than 4 months were at a significantly increased risk of pneumonia than those who did not use PPIs or took PPIs less than 4 months.GERD was significantly associated with long-term risk of pneumonia, especially in GERD with PPI use longer than 4 months or in the young population. Further prospective longitudinal studies should be conducted for validation and implementing clinical practice guidelines.

  19. Gastroesophageal reflux disease and risk for bipolar disorder: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Wan-Shan Lin

    Full Text Available BACKGROUND: Studies have shown that chronic inflammation may play a vital role in the pathophysiology of both gastroesophageal reflux disease (GERD and bipolar disorder. Among patients with GERD, the risk of bipolar disorder has not been well characterized. OBJECTIVE: We explored the relationship between GERD and the subsequent development of bipolar disorder, and examined the risk factors for bipolar disorder in patients with GERD. METHODS: We identified patients who were diagnosed with GERD in the Taiwan National Health Insurance Research Database. A comparison cohort without GERD was matched according to age, sex, and comorbidities. The occurrence of bipolar disorder was evaluated in both cohorts based on diagnosis and the prescription of medications. RESULTS: The GERD cohort consisted of 21,674 patients, and the comparison cohort consisted of 21,674 matched control patients without GERD. The incidence of bipolar disorder (incidence rate ratio [IRR] 2.29, 95% confidence interval [CI] 1.58-3.36, P<.001 was higher among GERD patients than among comparison cohort. Multivariate, matched regression models showed that the female sex (hazard ratio [HR] 1.78, 95% CI 1.76-2.74, P = .008, being younger than 60 years old (HR 2.35, 95% CI 1.33-4.16, P = .003, and alcohol use disorder (HR 4.89, 95% CI 3.06-7.84, P = .004 were independent risk factors for the development of bipolar disorder among GERD patients. CONCLUSIONS: GERD may increase the risk of developing bipolar disorder. Based on our data, we suggest that attention should be focused on female patients younger than 60 years, and patients with alcohol use disorder, following a GERD diagnosis.

  20. Role of Acid and Weakly Acidic Reflux in Gastroesophageal Reflux Disease Off Proton Pump Inhibitor Therapy

    OpenAIRE

    Sung, Hea Jung; Cho, Yu Kyung; Moon, Sung Jin; Kim, Jin Su; Lim, Chul Hyun; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Myung-Gye

    2012-01-01

    Background/Aims Available data about reflux patterns and symptom determinants in the gastroesophageal reflux disease (GERD) subtypes off proton pump inhibitor (PPI) therapy are lacking. We aimed to evaluate reflux patterns and determinants of symptom perception in patients with GERD off PPI therapy by impedance-pH monitoring. Methods We retrospectively reviewed the impedance-pH data in patients diagnosed as GERD based on results of impedance-pH monitoring, endoscopy and/or typical symptoms. T...

  1. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    OpenAIRE

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethn...

  2. Gastro-esophageal reflux disease among type-2 diabetes mellitus patients in a rural area

    Directory of Open Access Journals (Sweden)

    Christopher S. Suwita

    2015-04-01

    Full Text Available Background: One of the most neglected complications of diabetes mellitus (DM is gastro-esophageal reflux disease (GERD which arises from autonomic neuropathy and diabetic gastropathy related to the extent of DM. This study was done to find prevalence of GERD in DM patients with GERD-questionnaire (GERDQ, dietary factor proportion, and their association with other GERD risk factor in rural area. Methods: This cross sectional study was conducted in Puskesmas Pelaihari from August to September 2013. Subjects with DM aged ≥ 18 were selected consecutively from both newly and previously diagnosed patients with exclusion criteria: pregnancy, in proton-pump inhibitor therapy, and had other metabolic disease(s. DM was diagnosed with ADA criteria, while GERD was diagnosed in patients with score of ≥ 8 of Indonesian GERDQ. Results: There were 30 subjects (29.7% with GERD among 101 patients with DM and dietary factors found in GERD patients were spicy diet (90%, high-fat food (90%, irritative beverages (87%, and irritative diet (23%. Only female gender was associated with GERD vs non-GERD in DM patients (87% vs 68%, p = 0.048. Meanwhile, duration of DM (2 [0-13] vs 2 [0-19], p = 0.976, obesity (37% vs 38%, p = 0.897, age (53.2±10.5 vs 54.7 ± 9.3, p = 0.481, and uncontrolled diabetes (90% vs 94%, p = 0.421 were not associated with the GERD among DM patients.Conclusion: Prevalence of GERD in DM is somewhat high in this study. Female group with DM needs to be screened for GERD as early as possible.

  3. Prevalence of gastro-esophageal reflux disease and its risk factors in a community-based population in southern India.

    Science.gov (United States)

    Wang, Hai-Yun; Leena, Kondarapassery Balakumaran; Plymoth, Amelie; Hergens, Maria-Pia; Yin, Li; Shenoy, Kotacherry Trivikrama; Ye, Weimin

    2016-03-15

    The prevalence of gastro-esophageal reflux disease (GERD) varies widely around the world. This study aimed to investigate the prevalence and risk factors of GERD in a general population of southern India. An interview-based observational study was carried out in southern India during 2010 and early 2011 using a GERD questionnaire (GerdQ). In total 1072 participants were enrolled using a multi-stage cluster sampling method. Presence of GERD was defined as a score of ≥ 8. Logistic regression models were used to derive odds ratios (ORs) with 95 % confidence intervals (CIs). The prevalence of GERD was 22.2 % (238/1072) in southern India, and was more common among older subjects and men. Overweight and obese subjects had a dose-dependent increased risk of GERD, compared to those with body mass index less than 25 (multivariate-adjusted OR = 1.4, 95 % CI 1.0-2.0; OR = 2.3, 95 % CI 1.3-4.1, respectively). People residing in urban community were more vulnerable to GERD than those in rural community (multivariate-adjusted OR = 1.8, 95 % CI 1.3-2.5). Similarly, those with a lower educational level appeared to have an increased risk of GERD. Further, those with a habit of pan masala chewing were more likely to develop GERD compared with those abstained from the habit (multivariate-adjusted OR = 2.0, 95 % CI 1.2-3.2). GERD is highly prevalent in southern India. Increasing age and BMI, an urban environment, lower educational level, and pan masala chewing appear to be risk factors of GERD symptoms for the studied population.

  4. [Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia].

    Science.gov (United States)

    Mozharovskiy, V V; Tsyganov, A A; Mozharovskiy, K V; Tarasov, A A

    To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

  5. Physiology and pathogenesis of gastroesophageal reflux disease.

    Science.gov (United States)

    Mikami, Dean J; Murayama, Kenric M

    2015-06-01

    Gastroesophageal reflux disease (GERD) is one of the most common problems treated by primary care physicians. Almost 20% of the population in the United States experiences occasional regurgitation, heartburn, or retrosternal pain because of GERD. Reflux disease is complex, and the physiology and pathogenesis are still incompletely understood. However, abnormalities of any one or a combination of the three physiologic processes, namely, esophageal motility, lower esophageal sphincter function, and gastric motility or emptying, can lead to GERD. There are many diagnostic and therapeutic approaches to GERD today, but more studies are needed to better understand this complex disease process. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. [Gastroesophageal reflux disease in preschool children with asthma].

    Science.gov (United States)

    Yoshida, Yukinori; Kameda, Makoto; Nishikido, Tomoki; Takamatu, Isamu; Doi, Satoru

    2008-05-01

    In pediatric intractable asthma, there is occasionally an association with GERD (gastroesophageal reflux disease). It is not clear in which cases GERD should be suspected or how effective the GERD therapy is in treating the asthma. Twenty-seven preschool children (asthma attack in spite of asthma therapy underwent 24-hour esophageal pH monitoring. We examined retrospectively the incidence of GERD and the effectiveness of famotidine in GERD positive patients. 18 of the 27 patients (66.7%) had positive results (GERD positive group). In 12 of the 15 patients (80%) who underwent GERD therapy (famotidine), respiratory symptoms were decreased. In the GERD positive group, the incidence of acid reflux during waking hours was more frequent than during sleeping hours. In 8 of 12 patients (66.7%) in whom famotidine was effective, cough and wheeze often occurred during the daytime and corresponded with the time when acid reflux must commonly occurred. We conclude that children suffering from recurrent asthma attack in spite of asthma therapy must be examined for the presence of GERD.

  7. Swallowing problems

    Science.gov (United States)

    ... Health Topics Amyotrophic Lateral Sclerosis Cerebral Palsy Esophageal Cancer Esophagus Disorders GERD Head and Neck Cancer Huntington's Disease Multiple Sclerosis Muscular Dystrophy Oral Cancer ...

  8. [Comparative data of prokinetics in treatment of gastroesophageal reflux disease in patients with diabetes].

    Science.gov (United States)

    Fedorchenko, Iu L

    2013-01-01

    The purpose is to evaluate the effectiveness of itopride (IP) and domperidone (DP) in the treatment of patients with gastroesophageal reflux disease (GERD), in combination with diabetes mellitus (DM) type 1 and 2. 40 patients were examined with GERD and type 1 diabetes and 50 patients with GERD and type 2 diabetes. Each group of patients with GERD, DM 1 and 2 has been divided into: the basic subgroup receiving IG 50 mg 3 tid and control--DP 10 mg tid. Patients were also administered omeprazole. Both subgroups were strictly randomized to key indicators, except for therapy. Baseline and after 2 and 4 weeks, all patients were examined to identify complaints, endoscopy and pH-metric changes, gastric motility was studied by electrogastroenterographic method (PEGEG). In the subgroups of patients with GERD + DM 1 and GERD + DM 2, received treatment with IG complaints on heartburn, regurgitation, odynophagia relieved significantly earlier then in the subgroups treated with DP. After 4 weeks of therapy, decreasing in the number of gastroesophageal refluxes, number of patients with erosive esophagitis B level, and normalization of the motility of the stomach were significantly higher in the groups of GERD + DM 1 and GERD + DM 2 received treatment with IG when compared with the subgroup of PD. There were no side effects of prokinetics. IG was more effective then DP in the treatment of GERD in patients with diabetes, and may be recommended for inclusion in the scheme of treatment of this comorbidity.

  9. Gastroesophageal reflux disease and atrial fibrillation: a nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Chin-Chou Huang

    Full Text Available OBJECTIVES: Precise mechanisms of atrial fibrillation (AF are uncertain, but their association with esophageal disorders has been recently proposed. The association between gastroesophageal reflux disease (GERD, the most common gastroesophageal disorder, and AF remains undetermined. We therefore aimed to investigate the association between GERD and later development of AF. METHODS AND RESULTS: Patients with GERD were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. The study cohort comprised 29,688 newly diagnosed adult GERD patients; 29,597 randomly selected age-, gender-, comobidity-matched subjects comprised the comparison cohort. Cox proportional hazard regressions were performed as a means of comparing the AF-free survival rate for the two cohorts. During a maximum three years of follow-up, a total of 351 patients experienced AF, including 184 (0.62% patients in the GERD cohort and 167 (0.56% in the control group. The log-rank test showed that patients with GERD had significantly higher incidence of AF than those without GERD (p = 0.024. After Cox proportional hazard regression model analysis, GERD was independently associated with the increased risk of AF (hazard ratio, 1.31; 95% confidence interval, 1.06-1.61, p = 0.013. CONCLUSION: GERD was independently associated with an increased risk of future AF in a nationwide population-based cohort.

  10. Prevalence and characteristics of acid gastro-oesophageal reflux disease in Jackhammer oesophagus.

    Science.gov (United States)

    Mallet, Anne-Laure; Ropert, Alain; Bouguen, Guillaume; Siproudhis, Laurent; Boutroux, Dominique; Bretagne, Jean-François; Brochard, Charlène

    2016-10-01

    An association between acid gastro-oesophageal reflux disease (GERD) and Jackhammer oesophagus has been suggested. To assess the prevalence and characteristics of acid-GERD in Jackhammer oesophagus and the efficacy of proton pump inhibitors. Data and outcomes of patients with Jackhammer oesophagus were assessed. Two groups were compared: (i) GERD, defined by endoscopic oesophagitis or by an increase in acid exposure time or by an acid-hypersensitive oesophagus and (ii) non-GERD defined by normal oesophageal acid exposure without acid-hypersensitive oesophagus. Among the 1994 high-resolution manometries performed, 44 Jackhammer oesophagus (2.2%) were included (sex ratio M/F: 19/25; median age: 66 [61-75] years). Nineteen patients (43.2%) had GERD, 16 (36.4%) had no GERD and 9 patients (20.4%) were undetermined. Dysphagia was the predominant symptom (37/43 (86%)). After a median follow-up of 25.3 months [9.6-31.4], dysphagia was improved in 22/36 (61.1%) patients. Dysphagia improvement as well as other symptoms improvement was not associated with GERD status or proton-pump inhibitors use. The prevalence of GERD is high among patients with Jackhammer oesophagus. The rates of symptom improvement in Jackhammer oesophagus were high regardless of the use of proton-pump inhibitors treatment or of the presence of GERD. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  11. GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA AND CONSTIPATION PREDOMINANT IRRITABLE BOWEL SYNDROME: CLINICAL FEATURES AND EFFICACY OF LACTULOSE AND ITOPRIDE HYDROCHLORIDE

    Directory of Open Access Journals (Sweden)

    O. V. Krapivnaya

    2014-01-01

    Full Text Available Background: The frequent coexistence of gastroesophageal reflux disease (GERD with functional dyspepsia (FD and an irritable bowel syndrome (IBS has been described in the literature. Aim: To study the specific features of GERD clinical course and diagnosis in patients with GERD in combination with FD and constipation predominant IBS (IBS-C in comparison to patients with isolated GERD; to assess the efficacy of lactulose and itopride hydrochloride. Materials and methods: A total of 60 patients with GERD, FD (Rome criteria III, and IBS-C (Rome criteria III and 29 patients with isolated GERD were examined. GERD diagnosis was based on clinical, endoscopic, and pH-metric criteria. For 4 weeks 10 patients with combination of non-erosive reflux disease (NERD, FD and IBS-C received lactulose monotherapy and other 10 patients received combination of lactulose with itopride hydrochloride. Clinical symptoms and pH-metric parameters were assessed before and 4 weeks after treatment. Results: Combination of GERD, FD and IBS-C was noted more frequently in women under 40 with normal body mass index (р<0.05. Classic GERD symptoms were absent in 43.4% of patients with gastrointestinal comorbidity and in 10.3% of patients with isolated GERD (р=0.004. A higher prevalence of belching and nausea was found in patients, suffering from GERD, FD and IBS-C, than in those with isolated GERD (р<0.05. After 4-week lactulose and itopride hydrochloride treatment all the patients with GERD, FD and IBS-C showed a reduction of clinical symptoms (p<0.05 and normalization of pH-metric parameters (р<0.001. Conclusion: GERD course in patients with concomitant FD and IBS-C has the following peculiarities: predominance of women, absence of classic GERD-symptoms in almost half of these patients, and frequent combination with other functional symptoms. Combination therapy with lactulose and itopride hydrochloride enables successful control of GERD and FD symptoms as well as

  12. Integrated Weed Management Strategies for Control of Hydrilla

    National Research Council Canada - National Science Library

    Nelson, Linda S; Shearer, Judy F

    2009-01-01

    ...), and the fungal pathogen Mycoleptodiscus terrestris (Gerd.) Ostazeski, applied alone and in combination with one another, as an integrated weed management strategy against the nuisance aquatic plant, hydrilla...

  13. Incidência e fatores predisponentes da migração da fundoplicatura pela técnica de Nissen-Rossetti no tratamento da doença do refluxo Gastroesofágico Incidence and predisponent factors for the migration of the fundoplication by Nissen-Rossetti technique in the surgical treatment of GERD

    Directory of Open Access Journals (Sweden)

    Paulo Afonso Nunes Nassif

    2012-06-01

    Full Text Available RACIONAL: A doença do refluxo gastroesofágico é uma das enfermidades do trato gastrointestinal mais frequentes atualmente. A fundoplicatura de Nissen-Rossetti é técnica operatória muito empregada para o tratamento cirúrgico, sendo a migração intratorácica da válvula uma das principais complicações. OBJETIVO: Avaliar a incidência da migração da fundoplicatura e seus fatores de risco. MÉTODO: Analisou-se retrospectivamente 207 prontuários de pacientes submetidos à fundoplicatura videolaparoscópica pela técnica de Nissen-Rossetti para tratamento da doença do refluxo. As variáveis analisadas foram: sexo, idade, esofagite, grau de esofagite, tamanho da hérnia, alargamento da cárdia, encurtamento esofágico. Para as variáveis quantitativas, foi considerado o teste t de Student. Para as nominais, foi considerado o teste de Qui-quadrado ou o teste exato de Fisher. Valores de pBACKGROUND: Gastroesophageal reflux is the gastrointestinal tract disease most frequently find nowadays. The Nissen-Rossetti fundoplication is widely used for the surgical treatment, and intrathoracic migration of the valve is the most frequent complication. AIM: To assess the incidence of the fundoplication and its risk factors. METHODS: Were analyzed retrospectively medical records of 207 patients undergoing laparoscopic fundoplication by the Nissen-Rossetti technique for the treatment of reflux disease. The variables analyzed were: sex, age, esophagitis grade, size of the herniation, enlargement of the cardia and esophageal shortening. For quantitative variables, was considered the Student's t test. For the nominal, was considered the chi-square or Fisher's exact test. P values ​​<0.05 were considered statistically significant. RESULTS: Of the total, 135 were women (65.22% and 72 men (34.78% with mean age of 47.43 years. The size of the hernia varied between 2 and 6 cm. Two hundred patients had esophagitis (96.62% and 113 (56.50% grade I, 75 grade II (37.50% and 12 grade III or IV (6%. Enlargement of the cardia and Barrett's esophagus were seen in 153 (73.91% and 13 (6.28% cases, respectively. One patient had esophageal shortening. Among women, 33 (24.4% showed migration and among men, only six (8.3% (p = 0.005. The average age of patients with and without migration was 54.03 and 45.89 years, respectively (p = 0.001. CONCLUSION: The incidence of the fundoplication migration was 18.8%. The gender (female and higher age influence the probability of migration. The degree of esophagitis, size of hernia and enlargement of the cardia were not risk factors for intrathoracic migration of the fundoplication

  14. Risk of acute myocardial infarction in patients with gastroesophageal reflux disease: A nationwide population-based study.

