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Mena Mikhail, George Crowley, Syed Hissam Haider, Arul Veerappan, Rachel Lam, Angela Talusan, Emily Clementi, Dean Ostrofsky, Sophia Kwon, Anna Nolan
The prevalence of non-cardiac chest pain (NCCP) ranges from 13-33%. A majority of those presenting with a chief complaint of chest pain are found to have a diagnosis of NCCP. Aerodigestive diseases are a cause of NCCP, and billions of dollars are spent annually on the treatment of NCCP. Furthermore, NCCP can cause significant psychological stress. NCCP is commonly diagnosed when patients have chest pain despite a normal cardiac evaluation. The leading cause of NCCP is gastro-oesophageal reflux disease (GORD)...
December 2018: EMJ Gastroenterol
Lorenzo Fornaro, Caterina Vivaldi, Annamaria Parnofiello, Clara Ugolini, Giuseppe Aprile, Giovanna De Maglio, Irene Pecora, Donatella Iacono, Francesca Crivelli, Silvia Catanese, Giovanni Gerardo Cardellino, Monica Lencioni, Enrico Vasile, Francesca Salani, Mario Clerico, Lorenzo Calvetti, Alfredo Falcone, Gianpiero Fasola, Gabriella Fontanini, Francesco Montagnani
BACKGROUND: HER2 is the only validated predictive biomarker in gastro-oesophageal carcinoma (GOC). However, several factors, such as heterogeneity in protein expression, shortage of evaluable tumour tissue and need for quick target assessment, underline the usefulness of a pre-screening tool in order to anticipate HER2 status. METHODS: Data from 723 consecutive GOC analysed for HER2 at four Italian Institutions were collected. HER2 positivity was defined as 3+ by immunohistochemistry (IHC) or 2+ with gene amplification by in situ hybridisation (ISH)...
February 12, 2019: British Journal of Cancer
Ran Dong, Xianghuai Xu, Li Yu, Hongmei Ding, Jing Pan, Yiming Yu, Cuiqin Shi, Qiang Chen, Mengru Zhang, Hanjing Lv, Zhongmin Qiu
BACKGROUND: Neuromodulators are considered potential therapeutic options for refractory gastro-oesophageal reflux-induced chronic cough. AIM: To compare the efficacy of gabapentin and baclofen in patients with suspected refractory gastro-oesophageal reflux-induced chronic cough. METHODS: Two hundred and thirty-four patients with suspected refractory gastro-oesophageal reflux-induced chronic cough, who failed an 8-week course of omeprazole and domperidone, were recruited into the open-labelled study and randomly assigned to receive either gabapentin (maximum daily dose of 900 mg) or baclofen (maximum daily dose of 60 mg) for 8 weeks as add-on therapy to the previous treatment...
February 10, 2019: Alimentary Pharmacology & Therapeutics
Peter M George, Caroline M Patterson, Anna K Reed, Muhunthan Thillai
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with a poor prognosis. Lung transplantation is the only intervention shown to increase life expectancy for patients with IPF, but it is associated with disease-specific challenges. In this Review, we discuss the importance of a proactive approach to the management of IPF comorbidities, including gastro-oesophageal reflux, pulmonary hypertension, coronary artery disease, and malignancy. With a donor pool too small to meet demand and unacceptably high mortality on transplant waiting lists, we discuss different systems used internationally to facilitate organ allocation...
February 6, 2019: Lancet Respiratory Medicine
J F Christensen, C Simonsen, A Banck-Petersen, S Thorsen-Streit, A Herrstedt, S S Djurhuus, C Egeland, C E Mortensen, S C Kofoed, T S Kristensen, R S Garbyal, B K Pedersen, L B Svendsen, P Højman, P de Heer
Background: Neoadjuvant chemotherapy or chemoradiotherapy is used widely before tumour resection in cancer of the gastro-oesophageal junction (GOJ). Strategies to improve treatment tolerability are warranted. This study examined the safety and feasibility of preoperative exercise training during neoadjuvant treatment in these patients. Methods: Patients were allocated to a standard-care control group or an exercise group, who were prescribed standard care plus twice-weekly high-intensity aerobic exercise and resistance training sessions...
