Interventional functional diagnostics in gastrointestinal endoscopy: Combining diagnostic and therapeutic tools in the endoscopy suite with the functional lumen imaging probe

With technical progress of gastrointestinal functional testing, there has been a demand for more comprehensive examination of esophageal physiology and pathophysiology beyond high-resolution manometry. A new interventional technology based on impedance planimetry, the functional lumen imaging probe (FLIP), enables intraluminal measurement of distensibility and compliance of hollow organs. EndoFLIP uses balloon catheters to measure diameter and distension pressure to calculate cross-sectional area and distensibility in different organs (mostly esophagus, stomach, anorectal region) and can be used in wide variety of indications (diagnostics, pre- and post-treatment evaluation) and currently serves as a helpful adjunctive tool in ambiguous clinical cases. EsoFLIP is a therapeutic variation that uses a stiffer balloon catheter allowing for dilation. The trend to simplify the clinical process from diagnosis to treatment tends to a one-session procedure combining diagnostics and therapeutic interventions. In specified conditions like e.g. achalasia or gastroparesis, a combination of EndoFLIP and EsoFLIP procedures may therefore be useful. The aim of this narrative review is to introduce the clinical use of FLIP and its potential benefit in combined diagnostic-therapeutic procedures

Pencerakinan kajian istilah dan terjemahan BERNAMA Arab ke bahasa Melayu dan Inggeris

Artikel ini membincangkan aspek kajian istilah dan terjemahan yang dilakukan pada BERNAMA Arab ke bahasa Melayu dan juga Inggeris sebagai medan pembelajaran bagi pelajar bidang pengkhususan bahasa dan kesusasteraan Arab masa kini. Objektif kajian ini adalah untuk meneliti ketepatan penggunaan istilah dari BERNAMA Arab ke bahasa Melayu dan Inggeris, di samping menterjemahkan teks BERNAMA Arab dalam semua aspek ke bahasa Melayu dan Inggeris. Artikel ini juga bertujuan untuk memaparkan padanan istilah dari BERNAMA Arab ke istilah bahasa Melayu dan Inggeris. Keseluruhan kajian ini menggunakan kaedah kualitatif dengan mengaplikasi analisis kandungan seperti rujukan bahan ilmiah utama berdasarkan buku, kamus dan jurnal, di samping bahan utama daripada internet melalui tapak web BERNAMA.com dan tapak web lain yang berkaitan dengannya. Dapatan kajian menunjukkan padanan istilah dipadankan mengikut kesesuaian makna dan secara langsung turut memaparkan istilah yang dapat membantu khalayak pembaca memahami istilah yang sering diguna pakai. Selain itu, hasil kajian menunjukkan terdapat perkataan yang mempunyai istilah yang sama dan makna yang sama, gaya bahasa yang membawa maksud yang berlainan serta kata nama khas. Hasil kajian ini diharapkan dapat memberikan impak yang positif dan menyumbang kepada pemugaran pembelajaran bahasa Arab secara maya dengan lebih efektif

Endoscopic pyloromyotomy for the treatment of severe and refractory gastroparesis: a pilot, randomised, sham-controlled trial

