Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors examine the 1989 removal of the frontier region (Zonenrandgebiet) along the eastern border of the former Federal Republic of Germany. "The paper examines the socio-economic impacts on the North Bavarian section of the Zonenrandgebiet, which is characterized by its dispersed industrial base and lack of higher-order urban centres. Evidence is presented of rapid upturns in population growth and economic activity, together with a large inflow of commuters from the former East Germany and Czechoslovakia, following frontier opening. Traffic, environmental pressures and living costs have also increased. Both positive and negative impacts are strongest in districts contiguous with the former frontier. Long-term development prospects hinge on its newly-gained centrality within Germany. Substantial local benefits are anticipated...,but they are unlikely to induce a major reshaping of the German space-economy; this will be dominated by the rivalry between the largest metropolitan centres." (SUMMARY IN FRE AND GER)
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PMID:Opening the frontier: recent spatial impacts in the former inner-German border zone. 1231 67

Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90-132) in the sliding hiatal hernia group, whereas it was 200 minutes (180-210) in the paraesophageal hiatal hernia group. The mean hospital stay was 36 hours (24-96). Eight patients experienced mild dysphagia which resolved after four weeks. No postoperative dysphagia was recorded at 30-month median follow-up. We experienced one recurrence in the sliding hernia group and two recurrences in the paraesophageal hernia group, with two patients treated robotically. Robotic fundoplication in treating sliding hiatal hernia is feasible and safe but is more challenging in the large paraesophageal group. Improved patient outcomes hinge on the operative technique used and increasing surgeon experience. The increased dexterity that robotic surgery affords enables the esophageal surgeon to more adeptly apply the traditional principles of laparoscopic fundoplication.
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PMID:Robotic Fundoplication for Gastroesophageal Reflux Disease and Hiatal Hernia: Initial Experience and Outcome. 3060 53