February 2019: BJS open
Charles S Fuchs, Kohei Shitara, Maria Di Bartolomeo, Sara Lonardi, Salah-Eddin Al-Batran, Eric Van Cutsem, David H Ilson, Maria Alsina, Ian Chau, Jill Lacy, Michel Ducreux, Guillermo Ariel Mendez, Alejandro Molina Alavez, Daisuke Takahari, Wasat Mansoor, Peter C Enzinger, Vera Gorbounova, Zev A Wainberg, Susanna Hegewisch-Becker, David Ferry, Ji Lin, Roberto Carlesi, Mayukh Das, Manish A Shah
BACKGROUND: VEGF and VEGF receptor 2 (VEGFR-2)-mediated signalling and angiogenesis can contribute to the pathogenesis and progression of gastric cancer. We aimed to assess whether the addition of ramucirumab, a VEGFR-2 antagonist monoclonal antibody, to first-line chemotherapy improves outcomes in patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma. METHODS: For this double-blind, randomised, placebo-controlled, phase 3 trial done at 126 centres in 20 countries, we recruited patients aged 18 years or older with metastatic, HER2-negative gastric or gastro-oesophageal junction adenocarcinoma, an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and adequate organ function...
February 1, 2019: Lancet Oncology
Felicity Newell, Kalpana Patel, Michael Gartside, Lutz Krause, Sandra Brosda, Lauren G Aoude, Kelly A Loffler, Vanessa F Bonazzi, Ann-Marie Patch, Stephen H Kazakoff, Oliver Holmes, Qinying Xu, Scott Wood, Conrad Leonard, Guy Lampe, Reginald V Lord, David C Whiteman, John V Pearson, Katia Nones, Nicola Waddell, Andrew P Barbour
BACKGROUND: Oesophageal adenocarcinoma (EAC) incidence is increasing and has a poor survival rate. Barrett's oesophagus (BE) is a precursor condition that is associated with EAC and often occurs in conjunction with chronic gastro-oesophageal reflux, however many individuals diagnosed with BE never progress to cancer. An understanding of the genomic features of BE and EAC may help with the early identification of at-risk individuals. METHODS: In this study, we assessed the genomic features of 16 BE samples using whole-genome sequencing...
February 4, 2019: BMC Medical Genomics
Philip Taramarcaz, Jörg D Seebach, Leila Motteli, Charles Benaïm, Adrien J-P Schwitzguebel
AIMS: Vocal cord dysfunction (VCD) is characterised by paradoxical inspiratory laryngeal motion and is often misdiagnosed as asthma. Definitive diagnosis of VCD is difficult, because laryngoscopy is positive only during symptomatic episodes or upon provocation with exercise or inhaled irritants. The aims of the study were to better characterise the symptomatology of patients with VCD and to evaluate the potential usefulness of less-invasive diagnostic tools, namely provocation tests and spirometry...
December 3, 2018: Swiss Medical Weekly
Sree Krishna Venuthurupalli, Helen Healy, Robert Fassett, Anne Cameron, Zaimin Wang, Wendy Elizabeth Hoy
BACKGROUND: Chronic Kidney Disease, Queensland (CKD.QLD) is a multidisciplinary, collaborative research platform for CKD in Queensland. All public renal services contribute towards the CKD Registry, including Toowoomba Hospital which is a referral hospital for Darling Downs Health (DDH) serving largely regional population in Queensland. We aim to present the profile of the CKD cohort recruited to CKD.QLD Registry from Toowoomba Hospital, the first comprehensive report on pre-dialysis population from regional Australia METHODS: Study subjects were patients in the DDH service who consented to be included in the CKD...
