Die radiologische Breischluckuntersuchung wird derzeit noch vor einer Antirefluxchirurgie und Chirurgie der Hiatushernien zur Detektion und Klassifikation einer Hiatushernie empfohlen. Ziel der Arbeit war es zu untersuchen, ob die präoperative Breischluckuntersuchung bei der Diagnostik und Klassifikation von Hiatushernien einen zusätzlichen Nutzen hat und diese Befunde dann mit Endoskopie und schnittbildgebenden Verfahren zu vergleichen. / Barium swallow is a recommended study for the preoperative assessment and classification of hiatal hernias in laparoscopic antireflux and hiatal hernia surgery. The aim of this study was to investigate the additional value of barium swallow in correct detection and classification of hiatal hernias and compare these findings to preoperative endoscopy and computed tomography or magnetic resonance.

No description available.

O objetivo do presente estudo foi avaliar os efeitos do líquido de origem estomacal e duodenal na superfície do esmalte dental, simulando a ação do líquido refluído em pacientes com refluxo duodenogástrico. Foram selecionados 40 incisivos bovinos e obtidos fragmentos de esmalte medindo 4x4x2mm, e após o polimento, foram selecionados 40 espécimes através do teste de microdureza. Os espécimes foram isolados com resina composta deixando apenas metade da superfície do esmalte exposta aos desafios erosivos, foram então divididos aleatoriamente em quatro grupos (n=10), G1: HCl (pH 2.0), G2: HCl + Pepsina (pH = 2.1), G3: HCl + Bile de boi + NaHCO3 (pH 3.0), G4: HCl + Pancreatina + NaHCO3 (pH 3.0). Os fragmentos foram expostos em soluções a 37ºC, seis vezes por dia, durante 20 segundos sob agitação por cinco dias, posteriormente foram analisados por meio da avaliação morfológica, da rugosidade superficial e do desgaste (degrau) do esmalte dental com microscopia confocal a laser, em seguida os espécimes foram cortados longitudinalmente, planificados e polidos para a realização da microdureza longitudinal, onde foram realizadas 15 medidas em cada área (controle/protegida e exposta). Os dados foram analisados por meio do teste Kruskal-Wallis e de Dunn´s (p<0.05) para diferenciação das médias. Na análise dos dados mostrou maior degrau e rugosidade da superfície para o G3 (5.59 ± 1.69; 2.2 ± 1.61) e foi diferente estatisticamente significante com os grupos 1 e 2 nas duas análises (3.9 ± 1.55; 1.02 ± 0.18; 3.67 ± 1.45; 0.89 ± 0.12) (p<0.05), apenas o degrau do G4 (4.9, ± 1.8) foi semelhante ao G3 (p>0.05). Na análise da microdureza não foi observada diferença estatisticamente significante entre os grupos. Na análise morfológica observou-se maior perda estrutural nos grupos 3 e 4 com erosão intensa da região interprismática com áreas amorfas. Pode-se concluir que a bile e a pancreatina, de origem duodenal, em associação com o ácido clorídrico, podem promover uma erosão dentária mais intensa, com maior perda estrutural, aumento da rugosidade da superficial e perda da anatomia prismática do esmalte. / The goal of this study was to evaluate the effects of stomach and duodenal fluid on the enamel surface, simulating the action of refluxed liquid in patients with duodenogastric reflux. Forty bovine incisors were selected in order to obtain enamel fragments measuring 4x4x2mm each, which were then polished and brought to a microhardness test, where 40 final specimens were selected. The specimens were isolated with composite exposing only half of the enamel surface to erosive challenges and then randomly divided into 4 groups (n = 10), G1: HCl (pH 2.0); G2: HCl + pepsin (pH 2.1); G3: HCl + Ox Bile + NaHCO3 (pH 3.0); G4: HCl + Pancreatin + NaHCO3 (pH 3.0). The samples were exposed in 37°C solutions, 6 times a day, for 20 seconds, under stirring for 5 days. Subsequently, they were analyzed for morphologic evaluation, surface roughness and the step formed on the dental enamel, with confocal laser microscopy. The specimens were then cut longitudinally, their surfaces flattened and polished for holding the longitudinal microhardness, where 15 measurements were performed in each of the areas (control/protected and exposed). The data were analyzed using the Kruskal-Wallis test and Dunn\'s (p<0.05) means for differentiating. Both analysis showed a higher step and surface roughness for the G3 (5.59 ± 1.69, 2.2 ± 1.61), a difference that was statistically significant within groups 1 and 2 (3.9 ± 1, 55, 1.02 ± 0.18, 3.67 ± 1.45, 0.89 ± 0.12) (p <0.05) and only the step in G4 (4.9, ± 1.8) was similar to G3 (P> 0.05). The analysis of microhardness showed no statistically significant difference between groups. Morphological analysis showed greater structural loss in groups 3 and 4 with intense erosion of interprismatic region with amorphous areas. Therefore, it can be concluded that bile and pancreatin, from duodeno, in combination with hydrochloric acid, may promote greater dental erosion, with greater loss of structure, increased surface roughness and loss of enamel prismatic anatomy.

