Reflux Research Papers - Academia.edu (original) (raw)

Para las personas que sufren de Gastritis, sea cual sea su tipo y antigüedad, la nutrición es fundamental. La mayoría de las personas que tienen o han tenido un problema de salud estomacal o sufran de inflamación, Gastritis o ulceras... more

Para las personas que sufren de Gastritis, sea cual sea su tipo y antigüedad, la nutrición es fundamental.
La mayoría de las personas que tienen o han tenido un problema de salud estomacal o sufran de inflamación, Gastritis o ulceras deben implementar un cambio en su alimentación, pues es este el factor más importante para alcanzar la salud digestiva
y la salud en general.

1-6 Program Studi S1 Farmasi Sekolah Tinggi Ilmu Kesehatan Bhakti Mandala Husada Slawi, Jl. Cut Nyak Dhien No.16 Kalisapu, Slawi, Kabupaten Tegal Telp/Fax (0283) 6197570 ABSTRAK Telah dilakukan ekstraksi dengan metode refluks pada teh... more

1-6 Program Studi S1 Farmasi Sekolah Tinggi Ilmu Kesehatan Bhakti Mandala Husada Slawi, Jl. Cut Nyak Dhien No.16 Kalisapu, Slawi, Kabupaten Tegal Telp/Fax (0283) 6197570 ABSTRAK Telah dilakukan ekstraksi dengan metode refluks pada teh hitam (Camellia sinensia) dan dilanjutkan dengan isolasi kafein dengan metode mikrosublimasi, hasil kristal isolasi dilakukan identifikasi senyawa kafein dengan Kromatografi Lapis Tipis (KLT) dan Spektrofotometri Uv-Vis. Hasil isolasi berupa kristal berwarna putih diuji kualitatif dengan metode kromatografi lapis tipis (KLT) menggunakan fase gerak kloroform:etanol (99:1). Hasil uji kualitatif kromatografi lapis tipis (KLT) positif mengandung senyawa kafein terlihat dari bercak berpedar biru yang nampak pada panjang gelombang 254 nm, kristal hasil isolasi diperoleh nilai Rf 0,225 dan HRf 22,5 sejajar dengan bercak kafein standar dengan nilai Rf 0,237 dan HRf 23,7 sedangkan nilai HRx 94,9. Pada uji kualitatif menggunakan spektrofotometer Uv-Vis didapat 2 peak yang menandakan masih adanya senyawa lain yang terkandung dalam kristal hasil isolasi yang dihasilkan. Panjang gelombang maksimal kristal hasil isolasi pada spektrofotometer Uv-Vis sebesar 273,0 nm dan 206,8 nm sedangkan panjang gelombang maksimal standar kafein 273,5 yang menandakan bahwa kristal hasil isolasi terdapat senyawa kafein. Kata Kunci : kafein, daun teh hitam, KLT, spektofotomteri Uv-Vis.

A previous anecdotal survey of acid reflux patients (Aspiration of Upper Oesophageal Reflux – August 2014, Robinson C) had identified over 14 extra-oesophageal reflux symptoms evinced extensively amongst acid refluxers. Based on those... more

