Purpose Of Review: In recent years, several studies on the treatment and follow-up of achalasia have been published. This review aims at highlighting interesting publications from the recent years.
Recent Findings: Treatment of achalasia aims at relieving functional obstruction at the level of the esophagogastric junction. Several treatment options such as pneumodilation and laparoscopic Heller myotomy (LHM) are available for this purpose. A large prospective randomized trial comparing pneumodilation and LHM demonstrated comparable success rates and quality of life for the two treatment options. Long-term data demonstrate comparable treatment success rates, when redilation in case of recurrent symptoms after pneumodilation is accepted. The most important risk factor for treatment failure is the manometric subtype, with a worse outcome for type I and type III compared with type II achalasia. Recently, peroral endoscopic myotomy (POEM) has been described with high success rates. Comparative studies with longer follow-up are awaited. A prospective study assessing the risk of esophageal carcinoma in patients with achalasia showed a 28-fold increased risk to develop carcinoma.
Summary: Either LHM or pneumodilation have high comparable short-term clinical success rates. Based on the increased risk to develop esophageal carcinoma, a screening program may be indicated. POEM is a new interesting treatment but longer follow-up data are awaited.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1097/MOG.0b013e328353af8f | DOI Listing |
J Ultrasound
January 2025
Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
This systematic review and meta-analysis aimed to assess the accuracy and success rate of ultrasound in determining fetal sex. A search was conducted on Medline, Cochrane Library, and EMBASE databases, and the reference lists of selected studies were also reviewed. Meta-analyses were performed using Revman 5.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopedics and Traumatology, University Medical Center Mainz, Mainz, Germany.
Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. While conventional fluoroscopy remains the primary method for intraoperative guidance, precise preoperative planning using multiplanar reconstructions and three-dimensional volume rendering is crucial for ensuring accurate placement of iliosacral or transsacral screws.
View Article and Find Full Text PDFAnn Emerg Med
January 2025
Department of Emergency Medicine, Kaiser Permanente San Diego Medical Center, San Diego, CA.
Study Objective: This study analyzes emergency medicine airway management trends and outcomes among community emergency departments.
Methods: A multicenter, retrospective chart review was conducted on 11,475 intubations from 15 different community emergency departments between January 1, 2015, and December 31, 2022. Data collected included patient's age, sex, rapid sequence intubation medications, use of cricoid pressure, method of intubation, number of attempts, admission diagnosis, and all-cause mortality rates.
JACC Clin Electrophysiol
December 2024
Department of Pediatric Cardiology, Heart Center, First Hospital of Tsinghua University (Beijing Huaxin Hospital), Chaoyang District, Beijing, China.
Background: Atrial tachycardia (AT) originate from the atrial appendage present unique clinical challenges in pediatrics. It is typically persistent, frequently leading to tachycardiomyopathy, and poses significant treatment difficulties.
Objectives: This study aimed to collate and analyze the clinical characteristics and therapeutic outcomes of radiofrequency ablation (RFCA) and with atrial appendage resection for the treatment of AT originating from the atrial appendages in pediatric patients.
Mil Med
January 2025
Veterans Affairs Quality Scholars Fellowship, Ralph H. Johnson VA Medical Center, Charleston, SC 29412, USA.
Introduction: Cardiovascular disease (CVD) is the leading cause of death for women in the United States, and U.S. female Veterans have higher rates of CVD compared to civilian women.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!