    Directory of Open Access Journals (Sweden)

    Wei-Yi Lei

    Full Text Available Gastroesophageal reflux disease (GERD is a common disease which can cause troublesome symptoms and affect quality of life. In addition to esophageal complications, GERD may also be a risk factor for extra-esophageal complications. Both GERD and coronary artery disease (CAD can cause chest pain and frequently co-exist. However, the association between GERD and acute myocardial infarction (AMI remain unclear. The purpose of the study was to compare the incidence of acute myocardial infarction in GERD patients with an age-, gender-, and comorbidity matched population free of GERD. We also examine the association of the risk of AMI and the use of acid suppressing agents in GERD patients.We identified patients with GERD from the Taiwan National Health Insurance Research Database. The study cohort comprised 54,422 newly diagnosed GERD patients; 269,572 randomly selected age-, gender-, comorbidity-matched subjects comprised the comparison cohort. Patients with any prior CAD, AMI or peripheral arterial disease were excluded. Incidence of new AMI was studied in both groups.A total 1,236 (0.5% of the patients from the control group and 371 (0.7% patients from the GERD group experienced AMI during a mean follow-up period of 3.3 years. Based on Cox proportional-hazard model analysis, GERD was independently associated with increased risk of developing AMI (hazard ratio (HR = 1.48; 95% confidence interval (CI: 1.31-1.66, P < 0.001. Within the GERD group, patients who were prescribed proton pump inhibitors (PPIs for more than one year had slightly decreased the risk of developing AMI, compared with those without taking PPIs (HR = 0.57; 95% CI: 0.31-1.04, P = 0.066.This large population-based study demonstrates an association between GERD and future development of AMI, however, PPIs use only achieved marginal significance in reducing the occurrence of AMI in GERD patients. Further prospective studies are needed to evaluate whether anti-reflux medication may

  15. Effects of anxiety and depression in patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Kessing, Boudewijn F; Bredenoord, Albert J; Saleh, Caroline M G; Smout, André J P M

    2015-06-01

    Increased levels of anxiety and depression have been associated with esophageal hyperalgesia and an increased risk of gastroesophageal reflux disease (GERD). We investigated the effects of anxiety and depression on GERD symptoms and the perception of reflux episodes in a well-characterized group of patients. We performed a prospective study of 225 consecutive patients who had symptoms of GERD evaluated. Patients underwent ambulatory 24-hour pH impedance monitoring, and levels of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. GERD was diagnosed in 147 patients (78 patients had functional heartburn); 36 patients were hypersensitive to gastroesophageal reflux. Among patients with GERD, increased levels of anxiety were associated with more severe retrosternal pain and retrosternal burning. Furthermore, increased levels of anxiety and depression each were associated with lower scores of the mental component of quality of life questionnaire. Levels of anxiety or depression were not associated with the number of reflux symptoms reported during 24-hour pH impedance monitoring or with the number of symptoms associated with a reflux event. Among GERD patients with hypersensitivity to reflux, levels of anxiety and depression and decreases in quality of life were similar to those of other patients with GERD. Patients with functional heartburn had higher levels of anxiety than patients with GERD. In patients with GERD, increased levels of anxiety are associated with increased severity of retrosternal pain and heartburn and reduced quality of life. Patients with GERD with hypersensitivity to gastroesophageal reflux have similar levels of anxiety and similar quality-of-life scores as other patients with GERD. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  16. Gastroesophageal reflux disease in COPD: links and risks

    Directory of Open Access Journals (Sweden)

    Lee AL

    2015-09-01

    Full Text Available Annemarie L Lee,1–3 Roger S Goldstein1,2,4 1West Park Healthcare Centre, 2Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; 3Institute for Breathing and Sleep, Austin Hospital, Melbourne, VIC, Australia; 4Department of Medicine, University of Toronto, Toronto, ON, Canada Abstract: COPD is a long-term condition associated with considerable disability with a clinical course characterized by episodes of worsening respiratory signs and symptoms associated with exacerbations. Gastroesophageal reflux disease (GERD is one of the most common gastrointestinal conditions in the general population and has emerged as a comorbidity of COPD. GERD may be diagnosed by both symptomatic approaches (including both typical and atypical symptoms and objective measurements. Based on a mix of diagnostic approaches, the prevalence of GERD in COPD ranges from 17% to 78%. Although GERD is usually confined to the lower esophagus in some individuals, it may be associated with pulmonary microaspiration of gastric contents. Possible mechanisms that may contribute to GERD in COPD originate from gastroesophageal dysfunction, including altered pressure in the lower esophageal sphincter (which normally protect against GERD and changes in esophageal motility. Proposed respiratory contributions to the development of GERD include respiratory medications that may alter esophageal sphincter tone and changes in respiratory mechanics, with increased lung hyperinflation compromising the antireflux barrier. Although the specific cause and effect relationship between GERD and COPD has not been fully elucidated, GERD may influence lung disease severity and has been identified as a significant predictor of acute exacerbations of COPD. Further clinical effects could include a poorer health-related quality of life and an increased cost in health care, although these factors require further clarification. There are both medical and surgical options available for the

  17. Fewer acute respiratory infection episodes among patients receiving treatment for gastroesophageal reflux disease.

    Directory of Open Access Journals (Sweden)

    Herng-Ching Lin

    Full Text Available Patients with gastroesophageal reflux disease (GERD present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI on patients' subsequent healthcare utilization for acute respiratory infections (ARIs. This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory care visits for ARI (visits during a 7-day period bundled into one episode, were compared between the patient groups during the 1-year period before and after the index date (date of GERD diagnosis for study patients, first ambulatory visit in the same year for their matched comparison counterpart. Multiple regression analysis using a difference-in-difference approach was performed to estimate the adjusted association between GERD treatment and the subsequent annual ARI rate. We found that the mean annual ARI episode rate among GERD patients reduced by 11.4%, from 4.39 before PPI treatment, to 3.89 following treatment (mean change = -0.5 visit, 95% confidence interval (CI = (-0.64, -0.36. In Poisson regression analysis, GERD treatment showed an independent association with the annual ARI rate, showing a negative estimate (with p<0.001. The study suggests that GERD treatment with PPIs may help reduce healthcare visits for ARIs, highlighting the importance of treatment-seeking by GERD patients and compliance with treatment.

  18. Prevalence of Gastroesophageal Reflux Disease in Saudi Arabia.

    Science.gov (United States)

    Alsuwat, Obaidallah Buraykan; Alzahrani, Abdulrahman Ahmad; Alzhrani, Mohammed Abdullah; Alkhathami, Ali Mesfer; Mahfouz, Mohammad Eid Mahmoud

    2018-03-01

    Gastroesophageal reflux disease (GERD) is a common chronic gastrointestinal tract disease. The incidence is higher in Asian and Arab countries. In Saudi Arabia, there are few studies that have assessed the prevalence of GERD among some cities' communities. Hence, this study aims to study the prevalence of GERD among the general population of Saudi Arabia. A cross-sectional study was designed to determine the prevalence of GERD among the community of Saudi Arabia. The sample was randomly gathered through self-administered validated GERD questionnaire (GerdQ) to diagnose GERD, during the period from November to December 2016. The sociodemographic data was assessed for all participants. The data were analysed using Statistical Package for Social Sciences version 21.0 (SPSS); the t -test was used to assess the association of GERD and sociodemographic data. The sample was comprised of 2,043 participants. Female and male were 51.8% and 48.2%, respectively. Mean age was 29.6 years with the standard deviation of 10.5 years. The GERD prevalence was 28.7%. It was found statistically significant among divorced/widow (34.9%, P = 0.003). In contrast, there was no association between GERD's prevalence and gender, age, residence status, education level, occupation, and blood group (P > 0.05). The prevalence of GERD among Saudi population is higher than that in Western countries and East Asia. It affects divorced/widow, obese and those with a sedentary lifestyle. It is advocated that national programs and educational campaigns for prevention of this disease and its complications should be established.

  19. Association between sleep bruxism and gastroesophageal reflux disease.

    Science.gov (United States)

    Mengatto, Cristiane Machado; Dalberto, Charlene da Silveira; Scheeren, Betina; Barros, Sérgio Gabriel Silva de

    2013-11-01

    Rhythmic masticatory muscle activity, including sleep bruxism (SB), can be induced in healthy individuals by experimental esophageal acidification, which plays an important role in the pathogenesis of gastroesophageal reflux disease (GERD). However, no robust evidence supports the association between SB and GERD. The purpose of this study was to investigate the association between SB and GERD. Forty-five individuals were eligible to participate in this observational transversal study at the Gastroenterology Service of the Clinical Hospital of Porto Alegre, Brazil. The participants were classified into 2 groups, those with and without GERD, according to the Montreal Criteria and pH-metry/endoscopy findings. The diagnosis of SB was not assessed in a sleep laboratory but was based on self-report plus clinical inspection, according to the minimal diagnostic criteria of the American Academy of Sleep Medicine. The Lipp Stress Symptom Inventory was used to evaluate self-perceived stress. Univariate and multiple logistic regression analyses were performed with SB as dependent variable and GERD, sex, age, body mass index, and stress as predictors (α=.05; 90% power). The study population included individuals with SB without GERD (13.3%) and individuals with SB with GERD (31.1%). In participants with GERD, the prevalence of SB was 73.7%. Only the variable GERD was significantly associated with SB (P=.017; odds ratio 6.58; 95% confidence interval 1.40-30.98), although adjusted for stress and age. Sleep bruxism is prevalent in GERD patients, and GERD is highly associated with SB. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  20. Predictive value of routine esophageal high-resolution manometry for gastro-esophageal reflux disease.

    Science.gov (United States)

    van Hoeij, F B; Smout, A J; Bredenoord, A J

    2015-07-01

    Using conventional manometry, gastro-esophageal reflux disease (GERD) was associated with a reduced lower esophageal sphincter (LES) pressure and impaired peristalsis. However, with a large overlap between GERD patients and controls, these findings are of limited clinical relevance. It is uncertain whether the more detailed information of high-resolution manometry (HRM) can discriminate GERD patients. Therefore, we aimed to determine to which extent HRM findings can predict GERD. HRM measurements in 69 patients with GERD and 40 healthy subjects were compared and the predictive value of HRM for the diagnosis of GERD was explored. GERD patients had a significantly lower contraction amplitude (55 vs 64 mmHg; p = 0.045) and basal LES pressure (10 vs 13.2 mmHg; p = 0.034) than healthy controls. GERD patients more often had a hiatal hernia than healthy subjects (30% vs 7%; p = 0.005). Patients with reflux esophagitis had a lower DCI than patients without reflux esophagitis (558 vs 782 mmHg cm s; p = 0.045). No significant difference was seen in contractile front velocity, distal latency, number of peristaltic breaks, residual LES pressure and LES length. On multivariate logistic regression analysis, both esophagogastric junction type I (OR 4.971; 95% CI 1.33-18.59; p = 0.017) and mean wave amplitude (OR 0.95; 95% CI 0.90-0.98; p = 0.013) were found to be independent predictors of GERD. However, the sensitivity and specificity of these findings were low. Hiatal hernia, low contraction amplitude and LES pressure are associated with GERD, but do not predict the disease with sufficient accuracy. Routine esophageal HRM can therefore not be used to distinguish GERD patients from healthy subjects. © 2015 John Wiley & Sons Ltd.

  1. A generalization of resource-bounded measure, with an application (Extended abstract)

    Science.gov (United States)

    Buhrman, Harry; van Melkebeek, Dieter; Regan, Kenneth W.; Sivakumar, D.; Strauss, Martin

    We introduce resource-bounded betting games, and propose a generalization of Lutz's resource-bounded measure in which the choice of next string to bet on is fully adaptive. Lutz's martingales are equivalent to betting games constrained to bet on strings in lexicographic order. We show that if strong pseudo-random number generators exist, then betting games are equivalent to martingales, for measure on E and EXP. However, we construct betting games that succeed on certain classes whose Lutz measures are important open problems: the class of polynomial-time Turing-complete languages in EXP, and its superclass of polynomial-time Turing-autoreducible languages. If an EXP-martingale succeeds on either of these classes, or if betting games have the "finite union property" possessed by Lutz's measure, one obtains the non-relativizable consequence BPP ≠ EXP. We also show that if EXP ≠ MA, then the polynomial-time truth-table-autoreducible languages have Lutz measure zero, whereas if EXP = BPP, they have measure one.

  2. Waking up from the dream of reason; Rationality in the real world

    NARCIS (Netherlands)

    Van Hezewijk, René

    2007-01-01

    Review Essay of: Gerd Gigerenzer, Adaptive Thinking: Rationality in the Real World. Oxford: Oxford University Press, 2000. 344 pp. ISBN 0–19–513622–5 (hbk). Gerd Gigerenzer, Reckoning with Risk: Learning to Live with Uncertainty. London: Allen Lane/Penguin, 2002. 310 pp. ISBN 0–713–99512–2

  3. Inducing and Aggravating Factors of Gastroesophageal Reflux Symptoms

    Directory of Open Access Journals (Sweden)

    Radhiyatam Mardhiyah

    2016-12-01

    Full Text Available Gastroesophageal reflux disease (subsequently abbreviated as GERD is a disease commonly found in the community. Several factors have been recognized as inducing and aggravating factors of GERD symptoms such as older age, female gender, obesity, smoking habit, alcohol consumption, certain diet and poor eating habit like eating fatty, spicy, and acid food.

  4. Systematic review: questionnaires for assessment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Bolier, E. A.; Kessing, B. F.; Smout, A. J.; Bredenoord, A. J.

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality

  5. Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients.

    Science.gov (United States)

    Garg, Harshit; Vigneshwaran, Balasubiramaniyan; Aggarwal, Sandeep; Ahuja, Vineet

    2017-01-01

    The aim of this study was to analyse the impact of hiatal hernia repair (HHR) on gastro-oesophageal reflux disease (GERD) in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG). It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS) questionnaire and anti-reflux medications. Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80%) showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH) during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

  6. Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Harshit Garg

    2017-01-01

    Full Text Available Background: The aim of this study was to analyse the impact of hiatal hernia repair (HHR on gastro-oesophageal reflux disease (GERD in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG. Materials and Methods: It is a retrospective study involving ten morbidly obese patients with large hiatus hernia diagnosed on pre-operative endoscopy who underwent LSG and simultaneous HHR. The patients were assessed for symptoms of GERD using a Severity symptom score (SS questionnaire and anti-reflux medications. Results: Of the ten patients, five patients had GERD preoperatively. At the mean follow-up of 11.70 ± 6.07 months after surgery, four patients (80% showed complete resolution while one patient complained of persistence of symptoms. Endoscopy in this patient revealed resolution of esophagitis indicating that the persistent symptoms were not attributable to reflux. The other five patients without GERD remained free of any symptom attributable to GERD. Thus, in all ten patients, repair of hiatal hernia (HH during LSG led to either resolution of GERD or prevented any new onset symptom related to GER. Conclusion: In morbidly obese patients with HH with or without GERD undergoing LSG, repair of the hiatus hernia helps in amelioration of GERD and prevents any new onset GER. Thus, the presence of HH should not be considered as a contraindication for LSG.

  7. Current status of gastroesophageal reflux disease : diagnosis and treatment.

    Science.gov (United States)

    Chuang, Tang-Wei; Chen, Shou-Chien; Chen, Kow-Tong

    2017-01-01

    The aim of this study was to explore the recent advances in diagnosis and treatment of gastroesophageal reflux disease (GERD). Previous studies were searched using the terms "gastroesophageal reflux disease" and "diagnosis" or "treatment" in Medline and Pubmed. Articles that were not published in the English language, manuscripts without an abstract, reviews, meta-analysis, and opinion articles were excluded from the review. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the contemporary approaches to GERD. GERD has a variety of symptomatic manifestations, which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of other alarming symptoms, these symptoms allow one to make a presumptive diagnosis of GERD and initiate empiric therapy. GERD-associated complications include erosive esophagitis, peptic stricture, Barrett's esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modifications, medical and surgical therapy. Medical therapy involves acid suppression, which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The management of this disease requires a complex approach. Maintenance therapy of GERD after using anti-secretory drugs should be continuously monitored. © Acta Gastro-Enterologica Belgica.

  8. Peroral endoscopic cardial constriction in gastroesophageal reflux disease.

    Science.gov (United States)

    Hu, Hai-Qing; Li, Hui-Kai; Xiong, Ying; Zhang, Xiao-Bin; Zhi, Jun-Li; Wang, Xiao-Xiao; Ling-Hu, En-Qiang

    2018-04-01

    Gastroesophageal reflux disease (GERD) is a major digestive health problem with a high and increasing incidence worldwide. Peroral endoscopic cardial constriction (PECC) was developed by our group to provide a less invasive treatment for GERD.In this preliminary follow-up study, 16 patients were enrolled and 13 patients with GERD were targeted for analysis according to the Los Angeles classification of reflux esophagitis. The GERD health-related quality of life (GERD-HRQL) scale and esophageal pH monitoring were applied to assess clinical efficiency at 3 and 6 months after PECC treatment, respectively.All GERD patients successively received PECC, and no severe treatment-related complication was reported. Before PECC treatment, the GERD-HRQL scale was 19.92 ± 7.89. At 3 and 6 months after treatment, the GERD-HRQL scale was 4.46 ± 4.31 and 5.69 ± 5.07, respectively. DeMeester score was 125.50 ± 89.64 before PECC treatment, and 16.97 ± 12.76 and 20.32 ± 15.22 at 3 and 6 months after PECC treatment. Furthermore, the fraction time of a pH below 4 significantly decreased at 3 and 6 months after PECC treatment. Fraction time at pH reflux of stomach contents.