January 20, 2019: Nephrology
Xiangyu Meng, Lu Wang, Yan Zhao, Bo Zhu, Ting Sun, Tao Zhang, Xiaohu Gu, Zhichao Zheng
Background: Neoadjuvant chemoradiation (CRT) remains controversial in the treatment of the oesophagus or gastro-oesophageal junction (GOJ) carcinomas. Methods: We conducted a meta-analysis to assess the efficacy and safety of Neoadjuvant CRT plus surgery comparing with neoadjuvant CT plus surgery or surgery alone. Feasible studies were searched from electronic databases. The outcomes of survival, R0 resection rate and adverse effects were analyzed. The outcomes were measured with relative risk (RR) and odds ratio(OR)...
2019: Journal of Cancer
A K Shrestha, M Joshi, L DeBono, K Naeem, S Basu
PURPOSE: Repair of giant paraoesophageal herniae (GPEH) is technically challenging and requires significant experience in advanced foregut surgery. Controversy continues on suture versus mesh cruroplasty with the most recent systematic review and meta-analysis putting the onus on the operating surgeon. Study aim was to review whether the biological prosthesis (non-cross-linked bovine pericardium and porcine dermis) and the technique adopted for patients with GPEH had an influence on clinical and radiological recurrences...
January 19, 2019: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Sang-Nee Tan, Sai-Peng Sim
BACKGROUND: It has been found that chronic rhinosinusitis (CRS) increases the risk of developing nasopharyngeal carcinoma (NPC). CRS can be caused by gastro-oesophageal reflux (GOR) that may reach nasopharynx. The major component of refluxate, bile acid (BA) has been found to be carcinogenic and genotoxic. BA-induced apoptosis has been associated with various cancers. We have previously demonstrated that BA induced apoptosis and gene cleavages in nasopharyngeal epithelial cells. Chromosomal cleavage occurs at the early stage of both apoptosis and chromosome rearrangement...
January 15, 2019: BMC Medical Genomics
E J Ndebia, A M Sammon
BACKGROUND: Recent studies in rural Eastern Cape Province, South Africa, have shown an increased number of non-acid gastro-oesophageal reflux events, an increase in baseline gastric pH compared with other published series, and evidence suggestive of duodenogastric reflux. There are no published data on oesophageal pH in this community or in Africa. OBJECTIVES: To ascertain whether oesophageal pH in this rural community is within normal limits. METHODS: We carried out 24-hour oesophageal pH/impedance studies on 91 participants...
October 26, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Marilia Carabotti, Gianluca Esposito, Edith Lahner, Emanuela Pilozzi, Laura Conti, Giulio Ranazzi, Carola Severi, Massimo Bellini, Bruno Annibale
AIM: In patients affected by atrophic body gastritis (ABG) gastro-oesophageal reflux (GER) related symptoms have been reported, despite the presence of hypochlorhydria. OBJECTIVE: Objectives of this single-centre study was to assess in ABG the occurrence of GER-related symptoms and their relationship with histopathologic oesophageal findings. MATERIALS AND METHODS: Fifty-four consecutive patients (20.4%male, 57.6 ± 14 years) undergoing to follow-up for ABG, underwent assessment of GER-related symptoms and gastroscopy with multiple gastric and oesophageal biopsies to investigate the presence of microscopic esophagitis (ME)...
January 13, 2019: Scandinavian Journal of Gastroenterology
Sarmed S Sami, Adharsh Ravindran, Allon Kahn, Diana Snyder, Jose Santiago, Jacobo Ortiz-Fernandez-Sordo, Wei Keith Tan, Ross A Dierkhising, Julia E Crook, Michael G Heckman, Michele L Johnson, Ramona Lansing, Krish Ragunath, Massimiliano di Pietro, Herbert Wolfsen, Francisco Ramirez, David Fleischer, Kenneth K Wang, Cadman L Leggett, David A Katzka, Prasad G Iyer
OBJECTIVE: Surveillance interval protocols after complete remission of intestinal metaplasia (CRIM) post radiofrequency ablation (RFA) in Barrett's oesophagus (BE) are currently empiric and not based on substantial evidence. We aimed to assess the timeline, location and patterns of recurrence following CRIM to inform these guidelines. DESIGN: Data on patients undergoing RFA for BE were obtained from prospectively maintained databases of five (three USA and two UK) tertiary referral centres...
