AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains uncertain.The available data on the hist...AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains uncertain.The available data on the histological changes in NERD and the effect on Hpyloriinfection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpyloriinfection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD.In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of Hpyloriinfection was 70%.Twenty-nine patients out of 50 (58%) were NERD patients.No statistical significance was observed between the H pyloristatus and NERD.The remaining 21 (42%) were diagnosed as follows:13 (26%),6 (12%),2(4%) with esophagitis grade A,B and C respectively.A statistically significant correlation was observed between the Hpylori+ and esophagitis grade A,as well as between Hpylori-and grade B.Biopsies from 2 patients were not included because of insufficient materials.Histologically,a basal zone hyperplasia was found in 47 (97.91%) patients,alterations of glycogen content in 47 (97.91%),papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%),chronic inflammation in 21 (43.75%),infiltration with eosinophils,neutophils and T-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%) respectively.No correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION:Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease.Moreover,Hpyloriinfection may not act as an important factor in patients with NERD.展开更多
AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients. METHODS: Thirty constipated elderly patients ...AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients. METHODS: Thirty constipated elderly patients were randomly selected from two nursing homes. They were instructed to use the device once daily for 20 min. Rate of bowel movements, volume and consistency of stool and the use of laxantia were all recorded during a 3-wk baseline period and for 12-wk treatment period. Colonic transit time (CTT) was measured in 13 patients by radiopaque markers during the baseline and at the end of treatment. RESULTS: Bowel movement rate (BM/week) increased from 1.4±0.4 BM/wk during baseline to 3.9±0.8 BM/wk during treatment (P<5.0×10-7). Stool amount that was 'low' in 30 patients during baseline increased in 21 patients at the end of the study period (x2 = 19.048-P= 1.3×10-5). Stool consistency,that was 'hard' in 25 patients and 'soft' in 5 patients during baseline, ameliorated in 23 patients at the end of the study (only 2 patients referred 'hard' stool) (x2 = 21.043-P= 4.0×10-6). The mean baseline CTT measured was 92.3±32.3 h at baseline and decreased to 49.4±31.3 h during the study period (P = 0.000208). No side effects were observed during the study period. CONCLUSION: External mechanical vibration of the abdomen reduced CTT and helped to relieve severe constipation in elderly constipated patients.展开更多
BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis ...BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been elucidated.At the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely unknown.AIM To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver Tx.METHODS In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after 1998.Seventy-three studies were considered eligible.Data concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were retrieved.The Newcastle-Ottawa quality assessment scale appraised the quality of the eligible studies.Effect estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and Laird.Subgroup,sensitivity analysis,and meta-regressions were applied to assess heterogeneity.RESULTS QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterogeneity(I2=97.5%;95%CI:97.2%-97.8%);both Egger’s and Begg’s tests showed non-significance.QTc was elongated in patients with cirrhosis compared with controls(P<0.001).QTc was longer in patients with Child-Pugh C cirrhosis when compared with Child-Pugh B and A(P<0.001);Child-Pugh B patients presented longer QTc when compared with Child-Pugh A patients(P=0.003).The MELD score was higher in patients with cirrhosis with QTc>440 ms when compared with QTc≤440 ms(P<0.001).No correlation of QTc with age(P=0.693),sex(P=0.753),or etiology(P=0.418)was detected.β-blockers shortened QTc(P<0.001).QTc was prolonged during acute gastrointestinal bleeding(P=0.020).Tx tended to improve QTc(P<0.001).No other sources of QTc heterogeneity were revealed.CONCLUSION QTc is prolonged in cirrhosis independently of sex,age,and etiology but is correlated with severity and affected byβ-blockers and acute gastrointestinal bleeding.QTc is improved after liver Tx.展开更多
文摘AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease,either in non-erosive (NERD) or erosive esophagitis (ERD) remains uncertain.The available data on the histological changes in NERD and the effect on Hpyloriinfection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpyloriinfection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD.In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of Hpyloriinfection was 70%.Twenty-nine patients out of 50 (58%) were NERD patients.No statistical significance was observed between the H pyloristatus and NERD.The remaining 21 (42%) were diagnosed as follows:13 (26%),6 (12%),2(4%) with esophagitis grade A,B and C respectively.A statistically significant correlation was observed between the Hpylori+ and esophagitis grade A,as well as between Hpylori-and grade B.Biopsies from 2 patients were not included because of insufficient materials.Histologically,a basal zone hyperplasia was found in 47 (97.91%) patients,alterations of glycogen content in 47 (97.91%),papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%),chronic inflammation in 21 (43.75%),infiltration with eosinophils,neutophils and T-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%) respectively.No correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION:Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease.Moreover,Hpyloriinfection may not act as an important factor in patients with NERD.
文摘AIM: To evaluate the efficacy of a recently developed device that applies kneading-like motion on the abdomen in improving constipation in elderly long-term care patients. METHODS: Thirty constipated elderly patients were randomly selected from two nursing homes. They were instructed to use the device once daily for 20 min. Rate of bowel movements, volume and consistency of stool and the use of laxantia were all recorded during a 3-wk baseline period and for 12-wk treatment period. Colonic transit time (CTT) was measured in 13 patients by radiopaque markers during the baseline and at the end of treatment. RESULTS: Bowel movement rate (BM/week) increased from 1.4±0.4 BM/wk during baseline to 3.9±0.8 BM/wk during treatment (P<5.0×10-7). Stool amount that was 'low' in 30 patients during baseline increased in 21 patients at the end of the study period (x2 = 19.048-P= 1.3×10-5). Stool consistency,that was 'hard' in 25 patients and 'soft' in 5 patients during baseline, ameliorated in 23 patients at the end of the study (only 2 patients referred 'hard' stool) (x2 = 21.043-P= 4.0×10-6). The mean baseline CTT measured was 92.3±32.3 h at baseline and decreased to 49.4±31.3 h during the study period (P = 0.000208). No side effects were observed during the study period. CONCLUSION: External mechanical vibration of the abdomen reduced CTT and helped to relieve severe constipation in elderly constipated patients.
文摘BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been elucidated.At the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely unknown.AIM To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver Tx.METHODS In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after 1998.Seventy-three studies were considered eligible.Data concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were retrieved.The Newcastle-Ottawa quality assessment scale appraised the quality of the eligible studies.Effect estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and Laird.Subgroup,sensitivity analysis,and meta-regressions were applied to assess heterogeneity.RESULTS QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterogeneity(I2=97.5%;95%CI:97.2%-97.8%);both Egger’s and Begg’s tests showed non-significance.QTc was elongated in patients with cirrhosis compared with controls(P<0.001).QTc was longer in patients with Child-Pugh C cirrhosis when compared with Child-Pugh B and A(P<0.001);Child-Pugh B patients presented longer QTc when compared with Child-Pugh A patients(P=0.003).The MELD score was higher in patients with cirrhosis with QTc>440 ms when compared with QTc≤440 ms(P<0.001).No correlation of QTc with age(P=0.693),sex(P=0.753),or etiology(P=0.418)was detected.β-blockers shortened QTc(P<0.001).QTc was prolonged during acute gastrointestinal bleeding(P=0.020).Tx tended to improve QTc(P<0.001).No other sources of QTc heterogeneity were revealed.CONCLUSION QTc is prolonged in cirrhosis independently of sex,age,and etiology but is correlated with severity and affected byβ-blockers and acute gastrointestinal bleeding.QTc is improved after liver Tx.