  9. Pathophysiology of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Boeckxstaens, Guy E.; Rohof, Wout O.

    2014-01-01

    Gastroesophageal reflux disease (GERD) is one of the most common digestive diseases in the Western world, with typical symptoms, such as heartburn, regurgitation, or retrosternal pain, reported by 15% to 20% of the general population. The pathophysiology of GERD is multifactorial. Our understanding

  10. Insight Into the Relationship Between Gastroesophageal Reflux Disease and Asthma

    Science.gov (United States)

    Vaezi, Michael F

    2014-01-01

    Gastroesophageal reflux disease (GERD) is a common condition that presents with symptoms of heartburn and regurgitation. Asthma is an equally common medical condition that often coexists with GERD. The clinical scenario of difficult-to-treat asthma in the setting of concomitant GERD leads to the possibility of GERD-induced asthma. However, asthma may also induce GERD, so confusion has developed about the role of GERD in patients with moderate to severe asthma. Acid-suppressive therapy may be initiated in patients with asthma, but controlled studies have recently questioned the role of such therapy and, thus, have caused further confusion in this field. Recent advancements in the field of esophageal physiologic testing in GERD have introduced the concept of impedance–pH monitoring, which suggests a possible role of nonacid reflux in those who continue to be symptomatic despite acid-suppressive therapy. However, recent data caution about the role of surgical fundoplication based solely on the results of impedance monitoring. This article reviews current knowledge in the fields of GERD and asthma and suggests a possible treatment option for this group of patients. PMID:28435409

  11. Impact of gastroesophageal reflux disease symptoms on the quality of life in pregnant women: a prospective study.

    Science.gov (United States)

    Fill Malfertheiner, Sara; Seelbach-Göbel, Birgit; Costa, Serban-Dan; Ernst, Wolfgang; Reuschel, Edith; Zeman, Florian; Malfertheiner, Peter; Malfertheiner, Maximilian V

    2017-08-01

    Pregnant women often suffer from gastroesophageal reflux disease (GERD). GERD symptoms are known to influence the quality of life; however, there is a lack of data in pregnant women. The aim of this study was to establish the impact of GERD symptoms on health-related quality of life (HRQOL) during pregnancy. A prospective longitudinal cohort study to investigate the impact of GERD symptoms on the HRQOL was carried out in 510 pregnant women and 330 nonpregnant women as controls. Two validated questionnaires, the Reflux Disease Questionnaire and the Quality of Life in Reflux and Dyspepsia Questionnaire, were used. The study showed a significant negative impact on HRQOL in pregnant women with GERD symptoms. All five areas, emotional distress, sleep disturbance, vitality, food/drink problems, and physical/social functioning, were significantly reduced, but the most significant impact was on sleep (Quality of Life in Reflux and Dyspepsia Questionnaire score -35%). Overall, quality of life in women with GERD worsened throughout pregnancy. GERD is frequently seen in pregnant women and has a negative impact on HRQOL, especially in late pregnancy. Therefore, there is a need for adequate therapy of GERD in pregnant women and HRQOL could be an adequate monitoring tool in this population.

  12. Pediatric gastroesophageal reflux disease: Current diagnosis and management

    NARCIS (Netherlands)

    van der Pol, R.J.

    2014-01-01

    Pediatric gastroesophageal reflux disease (GERD) is a disorder difficult to diagnose and to treat. Due to the current definition of GERD, i.e. gastroesophageal reflux (GER) causing bothersome symptoms and/or complications, diagnosis is subject to broad interpretation. This thesis consists of studies

  13. Peculiarities of clinical course of gastroesophageal reflux disease in patients with type 2 diabetes and obesity

    Directory of Open Access Journals (Sweden)

    Andreeva E.l.

    2017-12-01

    Full Text Available Aim: to study the clinical course of gastroesophageal reflux disease (GERD in patients with type 2 diabetes and evaluation of the parameters of the esophagus 24-hour pH-metry. Material and Methods. In the examination of patients with GERD, three groups of patients were selected for 50 people each. The first group includes patients with GERD with combined course of obesity and type 2 diabetes (mean age 54.6±2.73 year; 32 females and 18 males. The second group included patients with GERD against obesity (mean age 42.3±2.11 year; 30 females and 20 males. The control group consisted of patients with GERD without excess body weight and concomitant pathology (average age43.6±2.11 year; 29 females and 21 males. In addition to collecting complaints and anamnesis, the patients and the control group underwent a 24-hour pH-metric study of the esophagus according to a conventional method. Results. Patients suffering from GERD in the background of type 2 diabetes have a clinically asymptomatic or asymptomatic course; there is a significant increase in the daily pH-metry, indicating a more pronounced nature of the changes. Conclusion. Patients suffering from GERD in the background of type 2 diabetes require a comprehensive examination of the upper digestive tract to identify GERD, even if there are no complaints characteristic of the disease.

  14. Congenital Diaphragmatic Hernia: Long-term Risk of Gastroesophageal Reflux Disease

    NARCIS (Netherlands)

    Peetsold, M.G.; Kneepkens, C.M.F.; Heij, H.A.; IJsselstijn, H.; Tibboel, D.; Gemke, R.J.B.J.

    2010-01-01

    Objectives: Gastroesophageal reflux disease (GERD) is a well-recognized consequence of congenital diaphragmatic hernia (CDH). Results of studies examining predictive factors for early and lateGERDare inconclusive. The aim of this study was to assess the incidence of early (<2 years) and late GERD

  15. Reflux in Children

    Science.gov (United States)

    What are reflux (GER) and GERD? The esophagus is the tube that carries food from your mouth to your stomach. If your child has reflux, his or ... into the esophagus. Another name for reflux is gastroesophageal reflux (GER). GERD stands for gastroesophageal reflux disease. It ...

  16. Reflux in Infants

    Science.gov (United States)

    What are reflux (GER) and GERD? The esophagus is the tube that carries food from your mouth to your stomach. If your baby has reflux, his or ... into the esophagus. Another name for reflux is gastroesophageal reflux (GER). GERD stands for gastroesophageal reflux disease. It ...

  17. Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Schwartz, Matthijs P.; Schreinemakers, J. Rieneke C.; Smout, André J. P. M.

    2013-01-01

    To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease (GERD). After unblinding and crossover, 50 patients (32 males, 18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized, placebo-controlled, single-center study,

  18. Epidemiology of gastroesophageal reflux disease: A general population-based study in Xi’an of Northwest China

    OpenAIRE

    Wang, Jin-Hai; Luo, Jin-Yan; Dong, Lei; Gong, Jun; Tong, Ming

    2004-01-01

    AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi’an, a northwestern city of China, and to explore the potential risk factors of GERD.

  19. Emerging drugs for gastroesophageal reflux disease

    NARCIS (Netherlands)

    Boeckxstaens, G. E.

    2009-01-01

    Proton pump inhibitors (PPIs) are very effective and safe drugs for the treatment of erosive and non-erosive gastroesophageal reflux disease (GERD). Nevertheless, a significant proportion of GERD patients (30 - 40%) continue to suffer from symptoms during PPI treatment, which has stimulated the

  20. Effects of anxiety and depression in patients with gastroesophageal reflux disease

    NARCIS (Netherlands)

    Kessing, Boudewijn F.; Bredenoord, Albert J.; Saleh, Caroline M. G.; Smout, André J. P. M.

    2015-01-01

    Increased levels of anxiety and depression have been associated with esophageal hyperalgesia and an increased risk of gastroesophageal reflux disease (GERD). We investigated the effects of anxiety and depression on GERD symptoms and the perception of reflux episodes in a well-characterized group of

  1. Oral soft tissue disorders are associated with gastroesophageal reflux disease: retrospective study.

    Science.gov (United States)

    Watanabe, Masaaki; Nakatani, Eiji; Yoshikawa, Hiroo; Kanno, Takahiro; Nariai, Yoshiki; Yoshino, Aya; Vieth, Michael; Kinoshita, Yoshikazu; Sekine, Joji

    2017-08-07

    Dental erosion (DE), one of oral hard tissue diseases, is one of the extraoesophageal symptoms defined as the Montreal Definition and Classification of gastroesophageal reflux disease (GERD). However, no study evaluated the relationship between GERD and oral soft tissues. We hypothesized that oral soft tissue disorders (OSTDs) would be related to GERD. The study aimed to investigate the association OSTDs and GERD. GERD patients (105 cases), older and younger controls (25 cases each) were retrospectively examined for oral symptoms, salivary flow volume (Saxon test), swallowing function (repetitive saliva swallowing test [RSST]), teeth (decayed, missing, and filled [DMF] indices), and soft tissues (as evaluation of OSTDs, gingivitis; papillary, marginal, and attached [PMA] gingival indexes, simplified oral hygiene indices [OHI-S], and inflammatory oral mucosal regions). Clinical histories, which included body mass index [BMI], the existence of alcohol and tobacco use, and bruxism, were also investigated. A P value of bruxism, as an exacerbation factor of periodontal disease, in the GERD patients was significantly more frequent than in either control group (P = 0.041). OSTDs were associated with GERD, which was similar to the association between DE and GERD.

  2. Association of Helicobacter pylori infection with gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Aswathy Chandramohan

    2016-01-01

    Full Text Available Introduction: The study was conducted to determine the association of Helicobactor pylori with endoscopic and histological parameters of gastroesophageal reflux disease (GERD. Materials and Methods: A cross-sectional study was undertaken. A total of 79 patients were evaluated prospectively in the endoscopic unit of a gastroenterology department for symptoms compatible with GERD. In all cases, routine endoscopy and Los Angeles grading of GERD were performed. In each subject, biopsies were taken from 3 cm above the squamocolumnar junction and from the antrum and assessed histologically. Results: Majority of the patients presented with complaints of heartburn (84.8% and regurgitation (75.9%. Nonerosive reflux disease was present in only five patients. Endoscopically, the remaining 74 cases were graded as follows: 25 had GERD A, 10 had GERD B, 35 had features of Barrett's esophagus, and 4 had miscellaneous findings. H. pylori positivity was present in 33.3% of patients with GERD A and 4.8% of those with GERD B. Majority of the histological parameters such as elongation of lamina propria papillae, intraepithelial inflammatory infiltrate, ballooning degeneration, lack of surface maturation, and dilatation and congestion of lamina propria capillaries did not show statistically significant association with H. pylori. The overall H. pylori prevalence was found to be 26.58% (21/79. Conclusion: On endoscopy, with the increased GERD severity, H. pylori incidence decreased. H. pylori was found to have no significant association with majority of the histological parameters.

  3. Esophageal acid exposure decreases intraluminal baseline impedance levels

    NARCIS (Netherlands)

    Kessing, Boudewijn F.; Bredenoord, Albert J.; Weijenborg, Pim W.; Hemmink, Gerrit J. M.; Loots, Clara M.; Smout, A. J. P. M.

    2011-01-01

    Intraluminal baseline impedance levels are determined by the conductivity of the esophageal wall and can be decreased in gastroesophageal reflux disease (GERD) patients. The aim of this study was to investigate the baseline impedance in GERD patients, on and off proton pump inhibitor (PPI), and in

  4. Variations in Definitions and Outcome Measures in Gastroesophageal Reflux Disease: A Systematic Review

    NARCIS (Netherlands)

    Singendonk, Maartje M. J.; Brink, Anna J.; Steutel, Nina F.; van Etten-Jamaludin, Faridi S.; van Wijk, Michiel P.; Benninga, Marc A.; Tabbers, Merit M.

    2017-01-01

    CONTEXT: Gastroesophageal reflux (GER) is defined as GER disease (GERD) when it leads to troublesome symptoms and/or complications. We hypothesized that definitions and outcome measures in randomized controlled trials (RCTs) on pediatric GERD would be heterogeneous. OBJECTIVES: Systematically assess

  5. The Association Between Gastroesophageal Reflux Disease and Recurrent Respiratory Papillomatosis : A Systematic Review

    NARCIS (Netherlands)

    San Giorgi, Michel R. M.; Helder, Herman M.; Lindeman, Robbert-Jan S.; de Bock, Geertruida H.; Dikkers, Frederik G.

    2016-01-01

    Objectives/Hypothesis: Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen the disease course of RRP. It is unclear if GERD really aggravates the disease course. The aims of this

  6. Efficacy and safety of histamine-2 receptor antagonists

    NARCIS (Netherlands)

    van der Pol, Rachel; Langendam, Miranda; Benninga, Marc; van Wijk, Michiel; Tabbers, Merit

    2014-01-01

    Histamine-2 receptor antagonists (H2RAs) are frequently used in the treatment of gastroesophageal reflux disease (GERD) in children; however, their efficacy and safety is questionable. To systematically review the literature to assess the efficacy and safety of H2RAs in pediatric GERD. PubMed,

  7. Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Oor, Jelmer E; Roks, David J; Ünlü, Çagdas; Hazebroek, Eric J

    BACKGROUND: The effect of sleeve gastrectomy (SG) on the prevalence of gastroesophageal reflux disease (GERD) remains unclear. We aimed to outline the currently available literature. DATA SOURCES: All relevant databases were searched for publications examining the effect of laparoscopic SG on GERD.

  8. What Is Vocal Cord Dysfunction (VCD)?

    Science.gov (United States)

    ... can be found. VCD may be triggered by: ■■ Acid reflux (GERD) ■■ Post-nasal drip ■■ Upper respiratory infection (cold) ■■ ... VCD is triggered by post-nasal drip or acid reflux (GERD), it is important to talk to your ...

  9. Canadian Consensus Conference on the Management of Gastroesophageal Reflux Disease in Adults – Update 2004

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2005-01-01

    Full Text Available BACKGROUND: Gastroesophageal reflux disease (GERD is the most prevalent acid-related disorder in Canada and is associated with significant impairment of health-related quality of life. Since the last Canadian Consensus Conference in 1996, GERD management has evolved substantially.

  10. Systematic review: role of acid, weakly acidic and weakly alkaline reflux in gastro-oesophageal reflux disease

    NARCIS (Netherlands)

    Boeckxstaens, G. E.; Smout, A.

    2010-01-01

    The importance of weakly acidic and weakly alkaline reflux in gastro-oesophageal reflux disease (GERD) is gaining recognition. To quantify the proportions of reflux episodes that are acidic (pH <4), weakly acidic (pH 4-7) and weakly alkaline (pH >7) in adult patients with GERD, and to evaluate their

  11. Partial symptom-response to proton pump inhibitors in patients with non-erosive reflux disease or reflux oesophagitis - a post hoc analysis of 5796 patients

    DEFF Research Database (Denmark)

    Bytzer, P; van Zanten, S Veldhuyzen; Mattsson, H

    2012-01-01

    Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief.......Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief....

  12. How reflux causes symptoms: reflux perception in gastroesophageal reflux disease

    NARCIS (Netherlands)

    Weijenborg, Pim W.; Bredenoord, Albert J.

    2013-01-01

    In gastroesophageal reflux disease (GERD) symptoms arise due to reflux of gastric content into the oesophagus. However, the relation between magnitude and onset of reflux and symptom generation in GERD patients is far from simple; gastroesophageal reflux occurs several times a day in everyone and

  13. Men’s and women’s honour

    DEFF Research Database (Denmark)

    Mai, Anne-Marie

    2017-01-01

    This article has the conceptions of honour in Henrik Ibsen’s A Doll’s House (1879/1889) as its springboard, includes the concept of honour in Thit Jensen’s novels about the modern, emancipated woman Gerd. Det tyvende Aarhundredes Kvinde (Gerd. Woman of the 20th century, 1918) and Aphrodite fra Fu...

  14. Long-Term Benefits of Smoking Cessation on Gastroesophageal Reflux Disease and Health-Related Quality of Life.

    Directory of Open Access Journals (Sweden)

    Yukie Kohata

    Full Text Available Smoking is associated with gastroesophageal reflux disease (GERD. Varenicline, a nicotinic receptor partial agonist, is used to aid smoking cessation. The purpose of this study was to prospectively examine the long-term benefits of smoking cessation on GERD and health-related quality of life (HR-QOL.Patients treated with varenicline were asked to fill out a self-report questionnaire about their smoking habits, gastrointestinal symptoms, and HR-QOL before and 1 year after smoking cessation. The prevalence of GERD, frequency of symptoms, and HR-QOL scores were compared. We also investigated associations between clinical factors and newly-developed GERD.A total of 141 patients achieved smoking cessation (success group and 50 did not (failure group at 1 year after the treatment. The GERD improvement in the success group (43.9% was significantly higher than that in the failure group (18.2%. The frequency of reflux symptoms significantly decreased only in the success group. There were no significant associations between newly developed GERD and clinical factors including increased body mass index and successful smoking cessation. HR-QOL significantly improved only in the success group.Smoking cessation improved both GERD and HR-QOL. Smoking cessation should be recommended for GERD patients.

  15. Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review.

    Science.gov (United States)

    Marsicano, Juliane A; de Moura-Grec, Patrícia G; Bonato, Rafaela C S; Sales-Peres, Matheus de Carvalho; Sales-Peres, Arsenio; Sales-Peres, Sílvia Helena de Carvalho

    2013-02-01

    In published studies, it has been suggested that dental wear is associated with gastroesophageal reflux disease (GERD). This systematic review was carried out to evaluate the association of GERD, dental erosion, and halitosis and to compare the indices adopted in epidemiological surveys. The Medline database (until October, 2011) was searched systematically to identify studies evaluating the prevalence of oral alterations, such as dental erosion and halitosis, in patients with GERD symptoms. Two reviewers analyzed all reports and the selected studies were evaluated according to the quality of evidence, using the validated Newcastle-Ottawa Quality Assessment Scale. Full-text copies of a total of 32 publications were obtained in duplicate. Sixteen publications were identified among the citations in the Bibliographic lists of studies that fulfilled the exclusion/inclusion criteria and quality of evidence. The relationship between dental erosion and GERD patients was significant in only seven studies. According to three studies, halitosis could be one of several extraesophageal symptoms or manifestations in GERD patients. In one study, it was found that the mucosa of GERD patients was significantly more acidic in comparison with that of the control group. This systematic review showed that there is a relationship between GERD and oral diseases (dental erosion and halitosis). The epidemiological surveys used different indices to analyze GERD and dental erosion. Further research could investigate the best method for assessing the two diseases.

