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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report 53 infants who by clinical history were thought to have infantile spasms but who video-electroencephalograms showed were having other episodes that closely mimicked infantile spasms. Nine patients had other types of seizures. Forty-five patients had episodic symptoms that were not seizures: 11 patients had spasticity, four had gastroesophageal reflux, and the other patients had nonepileptic myoclonus, including 19 patients with benign neonatal sleep myoclonus. Three patients had more than one type of symptom. Infantile spasms imitators occurred in neurologically normal or abnormal infants, in patients with normal or abnormal interictal electroencephalograms, and in patients who also had previous or current infantile spasms. Differentiation of these episodes from infantile spasms prevented the initiation or continuation of anticonvulsant treatment appropriate for infantile spasms but inappropriate for these other behaviors.
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PMID:Clinical imitators of infantile spasms. 146 48

Gastroesophageal reflux (GER) in the pediatric patient is a frequently recognized problem. Unlike the adult, in whom symptoms relating to esophagitis predominate, the infant and child may present with a variety of respiratory problems, vomiting and/or growth failure. GER is often seen in association with other conditions and must be considered in the evaluation of any pediatric patient with chronic recurring respiratory problems, vomiting or failure to thrive (FTT). Thirty-eight pediatric patients have been surgically managed at West Virginia University from 1977-1983 for GER. The patients fall into several different patterns of presentation and associated problems. Nine premature infants all with bronchopulmonary dysplasia (BPD) have undergone fundoplication for FTT, worsening BPD, and pneumonia. Seven infants and two older children had GER associated with previous esophageal atresia repairs. Esophagitis, vomiting and growth failure were the predominant complaints in this group, though all nine patients had recurring respiratory symptoms as well. Syndromes involving mental retardation and neurologic dysfunction affected another group of five patients, all of whom presented with the complications of long-term esophagitis. The remaining 15 children were otherwise healthy infants who had predominantly respiratory symptoms due to GER. The benefits of fundoplication in these severely affected infants and children far outweigh the relatively few complications. In the carefully selected patient, surgical management of GER is dramatically successful.
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PMID:Patterns of pediatric gastroesophageal reflux. 398 87

The aim of the present study was to determine the pattern of structural and functional disorders encountered in an Asian gastroenterological clinic and to compare this pattern with findings from Western centres. Consecutive new patients (totalling 2384) attending the clinics of two consultant gastroenterologists were studied. Of these, 2141 suffered from gastroenterological problems. One thousand and sixty-three (49.6%) had structural diseases, the commoner ones being liver disease, peptic ulcer, malignancy, haemorrhoids and gallstones. The remainder who were found to have no structural disease (n = 1078; 50.4%) were deemed to have functional disorders including non-ulcer dyspepsia, irritable bowel, simple constipation and functional diarrhoea. The proportions of functional and structural disease were similar to those in the West. Major differences included a higher frequency of hepatoma and a lower frequency of inflammatory bowel disease and gastro-oesophageal reflux in the present series.
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PMID:The pattern of functional and organic disorders in an Asian gastroenterological clinic. 800 43

The authors report a case of postural abnormality of the head and neck (Torticollis) in a fourteen month old infant with severe gastroesophageal reflux (GER). Disappearance of this abnormality after surgical correction of the reflux leads the authors to confirm the diagnosis of Sandifer's syndrome of which the main features are underlined. In its initial descriptions, Sandifer's syndrome was characterized by the sudden occurrence, usually during meals, of torticollis, consecutive to hiatal hernia in children. This torticollis disappears within days or weeks following surgical treatment of the hiatal hernia. It was later proved that the origin of the torticollis was not the hiatal hernia itself, but the consequent gastroesophageal reflux (GER).
West Afr J Med
PMID:Sandifer's syndrome--a report of one case. 913 25