OBJECTIVE Endoscopic pyloromyotomy (G-POEM) is a minimally invasive treatment option with promising uncontrolled outcome results in patients with gastroparesis. DESIGN In this prospective randomised trial, we compared G-POEM with a sham procedure in patients with severe gastroparesis. The primary outcome was the proportion of patients with treatment success (defined as a decrease in the Gastroparesis Cardinal Symptom Index (GCSI) by at least 50%) at 6 months. Patients randomised to the sham group with persistent symptoms were offered cross-over G-POEM. RESULTS The enrolment was stopped after the interim analysis by the Data and Safety Monitoring Board prior to reaching the planned sample of 86 patients. A total of 41 patients (17 diabetic, 13 postsurgical, 11 idiopathic; 46% male) were randomised (21 G-POEM, 20-sham). Treatment success rate was 71% (95% CI 50 to 86) after G-POEM versus 22% (8-47) after sham (p=0.005). Treatment success in patients with diabetic, postsurgical and idiopathic gastroparesis was 89% (95% CI 56 to 98), 50% (18-82) and 67% (30-90) after G-POEM; the corresponding rates in the sham group were 17% (3-57), 29% (7-67) and 20% (3-67).Median gastric retention at 4 hours decreased from 22% (95% CI 17 to 31) to 12% (5-22) after G-POEM and did not change after sham: 26% (18-39) versus 24% (11-35). Twelve patients crossed over to G-POEM with 9 of them (75%) achieving treatment success. CONCLUSION In severe gastroparesis, G-POEM is superior to a sham procedure for improving both symptoms and gastric emptying 6 months after the procedure. These results are not entirely conclusive in patients with idiopathic and postsurgical aetiologies. TRIAL REGISTRATION NUMBER NCT03356067; ClinicalTrials.gov

Serogroup and Clonal Characterization of Czech Invasive Neisseria meningitidis Strains Isolated from 1971 to 2015.

BACKGROUND:This study presents antigenic and genetic characteristics of Neisseria meningitidis strains recovered from invasive meningococcal disease (IMD) in the Czech Republic in 1971-2015. MATERIAL AND METHODS:A total of 1970 isolates from IMD, referred to the National Reference Laboratory for Meningococcal Infections in 1971-2015, were studied. All isolates were identified and characterized by conventional biochemical and serological tests. Most isolates (82.5%) were characterized by multilocus sequence typing method. RESULTS:In the study period 1971-2015, the leading serogroup was B (52.4%), most often assigned to clonal complexes cc32, cc41/44, cc18, and cc269. A significant percentage of strains were of serogroup C (41.4%), with high clonal homogeneity due to hyperinvasive complex cc11, which played an important role in IMD in the Czech Republic in the mid-1990s. Serogroup Y isolates, mostly assigned to cc23, and isolates of clonally homogeneous serogroup W have also been recovered more often over the last years. CONCLUSION:The incidence of IMD and distribution of serogroups and clonal complexes of N. meningitidis in the Czech Republic varied over time, as can be seen from the long-term monitoring, including molecular surveillance data. Data from the conventional and molecular IMD surveillance are helpful in refining the antimeningococcal vaccination strategy in the Czech Republic

Incidence of invasive meningococcal disease, Czech Republic, 1943–2015.

<p>Blue line is incidence (cases per 100 000 population) and the red line is surveillance since 1993.</p

Number of isolates of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech Republic, 1971–2015, n = 1970.

<p>Number of isolates of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech Republic, 1971–2015, n = 1970.</p

Annual distribution of major clonal complexes of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech Republic, 1971–2015, n = 1970 (cc = clonal complex, ccUA = unassigned clonal complex, nd = not defined).

<p>Annual distribution of major clonal complexes of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech Republic, 1971–2015, n = 1970 (cc = clonal complex, ccUA = unassigned clonal complex, nd = not defined).</p

Annual distribution of serogroups of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech republic, 1971–2015, n = 1970 (NG = non groupable, nd = not defined).

<p>Annual distribution of serogroups of <i>N</i>. <i>meningitidis</i> from invasive meningococcal disease, Czech republic, 1971–2015, n = 1970 (NG = non groupable, nd = not defined).</p

Clonal characterization of meningococcal isolates of <i>N</i>. <i>meningitidis</i> A, Y, and W from invasive meningococcal disease, Czech Republic, 1971–2015, n = 60 = investigated by MLST.

<p>Clonal characterization of meningococcal isolates of <i>N</i>. <i>meningitidis</i> A, Y, and W from invasive meningococcal disease, Czech Republic, 1971–2015, n = 60 = investigated by MLST.</p