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Journal of Family Medicine and Primary... Apr 2024Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal disorders worldwide. It manifests when the lower esophageal sphincter malfunctions,...
BACKGROUND
Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal disorders worldwide. It manifests when the lower esophageal sphincter malfunctions, causing the stomach's contents to reflux into the esophagus, lead to discomforting symptoms. Heartburn and regurgitation are the typical symptoms of GERD. This study aims to determine the prevalence of GERD and assess its risk factors.
MATERIALS AND METHODS
This cross-sectional study was conducted at IMSIU, Saudi Arabia. An online survey was distributed to the students' email addresses to determine the prevalence of GERD, its related risk factors, and understanding of its symptoms.
RESULTS
One thousand five hundred and thirty-three (1533) students participated in the survey. The prevalence of GERD was 34.6%. The majority (79.7%) of the respondent students had heard of GERD. Stress is believed to be a factor in developing GERD by 35.7% of students. Heartburn was the predominant symptom of GERD (76.2%). No association existed between the socio-demographic traits of those with GERD except for age and academic year.
CONCLUSIONS
It is imperative to raise public awareness of the disorder's characteristics and its modifiable risk factors to prevent the emergence of GERD and its complications.
PubMed: 38827728
DOI: 10.4103/jfmpc.jfmpc_1715_23 -
The World Allergy Organization Journal May 2024Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders... (Review)
Review
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
PubMed: 38827329
DOI: 10.1016/j.waojou.2024.100909 -
Cureus May 2024We present a rare neurocutaneous genetic disorder where patients develop a combination of cerebral dysgenesis, neuropathy, ichthyosis, and keratoderma, commonly known as...
We present a rare neurocutaneous genetic disorder where patients develop a combination of cerebral dysgenesis, neuropathy, ichthyosis, and keratoderma, commonly known as CEDNIK syndrome. It is an autosomal recessive inheritance involving the SNAP29 protein, mapped to the 22q11.2 gene. Phenotypic variation is seen with this disease, with clinical manifestation of developmental milestone delays ranging in severity. With only a handful of documented cases, available research, management of the syndrome, and prognosis are not well established. As CEDNIK syndrome has systemic implications, care coordination between specialists is essential in improving patient outcomes. Particularly important is preventing patients from meeting the criteria of failure to thrive, a commonly reported issue. In this case, we present a four-month-old male with a past medical history of pyloric stenosis status/post pyloromyotomy who has failure to thrive, gastroesophageal reflux disease, profound hypotonia, and delayed progression of developmental milestones. Additionally, the case is complicated by idiopathic pyloric stenosis, further contributing to the patient's failure to thrive. We aim to discuss the pathophysiology of this syndrome, explore the timeline of disease progression, as well as compare our case to the current literature.
PubMed: 38826968
DOI: 10.7759/cureus.59475 -
Heliyon May 2024Persistent cough is one of the most common complications following pulmonary resection, that impairs patients' quality of life and prolongs recovery time. However, a... (Review)
Review
BACKGROUND
Persistent cough is one of the most common complications following pulmonary resection, that impairs patients' quality of life and prolongs recovery time. However, a comprehensive review of persistent cough after pulmonary resection (CAP) has not been performed.
METHODS
A literature search of PubMed/MEDLINE, Web of Science, and Embase database was conducted for persistent-CAP up to June 2023. Subsequent qualitative systematic review focused on definition, risk factors, prevention, and treatment of persistent-CAP.
RESULTS
Persistent-CAP stands as a prevalent postoperative complication subsequent to pulmonary resection procedures. with an incidence of 24.4-55.0 %. Although persistent-CAP has a minor impact on survival, this condition is of critical importance because it presents a major hurdle in recovery after surgery. In this review, we proposed a systemic definition for persistent-CAP based on available evidence and our own data. Several assessment tools used to assess severity of persistent-CAP are also introduced. Risk factors associated with persistent-CAP are explored, including surgical approaches, resection extent, surgical site, lymph node dissection, postoperative gastroesophageal acid reflux, tracheal intubation anesthesia, preoperative comorbidity, and sex among others. Surgical and anesthesia preventions targeting risk factors to prevent persistent-CAP are elaborated. A number of studies have shown that a multidisciplinary approach can effectively relieve persistent-CAP.