A previous anecdotal survey of acid reflux patients (Aspiration of Upper Oesophageal Reflux – August 2014, Robinson C) had identified over 14 extra-oesophageal reflux symptoms evinced extensively amongst acid refluxers. Based on those findings, this study sought to confirm the prevalence of those symptoms and the efficacy of Acid Suppressant Medication and Anti-Reflux Surgery to manage them. Conclusion. Two thirds of patients on ASM still suffered with symptoms of EOR whilst ARS reduced symptoms by 57%. Recommendation: Patients predominantly exhibiting reflux symptoms should be considered for anti-reflux intervention rather than continued acid suppressant medication. Methodology Three parallel surveys were set up targetting different patient groups but using the same questions based on a rationalisation of the symptom list established by the 2014 study into 8 symptom groups concentrating on throat, chest, ears, eyes, nose and mouth manifestations. Surveys were set up using Survey Monkey and targetted at different Facebook groups. Analyses and results Survey 1 targetted refluxers from the " Acid Reflux / GERD /LPR " Facebook support group who didn't use daily pre-emptive medication but who may use occasional on-demand antacids as and when required. Over the collection period, 51 responses were garnered. As will be seen in Table 1, throat symptoms were most commonly identified with 63% reporting hoarseness, sore throat, loss of voice, throat clearing as a symptom. The prevalence of the other symptom categories may be seen in table 1: 45% reporting globus, 43% post nasal drip, sinusitis of catarrh, 33% bad breath or taste in mouth, 31% dry or gritty eyes, 31% ear problems: waxing, glue ear, tinnitus or dizziness, 27% chest complaints, cough or asthma like symptoms and 22% dental problems. Survey 2 targetted refluxers using daily medication from the " Barretts Esophagus Awareness " Facebook group. An initial question identified their usage of H2 blockers or Proton Pump Inhibitors at different doses. The maximum 100 responses were collected within 24 hours. Of those, 5 relied on H2 blockers, 13 on low dose PPI, 44 on high dose PPI (with 2 using H2 blockers to supplement) and 37 on high dose PPI (with 4 using H2 blockers to supplement). (A medium dose was identified as 20mg omeprazole = 30mg lansoprazole = 40mg pantoprazole = 20mg rabeprazole = 20mg esomeprazole = 30mg dexlansoprazole with anything less regarded as low dose and anything more as high dose.)

The multivessel batch column consists of a reboiler, several column sections, intermediate vessels and a condenser vessel. This configuration provides a generalization of previously proposed batch-distillation schemes, including the... more

The multivessel batch column consists of a reboiler, several column sections, intermediate vessels and a condenser vessel. This configuration provides a generalization of previously proposed batch-distillation schemes, including the inverted column and the middle-vessel column. The total reflux operation of the multivessel batch-distillation column was presented recently, and the main contribution of this article is to propose a simple feedback control strategy for its operation. We propose to adjust the vessel holdups indirectly by manipulating the reflux flow out of each vessel to control the temperature at some location in the column section below. The feasibility of this strategy is demonstrated by simulations.

This paper presents the results of the functionalization of Brazilian São Simão kaolinite with pyridine-2-carboxylic and pyridine-2,6-dicarboxylic acids. The functionalization involved refluxing of the pyridine-carboxylic acid in the... more

This paper presents the results of the functionalization of Brazilian São Simão kaolinite with pyridine-2-carboxylic and pyridine-2,6-dicarboxylic acids. The functionalization involved refluxing of the pyridine-carboxylic acid in the presence of kaolinite previously intercalated with dimethyl sulfoxide; both acids effectively displaced dimethyl sulfoxide from the clay interlayer. The resulting materials were characterized by X-ray diffraction, thermal analysis, infrared absorption spectroscopy, and C and N elemental analysis. The X-ray diffractograms revealed the incorporation of the acid molecules into the interlayer space of kaolinite. The thermogravimetric curves of the kaolinite samples functionalized with the pyridine-carboxylic acids indicated that the materials were thermally stable up to 300 °C. The displacements of the bands due to interlayer hydroxyls in the infrared absorption spectra also confirmed the functionalization of the kaolinite with the pyridine-carboxylic acids.Kaolinite, previously intercalated with dimethylsulfoxide, has been successfully functionalized with picolinic acids (pyridine-2-carboxylic and pyridine-2,6-dicarboxylic acids).

PURPOSE: Despite the benefits of the minimally invasive endoscopic treatment for vesicoureteral reflux (VUR) it has a major drawback which is low success rate in high grade VUR. For overcoming this problem, we introduce a new modified... more