O objetivo do presente estudo foi avaliar os efeitos do líquido de origem estomacal e duodenal na superfície do esmalte dental, simulando a ação do líquido refluído em pacientes com refluxo duodenogástrico. Foram selecionados 40 incisivos bovinos e obtidos fragmentos de esmalte medindo 4x4x2mm, e após o polimento, foram selecionados 40 espécimes através do teste de microdureza. Os espécimes foram isolados com resina composta deixando apenas metade da superfície do esmalte exposta aos desafios erosivos, foram então divididos aleatoriamente em quatro grupos (n=10), G1: HCl (pH 2.0), G2: HCl + Pepsina (pH = 2.1), G3: HCl + Bile de boi + NaHCO3 (pH 3.0), G4: HCl + Pancreatina + NaHCO3 (pH 3.0). Os fragmentos foram expostos em soluções a 37ºC, seis vezes por dia, durante 20 segundos sob agitação por cinco dias, posteriormente foram analisados por meio da avaliação morfológica, da rugosidade superficial e do desgaste (degrau) do esmalte dental com microscopia confocal a laser, em seguida os espécimes foram cortados longitudinalmente, planificados e polidos para a realização da microdureza longitudinal, onde foram realizadas 15 medidas em cada área (controle/protegida e exposta). Os dados foram analisados por meio do teste Kruskal-Wallis e de Dunn´s (p<0.05) para diferenciação das médias. Na análise dos dados mostrou maior degrau e rugosidade da superfície para o G3 (5.59 ± 1.69; 2.2 ± 1.61) e foi diferente estatisticamente significante com os grupos 1 e 2 nas duas análises (3.9 ± 1.55; 1.02 ± 0.18; 3.67 ± 1.45; 0.89 ± 0.12) (p<0.05), apenas o degrau do G4 (4.9, ± 1.8) foi semelhante ao G3 (p>0.05). Na análise da microdureza não foi observada diferença estatisticamente significante entre os grupos. Na análise morfológica observou-se maior perda estrutural nos grupos 3 e 4 com erosão intensa da região interprismática com áreas amorfas. Pode-se concluir que a bile e a pancreatina, de origem duodenal, em associação com o ácido clorídrico, podem promover uma erosão dentária mais intensa, com maior perda estrutural, aumento da rugosidade da superficial e perda da anatomia prismática do esmalte. / The goal of this study was to evaluate the effects of stomach and duodenal fluid on the enamel surface, simulating the action of refluxed liquid in patients with duodenogastric reflux. Forty bovine incisors were selected in order to obtain enamel fragments measuring 4x4x2mm each, which were then polished and brought to a microhardness test, where 40 final specimens were selected. The specimens were isolated with composite exposing only half of the enamel surface to erosive challenges and then randomly divided into 4 groups (n = 10), G1: HCl (pH 2.0); G2: HCl + pepsin (pH 2.1); G3: HCl + Ox Bile + NaHCO3 (pH 3.0); G4: HCl + Pancreatin + NaHCO3 (pH 3.0). The samples were exposed in 37°C solutions, 6 times a day, for 20 seconds, under stirring for 5 days. Subsequently, they were analyzed for morphologic evaluation, surface roughness and the step formed on the dental enamel, with confocal laser microscopy. The specimens were then cut longitudinally, their surfaces flattened and polished for holding the longitudinal microhardness, where 15 measurements were performed in each of the areas (control/protected and exposed). The data were analyzed using the Kruskal-Wallis test and Dunn\'s (p<0.05) means for differentiating. Both analysis showed a higher step and surface roughness for the G3 (5.59 ± 1.69, 2.2 ± 1.61), a difference that was statistically significant within groups 1 and 2 (3.9 ± 1, 55, 1.02 ± 0.18, 3.67 ± 1.45, 0.89 ± 0.12) (p <0.05) and only the step in G4 (4.9, ± 1.8) was similar to G3 (P> 0.05). The analysis of microhardness showed no statistically significant difference between groups. Morphological analysis showed greater structural loss in groups 3 and 4 with intense erosion of interprismatic region with amorphous areas. Therefore, it can be concluded that bile and pancreatin, from duodeno, in combination with hydrochloric acid, may promote greater dental erosion, with greater loss of structure, increased surface roughness and loss of enamel prismatic anatomy.