  16. Predictive value of routine esophageal high-resolution manometry for gastro-esophageal reflux disease

    NARCIS (Netherlands)

    van Hoeij, F. B.; Smout, A. J.; Bredenoord, A. J.

    2015-01-01

    Using conventional manometry, gastro-esophageal reflux disease (GERD) was associated with a reduced lower esophageal sphincter (LES) pressure and impaired peristalsis. However, with a large overlap between GERD patients and controls, these findings are of limited clinical relevance. It is uncertain

  17. Pulmonary function impairment after trachea-esophageal fistula: a minor role for gastro-esophageal reflux disease

    NARCIS (Netherlands)

    Peetsold, M.G.; Heij, H.A.; Nagelkerke, A.F.; Deurloo, J.A.; Gemke, R.J.B.J.

    2011-01-01

    Background: Long-term impairment of pulmonary function in trachea-esophageal fistula (TEF) patients is, at least in part, commonly ascribed to gastro-esophageal reflux disease (GERD). The objective of this study was to examine the independent effects of the underlying condition and GERD on

  18. Pulmonary Function Impairment After Trachea-Esophageal Fistula: A Minor Role for Gastro-Esophageal Reflux Disease

    NARCIS (Netherlands)

    Peetsold, M. G.; Heij, H. A.; Nagelkerke, A. F.; Deurloo, J. A.; Gemke, R. J. B. J.

    2011-01-01

    Background: Long-term impairment of pulmonary function in trachea-esophageal fistula (TEF) patients is, at least in part, commonly ascribed to gastro-esophageal reflux disease (GERD). The objective of this study was to examine the independent effects of the underlying condition and GERD on

  19. Classification of esophageal motor findings in gastro-esophageal reflux disease: Conclusions from an international consensus group

    NARCIS (Netherlands)

    Gyawali, C. P.; Roman, S.; Bredenoord, A. J.; Fox, M.; Keller, J.; Pandolfino, J. E.; Sifrim, D.; Tatum, R.; Yadlapati, R.; Savarino, E.; Azpiroz, Fernando; Babaei, Arash; Bhatia, Shobna; Boeckxstaens, Guy; Bor, Serhat; Carlson, Dustin; Castell, Donald; Cicala, Michele; Clarke, John; de Bortoli, Nicola; Drug, Vasile; Frazzoni, Marzio; Holloway, Richard; Kahrilas, Peter; Kandulski, Arne; Katz, Phil; Katzka, David; Mittal, Ravinder; Mion, Francois; Novais, Luis; Patel, Amit; Penagini, Roberto; Ribolsi, Mentore; Richter, Joel; Salvador, Renato; Savarino, Vincenzo; Serra, Jordi; Schnoll-Sussman, Felice; Smout, Andre; Soffer, Edy; Sweis, Rami; Tack, Jan; Tolone, Salvatore; Tutuian, Radu; Vaezi, Michael; Vela, Marcelo; Woodland, Philip; Wu, Justin; Xiao, Yinglian; Zerbib, Frank

    2017-01-01

    BackgroundHigh-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. MethodsFocused

  20. Classification of esophageal motor findings in gastro-esophageal reflux disease: Conclusions from an international consensus group.

    Science.gov (United States)

    Gyawali, C P; Roman, S; Bredenoord, A J; Fox, M; Keller, J; Pandolfino, J E; Sifrim, D; Tatum, R; Yadlapati, R; Savarino, E

    2017-12-01

    High-resolution manometry (HRM) has resulted in new revelations regarding the pathophysiology of gastro-esophageal reflux disease (GERD). The impact of new HRM motor paradigms on reflux burden needs further definition, leading to a modern approach to motor testing in GERD. Focused literature searches were conducted, evaluating pathophysiology of GERD with emphasis on HRM. The results were discussed with an international group of experts to develop a consensus on the role of HRM in GERD. A proposed classification system for esophageal motor abnormalities associated with GERD was generated. Physiologic gastro-esophageal reflux is inherent in all humans, resulting from transient lower esophageal sphincter (LES) relaxations that allow venting of gastric air in the form of a belch. In pathological gastro-esophageal reflux, transient LES relaxations are accompanied by reflux of gastric contents. Structural disruption of the esophagogastric junction (EGJ) barrier, and incomplete clearance of the refluxate can contribute to abnormally high esophageal reflux burden that defines GERD. Esophageal HRM localizes the LES for pH and pH-impedance probe placement, and assesses esophageal body peristaltic performance prior to invasive antireflux therapies and antireflux surgery. Furthermore, HRM can assess EGJ and esophageal body mechanisms contributing to reflux, and exclude conditions that mimic GERD. Structural and motor EGJ and esophageal processes contribute to the pathophysiology of GERD. A classification scheme is proposed incorporating EGJ and esophageal motor findings, and contraction reserve on provocative tests during HRM. © 2017 John Wiley & Sons Ltd.

  1. The diagnosis of gastro-esophageal reflux disease cannot be made with barium esophagograms

    NARCIS (Netherlands)

    Saleh, C. M. G.; Smout, A. J. P. M.; Bredenoord, A. J.

    2015-01-01

    For over 50 years, barium studies have been used to diagnose gastro-esophageal reflux disease (GERD), but the value of this test is controversial. Our study aimed to determine if barium esophagograms can be used to diagnose GERD. Barium esophagograms and pH-impedance measurement were performed in 20

  2. Assessing Old and New Diagnostic Tests for Gastroesophageal Reflux Disease.

    Science.gov (United States)

    Vaezi, Michael F; Sifrim, Daniel

    2018-01-01

    A detailed critique of objective measurements of gastroesophageal reflux disease (GERD) would improve management of patients suspecting of having reflux, leading to rational selection of treatment and better outcomes. Many diagnostic tests for GERD have been developed over the past decades. We analyze their development, positive- and negative-predictive values, and ability to predict response to treatment. These features are important for development of medical, surgical, and endoscopic therapies for GERD. We discuss the value of available diagnostic tests and review their role in management of patients with persistent reflux symptoms despite adequate medical or surgical treatment. This is becoming a significant health economic problem, due to the widespread use of proton pump inhibitors. GERD is believed to cause nonesophageal symptoms, such as those provoked by ear, nose, throat, or respiratory disorders. We analyze the value of GERD diagnostic tests in evaluation of these troublesome, nonesophageal symptoms. Copyright © 2018 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. Gastro-esophageal reflux disease and obesity, where is the link?

    Science.gov (United States)

    Emerenziani, Sara; Rescio, Maria Paola; Guarino, Michele Pier Luca; Cicala, Michele

    2013-10-21

    The confluence between the increased prevalence of gastro-esophageal reflux disease (GERD) and of obesity has generated great interest in the association between these two conditions. Several studies have addressed the potential relationship between GERD and obesity, but the exact mechanism by which obesity causes reflux disease still remains to be clearly defined. A commonly suggested pathogenetic pathway is the increased abdominal pressure which relaxes the lower esophageal sphincter, thus exposing the esophageal mucosal to gastric content. Apart from the mechanical pressure, visceral fat is metabolically active and it has been strongly associated with serum levels of adipo-cytokines including interleukin-6 and tumor necrosis factor α, which may play a role in GERD or consequent carcinogenesis. This summary is aimed to explore the potential mechanisms responsible for the association between GERD and obesity, and to better understand the possible role of weight loss as a therapeutic approach for GERD.

  4. An updated review on gastro-esophageal reflux in pediatrics.

    Science.gov (United States)

    Vandenplas, Yvan; Hauser, Bruno

    2015-01-01

    Comprehensive guidelines for the diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) were developed by the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition. GERD is reflux associated with troublesome symptoms or complications. The recognition of GER and GERD is relevant to implement best management practices. A conservative management is indicated in infants with uncomplicated physiologic reflux. Children with GERD may benefit from further evaluation and treatment. Since the publications of the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition guidelines in 2009, no important novelties in drug treatment have been reported. Innovations are mainly restricted to the management of regurgitation in infants. During the last 5 years, pros and cons of multichannel intraluminal impedance have been highlighted. However, overall 'not much has changed' in the diagnosis and management of GER and GERD in infants and children.

  5. Does treatment of gastro-esophageal reflux disease with omeprazole decrease allergic rhinitis symptoms?

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    Afshin Shirkani

    2014-08-01

    Full Text Available Background: Allergic rhinitis is the most common type of allergic disease among population. Its accurate treatment is very important for cutting of allergic march. On the other hand, gasteroesophageal reflux disease (GERD is one of the most common gastrointestinal problems among allergic patients mainly asthmatic cases. It might conflict treatment. Despite of asthma, a few studies have been conducted on the impact of GERD treatment on allergic rhinitis symptoms. In this study, we assessed GERD treatment and its effects on improving of allergic rhinitis patients with GERD. Materials and Methods: In a prospective cross-sectional study, March - September 2012, 103 consecutive patients with persistent moderate to severe seasonal allergic rhinitis enrolled. For allergic rhinitis patients with GERD 20 mg omeperazole once daily for 6 weeks prescribed, empirically. Conventional allergy treatment continued and finally the allergic rhinitis symptoms were assessed clinically and recorded before, 5th, 10th and 30th days of omeprazole treatment period. Results: Our study included 103 patients with seasonal allergic rhinitis who were divided into GERD (n=33, 38% and non-GERD (n=70, 68% groups with the mean age 28 and 25.7 years, respectively. The first group developed significant improvement for GERD symptoms on days 5, 10 and 30 after beginning of therapy (P=0.03. No association was found between GERD treatment and relief of allergic symptoms or TNSS improvement (P>0.05. Data analyzed by Epi info (ver 7 and SPSS software (ver 11.5, and by Chi squeare test and paired T test. P lower than 0.05 was considered as significant. Conclusion: This study showed no significant association between empirical treatment of GERD and improvement of allergic symptoms in patients with allergic rhinitis. However, further studies with a larger sample size might be needed.

  6. Systematic review: questionnaires for assessment of gastroesophageal reflux disease.

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    Bolier, E A; Kessing, B F; Smout, A J; Bredenoord, A J

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality of life of GERD patients. The aim of this review is to develop a complete overview of all available questionnaires, categorized per dimension of the assessment of GERD. A systematic search of the literature up to January 2013 using the Pubmed database and the Embase database, and search of references and conference abstract books were conducted. A total number of 65 questionnaires were extracted and evaluated. Thirty-nine questionnaires were found applicable for the assessment of GERD symptoms, three of which are generic gastrointestinal questionnaires. For the assessment of response to treatment, 14 questionnaires were considered applicable. Seven questionnaires with diagnostic purposes were found. In the assessment of quality of life in GERD patients, 18 questionnaires were found and evaluated. Twenty questionnaires were found to be used for more than one assessment dimension, and eight questionnaires were found for GERD assessment in infants and/or children. A wide variety of GERD questionnaires is available, of which the majority is used for assessment of GERD symptoms. Questionnaires differ in aspects such as design, validation and translations. Also, numerous multidimensional questionnaires are available, of which the Reflux Disease Questionnaire is widely applicable. We provided an overview of GERD questionnaires to aid investigators and clinicians in their search for the most appropriate questionnaire for their specific purposes. © 2013 International Society for Diseases of the Esophagus.

  7. Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women.

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    Pointer, S D; Rickstrew, J; Slaughter, J C; Vaezi, M F; Silver, H J

    2016-11-01

    Although obesity rates are higher in African-American than European-American women, gastro-oesophageal reflux disease (GERD) and its comorbidities are more prevalent in European-American women. A common denominator for increased adiposity, and consequent insulin resistance, is excess dietary macronutrient intake - which may promote greater prevalence and severity of GERD in women. To investigate whether GERD is more robustly associated with dietary carbohydrate intake, particularly dietary simple carbohydrate intake, and insulin resistance in European-American women. About 144 obese women were assessed at baseline and 16 weeks after consuming a high-fat/low-carbohydrate diet. GERD diagnosis and medication usage was confirmed in medical records with symptoms and medications assessed weekly. About 33.3% (N = 33) of European-American and 20.0% (N = 9) of African-American women had GERD at baseline. Total carbohydrate (r = 0.34, P < 0.001), sugars (r = 0.30, P = 0.005), glycaemic load (r = 0.34, P = 0.001) and HOMA IR (r = 0.30, P = 0.004) were associated with GERD, but only in European-American women. In response to high-fat/low-carbohydrate diet, reduced intake of sugars was associated with reduced insulin resistance. By the end of diet week 10, all GERD symptoms and medication usage had resolved in all women. GERD symptoms and medication usage was more prevalent in European-American women, for whom the relationships between dietary carbohydrate intake, insulin resistance and GERD were most significant. Nevertheless, high-fat/low-carbohydrate diet benefited all women with regard to reducing GERD symptoms and frequency of medication use. © 2016 John Wiley & Sons Ltd.

  8. An Epidemiological Study of Gastroesophageal Reflux Disease and Related Risk Factors in Urban Population of Mashhad, Iran

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    Vossoughinia, Hassan; Salari, Masoumeh; Mokhtari Amirmajdi, Elham; Saadatnia, Hassan; Abedini, Siavash; Shariati, Alireza; Shariati, Mohammadjavad; Khosravi Khorashad, Ahmad

    2014-01-01

    Background: Gastroesophageal Reflux Disease (GERD) is a chronic and common disease, which is characterized by heartburn and regurgitation. In the last couple of decades, GERD has received much attention and studies have shown an increase in its prevalence. Although there have been a few studies on the prevalence of GERD in Iran, no study has yet been done in the northeastern part of the country. The aim of our study was to evaluate the prevalence of GERD and its risk factors in a population from Mashhad. Objectives: To evaluate the epidemiology of GERD based on a population study in Mashhad. Patients and Methods: This was a cross sectional descriptive study conducted in 2010. In total, 2500 participants were selected based on cluster sampling. Modified and validated Mayo Clinic questionnaire for GERD was used for data collection. Overall, 1685 questionnaires were retrieved. Fifty-one participants were excluded because of pregnancies, history of abdominal surgery and being less than 18 years old. We analyzed data using the SPSS software version 16. Prevalence of GERD and significant risk factors (P value < 0.05) were determined. Results: In total, 420 participants (25.7%) had GERD symptoms. Risk factors with significant effects consisted of smoking, consumption of non-steroidal anti-inflammatory drugs (NASIDs), overeating, chronic diseases, tea and coffee consumption and GERD in spouse. Conclusions: The prevalence of GERD among people living in Mashhad was above the average prevalence in other cities of Iran. However, risk factors seemed to be similar to those reported by other studies. PMID:25763231

  9. Gastroesophageal reflux disease in COPD: links and risks

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    Lee, Annemarie L; Goldstein, Roger S

    2015-01-01

    COPD is a long-term condition associated with considerable disability with a clinical course characterized by episodes of worsening respiratory signs and symptoms associated with exacerbations. Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal conditions in the general population and has emerged as a comorbidity of COPD. GERD may be diagnosed by both symptomatic approaches (including both typical and atypical symptoms) and objective measurements. Based on a mix of diagnostic approaches, the prevalence of GERD in COPD ranges from 17% to 78%. Although GERD is usually confined to the lower esophagus in some individuals, it may be associated with pulmonary microaspiration of gastric contents. Possible mechanisms that may contribute to GERD in COPD originate from gastroesophageal dysfunction, including altered pressure in the lower esophageal sphincter (which normally protect against GERD) and changes in esophageal motility. Proposed respiratory contributions to the development of GERD include respiratory medications that may alter esophageal sphincter tone and changes in respiratory mechanics, with increased lung hyperinflation compromising the antireflux barrier. Although the specific cause and effect relationship between GERD and COPD has not been fully elucidated, GERD may influence lung disease severity and has been identified as a significant predictor of acute exacerbations of COPD. Further clinical effects could include a poorer health-related quality of life and an increased cost in health care, although these factors require further clarification. There are both medical and surgical options available for the treatment of GERD in COPD and while extensive studies in this population have not been undertaken, this comorbidity may be amenable to treatment. PMID:26392769

  10. Prevalence, risk factors and impact of gastroesophageal reflux disease symptoms: a population-based study in South China.

    Science.gov (United States)

    Chen, Minhu; Xiong, Lishou; Chen, Huixin; Xu, Angao; He, Longjun; Hu, Pinjin

    2005-07-01

    There are few data on the epidemiology of gastroesophageal reflux disease (GERD) in South China. The aim of this study was to assess the prevalence of GERD symptoms in South China and to evaluate the impact on health-related quality of life. A face-to-face interview was carried out in South China using a validated Chinese version of the Reflux Disease Questionnaire to assess the prevalence of GERD symptoms. A randomly clustered sampling of permanent inhabitants aged 18 to 90 years was carried out under stratification of urban and suburban areas. The impact of GERD symptoms on health-related quality of life was evaluated using the Chinese version of SF-36. A total of 3338 residents (1468 M, 1870 F) were investigated. Mean age of the responders was 42.6 +/- 16.4 years; response rate was 95%. The prevalence of heartburn and/or acid eructation occurring at least weekly was 6.2%. The age- and gender-adjusted point prevalence of GERD symptoms in South China is 2.3% (95% CI, 1.8%, 2.8%) according to the definition in this study. There was no difference in prevalence between male (2.6%) and female (2.4%) subjects and there was no significant association between age and prevalence of GERD symptoms. Divorced/widowed/separated subjects (OR 4.61; 95% CI, 2.15%, 9.89%) and subjects with a heavy burden of work (OR 3.43, 95% CI, 1.72%, 6.84%) were significantly more likely to report GERD symptoms. As compared with the general population, subjects with GERD symptoms experienced considerable impairment in quality of life. The prevalence of GERD symptoms in South China was much lower than that reported in Western countries. GERD had a negative impact on quality of life.