PURPOSE: Despite the benefits of the minimally invasive endoscopic treatment for vesicoureteral reflux (VUR) it has a major drawback which is low success rate in high grade VUR. For overcoming this problem, we introduce a new modified technique of endoscopic treatment called periureteral injection technique (PIT).
MATERIALS AND METHODS: In a prospective study a total of 37 ureters in 19 boys and 14 girls were treated, including 3 bilateral cases. Of 37 units, 30 (81.1%) had grade IV and 7 (18.9%) had grade V primary VUR (18 right, 13 left and 3 bilateral units). Subureteral injection of Vantris(®) was done at the 5-o'clock and 7-o'clock positions in which the direction of injecting needles were almost parallel. Pre- and post-operative evaluation included urinalysis, urinary tract ultrasonography, voiding cystourethrography (VCUG), dimercaptosuccinic acid scan and urodynamic studies.
RESULTS: The median age was 38 months (range 8-125). At 6 months follow up period confirmed with VCUG, the VUR has been disappeared in 34 (91.8%) units and 3 units [2 (5.4%) grade II and 1 (2.7%) had grade III)] had downgraded VUR. Complications included early fever due to urinary tract infection in 1 children, transient dysuria in 2 patients and low back pain in one patient (Summary Table).
CONCLUSION: The success rate of PIT for treatment of high grade VUR is high. However, further studies with more patients and longer follow up periods are needed to draw final conclusion.

After oral gavage dosing of rats, reflux may occur, resulting in serious respiratory effects and mortality. Published information on gavage-related reflux is limited, as it has not yet been a focus of research. Nevertheless, it represents... more

After oral gavage dosing of rats, reflux may occur, resulting in serious respiratory effects and mortality. Published information on gavage-related reflux is limited, as it has not yet been a focus of research. Nevertheless, it represents a recurrent challenge in daily toxicology practice of oral gavage dosing. The absence of clear guidance and criteria for the identification and management of reflux-induced effects can limit the ability to properly interpret toxicity study results. The review presented herein includes an overview of experimental data from gavage studies in rats, in which reflux was observed, and provides a comprehensive analysis of the literature on reflux in general and the different potential pathways contributing to gavage-related reflux in rats. The article aims to increase the awareness and understanding of the pathogenesis of gavage-related reflux and provides guidance on identification of potential risk factors, as well as interpretation of histological chan...

Physicians are often asked to diagnose and treat infants with clinical signs of gastroesophageal reflux (GER) symptoms and in extreme cases gastroesophageal reflux disease (GERD). Some infants are left to work out their pain,... more

Physicians are often asked to diagnose and treat infants with clinical signs of gastroesophageal reflux (GER) symptoms and in extreme cases gastroesophageal reflux disease (GERD). Some infants are left to work out their pain, regurgitation and vomiting until they outgrow the symptoms while others may undergo expensive, invasive endoscopic procedures in the operating room under general anesthesia. Initial treatment is often for infants to be placed on prescription adult acid reflux medications, which have limited benefits [1]. Drugs prescribed include: H-2 blockers such as ranitidine (Zantac), a proton pump inhibitor such as omeprazole (Prilosec) or lansoprazole (Prevacid). TOTS may cause aerophagia, a condition where the infant's latch onto the mother's breast or bottle allows the infant to swallow excessive amounts of air into the stomach during feeding. This aerophagia may be responsible for symptoms mimicking GER or GERD [2]. When these infants are examined for symptoms of GER the differential diagnosis of tethered oral tissues (TOTS) may not be addressed [3]. Tethered oral tissues may involve ankyloglossia (tongue-tied), maxillary and /or mandibular frenum lip-ties and in some instances buccal frenum ties. These tethered oral tissues (TOTS) prevent the infant from achieving a good seal onto the breast and or bottle with the resulting ingestion of excessive amounts of air. Background: When assessing infants presenting with gastroesophageal reflux symptoms, aerophagia secondary to tethered oral tissues (tongue-ties ,Lip-ties) should be considered in the differential diagnosis since the release of these tissues may eliminate the need for invasive gastrointestinal investigations and pharmacologic treatment of gastroesophageal reflux. Patient Pool: 340 infants ranging from 1 week to 3 months were referred for the evaluation and release of lingual and maxillary lips which were interfering with infant's ability to achieve a good seal and latch onto the mother's breast of infant bottle .The survey the parents completed indicated that 208 or 61% of the infants had signs of gastroesophageal reflux (GER) such as; vomiting, regurgitation, inability to sleep lying supine, fussiness, crying after nursing and morning congestion. Of the 208 infants 40% (83 infants) were or had been treated for GER with pharmacologic medications such as proton pump inhibitors or H2 blockers without any resolution of the symptoms. Findings: All of the infants presenting with these signs and symptoms underwent laser revisions of the tethered attachments. Upon completion of the procedure and at a 48 hour post-surgical follow-up discussion with the parents 93% (194 infants) of the infants showed immediate improvements and were able to breastfeed successfully without signs or symptoms of GER. Survey returned at the end of two weeks post-surgery had similar results Conclusion: Infants presenting with signs of GER should also be evaluated for restrictive tethered oral tissues (TOTS) such as ankyloglossia, lip and buccal ties. If they are present, strong consideration should be given to the release of these tissues as an initial approach. This may eliminate the need for pharmacologic treatment of GER.