No description available.

No description available.

No description available.

Class of 2006 Abstract / Objectives: Gastroesophageal reflux disease (GERD) afflicts close to 20 million adults in the United States. Pharmacy schools should ensure that appropriate teaching measures are implemented to optimize students learning of managing GERD. The purpose of this study was to evaluate the curriculum pertaining to GERD at the University of Arizona College of Pharmacy. Methods: We used a repeated measures design to longitudinally evaluate the curriculum on the subject of GERD. Sixty-six subjects from the class of 2007 were initially enrolled in the study, 31 completed the study. Students were tested using a case-based assessment. Descriptive statistics (mean + SD) were used for baseline demographics and a student’s t-test was used to analyze the results. Results: Student’s mean scores improved significantly over the course of the test administrations from 15.03 + 6.7 to 23.25 + 7.6 (p<0.0001). No significant difference was noted in either administration of the assessment between those who had experienced heartburn and those who had not. Mean scores significantly increased in patients who had work experience (p<0.05). Conclusions: Although student’s scores significantly improved during the study, no student achieved the minimally competent score of 70% and there was a high attrition rate, >50%. This high attrition rate possibly contributed to the poor results of the study. There may be a need for further evaluation and revision of the curriculum in this area at the University of Arizona College of Pharmacy.

by Yeung Chung Kwong. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 279-311). / STATEMENT OF ORIGINALITY --- p.8 / ABSTRACT --- p.9 / INDEX TO TABLES --- p.17 / INDEX TO FIGURES --- p.19 / ACKNOWLEDGEMENTS --- p.22 / Chapter SECTION I --- INTRODUCTION / Chapter CHAPTER 1 --- Traditional Concepts of Vesicoureteric Reflux --- p.25 / Chapter 1.1 --- Historic Review --- p.26 / Chapter 1.2 --- Vesicoureteric Reflux (VUR) as an Anomaly --- p.28 / Chapter 1.2.1 --- The Normal Ureterovesical Junction --- p.28 / Chapter 1.2.2 --- Proposed Pathogenesis of VUR --- p.29 / Chapter 1.2.3 --- Ureteric Bud Theory --- p.31 / Chapter 1.2.4 --- Primary versus Secondary VUR --- p.31 / Chapter 1.3 --- Prevalence and Sex Distribution of VUR --- p.33 / Chapter 1.4 --- Diagnosis and Grading --- p.35 / Chapter 1.4.1 --- Micturating Cystourethrogram in the Diagnosis of VUR --- p.35 / Chapter 1.4.2 --- Radionuclide Cystography --- p.36 / Chapter 1.4.3 --- Grading Systems of VUR --- p.37 / Chapter 1.5 --- Natural History of VUR --- p.38 / Chapter CHAPTER 2 --- Reflux Nephropathy --- p.40 / Chapter 2.1 --- Introduction --- p.41 / Chapter 2.2 --- Pathogenesis of Reflux-associated Scarring --- p.41 / Chapter 2.2.1 --- VUR and Urinary Tract Infection --- p.43 / Chapter 2.2.2 --- "Intrarenal Reflux and ""Big Bang"" Theory" --- p.45 / Chapter 2.2.3 --- VUR with Sterile Urine --- p.47 / Chapter 2.3 --- Effect of VUR on Renal Growth and Function --- p.49 / Chapter CHAPTER 3 --- Management of VUR --- p.52 / Chapter 3.1 --- Introduction --- p.53 / Chapter 3.2 --- Medical Management --- p.54 / Chapter 3.3 --- Antireflux surgery --- p.56 / Chapter 3.3.1 --- Ureteric Reimplantation --- p.57 / Chapter 3.3.2 --- Endoscopic Procedure --- p.58 / Chapter 3.4 --- Medical versus Surgical Treatment: Continuing Dilemma --- p.59 / Chapter CHAPTER 4 --- Antenatal Diagnosis of Fetal Uropathies: Impact on Pathogenesis of VUR --- p.63 / Chapter 4.1 --- Primary VUR Detected Following Antenatal Diagnosis of Fetal Hydronephrosis --- p.64 / Chapter 4.2 --- Impact on Traditional Concepts of VUR and Reflux Nephropathy --- p.67 / Chapter CHAPTER 5 --- Cystometric Concept of VUR --- p.70 / Chapter 5.1 --- Introduction --- p.71 / Chapter 5.2 --- Bladder Dysfunctions Associated with VUR --- p.73 / Chapter 5.3 --- Need for A Cystometric Classification of VUR --- p.75 / Chapter CHAPTER 6 --- "Summary, Hypothesis and Outline of Studies" --- p.77 / Chapter 6.1 --- Continuing Controversies in VUR and Reflux Nephropathy --- p.78 / Chapter 6.2 --- "Hypothesis, Objectives and Outline of Studies" --- p.81 / Chapter SECTION II --- STUDY DESIGN AND RESULTS / Chapter CHAPTER 7 --- Primary VUR in Infants with Prenatally Diagnosed Hydronephrosis: Differences Between the Two Sexes --- p.87 / Chapter CHAPTER 8 --- A Clinicopathological Study on Reflux Nephropathy in Children Submitted to Unilateral Nephrectomy --- p.109 / Chapter CHAPTER 9 --- Urethrograms in Male Refluxing Infants with Prenatally Diagnosed Hydronephrosis: Further Evidence for Transient In-utero Bladder Outlet Obstruction --- p.127 / Chapter CHAPTER 10 --- Urodynamic Studies in Children --- p.144 / Chapter 10.1 --- Conventional Cystometry in Children --- p.145 / Chapter 10.2 --- Difficulties for Conventional Cystometry in Infants with VUR --- p.146 / Chapter CHAPTER 11 --- Natural Filling Cystometry in Infants and Young Children: A New Technique --- p.149 / Chapter CHAPTER 12 --- Some New Insights into Bladder Function in Infancy --- p.168 / Chapter CHAPTER 13 --- Natural Filling Urodynamic Studies in Young Infants with Primary VUR --- p.185 / Chapter CHAPTER 14 --- Primary VUR Detected in Early Infancy: Relationship Between Bladder Functional Status and Outcome of Reflux in the Second Year of Life --- p.207 / Chapter CHAPTER 15 --- Natural Filling Direct Isotope Cystography with Synchronous Urodynamic Study (NFDIC): A New Technique with Significant Prognostic Value for Primary VUR --- p.226 / Chapter CHAPTER 16 --- Quantitation of VUR and Bladder Emptying by Synchronous Isotope Cystograpgy and Urodynamic Recording (QIC) --- p.242 / SECTION III DISCUSSION --- p.266 / REFERENCES --- p.279

Thèse d'exercice : Médecine. Chirurgie générale : Université de Nantes : 2005. / Bibliogr. f. 63-68 [64 réf.].