Acid-peptic disease is widely considered conquered or controlled, future advances being refinements of existing treatments rather than radical new developments. Yet controversies remain and developments have yet to be made. DUODENAL ULCER: Daily maintenance treatment with the anti-secretory drugs, histamine H2 receptor antagonists and proton pump blockers, controls duodenal ulcer effectively, markedly reducing relapse rate at one year after treatment from about 75 percent to 15 to 20 percent (and to about 10 percent on proton pump blockers). In contrast, Helicobacter pylori eradication with a one to two week course of treatment yields prolonged remission or cure. The consequent reduction in drug costs in individual patients, however, has been exceeded by increasing community use on the more expensive proton pump blockers for the treatment of gastroesophageal reflux disease. The marked decline in elective surgery since the introduction of histamine H2 receptor antagonists is commonly attributed to the power of these drugs. The fall, however, had started much earlier, indicating that the decline is due to changing natural history. In contrast, complication rates remain unaltered. An increasing proportion of newly diagnosed duodenal ulcer patients are elderly, and more of them now present for the first time with complications (in this center, about 40 percent), which consequently cannot be forestalled. Thus, duodenal ulcer disease is likely to remain a problem and in many will be a serious illness. GASTROESOPHAGEAL REFLUX DISEASE: The proton pump blockers have revolutionized the treatment of gastroesophageal reflux disease. In clinical trials they have proven markedly superior to the histamine H2 receptor antagonists in healing (at eight weeks, 80 to 90 percent vs. 50 to 60 percent), symptom relief, prevention of relapse on maintenance therapy and cost-effectiveness. However, several issues remain. The prevalence of gastroesophageal reflux disease seems to be rising and is now probably the commonest acid-peptic disease encountered in the West. Most clinical trials comparing proton pump blockers vs. histamine H2 receptor antagonists have been done in patients with erosive esophagitis, whereas the majority (50 to 60 percent) of patients with gastroesophageal reflux disease have milder, generally non-erosive, disease. The therapeutic gain of proton pump blockers diminishes in mild disease so may not be worth the higher drug costs. This is an important area for investigation. The majority of patients with erosive esophagitis relapse when treatment is stopped (about 75 percent at one year). Relapse is markedly reduced (to 20 to 25 percent) by daily maintenance treatment with proton pump blockers. Mild disease relapses less often, so longterm therapy by intermittent treatment may prove acceptable and more cost-effective than maintenance treatment. This strategy remains unexplored in trials. The ideal profile of an anti-secretory drug for intermittent treatment would combine rapid onset of action (similar to histamine H2 receptor antagonists) with powerful effect (as with proton pump blockers). The new class of drug, the reversible proton pump blocker (e.g., BY841) approaches this requirement.
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PMID:Duodenal ulcer and gastroesophageal reflux disease today: long-term therapy--a sideways glance. 916 90

The dumping syndrome in childhood is an uncommon complication of gastro-oesophageal surgery, principally Nissen fundoplication. A Jamaican child developed the syndrome after fundoplication and pyloroplasty to relieve gastro-oesophageal reflux complicating the repair of a congenital tracheo-oesophageal fistula. He developed marasmus and failed to gain weight on the standard remedial milk-based high-energy diet. An oral glucose tolerance test confirmed the diagnosis of dumping syndrome. A low sugar low milk diet based on adult type meals with continuous nibbling of fried dumplings relieved his diarrhoea and hypoglycaemia and he gained weight. This is a cheaper and more practical dietary therapy than the regimens described previously.
West Indian Med J 1998 Dec
PMID:Dumping syndrome in a young Jamaican child. 1009 70

Gastro-oesophageal reflux disease (GORD) is a highly prevalent condition in Western countries; at least 20% of the population have weekly symptoms. The incidence appears to be rising in the West and in some developing countries. Heartburn, based on a carefully elicited history, is reasonably specific for identifying GORD if it is a predominant complaint. Symptoms, however, appear to correlate poorly with oesophagitis; hence, severe symptoms do not indicate there is greater oesophageal damage. Only one-third to one-half of patients with GORD undergoing endoscopy have oesophagitis. GORD is usually a chronic disease but one-third may lose their symptoms over time. An ill-defined subset of patients over time may progress to develop abnormal acid exposure or oesophagitis, or both, when none existed at baseline. GORD has a significant negative impact on quality of life to the same degree as other chronic medical conditions, but impairment in quality of life is independent of oesophagitis.
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PMID:Epidemiology and natural history of reflux disease. 1100 7

The author examines trends in labor migration to West Germany during the 1980s, with an emphasis on the spatial distribution of migrants. Urban and rural differentials in distribution and the effcts of rising unemployment on labor migration are discussed. Information is included on migrants' population size and their countries of origin. (SUMMARY IN FRE AND GER)
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PMID:West Germany's declining guestworker population: spatial change and economic trends in the 1980s. 1228 34

International migration trends associated with the oil boom and bust that occurred in Nigeria between 1976 and 1986 are analyzed. "Large numbers came from Ghana..., [and] Niger, Chad and Togo, whose countries were suffering from a mixture of drought, political instability and stagnant economies. The resultant labour market became segmented according to job skills, nationality and ethnicity...." The decline in the oil industry led to the expulsion of some two million aliens between 1983 and 1986, causing considerable friction between Nigeria and its neighbors. The author concludes that "the rise and fall of migrant labour in Nigeria and the political situation within the country were embedded in the changing regional political economy of West Africa and its linkages to the larger world capitalist economy." (SUMMARY IN GER)
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PMID:International labour migration in Nigeria 1976-1986: employment, nationality and ethnicity. 1228 60

"Using a certain number of hypotheses on labour efficiency, it is possible to evaluate the impact of reunification on West Germany's growth from 1988 to 1993. The additional growth generated by this increase in the labour force is approximately six points of GDP over the period. From 1989 to 1991, years during which immigration was at its height, the annual growth rate was 1.2 to 1.5 points higher than it would have been had reunification not taken place. Since 1991, this potential growth has been on the downturn and should become moderate in coming years." (SUMMARY IN ENG AND GER AND SPA)
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PMID:[Reunification: the impact of migration on potential West German growth]. 1229 Aug 46


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