Navegando por Palavras-chave "Gastroesophageal reflux disease"
Agora exibindo 1 - 4 de 4
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Avaliaçãoobjetiva da doença do refluxo gastroesofágico em portadores de fibrilação atrial paroxística(Universidade Federal de São Paulo (UNIFESP), 2018-11-26) Coutinho, Enia Lucia [UNIFESP]; Paola, Angelo Amato Vincenzo de [UNIFESP]; Fernandes, Fernando Augusto Mardiros Herbella [UNIFESP]; http://lattes.cnpq.br/4035568020554599; http://lattes.cnpq.br/6259836166380719; http://lattes.cnpq.br/2009601020813967; Universidade Federal de São Paulo (UNIFESP)Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Some evidence shows that gastroesophageal reflux disease (GERD) may be a trigger for paroxysmal AF (PAF). Most of the previous studies that correlated GERD and AF used questionnaires to diagnose GERD, not an objective evaluation. This study aims to evaluate in patients with PAF: (a) accuracy of symptoms to diagnose GERD; (b) prevalence of GERD; and (c) temporal correlation between cardiac arrhythmia and reflux. Methods: Twentytwo patients (59% females, mean age 68 years) with PAF underwent esophageal manometry followed by ambulatory pH monitoring and concurrent Holter. Eight (36%) patients had GERD symptoms. Patients were grouped as GERD+ or GERDbased on the DeMeester score. Temporal correlation between arrhythmia and reflux was recorded. Results: Six (27%) patients were GERD+. Symptoms had sensitivity and specificity of 50 and 70%, respectively, for the diagnosis of GERD. Episodic AF occurred in one patient only (GERD). There were 23 episodes of AF during the test with 14% correlation with reflux. Persistent AF during the period of the test was found in five patients (60% GERD?). Conclusions: Our results show: (a) Symptoms have a low accuracy for the diagnosis of GERD; (b) the prevalence of GERD in patients with PAF is low; and (c) temporal correlation between episodes of reflux and cardiac arrhythmia is low. Key Words: Gastroesophageal reflux – paroxistic atrial fibrillation – esophageal pH monitoring – gastroesophageal reflux disease.
- ItemAcesso aberto (Open Access)Gastroesophageal reflux disease: exaggerations, evidence and clinical practice(Soc Brasil Pediatria, 2014-03-01) Ferreira, Cristina Targa; Carvalho, Elisa de; Sdepanian, Vera Lucia [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Vieira, Mario Cesar; Silva, Luciana Rodrigues; Hosp Crianca Santo Antonio; Univ Fed Ciencias Saade Porto Alegre; Dept Gastroenterol; Hosp Base Distrito Fed; Hosp Crianca Brasilia; Universidade de Brasília (UnB); Dept Pediat Gastroenterol; Universidade Federal de São Paulo (UNIFESP); Hosp Israelita Albert Einstein; Pontificia Univ Catolica Parana; Hosp Pequeno Principe; Universidade Federal da Bahia (UFBA); Acad Brasileira PediatObjective: 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.Data source: a search was conducted in the MEDLINE, Pub Med, 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.Data synthesis: 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.Conclusions: 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. (C) 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
- ItemSomente MetadadadosImportance of esophageal manometry and pH monitoring for the evaluation of otorhinolaryngologic (ENT) manifestations of GERD. A multicenter study(Springer, 2016) Herbella, Fernando Augusto Mardiros [UNIFESP]; Andolfi, Ciro; Vigneswaran, Yalini; Patti, Marco G.; Pinna, Bruno de Rezende [UNIFESP]Patients with otorhinolaryngologic (ear, nose, and throat-ENT) symptoms attributed to gastroesophageal reflux disease (GERD) are usually treated with medication based on the findings of nasal endoscopy and laryngoscopy only. This study aims to determine sensitivity and specificity of symptoms, nasal endoscopy, and laryngoscopy for the diagnosis of GERD as compared to pH monitoring. We studied 79 patients (mean age 53 years, 38 % males) in whom ENT symptoms were assumed to be secondary to GERD. All patients underwent a transnasal laryngoscopy by the ENT team and upper endoscopy and esophageal function tests by the surgical team. GERD was defined by a pathological pH monitoring. Pathologic reflux by pH monitoring was documented in 36 of the 79 patients (46 %), with a mean DeMeester score of 44. In 25 of the 36 patients (69 %), distal and proximal reflux was present. Among patients with negative pH monitoring, one patient was diagnosed with achalasia. ENT symptom sensitivity for globus, hoarseness and throat clearing was respectively 11, 58, and 33 %
- ItemSomente MetadadadosInhaled 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)(Springer, 2016) Del Grande, Leonardo de Mello [UNIFESP]; Herbella, Fernando Augusto Mardiros [UNIFESP]|Bigatao, Amilcar Marcelo [UNIFESP]; Jardim, Jose Roberto [UNIFESP]; Patti, Marco G.Background 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. Aims This study aims to evaluate the effect of inhaled beta agonist bronchodilators on the trans-diaphragmatic pressure gradient and the esophagogastric barrier. Methods 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. Results 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. Conclusion 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.