CONCLUSIONS
Although the mechanisms underlying persistent-CAP are still unclear, existing studies demonstrated that persistent-CAP is related to surgical and anesthesia factors. Therefore, in the future, prevention and treatment should be developed based on risk factors to overcome the hurdle of persistent-CAP.
PubMed: 38826748
DOI: 10.1016/j.heliyon.2024.e31338 -
Scientific Reports Jun 2024Accumulating evidence from observational studies have suggested an association between gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease... (Meta-Analysis)
Meta-Analysis
Accumulating evidence from observational studies have suggested an association between gastroesophageal reflux disease (GERD) and non-alcoholic fatty liver disease (NAFLD). However, due to that such studies are prone to biases, we imported Mendelian randomization (MR) to explore whether the causal association between two diseases exsit. Hence, we aimed to analysis the potential association with MR. The single nucleotide polymorphisms (SNPs) of GERD were retrieved from the genome-wide association study dataset as the exposure. The SNPs of NAFLD were taken from the FinnGen dataset as the outcome. The relationship was analyzed with the assistance of inverse variance weighted, MR-Egger, and weighted median. We also uitilized the MR-Egger intercept, Cochran's Q test, leave-one-out analysis, MR-PRESSO, and Steiger directionality test to evaluate the robustness of the causal association. The meta-analysis were also implemented to give an overall evaluation. Finally, our analysis showed a causal relationship between GERD and NAFLD with aid of MR and meta-analysis (OR 1.71 95% CI 1.40-2.09; P < 0.0001).
Topics: Non-alcoholic Fatty Liver Disease; Humans; Gastroesophageal Reflux; Mendelian Randomization Analysis; Polymorphism, Single Nucleotide; Genome-Wide Association Study; Genetic Predisposition to Disease
PubMed: 38824176
DOI: 10.1038/s41598-024-63646-z -
BMC Surgery May 2024The aim of this study is to investigate the effect of double-tract reconstruction on short-term clinical outcome, quality of life and nutritional status of patients... (Comparative Study)
Comparative Study
PURPOSE
The aim of this study is to investigate the effect of double-tract reconstruction on short-term clinical outcome, quality of life and nutritional status of patients after proximal gastrectomy by comparing with esophagogastrostomy and total gastrectomy with Roux-en-Y reconstruction.
METHODS
The clinical data of patients who underwent double tract reconstruction (DTR), esophagogastrostomy (EG), total gastrectomy with Roux-en-Y reconstruction (TG-RY) were retrospectively collected from May 2020 to May 2022. The clinical characteristics, short-term surgical outcomes, postoperative quality of life and nutritional status were compared among the three groups.
RESULTS
Compared with the DTR group, the operation time in the TG group was significantly shorter (200(180,240) minutes vs. 230(210,255) minutes, p < 0.01), and more lymph nodes were removed (28(22, 25) vs. 22(19.31), p < 0.01), there were no significant differences in intraoperative blood loss, first flatus time, postoperative hospital stay and postoperative complication rate among the three groups. Postoperative digestive tract angiography was completed in 36 patients in the DTR group, of which 21 (58.3%) showed double-tract type of food passing. The incidence of postoperative reflux symptoms was 9.2% in the DTR group, 43.8% in the EG group and 23.2% in the TG group, repectively (P < 0.01). EORTCQLQ-STO22 questionnaire survey showed that compared with EG group, DTR group had fewer reflux symptoms (P < 0.05), fewer anxiety symptoms (P < 0.05) and more swallowing symptoms (P < 0.05). Compared with TG group, DTR group had fewer reflux symptoms (P < 0.05). There were no other significant differences between the two groups. Compared with TG group and EG group, DTR can better maintain postoperative BMI, and there is no statistical difference between the three groups in terms of hemoglobin and albumin.
CONCLUSIONS
Although partial double-tract reconstruction approach does not always ensure food to enter the distal jejunum along the two pathways as expected, it still shows satisfactory anti-reflux effect. Moreover, it might improve patients' quality of life and maintain better nutritional status comparing with gastroesophageal anastomosis and total gastrectomy with Roux-en-Y reconstruction.
