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RISS 인기검색어
- 검색키워드
- 저자 : ( Ivana Bravi ) (검색결과 2 건)
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( Alessandra Elvevi ),( Ivana Bravi ),( Aurelio Mauro ),( Delia Pugliese ),( Andrea Tenca ),( Ivan Cortinovis ),( Silvano Milani ),( Dario Conte ),( Roberto Penagini ) 대한소화기기능성질환·운동학회 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.1
Background/Aims Swallowing of cold liquids decreases amplitude and velocity of peristalsis in healthy subjects, using standard manometry. Patients with achalasia and non obstructive dysphagia may have degeneration of sensory neural pathways, affecting motor response to cooling. To elucidate this point, we used high-resolution manometry. Methods Fifteen healthy subjects, 15 non-obstructive dysphagia and 15 achalasia patients, after pneumatic dilation, were studied. The 3 groups underwent eight 5 mL single swallows, two 20 mL multiple rapid swallows and 50 mL intraesophageal water infusion (1 mL/sec), using both water at room temperature and cold water, in a randomized order. Results In healthy subjects, cold water reduced distal contractile integral in comparison with water at room temperature during single swallows, multiple rapid swallows and intraesophageal infusion (ratio cold/room temperature being 0.67 [95% CI, 0.48-0.85], 0.56 [95% CI, 0.19-0.92] and 0.24 [95% CI, 0.12-0.37], respectively). A similar effect was seen in non-obstructive dysphagia patients (0.68 [95% CI, 0.51-0.84], 0.69 [95% CI, 0.40-0.97] and 0.48 [95% CI, 0.20-0.76], respectively), whereas no changes occurred in achalasia patients (1.06 [95% CI, 0.83-1.29], 1.05 [95% CI, 0.77-1.33] and 1.41 [95% CI, 0.84-2.00], respectively). Conclusions Our data suggest impairment of esophageal reflexes induced by cold water in patients with achalasia, but not in those with non obstructive dysphagia. (J Neurogastroenterol Motil 2014;20:79-86)
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( Andrea Tenca ),( Pietro Campagnola ),( Ivana Bravi ),( Luigi Benini ),( Daniel Sifrim ),( Roberto Penagini ) 대한소화기기능성질환·운동학회 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.2
Background/AimsSymptom reflux association analysis is especially helpful for evaluation and management of proton pump inhibitor (PPI) refractorypatients. An accurate calculation requires manual editing of 24-hour multichannel intraluminal impedance-pH (MII-pH)tracings after automatic analysis. Intra- and inter-observer agreement as well as reliability of rapid editing confined to the timearound symptomatic episodes are unknown. Aim of this study was to explore these topics in a prospective multicenter study. MethodsForty consecutive patients who were off PPI therapy underwent MII-pH recordings. After automatic analysis, their tracings wereanonymized and randomized. Three experienced observers, each one trained in a different European center, independently performedmanual editing of 24-hour tracings on 2 separate occasions. Values of symptom index and symptom association probabilityfor acid and non acid reflux were transformed into binary response (i.e., positive or negative). ResultsIntra-observer agreement on symptom reflux association was 92.5% to 100.0% for acid and 85.0% to 97.5% for non-acidreflux. Inter-observer agreement was 100.0% for acid and 82.5% to 95.0% for non-acid reflux. Values for symptom index andsymptom association probability were similar. Concordance between 24-hour and rapid (2 minutes-window before each symptomaticepisode) editings for symptom reflux association occured in 39 to 40 patients (acid) and in 37 to 40 (non-acid), dependingon the observer. ConclusionsIntra- and inter-observer agreement in classifying patients with or without symptom reflux association at manual editing of24-hour tracings was high, especially for acid reflux. Classifying patients according to a rapid editing showed excellent concordancewith the 24-hour one and can be adopted in clinical practice.
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