Intersalation reactions of the complexes [Ni(L-L)(3)]SO(4) and [Ni(L-L)(3)]Cl(2) (L-L=1,10-phenanthroline (phen), 2,2'-bipyridyl (bpy)), with Na-montmorillonite carried out under different dynamic conditions such as ultrasonic... more

Intersalation reactions of the complexes [Ni(L-L)(3)]SO(4) and [Ni(L-L)(3)]Cl(2) (L-L=1,10-phenanthroline (phen), 2,2'-bipyridyl (bpy)), with Na-montmorillonite carried out under different dynamic conditions such as ultrasonic irradiation, refluxing, autoclaving, and vigorous stirring showed that under ultrasonic irradiation, maximum adsorption of the metal complexes occurred within a period of 30 min. Metal complexes containing the phen ligand showed higher adsorption than those containing bpy. Maximum adsorption up to about three times the cation exchange capacity (CEC) of the clay was observed. Aggregated (basal spacing d(001) 12.5 Å) Na-montmorillonite, in treatment with a higher amount (>CEC) of metal complexes, formed monolayered (basal spacing d(001) 17.6 Å) species, while with predispersed clay, bilayered (basal spacing d(001)>28 Å) or pseudo-trilayer (basal spacing d(001)>32 Å) species were formed. The bilayered species were thermally stable up to 250 degrees C...

Background: Extraesophageal reflux (EER) is a heterogeneous disease, caused by the regur-gitation of gastroduodenal contents into the larynx. The Upper Esophageal Sphincter (UES) Assist Device is a novel medical device designed to prevent... more

Background: Extraesophageal reflux (EER) is a heterogeneous disease, caused by the regur-gitation of gastroduodenal contents into the larynx. The Upper Esophageal Sphincter (UES) Assist Device is a novel medical device designed to prevent gastroduodenal reflux into the laryngopharynx. Objective: A multicenter prospective study assessing safety and effectiveness of the UES Assist Device in patients with EER. Methods: Patients with Reflux Symptom Index (RSI) >13 were enrolled. The device was fit and adjusted to at least 20 mmHg applied external cricoid pressure. The primary effectiveness end-point was reduction in RSI at 4-weeks compared to baseline. 36-Item Short Form Health Survey or SF-36 ® Health Survey (SF-36), patient and physician satisfaction, and Functional Outcomes of Sleep Questionnaire (FOSQ) were secondary end-points. Safety was based on reported adverse reactions. Results: Eighty-nine of 95 patients completed the study [mean(Standard Deviation (SD)) age=48.8(+/-13.7); mean(SD) Body Mass Index (BMI)=25.5(+/-4.2); 69.5% female, 81.1% Caucasian]. Most common troublesome symptoms included chronic cough (21.3%) and excess mucus/post nasal drip (20.2%). There was a significant (p<0.0001) reduction in median (Intelligence Quotient (IQ)) RSI at 2-and 4-weeks [12.5(8.0-20.0) and 10.0(5.8-16.5), respec-tively] compared to baseline [25.6(21.0-30.0)]. Eighty-two percent (82%) reported improvement greater than 25% with 30.1% having an improvement of 75% or more. 84.7% of patients and 95.2% of providers reported satisfaction. Adverse events were generally mild and transient with no withdrawals due to adverse events. Conclusion: The UES Assist Device is a safe and effective for the treatment of extraesophageal symptoms and may be an alternative for the many patients that do not respond to Proton Pump Inhibitors (PPI) therapy.