Topics: Humans; Stomach Neoplasms; Quality of Life; Male; Female; Gastrectomy; Middle Aged; Retrospective Studies; Body Mass Index; Aged; Anastomosis, Roux-en-Y; Nutritional Status; Postoperative Complications; Treatment Outcome; Plastic Surgery Procedures; Operative Time
PubMed: 38822305
DOI: 10.1186/s12893-024-02454-8 -
European Journal of Surgical Oncology :... Jul 2024While most survivors of oesophageal cancer suffer from multiple symptoms, studies on combined symptom burden are scarce, particularly when looking at long-term outcomes....
INTRODUCTION
While most survivors of oesophageal cancer suffer from multiple symptoms, studies on combined symptom burden are scarce, particularly when looking at long-term outcomes. Therefore, we aimed to investigate the association between gastro-oesophageal reflux and health-related quality of life in malnourished survivors during the first years after oesophagectomy for cancer.
MATERIALS AND METHODS
This nationwide prospective cohort study included all Swedish patients who underwent curatively intended oesophagectomy for oesophageal cancer between 2013 and 2020 with 3-year follow-up. Linear mixed effect models were used to analyse the associations between reflux symptoms, malnutrition and HRQL at 1-, 2- and 3 years post-surgery and were presented with mean score difference (MSD) and 95 % confidence intervals (CI).
RESULTS
Among 406 included individuals, malnourished survivors with severe reflux reported more problems with nausea/vomiting (MSD 16.3, 95 % CI: 11.4 to 21.3), pain (MSD 16.5, 95 % CI: 10.2 to 22.8), body image (MSD 12.3, 95 % CI: 5.6 to 19.0), eating restrictions (MSD 11.3, 95 % CI: 6.1 to 16.5), swallowing saliva (MSD 10.0, 95 % CI: 5.2 to 14.8), dry mouth (MSD 10.5, 95 % CI: 2.4 to 18.7), and taste (MSD 14.1, 95 % CI: 7.1 to 21.0) compared to malnourished survivors with no reflux. Nausea/vomiting, financial difficulties, body image, and cognitive function were consistently worse for malnourished individuals with reflux throughout the 3 years.
CONCLUSIONS
The study suggests that gastro-oesophageal reflux negatively influences health-related quality of life in malnourished oesophageal cancer survivors. Nausea and/or vomiting were consistently worse for malnourished individuals with reflux independent of time point.
Topics: Humans; Quality of Life; Esophageal Neoplasms; Male; Female; Malnutrition; Prospective Studies; Middle Aged; Gastroesophageal Reflux; Sweden; Esophagectomy; Aged; Postoperative Complications
PubMed: 38820925
DOI: 10.1016/j.ejso.2024.108435 -
PloS One 2024Gastroesophageal reflux disease (GERD) may influence the risk of atrial fibrillation (AF). We investigated the association between symptoms of GERD and AF in the...
AIMS
Gastroesophageal reflux disease (GERD) may influence the risk of atrial fibrillation (AF). We investigated the association between symptoms of GERD and AF in the Trøndelag Health Study (HUNT).
METHODS
The study cohort comprised 34,120 adult men and women initially free of AF with information on GERD symptoms. Participants were followed from the baseline clinical examination (1 October 2006 to 30 June 2008) to March 31, 2018.
RESULTS
During a median follow-up of 8.9 years, 1,221 cases of AF were diagnosed. When looking at the whole population, participants with much GERD symptoms did not have an increased risk of AF (HR: 1.01; CI: 95%, 0.82 to 1.24) while participants with little GERD symptoms had a 14% lower risk of AF compared those with no GERD symptoms (HR: 0.86; CI: 95%, 0.76 to 0.97). Among younger participants (<40 years of age), the risk of AF had a trend towards increased risk with increasing symptom load of GERD (little GERD symptoms, HR: 3.09; CI: 95%, 0.74 to 12.94 and much GERD symptoms, HR: 5.40; 95% CI: 0.82 to 35.58). Among older participants (≥65 years of age), we saw a slightly reduced risk of AF in participants with little symptoms (HR: 0.84; CI: 0.72 to 0.97) and no association among those with much GERD symptoms (HR: 1.06; 95% CI: 0.82 to 1.36).
CONCLUSION
We did not find support for a clinically important association between symptoms of GERD and AF across all age groups but for some younger people, GERD might play a role in the development of AF. However, our estimates for this age group were very imprecise and larger studies including younger individuals are warranted.