  11. Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

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    Chi-Kuei Hsu

    2016-12-01

    Full Text Available This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05. A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]. The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012. In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

  12. The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China.

    Science.gov (United States)

    Du, Xing; Wang, Feng; Hu, Zhiwei; Wu, Jimin; Wang, Zhonggao; Yan, Chao; Zhang, Chao; Tang, Juan

    2017-10-17

    None of current diagnostic methods has been proven to be a reliable tool for gastro-esophageal reflux disease (GERD). Pepsin in saliva has been proposed as a promising diagnostic biomarker for gastro-esophageal reflux. We aimed to determine the diagnostic value of salivary pepsin detection for GERD. Two hundred and fifty patients with symptoms suggestive of GERD and 35 asymptomatic healthy volunteers provided saliva on morning waking, after lunch and dinner for pepsin determination using the Peptest lateral flow device. All patients underwent 24-h multichannel intraluminal impedance pH (24-h MII-pH) monitoring and upper gastrointestinal endoscopy. Based on 24-h MII-pH and endoscopy study, patients were defined as GERD (abnormal MII-pH results and/or reflux esophagitis) and non-GERD otherwise. Patients with GERD had a higher prevalence of pepsin in saliva and higher pepsin concentration than patients with non-GERD and healthy controls (P < 0.001 for all). The pepsin test had a sensitivity of 73% and a specificity of 88.3% for diagnosing GERD using the optimal cut-off value of 76 ng/mL. Postprandial saliva samples collected when the symptoms occurred had a more powerful ability to identify GERD. Salivary pepsin test had moderate diagnostic value for GERD. It may be a promising tool to replace the use of currently invasive tools with advantages of non-invasive, easy to perform and cost effective. ChiCTR-DDD-16009506 (date of registration: October 20, 2016).

  13. The prevalence of gastro-esophageal reflux disease and esophageal dysmotility in Chinese patients with idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Gao, Feng; Hobson, Anthony Robert; Shang, Zhan Min; Pei, Yan Xiang; Gao, Yan; Wang, Jian Xin; Huang, Wan Nong

    2015-02-19

    The cause of idiopathic pulmonary fibrosis (IPF) remains unknown, yet gastro-esophageal reflux disease (GERD) is highly prevalent in this population. GERD prevalence was studied, and esophageal function tests (EFT) were assessed in Chinese IPF patients. We prospectively studied 69 IPF patients who undertook both stationary High Resolution esophageal Manometry/Impedance (HRiM) and 24-hour esophageal Multi-Channel Intraluminal Impedance with pH Recordings (MII/pH). Patients were divided into GERD+ and GERD- groups according to pH results. Controls were HRiM treated healthy volunteers, and patients without IPF received HRiM and MII/pH diagnosed with GERD. 69 IPF patients, 62 healthy volunteers, and 88 IPF negative GERD patients were selected. GERD prevalence in IPF was 43/69 (62.3%), and 58.1% of patients presented with at least one typical symptom. Symptoms had a sensitivity of 58.1%, a specificity of 61.6%, a positive predictive value of 71.4% and a negative predictive of 47.1%. Compared with healthy volunteers, IPF patients had significantly decreased lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure (UESP) and complete bolus transit rate (CBTR). By contrast, IPF patients had increased total bolus transit time and prevalence of weak peristalsis. MII/pH showed that one third of IPF patients had abnormal distal and proximal reflux, especially non-acid reflux. Compared with GERD patients without IPF, GERD patients with IPF had significantly decreased CBTR and UESP with increased bolus exposure time. GERD prevalence in IPF was high, but symptoms alone were an unreliable predictor of reflux. IPF patients had lower LESP and UESP, impaired esophageal peristalsis and bolus clearance function with more proximal reflux events.

  14. A Literature Review of Cultural Resources in Morgan County, Colorado,

    Science.gov (United States)

    1978-06-02

    MILES APPRCXI: %TE LOCATIONS OF SURVEY AREAS 1. NARROWS DAM SURVEY 2. WILDCAT CREEK SURVEY 3. BRUS { FLOOD CO’IOL PROJECT L B3I B LI 0 RAP H Y...Kenneth L. 1975 Edible plants available to aboriginal occupants of the Narrows area. IN Morris, Elizabeth Ann, Bruce J. Lutz, N. Ted Ohr, Timothy J...Reservoi - , Morgan County. Prepared for -1e Riverside IrrigaLion District and Public Service Company of Colorado. Morris, Elizabeth Ann, Bruce J. Lutz, N

  15. Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study

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    Gisbert, Javier P; Cooper, Alun; Karagiannis, Dimitrios; Hatlebakk, Jan; Agréus, Lars; Jablonowski, Helmut; Nuevo, Javier

    2009-01-01

    Background The RANGE (Retrospective ANalysis of GastroEsophageal reflux disease [GERD]) study assessed differences among patients consulting a primary care physician due to GERD-related reasons in terms of: symptoms, diagnosis and management, response to treatment, and effects on productivity, costs and health-related quality of life. This subanalysis of RANGE determined the impact of GERD on productivity in work and daily life. Methods RANGE was conducted at 134 primary care sites across six European countries (Germany, Greece, Norway, Spain, Sweden and the UK). All subjects (aged ≥18 years) who consulted with their primary care physician over a 4-month identification period were screened retrospectively, and those consulting at least once for GERD-related reasons were identified (index visit). From this population, a random sample was selected to enter the study and attended a follow-up appointment, during which the impact of GERD on productivity while working (absenteeism and presenteeism) and in daily life was evaluated using the self-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD (WPAI-GERD). Results Overall, 373,610 subjects consulted with their primary care physician over the 4-month identification period, 12,815 for GERD-related reasons (3.4%); 2678 randomly selected patients attended the follow-up appointment. Average absenteeism due to GERD was highest in Germany (3.2 hours/week) and lowest in the UK (0.4 hours/week), with an average of up to 6.7 additional hours/week lost due to presenteeism in Norway. The average monetary impact of GERD-related work absenteeism and presenteeism were substantial in all countries (from €55/week per employed patient in the UK to €273/patient in Sweden). Reductions in productivity in daily life of up to 26% were observed across the European countries. Conclusion GERD places a significant burden on primary care patients, in terms of work absenteeism and presenteeism and in daily

  16. Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study

    Directory of Open Access Journals (Sweden)

    Hatlebakk Jan

    2009-10-01

    Full Text Available Abstract Background The RANGE (Retrospective ANalysis of GastroEsophageal reflux disease [GERD] study assessed differences among patients consulting a primary care physician due to GERD-related reasons in terms of: symptoms, diagnosis and management, response to treatment, and effects on productivity, costs and health-related quality of life. This subanalysis of RANGE determined the impact of GERD on productivity in work and daily life. Methods RANGE was conducted at 134 primary care sites across six European countries (Germany, Greece, Norway, Spain, Sweden and the UK. All subjects (aged ≥18 years who consulted with their primary care physician over a 4-month identification period were screened retrospectively, and those consulting at least once for GERD-related reasons were identified (index visit. From this population, a random sample was selected to enter the study and attended a follow-up appointment, during which the impact of GERD on productivity while working (absenteeism and presenteeism and in daily life was evaluated using the self-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD (WPAI-GERD. Results Overall, 373,610 subjects consulted with their primary care physician over the 4-month identification period, 12,815 for GERD-related reasons (3.4%; 2678 randomly selected patients attended the follow-up appointment. Average absenteeism due to GERD was highest in Germany (3.2 hours/week and lowest in the UK (0.4 hours/week, with an average of up to 6.7 additional hours/week lost due to presenteeism in Norway. The average monetary impact of GERD-related work absenteeism and presenteeism were substantial in all countries (from €55/week per employed patient in the UK to €273/patient in Sweden. Reductions in productivity in daily life of up to 26% were observed across the European countries. Conclusion GERD places a significant burden on primary care patients, in terms of work absenteeism and

  17. Impact of gastroesophageal reflux disease on work absenteeism, presenteeism and productivity in daily life: a European observational study.

    Science.gov (United States)

    Gisbert, Javier P; Cooper, Alun; Karagiannis, Dimitrios; Hatlebakk, Jan; Agréus, Lars; Jablonowski, Helmut; Nuevo, Javier

    2009-10-16

    The RANGE (Retrospective ANalysis of GastroEsophageal reflux disease [GERD]) study assessed differences among patients consulting a primary care physician due to GERD-related reasons in terms of: symptoms, diagnosis and management, response to treatment, and effects on productivity, costs and health-related quality of life. This subanalysis of RANGE determined the impact of GERD on productivity in work and daily life. RANGE was conducted at 134 primary care sites across six European countries (Germany, Greece, Norway, Spain, Sweden and the UK). All subjects (aged >or=18 years) who consulted with their primary care physician over a 4-month identification period were screened retrospectively, and those consulting at least once for GERD-related reasons were identified (index visit). From this population, a random sample was selected to enter the study and attended a follow-up appointment, during which the impact of GERD on productivity while working (absenteeism and presenteeism) and in daily life was evaluated using the self-reported Work Productivity and Activity Impairment Questionnaire for patients with GERD (WPAI-GERD). Overall, 373,610 subjects consulted with their primary care physician over the 4-month identification period, 12,815 for GERD-related reasons (3.4%); 2678 randomly selected patients attended the follow-up appointment. Average absenteeism due to GERD was highest in Germany (3.2 hours/week) and lowest in the UK (0.4 hours/week), with an average of up to 6.7 additional hours/week lost due to presenteeism in Norway. The average monetary impact of GERD-related work absenteeism and presenteeism were substantial in all countries (from euro55/week per employed patient in the UK to euro273/patient in Sweden). Reductions in productivity in daily life of up to 26% were observed across the European countries. GERD places a significant burden on primary care patients, in terms of work absenteeism and presenteeism and in daily life. The resulting costs to the

  18. Gastro-oesophageal Reflux Disease: An Update

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    T Murphy

    2015-09-01

    Full Text Available Gastro-oesophageal reflux disease (GERD is a disorder in which reflux of stomach contents causes troublesome symptoms and/or complications and which affects health-related quality of life. It is one of the commonest disorders and appears to be increasing in incidence. The mechanisms leading to reflux are complex and multifactorial. The lower oesophageal sphincter (LES is an important part of the gastro-oesophageal barrier. Transient LES relaxations (TLESRs lead to reflux as these vagally mediated motor patterns cause relaxation of the LES and also result in oesophageal shortening and inhibition of the crural diaphragm. Heartburn and regurgitation are the characteristic symptoms of GERD. A clinical diagnosis of GERD can be made with typical symptoms. Oesophagitis is seen in a minority of patients with GERD. Lifestyle modification is widely advocated for patients with GERD. For short-term relief of symptoms of mild GERD, antacids/alginates are frequently used but they do not heal oesophagitis. Both histamine 2 receptor antagonists (H2RA and proton pump inhibitors (PPI have been shown to heal and prevent relapse of oesophagitis, although PPIs have been shown to be superior. The PPIs are the recommended first-line therapy for erosive oesophagitis and initial management of non-erosive reflux disease. Maintenance PPI therapy should be given to patients with oesophagitis, those who have recurrence of symptoms after discontinuation of medication and for those with complications of GERD.

  19. Effect of shakers exercise with kinesio taping in subjects with gastroesophageal reflux disease: A randomized controlled trial

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    Tanvi Padwal

    2016-10-01

    Full Text Available The prevalence of GERD in India ranges from 8-20% according to recently conducted studies based on different case definitions and study methodology. Although GERD is rarely life-threatening, it can severely limit daily activities and productivity. The principal goal for GERD treatment is relief of symptoms. Hence the aim of this study was to compare the effect of Shakers Exercise with kinesio taping and medical management over only medical management of GERD on severity of the disease and functional limitation. 30 participants clinically diagnosed with GERD were recruited.15 participants were allocated to control group (CMED where only medical management was given and other 15 were allocated to intervention group (SKT where shakers exercise, kinesio taping and medical management were given. Frequency Scale for the Symptoms of GERD was the outcome measure. Paired and unpaired t-test was used to test the significance of difference between mean values of two groups (CMED and (SKT.Statistically significant improvement was observed in both the groups when compared before and after intervention. However, the SKT showed to be better than CMED group post intervention. It was concluded that Shakers exercise and Kinesio Taping should be incorporated along with medical management in the treatment of patients with GERD on routine basis.

  20. Impact of obesity treatment on gastroesophageal reflux disease.

    Science.gov (United States)

    Khan, Abraham; Kim, Aram; Sanossian, Cassandra; Francois, Fritz

    2016-01-28

    Gastroesophageal reflux disease (GERD) is a frequently encountered disorder. Obesity is an important risk factor for GERD, and there are several pathophysiologic mechanisms linking the two conditions. For obese patients with GERD, much of the treatment effort is focused on weight loss and its consistent benefit to symptoms, while there is a relative lack of evidence regarding outcomes after novel or even standard medical therapy is offered to this population. Physicians are hesitant to recommend operative anti-reflux therapy to obese patients due to the potentially higher risks and decreased efficacy, and these patients instead are often considered for bariatric surgery. Bariatric surgical approaches are broadening, and each technique has emerging evidence regarding its effect on both the risk and outcome of GERD. Furthermore, combined anti-reflux and bariatric options are now being offered to obese patients with GERD. However, currently Roux-en-Y gastric bypass remains the most effective surgical treatment option in this population, due to its consistent benefits in both weight loss and GERD itself. This article aims to review the impact of both conservative and aggressive approaches of obesity treatment on GERD.

  1. Gastroesophageal reflux disease symptoms and dietary behaviors are significant correlates of short sleep duration in the general population: the Nagahama Study.

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    Murase, Kimihiko; Tabara, Yasuharu; Takahashi, Yoshimitsu; Muro, Shigeo; Yamada, Ryo; Setoh, Kazuya; Kawaguchi, Takahisa; Kadotani, Hiroshi; Kosugi, Shinji; Sekine, Akihiro; Nakayama, Takeo; Mishima, Michiaki; Chiba, Tsutomu; Chin, Kazuo; Matsuda, Fumihiko

    2014-11-01

    To examine relationships among gastroesophageal reflux disease (GERD) symptoms, dietary behaviors, and sleep duration in the general population. Cross-sectional. Community-based. There were 9,643 participants selected from the general population (54 ± 13 y). None. Sleep duration, sleep habits, and unfavorable dietary behaviors of each participant were assessed with a structured questionnaire. Participants were categorized into five groups according to their sleep duration: less than 5 h, 5 to less than 6 h, 6 to less than 7 h, 7 to less than 8 h, and 8 or more h per day. GERD was evaluated using the Frequency Scale for the Symptoms of GERD (FSSG) and participants having an FSSG score of 8 or more or those under treatment of GERD were defined as having GERD. Trend analysis showed that both the FSSG score and the number of unfavorable dietary habits increased with decreasing sleep duration. Further, multiple logistic regression analysis showed that both the presence of GERD (odds ratio = 1.19, 95% confidence interval (CI) = 1.07-1.32) and the number of unfavorable dietary behaviors (odds ratio = 1.19, 95% CI = 1.13-1.26) were independent and potent factors to identify participants with short sleep duration even after controlling for other confounding factors. The current study showed that both GERD symptoms and unfavorable dietary behaviors were significant correlates of short sleep duration independently of each other in a large sample from the general population.

  2. Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome.

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    de Bortoli, Nicola; Martinucci, Irene; Bellini, Massimo; Savarino, Edoardo; Savarino, Vincenzo; Blandizzi, Corrado; Marchi, Santino

    2013-09-21

    Several studies indicate a significant degree of overlap between irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD). Likewise, both functional heartburn (FH) and IBS are functional digestive disorders that may occur in the same patients. However, data establishing a solid link between FH and IBS are lacking, mainly because the clinical definition of FH has undergone substantial changes over the years. The available literature on the overlap between GERD or FH and IBS highlights considerable heterogeneity in terms of the criteria and diagnostic procedures used to assess heartburn and IBS. In particular, several epidemiological studies included patients with concomitant IBS and GERD without any attempt to distinguish FH (as defined by the Rome III criteria) from GERD via pathophysiological investigations. Independent of these critical issues, there is preliminary evidence supporting a significant degree of FH-IBS overlap. This underscores the need for studies based on updated diagnostic criteria and accurate pathophysiological classifications, particularly to distinguish FH from GERD. This distinction would represent an essential starting point to achieving a better understanding of pathophysiology in the subclasses of patients with GERD and FH and properly assessing the different degrees of overlap between IBS and the subcategories of heartburn.The present review article intends to appraise and critically discuss current evidence supporting a possible concomitance of GERD or FH with IBS in the same patients and to highlight the pathophysiological relationships between these disorders.

  3. Gastroesophageal reflux disease: A clinical overview for primary care physicians.

    Science.gov (United States)

    Pandit, Sudha; Boktor, Moheb; Alexander, Jonathan S; Becker, Felix; Morris, James

    2018-03-01

    GERD is among the most common outpatient disease processes encountered by clinicians on a daily basis. This review provides insights about how to approach GERD in terms of disease management and treatment. Review articles were searched using PUBMED and MEDLINE using criteria that included English language articles published in the last 5 years concerning studies carried out only in humans. The key words used in the searches were GERD, PPI, and erosive esophagitis. Recommendations from the American College of Gastroenterology are also included in this manuscript. The search resulted in ∼260 articles. The manuscript brings together and presents the results of recent recommendations from professional societies and recently published review articles on GERD. GERD is one of the most common diagnoses made by gastroenterologists and primary care physicians. It is important to recognize the typical and atypical presentations of GERD. This paper helps primary care physicians understand the disease's pathophysiology, and when, how, and with what to treat GERD before referring patients to gastroenterologists or surgeons. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Lifestyle Characteristics and Gastroesophageal Reflux Disease: A Population-Based Study in Albania

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    Lulzim Çela

    2013-01-01

    Full Text Available Aim. We aimed to assess the prevalence and lifestyle correlates of gastroesophageal reflux disease (GERD in the adult population of Albania, a Mediterranean country in Southeast Europe which has experienced major behavioral changes in the past two decades. Methods. A cross-sectional study, conducted in 2012, included a population-representative sample of 845 individuals (≥18 years residing in Tirana (345 men, mean age: ; 500 women, mean age: ; response rate: 84.5%. Assessment of GERD was based on Montreal definition. Covariates included socioeconomic characteristics, lifestyle factors, and body mass index. Logistic regression was used to assess the association of socioeconomic characteristics and lifestyle factors with GERD. Results. The overall prevalence of GERD was 11.9%. There were no significant sex differences, but a higher prevalence among the older participants. In fully adjusted models, there was a positive relationship of GERD with smoking, physical inactivity, fried food consumption, and obesity, but not so for alcohol intake and meat consumption. Conclusion. We obtained important evidence on the prevalence and lifestyle correlates of GERD in a Western Balkans' country. Smoking, physical inactivity, and obesity were strong “predictors” of GERD in this population. Findings from this study should be replicated in prospective studies in Albania and other transitional settings.