Gastroesophageal reflux (GER) occurs in 22-66%of patients with noncardiac chest pain (NCCP). Althoughopen-label investigations have shown beneficial effectsof antireflux therapy in NCCP, no double-blind, prospective, placebo-controlled... more

Gastroesophageal reflux (GER) occurs in 22-66%of patients with noncardiac chest pain (NCCP). Althoughopen-label investigations have shown beneficial effectsof antireflux therapy in NCCP, no double-blind, prospective, placebo-controlled studies havebeen conducted. The purpose of this study was toevaluate the effects of omeprazole compared to placeboin a prospective, double-blind, randomized trial ofpatients with NCCP and GER. Thirty-six consecutivepatients with NCCP and GER documented

Reflux disease continues to be one of the most common pathologies in the world. There is much discussion regarding the mechanism of developing and the variety of possible symptoms. In recent years, the use of new technologies, like... more

Reflux disease continues to be one of the most common pathologies in the world. There is much discussion regarding the mechanism of developing and the variety of possible symptoms. In recent years, the use of new technologies, like high-resolution manometry and pH impedance, brought new insights into this disease. Also, there are emerging therapies that are covering the gap between the patients treated with proton-pump inhibitor (PPI) therapy and those who benefit the most from laparoscopic treatment (hiatal hernia, complications of gastroesophageal reflux disease (GERD). Also, most of them are less invasive than a laparoscopic fundoplication. We present a short review of the treatment options in patients who need more than lifestyle changes and PPI therapy.

Aim The aim of the study was to perform histomorphologic, endoscopic, and radiologic studies of the ileocecal junction (ICJ). A clearer understanding of the anatomical structure of the ICJ may shed some light on its function.... more

Aim The aim of the study was to perform histomorphologic, endoscopic, and radiologic studies of the ileocecal junction (ICJ). A clearer understanding of the anatomical structure of the ICJ may shed some light on its function. Methods Histomorphologic studies were performed in 18 cadavers and radiologic in 22 and endoscopic in 10 healthy volunteers. Morphologic studies were done with the help of

Aim: The marked increase in prevalence of obesity has been associated with an increase in obese patients seeking surgical treatment for refractory gastroesophageal reflux disease (GORD). The management of GORD in such patients remains... more

Aim: The marked increase in prevalence of obesity has been associated with an increase in obese patients seeking surgical treatment for refractory gastroesophageal reflux disease (GORD). The management of GORD in such patients remains contentious with no published guidelines. Methods: A snapshot 9-item online survey was undertaken to elicit professional opinions of UK surgeons regarding the surgical management of refractory GORD in obese patients. Results: Eighty-two percent and 51% of surgeons performed more than 10 anti-reflux procedures and more than 10 bariatric procedures per year, respectively. Nearly 80 of responders would consider laparoscopic fundoplication as the preferred option for management of refractory GORD in patients with body mass index (BMI) of 30-34.9 kg/m 2. In contrast, 58% and 80% would discuss bariatric surgery as an alternative treatment option for refractory GORD in patients with BMI 35-39.9 and ≥ 40 kg/m 2 , respectively. Moreover, a bariatric procedure was considered the preferred option by 74% of respondents for patients with BMI ≥ 40 kg/m 2 with refractory GORD, and by 58% for BMI ≥ 35 patients with refractory GORD and significant comorbidities. Eighty percent of surgeons agreed that laparoscopic Roux en-Y gastric bypass (LRYGB) was the preferred bariatric procedure for the management of obese patients with documented GORD. Conclusion: Our survey demonstrated that amongst UK upper gastrointestinal surgeons, bariatric surgery, specifically LRYGB, was a preferred option for management of patients with a BMI ≥ 35 kg/m 2 and refractory GORD. Updated national guidelines are necessary to inform consensus on the management of GORD in obese patients.