Topics: Humans; Gastroesophageal Reflux; Atrial Fibrillation; Male; Female; Middle Aged; Adult; Risk Factors; Aged; Cohort Studies; Norway
PubMed: 38820508
DOI: 10.1371/journal.pone.0304624 -
Journal of Medical Economics 2024One of the most prevalent conditions in Western societies is gastroesophageal reflux disease (GERD). In Switzerland, the standard treatment for GERD is proton pump...
BACKGROUND
One of the most prevalent conditions in Western societies is gastroesophageal reflux disease (GERD). In Switzerland, the standard treatment for GERD is proton pump inhibitor (PPI)-based medical management, but surgical options such as Nissen fundoplication and magnetic sphincter augmentation (MSA) are available. RefluxStop is a novel device that offers an alternative solution. The purpose of this report is to evaluate the cost-effectiveness of RefluxStop compared to PPIs and existing surgical treatments.
METHODS
A model (Markov) was developed using the Swiss healthcare payer perspective with a lifetime horizon, 1-month cycle length, and a 3% annual discount rate for costs and benefits. Adverse events specific to treatment arms were incorporated, and benefits were measured in quality-adjusted life-years (QALYs). Clinical efficacy data for RefluxStop was obtained from its CE mark study, and comparator treatments were based on published literature. Deterministic and probabilistic sensitivity analyses were used to explore uncertainty. Since there are no head-to-head studies between RefluxStop and PPI therapy, Nissen fundoplication, or MSA, a limitation of this study is the use of naïve, indirect comparison of clinical effectiveness between the studied treatment options.
RESULTS
Higher QALYs and lower costs were provided by RefluxStop compared to Nissen fundoplication and the MSA system. The incremental cost-effectiveness ratio (ICER) for RefluxStop was CHF 2,116 in comparison to PPI-based medical management. At a cost-effectiveness threshold of CHF 100,000 per QALY gained, the probability of RefluxStop being cost-effective was high, with probabilities of 100%, 97%, and 100% against PPI-based medical management, Nissen fundoplication, and MSA, respectively. The robustness of the analysis was provided by deterministic and probabilistic sensitivity analyses.
CONCLUSION
This cost-effectiveness analysis demonstrates that there is a high likelihood of RefluxStop being a cost-effective treatment modality in adults with GERD when compared with other treatment options available in Switzerland.
Topics: Gastroesophageal Reflux; Humans; Cost-Benefit Analysis; Quality-Adjusted Life Years; Switzerland; Proton Pump Inhibitors; Fundoplication; Female; Markov Chains; Male; Middle Aged; Adult; Aged
PubMed: 38820006
DOI: 10.1080/13696998.2024.2362564 -
European Journal of Translational... May 2024Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as...
Gastroesophageal reflux disease (GERD) is a gastrointestinal tract disorder associated with regurgitation of gastric acid into the oesophagus. It can present itself as non-erosive reflux condition or erosive esophagitis. Our main objective was to evaluate the impact of oesophageal reflux disease on muscle fatigue among patients. The prospective study design was adopted using surveys performed at the South West China Medical University. All patients who were subjected to screening endoscopy at the South West China Medical University were prospectively enrolled in the study. Our study was conducted according to ethical guidelines involving animal and human subjects. Our study used Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), and the Multidimensional Fatigue Inventory (MFI) questionnaires to perform data collection on the levels of fatigue, depression, daytime hypersomnolence and anxiety. In the (HADS, Anxiety (β = 0.657, p < .001) and Depression (β = 2.927, p < .001) exhibited significant positive associations with the predicted fatigue. The Epworth Sleepiness Scale (ESS) showed no significant difference between individuals with and without reflux esophagitis (p = 0.787, power = 0.071). However, a significant difference was observed based on the presence of GERD symptoms (p = 0.003, power = 0.789), with higher mean scores for those with GERD symptoms (6.1±3.5) compared to those without (4.9±2.9). In MFI, significant differences were observed between the two groups for General and Physical Fatigue (p = 0.040, power = 0.823), Mental Fatigue (p = 0.002, power = 0.767), and MFI Total Score (p = 0.002, power = 0.981). In conclusion, GERD symptoms exhibited stronger associations with fatigue and daytime sleepiness than endoscopic findings, emphasizing the impact of symptomatic experiences on well-being.
PubMed: 38818777
DOI: 10.4081/ejtm.2024.12243