  5. Extraoesophageal symptoms and signs of gastroesophageal reflux disease

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    Bojan Tepeš

    2006-04-01

    Full Text Available Background Gastroesophageal reflux disease (GERD is very common in developed world, with the prevalence of disease is between 6 and 20%. Pathologic reflux can provoke not only typical symptoms (heartburn and regurgitation but also atypical symptoms and diseases of extraoesophageal organs (pulmonary, ENT, mouth. High prevalence of GERD in patients with unexplained chest pain, asthma, chronic cough, chronic laryngitis, hoarsness and dental erosions is not a proof of causality. GERD can cause these diseases with reflux of acid and pepsin into pharynx, larynx, lungs and mouth (reflux theory or through vasovagal mechanisms (reflex theory. Conclusions Good therapeutic success with medical or operative treatment in early methodologically not well conducted studies has not been completely proven in double-blind placebo controlled studies. GERD is an ethyological reason for these extraoesophageal symptoms and diseases in an approximately one third of patients. With diagnostic modalities that we have now, we cannot clearly define in which patient is GERD is an ethyologic factor or a contributer, before we start the treatment. In patients suspected of having GERD, there is therapeutic option of a trial with high dose of proton pump inhibitor for 3 to 6 months. In other patients with low clinical suspicion of GERD, 24-hour pH testing should be done first.

  6. Is histologic esophagitis associated with dental erosion: a cross-sectional observational study?

    Science.gov (United States)

    Friesen, Lynn Roosa; Bohaty, Brenda; Onikul, Robin; Walker, Mary P; Abraham, Caren; Williams, Karen B; Cocjin, Jose T; Cocjin, Eileen L; Friesen, Craig A

    2017-08-10

    Gastroesophageal reflux disease (GERD) affects 15-25% of children and adolescents in the United States. The diagnosis of GERD in children is complex as reported symptoms or symptom profiles have been found to be unreliable. Frequently, the diagnosis must be confirmed by objective tests such as pH monitoring or histological evidence of esophagitis on an esophageal biopsy. Dental erosion has been shown to be associated with GERD as an atypical complication and has the potential to be a marker of GERD. The purposes of this study were to compare the frequency and patterns of dental erosion in children and adolescents with and without histologic esophagitis. Twenty-five subjects were recruited from patients scheduled for an upper gastrointestinal endoscopy. Information regarding potential GERD symptoms, food habits, and dental hygiene habits were obtained. Intra-oral photographs were taken, and a dental exam for erosion was performed. The results of a standard biopsy taken from the lower third of the esophagus during an endoscopy were used to divide subjects into either the control group or the GERD group (i.e. those with histologic esophagitis). Twenty-two subjects yielded 586 evaluable teeth. No significant difference was found between frequency or erosion patterns of those with and without histologic esophagitis. Dental erosions were more frequent in primary teeth. Dental erosions do not appear to be associated with histologic esophagitis indicative of GERD.

  7. Histologic definition of gastro-esophageal reflux disease.

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    Chandrasoma, Parakrama T

    2013-07-01

    To review recent data supporting the development of new histology-based definitions of gastro-esophageal reflux disease (GERD). Three precisely definable columnar epithelial types--cardiac, oxyntocardiac and intestinal--may be interposed between esophageal squamous epithelium and gastric oxyntic (acid secreting) mucosa. This enables definition of a new histologic concept: the squamo-oxyntic gap. The squamo-oxyntic gap is zero or very small in autopsies performed on patients without evidence of GERD. The gap progressively increases in length with the severity of GERD, indicating that the squamo-oxyntic gap is a marker for chronic GERD. The distal part of the gap lines gastric-type rugal folds and, therefore, is distal to the present endoscopic definition of the gastro-esophageal junction. I contend that this distal gap segment (which has esophageal submucosal glands) is actually the dilated distal esophagus; this is the pathologic correlate of destruction of the abdominal segment of the lower esophageal sphincter. The dilated distal esophagus is mistaken for 'gastric cardia' by present endoscopic definitions. I believe that these data support the adoption of novel histologic definitions of GERD as follows: the presence of any squamo-oxyntic gap defines GERD; the length of the gap is a measure of severity of chronic GERD; and the presence of intestinal metaplasia in the gap defines Barrett esophagus and cancer risk.

  8. Risk factors for recurrent gastroesophageal reflux disease after fundoplication in pediatric patients: a case-control study.

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    Ngerncham, Monawat; Barnhart, Douglas C; Haricharan, Ramanath N; Roseman, Jeffrey M; Georgeson, Keith E; Harmon, Carroll M

    2007-09-01

    Recurrent gastroesophageal reflux disease (rGERD) is a common problem after fundoplication. Previous studies attempting to identify risk factors for rGERD have failed to control for confounding variables. The purpose of this study was to identify significant risk factors for rGERD after controlling for potential confounding variables. A retrospective, matched case-control study was conducted at a tertiary children's hospital. Cases (n = 116) met 1 of these criteria: reoperation for rGERD, symptomatic rGERD (confirmed by upper gastrointestinal series, esophagogastroduodenoscopy, or pH monitoring), or postoperative reinstitution of antireflux medication for more than 8 weeks. Controls (n = 209) were matched for surgeon, approach (laparoscopic/open), technique (partial/complete), and approximate operative date. Univariate and multivariable associations were analyzed by conditional logistic regression. Significant risk factors for rGERD were age of less than 6 years (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.7-7.5), preoperative hiatal hernia (OR, 3.2; 95% CI, 1.4-7.3), postoperative retching (OR, 5.1; 95% CI, 2.6-10.0), and postoperative esophageal dilatation (OR, 10.8; 95% CI, 1.8-65.4). Interestingly, significant association was not found between neurologic impairment and rGERD after controlling for potential confounding variables. Age of less than 6 years, preoperative hiatal hernia, postoperative retching, and postoperative esophageal dilatation are independently associated with increased risk of rGERD. Neurologic impairment alone does not increase the risk of developing rGERD.

  9. The association between gastroesophageal reflux disease and recurrent respiratory papillomatosis: A systematic review.

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    San Giorgi, Michel R M; Helder, Herman M; Lindeman, Robbert-Jan S; de Bock, Geertruida H; Dikkers, Frederik G

    2016-10-01

    Antireflux therapy is incorporated in many treatment protocols for recurrent respiratory papillomatosis (RRP) because gastroesophageal reflux (GERD) is thought to worsen the disease course of RRP. It is unclear if GERD really aggravates the disease course. The aims of this systematic review were to 1) evaluate incidence of GERD among RRP patients and 2) report if GERD changes the clinical course or tissue properties of RRP. A search was conducted in PubMed, Embase, and Google Scholar, following the methods of Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles with original data, published after January 1, 1990, on RRP with GERD as a determinant were eligible. There was no language restriction. Data on study design, study population, statistics, outcomes (incidence and influence of GERD), and risk of bias were collected and evaluated following PRISMA protocols. Of 1,277 articles, 19 were selected. Gastroesophageal reflux was objectified in 25% to 100% of RRP patients. Subjective GERD was present in 0% to 70% of patients. There is no proof that GERD aggravated the clinical course or tissue properties of RRP, as measured by the number of surgeries, severity scoring systems, or dysplasia. One study did find a higher chance of web formation in patients with anterior or posterior glottic papillomas who did not receive antireflux therapy, but these results should be interpreted with care due to the study's quality. There is insufficient proof that GERD does or does not aggravate the clinical course or tissue properties of RRP. Laryngoscope, 126:2330-2339, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  10. Gastroesophageal reflux disease: exaggerations, evidence and clinical practice.

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    Ferreira, Cristina Targa; Carvalho, Elisa de; Sdepanian, Vera Lucia; Morais, Mauro Batista de; Vieira, Mário César; Silva, Luciana Rodrigues

    2014-01-01

    there are many questions and little evidence regarding the diagnosis and treatment of gastroesophageal reflux disease (GERD) in children. The association between GERD and cow's milk protein allergy (CMPA), overuse of abdominal ultrasonography for the diagnosis of GERD, and excessive pharmacological treatment, especially proton-pump inhibitors (PPIs) are some aspects that need clarification. This review aimed to establish the current scientific evidence for the diagnosis and treatment of GERD in children. a search was conducted in the MEDLINE, PubMed, LILACS, SciELO, and Cochrane Library electronic databases, using the following keywords: gastroesophageal reflux; gastroesophageal reflux disease; proton-pump inhibitors; and prokinetics; in different age groups of the pediatric age range; up to May of 2013. abdominal ultrasonography should not be recommended to investigate gastroesophageal reflux (GER). Simultaneous treatment of GERD and CMPA often results in unnecessary use of medication or elimination diet. There is insufficient evidence for the prescription of prokinetics to all patients with GER/GERD. There is little evidence to support acid suppression in the first year of life, to treat nonspecific symptoms suggestive of GERD. Conservative treatment has many benefits and with low cost and no side-effects. there have been few randomized controlled trials that assessed the management of GERD in children and no examination can be considered the gold standard for GERD diagnosis. For these reasons, there are exaggerations in the diagnosis and treatment of this disease, which need to be corrected. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  11. A New Algorithm to Reduce the Incidence of Gastroesophageal Reflux Symptoms after Laparoscopic Sleeve Gastrectomy.

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    Ece, Ilhan; Yilmaz, Huseyin; Acar, Fahrettin; Colak, Bayram; Yormaz, Serdar; Sahin, Mustafa

    2017-06-01

    Laparoscopic sleeve gastrectomy (LSG) is one of the most prefered treatment option for morbid obesity. However, the effects of LSG on gastroesophageal reflux disease (GERD) are controversial. Asymptomatic GERD and hiatal hernia (HH) is common in obese patients. Therefore, it is important to identify the high risk patients prior to surgery. This study aims to evaluate efficacy of cruroplasty for HH during LSG in morbidly obese patients using ambulatory pH monitoring (APM) results, and to investigate the patients' selection criteria for this procedure. This retrospective study includes outcomes of 59 patients who underwent LSG and HH repair according to our patient selection algorithm. Outcomes included preoperative GERD Health-Related Quality of Life (GERD-HRQL) questionnaire, APM results, percentage of postoperative excess weight loss, and total weight loss. For a total of 402 patients, APM was applied in 70 patients who had a positive score of GERD-HRQL, and 59 patients underwent LSG and concomitant HH repair who had a DeMeester score of 14.7% or above. There was no statistically significant difference in weight loss at 6 and 12-month follow-up. Two patients (3.3%) had symptoms of GERD at 12 months postoperatively, and only one (1.6%) patient required treatment of proton pump inhibitor for reflux. In the total cohort, 11 (2.7%) patients also evolved de novo GERD symptoms. This study confirm that careful attention to patient selection and surgical technique can reduce the symptoms of GERD at short-term. Routine bilateral crus exploration could be a major risk factor of postoperative GERD.

  12. Self-Reported Sleep Bruxism and Nocturnal Gastroesophageal Reflux Disease in Patients with Obstructive Sleep Apnea: Relationship to Gender and Ethnicity§

    Science.gov (United States)

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Study Objectives : Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. Methods : A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. Results : In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Conclusion : Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups. PMID:25352924

  13. Predictive Biomarkers of Gastroesophageal Reflux Disease and Barrett's Esophagus in World Trade Center Exposed Firefighters: a 15 Year Longitudinal Study.

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    Haider, Syed H; Kwon, Sophia; Lam, Rachel; Lee, Audrey K; Caraher, Erin J; Crowley, George; Zhang, Liqun; Schwartz, Theresa M; Zeig-Owens, Rachel; Liu, Mengling; Prezant, David J; Nolan, Anna

    2018-02-15

    Gastroesophageal reflux disease (GERD) and Barrett's Esophagus (BE), which are prevalent in the World Trade Center (WTC) exposed and general populations, negatively impact quality of life and cost of healthcare. GERD, a risk factor of BE, is linked to obstructive airways disease (OAD). We aim to identify serum biomarkers of GERD/BE, and assess the respiratory and clinical phenotype of a longitudinal cohort of never-smoking, male, WTC-exposed rescue workers presenting with pulmonary symptoms. Biomarkers collected soon after WTC-exposure were evaluated in optimized predictive models of GERD/BE. In the WTC-exposed cohort, the prevalence of BE is at least 6 times higher than in the general population. GERD/BE cases had similar lung function, D LCO , bronchodilator response and long-acting β-agonist use compared to controls. In confounder-adjusted regression models, TNF-α ≥ 6 pg/mL predicted both GERD and BE. GERD was also predicted by C-peptide ≥ 360 pg/mL, while BE was predicted by fractalkine ≥ 250 pg/mL and IP-10 ≥ 290 pg/mL. Finally, participants with GERD had significantly increased use of short-acting β-agonist compared to controls. Overall, biomarkers sampled prior to GERD/BE presentation showed strong predictive abilities of disease development. This study frames future investigations to further our understanding of aerodigestive pathology due to particulate matter exposure.

  14. Features of the clinical course of comorbid gastroesophageal reflux disease and chronic gastroduodenitis in children

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    N.V. Kirianchuk

    2018-04-01

    Full Text Available Background. The incidence of gastroesophageal reflux disease (GERD in children varies from 2–4 to 9–49 % according to different authors, and comorbid lesions of the upper digestive tract — from 15 to 38 %. The improvement of non-invasive diagnosis of these conditions in children is relevant. To study the clinical features of GERD and chronic gastroduodenitis (CGD in children was the purpose of our study. Materials and methods. We have examined 71 patients aged from 10 to 18 years. Group I included 33 children with comorbid GERD and chronic gastroduodenitis, group II consisted of 16 individuals with GERD, and group III — of 22 children with chronic gastroduodenitis. Diagnoses of GERD and chronic gastroduodenitis were made according to International Classification of Diseases, 10th revision, on the basis of the complaints and medical histories, as well as objective examination, and verified by endoscopic examination. Analysis of the obtained results was performed using non-parametric methods of chi-square test and Fisher’s exact test. Results. We compared the incidence of the main clinical symptoms in the study groups. The incidence of heartburn, sour taste in the mouth, nausea was not statistically different in children of different groups. The incidence of abdominal pain was not different in groups with comorbid GERD and CGD, but it was significantly less common in children with GERD. It was also found that non-esophageal symptoms (pathological changes of the tongue, carious teeth, signs of chronic pharyngitis, cardialgia, palpitations were significantly more common in children with comorbid GERD and chronic gastroduodenitis compared with a group of children with CGD. Conclusions. The obtained results can be used to develop algorithms for the diagnosis of comorbid GERD and CGD.

  15. Determinants of Gastroesophageal Reflux Disease, Including Hookah Smoking and Opium Use– A Cross-Sectional Analysis of 50,000 Individuals

    Science.gov (United States)

    Islami, Farhad; Nasseri-Moghaddam, Siavosh; Pourshams, Akram; Poustchi, Hossein; Semnani, Shahryar; Kamangar, Farin; Etemadi, Arash; Merat, Shahin; Khoshnia, Masoud; Dawsey, Sanford M.; Pharoah, Paul D.; Brennan, Paul; Abnet, Christian C.; Boffetta, Paolo; Malekzadeh, Reza

    2014-01-01

    Background Gastroesophageal reflux disease (GERD) is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time. Methods We performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn. Results Approximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02–1.75) and opium use (OR 1.70, 95% CI 1.55–1.87) were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76–0.99). After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined). Conclusion GERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere. PMID:24586635

  16. Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- a cross-sectional analysis of 50,000 individuals.

    Science.gov (United States)

    Islami, Farhad; Nasseri-Moghaddam, Siavosh; Pourshams, Akram; Poustchi, Hossein; Semnani, Shahryar; Kamangar, Farin; Etemadi, Arash; Merat, Shahin; Khoshnia, Masoud; Dawsey, Sanford M; Pharoah, Paul D; Brennan, Paul; Abnet, Christian C; Boffetta, Paolo; Malekzadeh, Reza

    2014-01-01

    Gastroesophageal reflux disease (GERD) is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time. We performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼ 50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn. Approximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02-1.75) and opium use (OR 1.70, 95% CI 1.55-1.87) were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76-0.99). After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined). GERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere.

  17. A population-based study of gastroesophageal reflux disease and sleep problems in elderly twins.

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    Anna Lindam

    Full Text Available BACKGROUND & AIMS: Previous studies indicate an association between sleep problems and gastroesophageal reflux disease (GERD. Although both these conditions separately have moderate heritabilities, confounding by genetic factors has not previously been taken into account. This study aimed to reveal the association between sleep problems and GERD, while adjusting for heredity and other potential confounding factors. METHODS: This cross-sectional population-based study included all 8,014 same-sexed twins of at least 65 years of age and born in Sweden between 1886 and 1958, who participated in telephone interviews in 1998-2002. Three logistic regression models were used 1 external control analysis, 2 within-pair co-twin analysis with dizygotic (DZ twin pairs discordant for GERD, and 3 within-pair co-twin analysis with monozygotic (MZ twin pairs discordant for GERD. Odds ratios (ORs with 95% confidence intervals (CIs were calculated and adjusted for established risk factors for GERD, i.e. sex, age, body mass index (BMI, tobacco smoking, and educational level. RESULTS: A dose-response association was identified between increasing levels of sleep problems and GERD in the external control analysis. Individuals who often experienced sleep problems had a two-fold increased occurrence of GERD compared to those who seldom had sleep problems (OR 2.0, 95% CI 1.8-2.4. The corresponding association was of similar strength in the co-twin analysis including 356 DZ pairs (OR 2.2, 95% CI 1.6-3.4, and in the co-twin analysis including 210 MZ pairs (OR 1.5, 95% CI 0.9-2.7. CONCLUSION: A dose-dependent association between sleep problems and GERD remains after taking heredity and other known risk factors for GERD into account.

