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Achalasia.
Achalasia is a rare disorder of the oesophageal smooth muscle characterized by impaired relaxation of the lower oesophageal sphincter (LES) and absent or spastic contractions in the oesophageal body. The key pathophysiological mechanism is …
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Hypercontractile Esophagus From Pathophysiology to Management: Proceedings of the Pisa Symposium.
Hypercontractile esophagus (HE) is a heterogeneous major motility disorder diagnosed when ≥20% hypercontractile peristaltic sequences (distal contractile integral >8,000 mm Hg*s*cm) are present within the context of normal lower esophageal …
- A case of acute pancreatitis after intrapyloric botulinum toxin injection to treat gastroparesis.
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Chicago Classification Update (v4.0): Technical review on diagnostic criteria for distal esophageal spasm.
Distal esophageal spasm (DES) is defined as a manometric pattern of at least 20% of premature contractions in a context of normal esophago-gastric junction relaxation in a patient with dysphagia or non-cardiac chest pain. The definition of …
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Development of quality indicators for the diagnosis and management of achalasia.
[BACKGROUND] The management of achalasia has improved due to diagnostic and therapeutic innovations. However, variability in care delivery remains and no established measures defining quality of care for this population exist. We aimed to u…
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Long-term outcomes of per-oral endoscopic myotomy in achalasia patients with a minimum follow-up of 4 years: a multicenter study.
Per-oral endoscopic myotomy (POEM) is associated with a short-term clinical response of 82 % to 100 % in treatment of patients with achalasia. Data are limited on the long-term durability of the clinical response in these patients. The aim …
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Botulinum toxin for the treatment of hypercontractile esophagus: Results of a double-blind randomized sham-controlled study.
[INTRODUCTION] Botulinum toxin injection is known to be efficient to treat achalasia. We conducted a randomized trial in order to evaluate its efficacy to treat symptomatic hypercontractile esophageal disorders as characterized by esophagea…
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The treatment of achalasia patients with esophageal varices: an international study.
[BACKGROUND] Treatment options for achalasia include endoscopic and surgical techniques that carry the risk of esophageal bleeding and perforation. The rare coexistence of esophageal varices has only been anecdotally described and treatment…
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An international multicenter study evaluating the clinical efficacy and safety of per-oral endoscopic myotomy in octogenarians.
[BACKGROUND AND AIMS] Per-oral endoscopic myotomy (POEM) for achalasia is particularly appealing in the elderly because it is minimally invasive. However, data in patients aged ≥80 years are scarce. The aim of this study was to assess the c…
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Complications of botulinum toxin injections for treatment of esophageal motility disorders†.
In achalasia and spastic esophageal motility disorders, botulinum toxin (botox) injection is considered an effective and low-risk procedure for short-term symptom relief. It is mainly offered to medically high-risk patients. However, no ana…
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Botulinum toxin injection for hypercontractile or spastic esophageal motility disorders: may high-resolution manometry help to select cases?
Endoscopic injections of botulinum toxin in the cardia or distal esophagus have been advocated to treat achalasia and spastic esophageal motility disorders. We conducted a retrospective study to evaluate whether manometric diagnosis using t…
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Progressive spontaneous unilateral enlargement of the breast twenty-two years after prosthetic breast augmentation.
Late spontaneous enlargement of the breast is a rare complication after prosthetic breast augmentation. It has been intermittently described in the literature over the last 24 years but its exact aetiology remains unknown. Several possible …
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Gene therapy in plastic and reconstructive surgery.
Gene therapy has been investigated in many aspects of plastic and reconstructive surgery. These areas ultimately involve various forms of tissue healing and the manipulation of bony and soft tissues to reconstruct defects secondary to neopl…