January 11, 2019: Gut
Tadayuki Oshima, Eitatsu Arai, Masato Taki, Takashi Kondo, Toshihiko Tomita, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
BACKGROUND: Proton pump inhibitors (PPIs) are widely used to treat gastro-oesophageal reflux disease (GORD). However, the onset of action is considered slow and PPIs cannot completely block acid secretion at night. A new potassium-competitive acid blocker (P-CAB) can rapidly block acid secretion. However, whether this P-CAB can relieve GORD symptoms quickly and adequately soon after starting treatment is unknown. AIM: To determine how rapidly vonoprazan and lansoprazole provide heartburn relief...
January 2019: Alimentary Pharmacology & Therapeutics
Stefan Gabrielson, Jon A Tsai, Fuat Celebioglu, Magnus Nilsson, Ioannis Rouvelas, Mats Lindblad, Annie Bjäreback, Artur Tomson, Rimma Axelsson
BACKGROUND: In current best practise, curatively intended treatment for oesophageal cancer usually consists of neoadjuvant chemo-radiotherapy (nCRT) or perioperative chemotherapy, and oesophagectomy. Sentinel Lymph Node Biopsy (SLNB) has the potential to identify patients without lymph node metastases and thus improve the staging accuracy and influence treatment. The impact of neoadjuvant treatment on the lymphatic drainage of oesophageal cancers and subsequently the SLNB procedure in this tumour type has previously not been well studied...
December 18, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Kalinne Kelly Lima Gadelha, Francisco José Batista-Lima, Daniel Maia Nogueira de Oliveira, Emanuella Feitosa de Carvalho, Daniel Sifrim, Armênio Aguiar Dos Santos, Pedro Jorge Caldas Magalhães
NEW FINDINGS: What is the central question of this study? Is the responsiveness of isolated segments of the rat oesophagus to contractile or relaxant stimuli susceptible to acute luminal exposure of the oesophagus to an acid solution that contains pepsin and bile salt? What is the main finding and its importance? The study reveals that luminal acidity is an important factor that disrupts barrier function in the oesophagus to allow the diffusion of noxious agents, such as bile acid, that alter the contractile status of the oesophageal body, even in the absence of inflammation...
November 22, 2018: Experimental Physiology
Wim A Wuyts, Caroline Dahlqvist, Hans Slabbynck, Marc Schlesser, Natacha Gusbin, Christophe Compere, Sofie Maddens, Klaus-Uwe Kirchgaessler, Karen Bartley, Benjamin Bondue
Introduction: PROOF (a Prospective Observational Registry to Describe the Disease Course and Outcomes of Idiopathic Pulmonary Fibrosis) is an ongoing, observational registry initiated in 2013 with the aim of collecting real-world data from patients with idiopathic pulmonary fibrosis (IPF). Here, we present comprehensive baseline data, which were collected from patients on registry inclusion. Methods: Patients with IPF were enrolled across eight centres in Belgium and Luxembourg...
2018: BMJ Open Respiratory Research
Shao-Hua Xie, Jesper Lagergren
The two main histological subtypes of oesophageal cancer, squamous cell carcinoma and adenocarcinoma, have distinct risk factor profiles. For oesophageal squamous cell carcinoma, tobacco smoking and excess alcohol use are the main risk factors. For adenocarcinoma, gastro-oesophageal reflux disease and obesity are main risk factors, whereas tobacco smoking is a moderately strong risk factor and infection with Helicobacter pylori decreases the risk. Dietary factors may influence the risk of both types of oesophageal cancer...
October 2018: Best Practice & Research. Clinical Gastroenterology
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