  18. Determinants of gastroesophageal reflux disease, including hookah smoking and opium use- a cross-sectional analysis of 50,000 individuals.

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    Farhad Islami

    Full Text Available Gastroesophageal reflux disease (GERD is a common cause of discomfort and morbidity worldwide. However, information on determinants of GERD from large-scale studies in low- to medium-income countries is limited. We investigated the factors associated with different measures of GERD symptoms, including frequency, patient-perceived severity, and onset time.We performed a cross-sectional analysis of the baseline data from a population-based cohort study of ∼ 50,000 individuals in in Golestan Province, Iran. GERD symptoms in this study included regurgitation and/or heartburn.Approximately 20% of participants reported at least weekly symptoms. Daily symptoms were less commonly reported by men, those of Turkmen ethnicity, and nass chewers. On the other hand, age, body mass index, alcohol drinking, cigarette smoking, opium use, lower socioeconomic status, and lower physical activity were associated with daily symptoms. Most of these factors showed similar associations with severe symptoms. Women with higher BMI and waist to hip ratio were more likely to report frequent and severe GERD symptoms. Hookah smoking (OR 1.34, 95% CI 1.02-1.75 and opium use (OR 1.70, 95% CI 1.55-1.87 were associated with severe symptoms, whereas nass chewing had an inverse association (OR 0.87, 95% CI 0.76-0.99. After exclusion of cigarette smokers, hookah smoking was still positively associated and nass chewing was inversely associated with GERD symptoms (all frequencies combined.GERD is common in this population. The associations of hookah and opium use and inverse association of nass use with GERD symptoms are reported for the first time. Further studies are required to investigate the nature of these associations. Other determinants of GERD were mostly comparable to those reported elsewhere.

  19. Self-reported sleep bruxism and nocturnal gastroesophageal reflux disease in patients with obstructive sleep apnea: relationship to gender and ethnicity.

    Science.gov (United States)

    Hesselbacher, Sean; Subramanian, Shyam; Rao, Shweta; Casturi, Lata; Surani, Salim

    2014-01-01

    Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity. A retrospective chart review was performed of patients diagnosed with OSA at an academic sleep center. The patients completed a sleep questionnaire prior to undergoing polysomnography. Patients with confirmed OSA were evaluated based on gender and ethnicity. Associations were determined between sleep bruxism and nocturnal GERD, and daytime sleepiness, insomnia, restless legs symptoms, and markers of OSA severity in each group. In these patients with OSA, the prevalence of nocturnal GERD (35%) and sleep bruxism (26%) were higher than the general population. Sleep bruxism was more common in Caucasians than in African Americans or Hispanics; there was no gender difference. Nocturnal GERD was similar among all gender and ethnic groups. Bruxism was associated with nocturnal GERD in females, restless legs symptoms in all subjects and in males, sleepiness in African Americans, and insomnia in Hispanics. Nocturnal GERD was associated with sleepiness in males and African Americans, insomnia in females, and restless legs symptoms in females and in Caucasians. Patients with OSA commonly have comorbid sleep bruxism and nocturnal GERD, which may require separate treatment. Providers should be aware of differences in clinical presentation among different ethnic and gender groups.

  20. Association between dental erosion and possible risk factors: A hospital-based study in gastroesophageal reflux disease patients

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    Vamsi Krishna Reddy

    2016-01-01

    Full Text Available Introduction: Gastroesophageal reflux disease (GERD is a condition, with a prevalence of up to 10–20% in the general population. GERD may involve damage to the oral cavity, and dental erosion may occur with a higher frequency. Aim: To estimate the prevalence of dental erosion in GERD patients and to evaluate the association between dental erosion and possible risk factors. Materials and Methods: The study was conducted in the Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow among patients attending outpatient department between June and August 2014. The study group comprised 91 subjects with GERD and 114 subjects without GERD. Information regarding symptoms of GERD, medicines, any chronic disease, and dietary habits were recorded. Dental examination was done to assess the presence or absence of dental erosions and its severity was measured using O'Sullivan Index (2000. Statistical analysis was done using Mann–Whitney U-test and Kruskal–Wallis test. Results: Of 91 GERD patients, 87 (95.6% patients had dental erosion. In both groups, association between frequent intake of fruit juice, carbonated drinks, milk, yoghurt, fruits, and tea/coffee with occurrence of dental erosion were statistically significant (P < 0.05. In GERD patients, association between intake of milk and occurrence of dental erosion were statistically significant (P < 0.05. Association of medication with dental erosion was found to be statistically significant (P < 0.05. Chronic diseases like diabetes and asthma were also found to be statistically significant with dental erosion (P < 0.05. Conclusion: This study showed that GERD patients were at increased risk of developing dental erosion compared to controls.

  1. Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients.

    Directory of Open Access Journals (Sweden)

    Kosuke Sakitani

    Full Text Available To determine if a discrepancy exists between subjective symptoms and the grade of endoscopic gastroesophageal reflux disease (GERD in diabetes mellitus (DM patients.All 2,884 patients who underwent esophagogastroduodenoscopy completed the modified Gastrointestinal Symptom Rating Scale (GSRS, an interview-based rating scale consisting of 16 items including a question on acid regurgitation. Patients were divided into DM and non-DM groups (1,135 and 1,749 patients, respectively. GERD was diagnosed endoscopically and graded according to the Los Angeles classification. Grade B or more severe GERD was defined as severe endoscopic GERD. The intergroup GSRS score was compared statistically.In severe endoscopic GERD patients, the prevalence of patients with a positive GSRS score in the acid regurgitation question was statistically lower in DM patients than non-DM patients. Of the 60 non-DM patients with severe endoscopic GERD, 40 patients (67% had a positive GSRS score for acid regurgitation; however, of the 51 DM patients with severe endoscopic GERD, 23 patients (45% had a positive GSRS score. Multivariate analysis showed that severe endoscopic GERD (OR: 2.01; 95% CI: 1.21-3.33; p = 0.0066, non-DM (OR: 0.74; 95% CI: 0.54-0.94; p = 0.0157, younger age (OR: 0.98; 95% CI: 0.97-0.99; p = 0.0125, and hiatal hernia (OR: 1.46; 95% CI: 1.12-1.90; p = 0.0042 were associated with acid regurgitation symptoms.There is a discrepancy between subjective symptoms and endoscopic GERD grade in DM patients. The ability of DM patients to feel acid regurgitation may be decreased.

  2. Investigation of extraesophageal gastroesophageal reflux disease

    Science.gov (United States)

    Tsoukali, Emmanouela; Sifrim, Daniel

    2013-01-01

    The most common extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, asthma and laryngitis. There are two mechanisms proposed to explain extraesophageal syndromes caused by GERD. The first one is a direct way via irritation and/or microaspiration and the second one is an indirect, vagally mediated way. The investigation of extraesophageal manifestations of GERD is difficult and the empirical therapy with proton pump inhibitors usually double dose for at least three months is still the most common approach. PMID:24714277

  3. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  4. Psychological Dysadaptation in Patients with Gastroesophageal Reflux Disease: Review and Own Researches

    Directory of Open Access Journals (Sweden)

    L.M. Mosiichuk

    2014-11-01

    Full Text Available he article presents up-to-date data concerning psychosomatic problem in medicine, in particular world experience of studying disorders of psychological of adaptation in patients with gastroesophageal reflux disease (GERD, as well as own researches data. When using psychological tests, detection rate of anxiety and depression in patients with GERD was 100 and 91.2 %, respectively. Follow-up research studies revealed that presence of psychological dysadaptation in patients with GERD makes it impossible to achieve a stable remission of the underlying disease and necessitates appropriate correction.

  5. Influence on consumer behavior: the impact of direct-to-consumer advertising on medication requests for gastroesophageal reflux disease and social anxiety disorder.

    Science.gov (United States)

    Khanfar, Nile M; Polen, Hyla H; Clauson, Kevin A

    2009-01-01

    A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD). Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that they subsequently initiated a conversation with their physician. Nearly half of respondents, 47.4% for GERD and 40% for SAD, reported that a change in therapy occurred as a direct result of these discussions. Televised DTCA for these two drug classes can have a significant impact on patient-initiated prescription requests.

  6. Signaling warmth: how brand warmth and symbolism affect consumers’ online brand endorsements

    NARCIS (Netherlands)

    Bernritter, S.F.; Verlegh, P.; Voorveld, H.; Eisend, M.

    2016-01-01

    In their efforts to promote their brands, products and services, advertisers often enlist endorsement by other parties, such as celebrities or experts (e.g., Biswas, Biswas, and Das, 2006; Rice, Kelting, and Lutz, 2012). Increasingly, brands and organizations are also seeking endorsement by their

  7. Journal of Biosciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    2004-10-27

    Oct 27, 2004 ... Heat stress response in plants: a complex game with chaperones and more than twenty heat stress transcription factors. Sanjeev Kumar Baniwal Kapil Bharti Kwan Yu Chan Markus Fauth Arnab Ganguli Sachin Kotak Shravan Kumar Mishra Lutz Nover Markus Port Klaus-Dieter Scharf Joanna Tripp ...

  8. Damage by the Sitka spruce weevil (Pissodes strobi) and growth patterns for 10 spruce species and hybrids over 26 years in the Pacific Northwest.

    Science.gov (United States)

    Russel G. Mitchell; Kenneth H. Wright; Norman E. Johnson

    1990-01-01

    Ten species and hybrids of spruce (Picea spp.) were planted and observed annually for 26 years at three coastal locations in Oregon and Washington to evaluate growth rates and susceptibility to the Sitka spruce weevil (= white pine weevil), Pissodes strobi The 10 spruce were: Sitka spruce, Norway spruce, Lutz spruce, black...

  9. Modifiers and mechanisms of multi-system polyglutamine ...

    Indian Academy of Sciences (India)

    case of polyQ repeat disorders such as HD (reviewed in Lutz. 2007). The different .... saccades, h ypertrophic cardiomyopath y, diabetes mellitus. Campuzano et al . (1996), ...... serine–threonine kinase Akt which phosphorylates mutant huntingtin at ...... systematic analysis of human disease-associated gene sequences.

  10. Old lower stem bark lesions apparently caused by unsuccessful spruce beetle attacks still evident on live spruce trees years later

    Science.gov (United States)

    John S. Hard; Ken P. Zogas

    2010-01-01

    We examined old bark lesions on Lutz spruce in young stands on the Kenai Peninsula, Alaska, to determine their cause. Distribution of these lesions along lower stems was similar to the distribution of spruce beetle attacks during epidemics. These lesions apparently resulted from unsuccessful attacks by spruce beetles during the late 1980s and early 1990s and appear to...

  11. Mechanism of Huiru decoction on hyperprolactinemia in rats

    African Journals Online (AJOL)

    of HD (9.6 g/kg body weight) reduced PRL level of hyperPRL rats effectively (p < 0.01). HD increased dopamine ..... 4. Gerhard Lutz. Hair loss and hyperprolactinemia in women. ... benefits of herbal medicines for schizophrenia: from empirical ...

  12. Attitude change as a function of the observation of vicarious reinforcement and friendliness

    OpenAIRE

    Stocker-Kreichgauer, Gisela

    1982-01-01

    Attitude change as a function of the observation of vicarious reinforcement and friendliness : hostility in a debate / Lutz von Rosenstiel ; Gisela Stocker- Kreichgauer. - In: Group decision making / ed. by Gisela Stocker-Kreichgauer ... - London u.a. : Acad. Press, 1982. - S. 241-255. - (European monographs in social psychology ; 25)

  13. Darshana Jolts

    Indian Academy of Sciences (India)

    can recall this dedication in the names of the week in all languages, in Indian ... That is what the game of science is all about: to go beyond the impressions created by our ... The book, dating back roughly to the second century C E, was known ..... See Lutz B Schmadel, Dictionary of minor planet names (online Edition).

  14. Journal of Biosciences | Indian Academy of Sciences

    Indian Academy of Sciences (India)

    Heat stress response in plants: a complex game with chaperones and more than twenty heat stress transcription factors · Sanjeev Kumar Baniwal Kapil Bharti Kwan Yu Chan Markus Fauth Arnab Ganguli Sachin Kotak Shravan Kumar Mishra Lutz Nover Markus Port Klaus-Dieter Scharf Joanna Tripp Christian Weber Dirk ...

  15. Back-breeding the aurochs: the Heck brothers, National Socialism and imagined geographies for nonhuman Lebensraum

    NARCIS (Netherlands)

    Driessen, C.P.G.; Lorimer, J.

    2016-01-01

    This chapter investigates the bio-geographical imaginations behind the animal 'back-breeding' programs carried out by Lutz and Heinz Heck - two influential German zoologists who ran Berlin and Munich zoos. Partly with close connections to and patronage from the National Socialist elite, the Heck

  16. Lista anotada y clave de los sapos marsupiales (Anura: Hylidae: Gastrotheca de Colombia Lista anotada y clave de los sapos marsupiales (Anura: Hylidae: Gastrotheca de Colombia

    Directory of Open Access Journals (Sweden)

    Duellman William E.

    1989-09-01

    Full Text Available Los anuros marsupiales se hallan representados en Colombia por diez y seis especies pertenecientes al género Gastrotheca. G. humbertoi  Lutz, 1977, pasa a la sinonimia de G. andaquiensis Ruiz y Hernández, 1976. G. medemi Cochran y Goin, 1970, G. nicefori descampsi Lutz y Ruiz, 1977, y G. yacambuensis Yustiz, 1978, son incluidas en la sinonimia de G. nicefori Gaige, 1933. Se presenta un breve diagnóstico y comentario sobre la distribución para cada una de las especies colombianas junto con una clave para su identificación. Marsupial frogs are represented in Colombia by sixteen species of Gastrotheca. Gastrotheca humbertoi Lutz, 1977 is placed in the synonymy of G. andaquiensis Ruiz y Hernández, 1976. G. medemi Cochran and Goin, 1970, G. nicefori descampsi Lutz and Ruiz, 1977, and G.Yacambuensis Yustiz, 1978 are placed inthesynonymy of G. nicefori Gaige, 1933. A brief diagnosis and statement of distribution are presented for each Colombian species, and a key for identification of the species is provided.

  17. Taxonomy and Biology of Phlebotomine Vectors of Human Disease

    Science.gov (United States)

    1987-12-31

    Sobre o encontro de Lutzomyiu longipalpis (Lutz & Neiva, 1912) no Estado de Sao Paulo, Brasil, Rev. Saude Publ. Sac Paulo 4:99-100. 3 Forattini, 0. P...Almeida. /1964. Flebotomos do nordeste. I. Encontro de "Plboou cht, " "P. gmgxi e ’T. 1QnstispinJ. em Pernambuco (Diptera, Psychodidae). Rev. Brasil. Biol

  18. Guide to the Identification and Geographic Distribution of Lutzomyia Sand Flies in Mexico, the West Indies, Central and South America (Diptera:Psychodidae)

    Science.gov (United States)

    1994-03-31

    1971. S-6bre o encontro deiutzomtyia longipalpis (Lutz& Neiva, 1912) no Estado do Sio Paulo, Brasil. Rev. Silude Pub]. Sio Paulo 4:99-100. Forattini, 0...271-282. t~~ f References Cited 831 Lucern, D. T. & L. Almeida. 1964. Fleb6tomos do nordeste. I. Encontro de "Phlebotomus choti," "P. aragaoi" e "P

  19. DMPD: Receptor tyrosine kinases and the regulation of macrophage activation. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 14726496 Receptor tyrosine kinases and the regulation of macrophage activation. Cor...osine kinases and the regulation of macrophage activation. PubmedID 14726496 Title Receptor tyrosine...rell PH, Morrison AC, Lutz MA. J Leukoc Biol. 2004 May;75(5):731-7. Epub 2004 Jan 14. (.png) (.svg) (.html) (.csml) Show Receptor tyr

  20. Development of a Novel Method to Detect Prostate Cancer Circulating Tumor Cells (CTCs) Based on Epithelial-Mesenchymal Transition Biology

    Science.gov (United States)

    2014-12-01

    Lewis Phillips, G. D.; Li, G.; Dugger, D. L.; Crocker, L. M.; Parsons, K. L.; Mai, E.; Blattler, W. A.; Lambert , J. M.; Chari, R. V. J.; Lutz, R...cells. Molecular Carcinogenesis. doi:10.1002/mc.22014. 150. Sun, Y., Campisi, J., Higano, C., Beer , T. M., Porter, P., Coleman, I., True, L., & Nelson, P

  1. Proceedings of the Annual Conference (28th) of the Military Testing Association Held in New London, Connecticut on 3-7 November 1986

    Science.gov (United States)

    1986-11-07

    Lutz, R.J. (1975). Changing Brand Attitudes through Modification of Cognitive Burke, J.S. and Faris, J.H. (1982). Structure, Journal of Consumer...as design: Using typography to improve access and understanding. In D. H. Jonassen (Ed.), The technology of text: Principles for structuring, designing

  2. Koorekommikatla kohale kuhjuvad tõrvapilved / Pille-Riin Purje

    Index Scriptorium Estoniae

    Purje, Pille-Riin, 1963-

    2008-01-01

    Rakvere teatri uuslavastustest: Joel Chandler Harrise "Onu Remuse lood" - lavastaja Jaanika Juhanson (esietendus 5. septembril), Urs Widmeri "Top Dogs" - lavastaja Kati Kivitar (esietendus 20. septembril) ja Lutz Hübneri noortenäidend "Creeps" - lavastaja Üllar Saaremäe (esietendus 4. oktoobril)

  3. Prantsusmaa on kõigest üks riik, leiavad eurosotsid / Priit Simson

    Index Scriptorium Estoniae

    Simson Priit, 1977-

    2005-01-01

    Euroopa Parlamendi sotsialistide juht Martin Schultz on seisukohal, et EL-i põhiseadusleping ei ole Prantsusmaal toimunud referendumi tõttu läbikukkunud, ning soovitab ära oodata leppe heakskiitmise teistes EL-i riikides. Euroopa Parlamendi sotsialistide väljasõiduistungist Tallinnas

  4. Evaluation of severity and therapy in children with atopic dermatitis

    NARCIS (Netherlands)

    A. Wolkerstorfer (Albert)

    1999-01-01

    textabstractAtopic dennatitis (AD) is a conUllon chronically relapsing skin disorder affecting 9-20% of those born after 1970 [Schultz Larsen 1993]. TI,e aetiology is still not entirely elucidated and research is complicated by the multifactorial nature of the disease. Both genetical

  5. The exact solution of the Ising quantum chain with alternating single and sector defects

    International Nuclear Information System (INIS)

    Zhang Degang; Li Bozang; Li Yun

    1992-10-01

    The Ising quantum chain with alternating single and sector defects is solved exactly by using the technique of Lieb, Schultz and Mattis. The energy spectrum of this model is shown to have a tower structure if and only if these defects constitute a commensurate configuration. This means that conformal invariance is preserved under these circumstances. (author). 13 refs

  6. The Effect of Type of Education on an Individual's Self Employment Choice: Comparison of Vocational and College Education

    Science.gov (United States)

    Edenborg, Michelle D.

    2013-01-01

    Using theoretical constructs of the human capital theory (Schultz, 1959) and the resource-based view of the firm (Barney, 1991), this study examines whether the type of education completed has an impact on an individual's choice between self-employment and employment with a firm. In addition, this study seeks to understand the geographic…

  7. Minutes: Annual Meeting of the President's Committee on Employment of the Handicapped (Washington, D.C., May 1-2, 1969).

    Science.gov (United States)

    President's Committee on Employment of the Handicapped, Washington, DC.

    Reporting the events of the meeting of the President's Committee on Employment of the Handicapped, the text includes speeches by Chairman Russell, Senator Bob Dole, Secretary of Labor Schultz, Rene Carpenter, Mr. Lustenberger of the W.T. Grant Company, W.F. Schnitzler of the AFL-CIO, Mrs. Koontz of the Department of Labor, Dr. Harlem, President of…

  8. Plan well, plan often

    Science.gov (United States)

    Bill Block

    2013-01-01

    This issue includes an invited paper by Courtney Schultz and her colleagues commenting on the application of the newly adopted U.S. Forest Service Planning Rule (hereafter, the rule) for wildlife. The rule is basically implementing language to interpret the spirit and intent of the National Forest Management Act (NFMA) of 1976. Laws such as NFMA require additional...

  9. In Memoriam: James Harlan Steele (1913—2013)

    Centers for Disease Control (CDC) Podcasts

    2014-05-19

    Drs. Jennifer McQuiston and Casey Barton Behravesh talk with Dr. Myron Schultz about the legendary Dr. James Harlan Steele.  Created: 5/19/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 5/20/2014.

  10. Transparency, price-dependent demand and product variety

    OpenAIRE

    Gu, Yiquan; Wenzel, Tobias

    2010-01-01

    This paper revisits the relationship between transparency on the consumer side and product variety as analyzed in Schultz (2009). We identify two welfare effects of transparency. More transparency decreases price-cost margins which is beneficial forwelfare. On the other hand, more transparency reduces variety which can be positive or negative for welfare. Overall, more transparency is always welfareimproving.

  11. Identifying and Solving the Real Problems Facing the Integrated Disability Evaluation System (IDES)

    Science.gov (United States)

    2013-06-14

    353. Boal, Kimberly B., and Patrick L. Schultz. 2007. Storytelling , time and evolution: The role of strategic leadership in complex adaptive...culture, change and emotions : A qualitative study. Journal of Change Management 9, no. 4: 435-457. Snavely, Kevin, and Uday Desai. Mapping local

  12. Peak Performance Through Nutrition and Exercise

    Science.gov (United States)

    1999-09-01

    Keith Avery, J02 Cerise Fenton , Dr. Jeffrey Bennett, and Dawn Schultz. Also, many thanks to HM1 (FMF) Otis B. Brown, the USUHS Brigade, and Morale...ability to perform physical activities. Regular physical activity leads to improved physical fitness and many other physiologic, cosmetic , and

  13. The Adaptation and Validation of the Emotion Matching Task for Preschool Children in Spain

    Science.gov (United States)

    Alonso-Alberca, Natalia; Vergara, Ana I.; Fernandez-Berrocal, Pablo; Johnson, Stacy R.; Izard, Carroll E.

    2012-01-01

    The Emotion Matching Task (EMT; Izard, Haskins, Schultz, Trentacosta, & King, 2003) was developed to assess emotion knowledge in preschoolers and was demonstrated to show adequate convergent and predictive validity in an American sample (Morgan, Izard, & King, 2010). In light of the need for valid measures for assessing emotion…

  14. Kas Starbucks langeb enda edu ohvriks? / Neeme Raud

    Index Scriptorium Estoniae

    Raud, Neeme, 1969-

    2007-01-01

    Kuigi USA juhtiv kohvipoodidekett Starbucks on üha edukam laienedes üha uutesse maailma riikidesse, on ettevõtte juht Howard Schultz tunnistanud, et muretseb varem kundedele garanteeritud Starbucksi elamuse kadumise pärast. Vt. samas: Heineken - kas uus Starbucks?; Katke Starbucksi tegevjuhi Howard Schultzi memost; Starbucksi võidukäik; Starbucksiga kavatseb rinda pistma hakata ka McDonalds

  15. On the Methodological and Philosophical Challenges of Sociomaterial Theorizing

    DEFF Research Database (Denmark)

    Mueller, Benjamin; Raeth, Philip; Faraj, Samer

    2012-01-01

    This panel discusses how to take the ontological paradigm of Sociomateriality to the field using alternative theoretical lenses that embody sociomaterial ideas. Based on exemplary papers, Samer Faraj, Karlheinz Kautz, Daniel Robey, and Ulrike Schultze present the advantages of the lens they have ...... to contribute to sociomaterial theorizing, thus supporting the recent trend towards Sociomateriality in the IS research community....

  16. Polymorphism in TNP-1 gene of Murrah buffalo bulls

    African Journals Online (AJOL)

    hope&shola

    different types of anomalies (Yadav et al., 1990), how- ever as ... processes of modification in mammals (Lewis et al,. 2003). ... (Dadoune et al., 1988, Hofmann et al., 1990). ..... Cho C, Jung-Ha H, Willis WD, Goulding EH, Stein P, Xu Z, Schultz.

  17. Synthesis, characterization and gas sensitivity of MoO3 nanoparticles

    Indian Academy of Sciences (India)

    TECS

    Sol–gel citrate; metal oxide; gas sensing; nanoparticles; SEM. 1. Introduction ... et al (2005) demonstrated the advantageous use of nano- structured cerium oxide .... Hoffheins B, Taylor R F and Schultz J S (eds) 1996 Solid state resistive gas ...

  18. A Strategic Marketing Guide for the

    Science.gov (United States)

    1995-12-27

    family as opposed to just the major bread-winner. Focusing on total quality in service enabled the Ritz - Carlton to become the first member of the...hospitality community to win the very prestigious Malcom Baldridge Award. By using the award criterion and the advice of Ritz -Canton CEO Horste Schultze

  19. "Infootsingu 2010" võitja on Krõõt Kaljusto-Munck / Krista Lepik

    Index Scriptorium Estoniae

    Lepik, Krista, 1979-

    2010-01-01

    Raamatukoguhoidjate infootsingu võistluse eelvoorust, finaalist ja võitjatest. Lisa: Üks küsimus võitjatele. Mis on motiveerinud sind infootsingu võistlusel osalema? Vastavad Krõõt Kaljusto-Munck, Kristi Ütt ja Carolina Schultz

  20. Electronic and Printed Books with and without Adult Support as Sustaining Emergent Literacy

    Science.gov (United States)

    Korat, Ofra; Segal-Drori, Ora; Klien, Pnina

    2009-01-01

    Emergent literacy (EL) enhancement has been the goal of numerous educational programs for years, especially for children from low socioeconomic statuses (LSES) (Snow, 1994; Whitehurst, Zevebergen, Crone, Schultz, Velting, & Fischel, 1999). During the past decade, technology software, including electronic books (e-books), have become…

  1. The power of regression to the mean: a social norm study revisited

    NARCIS (Netherlands)

    Verkooijen, K.T.; Stok, F.M.; Mollen, S.

    2015-01-01

    This research follows up on a study by Schultz et al. (2007), in which the effect of a social norm intervention on energy consumption was examined. The present studies included control groups to examine whether social norm effects would persist beyond regression to the mean. Both studies had a 2

  2. The power of regression to the mean: A social norm study revisited

    NARCIS (Netherlands)

    Verkooijen, K.T.; Stok, F.M.; Mollen, S.

    2015-01-01

    This research follows up on a study by Schultz et al. (2007), in which the effect of a social norm intervention on energy consumption was examined. The present studies included control groups to examine whether social norm effects would persist beyond regression to the mean. Both studies had a 2

  3. Strategies for High-Resolution 3-D Millimeter Wave Imaging.

    Science.gov (United States)

    1987-02-01

    Co-Investigator K.S. Lee - Graduate Student (50%) P. Frangos - Graduate Student (50%) Y. Shen - Graduate Student (50%) K. Schultz - Graduate...period of this report: * P. Frangos (Ph.D.) - "One-Dinensionl Inverse Scattering: Exact Methods and Applications", * C.L. Werner (Ph.D.) - ŗ-D

  4. Interstitial Area Final Range Environmental Assessment, Revision 1

    Science.gov (United States)

    2009-04-01

    water quality concern. Historically, primer components contained mercury in the form of mercury fulminate , but this compound has not been used in...Mitsch, W. J., and J. G. Gosselink, 2000. Wetlands, 3rd Edition. John Wiley & Sons: New York. Schultz, T. J., 1978. Synthesis of social surveys on noise

  5. Protection against Acute Lethal Viral Infections with the Native Steroid Dehydroepiandrosterone (DHEA)

    Science.gov (United States)

    1988-01-01

    of gout , hyperlipemia, and in post-coronary patients Protection Against Viral Inftiom With DHEA 311 [Regelson, 19881. In animal models [Yen, 19771 and...3333. Johnson DA, Schultz LD, Bedigian HG (1982): Immunodeficiency and reticulum cell sarcoma in mice segregating for HRS/J and SJL/J genes . Leukemia

  6. 1982 Federal Acquisition Research Symposium, Integrating Theory and Experience: The Acquisition Research Connection

    Science.gov (United States)

    1982-05-07

    Technology. March 1981. 114(157. 16-17. Guetzkow, Harold, Kotler , Philip, i Schultz, Randall L, Simulation in social and administrative science...07801 Mr. W. L. Armstrong Supervisory Contracting Officer Procurement and Production Directorate (DRSMI-IZ) US Army Missile Command Redstone

  7. Technical efficiency of peasant farmers in northern Ethiopia: a stochastic frontier approach

    NARCIS (Netherlands)

    Gebreegziabher, Z.; Oskam, A.J.; Woldehanna, T.

    2004-01-01

    Empirical works on efficiency of small farmers has been triggered by Schultz's (1964) popular 'poor-but-efficient hypothesis'. Peasant farmers in traditional agricultural settings are reasonably efficient in allocating their resources and they respond positively to price incentives. If farmers are

  8. Interference control in children with first episode major depression : A brief report

    NARCIS (Netherlands)

    van der Meere, Jaap; Börger, Norbert A.; Pirila, Silja; Sallee, Floyed

    2011-01-01

    The ability to deal with sources of conflict, that is, interference control, was evaluated in a group of 11 children with first episode Major Depression and a peer control group. To this end, the Eriksen and Schultz (1979) task was used. Here, the participant is presented with a stimulus that

  9. A Technology Integration Education (TIE) Model: Millennial Preservice Teachers' Motivations about Technological, Pedagogical, and Content Knowledge (TPACK) Competencies

    Science.gov (United States)

    Holland, Denise D.; Piper, Randy T.

    2014-01-01

    Nobel laureates Schultz (1971) and Becker (1964, 1993) reinvigorated the analysis of education investments. Human capital investments that improve cognitive skills for elementary and secondary students have important economic implications. An interdisciplinary, 12-construct technology integration education (TIE) model was developed. The sample…

  10. The content of parthenolide and its yield per plant during the growth of Tanacetum parthenium

    NARCIS (Netherlands)

    Hendriks, H; Anderson-Wildeboer, Y.; Bos, R.; Woerdenbag, H.J.

    During the growth of Tanaceum parthenium (L.) Schultz-Bip. Feverfew, Asteraceae) the percentage of parthenolide was the highest at an early stage (just before the formation of stems), The yield of parthenolide per individual plant gradually increased from about 10 mg at the beginning of the study to

  11. ORIGINAL ARTICLE Value of apparent diffusion coefficient (ADC) in ...

    African Journals Online (AJOL)

    also be used to evaluate the response of cervical carcinoma to treatment. ... biopsy-proven untreated cancer of the cervix that was suitable for ..... Van de Bunt L, Van der Heide UA, Ketelaars M, De Kort GA, Jürgenliemk-Schultz IM.

  12. 76 FR 58277 - Performance Review Board Members

    Science.gov (United States)

    2011-09-20

    .... Cantrell, Patrick H. Conway, Kathleen M. Crosby, John Czajkowski, Cheryl R. Dammons, Michelle S. Davis..., William B. Schultz, Neil Shapiro, Jeremy B. Sharp, George H. Sheldon, Steven D. Silverman, Rebecca T... E. Tyler Jr., Stephen J. Veneruso, Karen V. Walker Bryce, Luis A. Wilmot, Holly J. Wong, Robert K...

  13. Some exact calculations on a chain of spins 1/2 II

    NARCIS (Netherlands)

    Niemeijer, Th.

    1968-01-01

    The chain of spins 1/2 with anisotropic nearest neighbour interaction, known as the X–Y model, which was introduced by Lieb, Schultz and Mattis1) and studied in ref. 2*) in the presence of a constant field along the z axis, is now studied with a small oscillating field superimposed on the constant

  14. “Speaking through the other”

    DEFF Research Database (Denmark)

    Jensen Schleiter, Astridur; Maagaard, Cindie Aaen; Rasmussen, Rasmus Kjærgaard

    2017-01-01

    of external stakeholders, including the press. “While CSR is generally associated with positive corporate values and reflects an organization’s status and activities with respect to its perceived societal obligations, corporate CSR messages have also proven to attract critical attention” (Morsing and Schultz...

  15. Applications of Miniaturized Atomic Magnetic Sensors in Military Systems

    Science.gov (United States)

    2012-10-01

    system - sensors are obscured under traffic cones and laid out in an array depending on the protection scenario; The Operator Control Station tablet PC...T., Peters, M., Sandin, H., Savukov, I., Schultz, L., Urbatis, A., Volegov, P., and Zotev, V., 2010, Ultra-low-field MRI for the detection of

  16. Indian Academy of Sciences Conference Series | Indian Academy of ...

    Indian Academy of Sciences (India)

    Home; Journals; Indian Academy of Sciences Conference Series. PAUL SCHULTZ. Articles written in Indian Academy of Sciences Conference Series. Volume 1 Issue 1 December 2017 pp 51-60 Proceedings of the Conference on Perspectives in Nonlinear Dynamics - 2016. Inferring interdependencies from short time ...

  17. Simplified Analysis Procedures for Flexible Approach Wall Systems Founded on Groups of Piles and Subjected to Barge Train Impact

    Science.gov (United States)

    2012-09-01

    reinforced concrete piles (Figure 2-4a, b, c) can be developed using procedures described in Derecho et al. (1978). The points on the interaction...Instruction Report ITL-94-6. US Army Engineer Waterways Experiment Station, Vicksburg, MS. Derecho , A. T., D. M. Schultz, and M. Fintel. 1978

  18. Mixed Methodology to Predict Social Meaning for Decision Support

    Science.gov (United States)

    2013-09-01

    centered on the appearance of advertisements for pornography on the HoodUp Web site. As with the informational threads, gang affiliation carries...ARMY CERDEC CP&I (PDFs) ATTN RDER- CPM -IM R SCHULTZ ATTN RDER- CPM -IM T TRUONG 2 US ARMY RESEARCH LAB (PDFs) ARO RESEARCH TRIANGLE PARK ATTN

  19. Entartung: Forestillinger om en syg kunst

    DEFF Research Database (Denmark)

    Paldam, Camilla Skovbjerg

    2010-01-01

    Opfattelsen af moderne kunst som noget sygt nåede et klimaks under 1930'ernes og 1940'ernes nazisme. Med udgangspunkt i den tyske arkitekt Paul Schultze-Naumburgs bog Kunst und Rasse (1928) undersøger artiklen argumentationsgangen og genealogien bag den påståede sammenhæng mellem kunst og sygdom...

  20. Saue - Hera ja Heraklese kaitse all / Jüri Kuuskemaa

    Index Scriptorium Estoniae

    Kuuskemaa, Jüri, 1942-

    2003-01-01

    Saue mõisa ajaloost, omanikest, härrastemajast (arhitekt Johann Schultz), selle restaureeritud ja hästi säilinud ruumidest, inglispärasest tagaaiast, barokipäraselt regulaarse kujundusega eesaiast, Heraklese ja jumalanna (Hera, Juno) kujust aias, pargipaviljonist. 12 ill