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Biomedical subjects

J C Chiocca

Publications and source records attributed to J C Chiocca.

At least 19 recordsLinked to original sources
PubMed2005

Prevalence, clinical spectrum and atypical symptoms of gastro-oesophageal reflux in Argentina: a nationwide population-based study.

BACKGROUND: Population-based data on gastro-oesophageal reflux in Latin America are lacking. AIM: To assess gastro-oesophageal reflux symptom prevalence, clinical spectrum and association with the atypical symptoms in our country. METHODS: Gastro-oesophageal reflux self-report questionnaires validated at Mayo Clinic, USA, were submitted to a sample of 1000 residents (aged 18-80 years) from 17 representative geographical areas of Argentina. The samples were selected and stratified according to age, gender, geographical areas and size of town of residence provided by the Argentine Bureau of Statistics and Census. RESULTS: The overall prevalence of any typical gastro-oesophageal reflux symptom experienced in the previous year was 61.2% (95% CI, 57.9-64.6), the prevalence of frequent gastro-oesophageal reflux symptoms was 23.0% (95% CI, 20.1-25.9) and the prevalence of gastro-oesophageal reflux disease was 11.9% (95% CI, 9.6-14.1). Frequent gastro-oesophageal reflux symptoms were associated with dysphagia (OR 2.12, 95% CI, 1.27-3.54, P < 0.01), globus (OR 2.22, 95% CI, 1.35-3.66, P < 0.01) and non-cardiac chest pain (OR 1.55, 95% CI, 1.04-2.31, P < 0.05). CONCLUSIONS: In Argentina, typical symptoms of gastro-oesophageal reflux are highly prevalent at the national level, and frequent gastro-oesophageal reflux symptoms are significantly associated with dysphagia, globus and non-cardiac chest pain.

Adolescent↗
PubMed2004

Pneumatic dilatation in achalasia of the esophagus: a report from Argentina.

We review the treatment of esophageal achalasia by means of pneumatic dilatation (PD), analyzing its results and comparing them with those of the literature. We conclude that our personal experience is similar to that of the literature: PD and surgery produce similar results (67-95%), morbidity (2-9.5%), and mortality (0.7-1%); and PD is cheaper than surgery. According to these conclusions, we believe that the decision of the appropriate treatment should be based on a combination of the choice of the properly informed patient and the operator's experience. However, we also conclude that surgery is mandatory in selected cases, such as achalasia associated with hiatus hernia, esophageal diverticula and neoplasia, history of previous PD failure (since in our experience the results after a second PD are very poor), postoperative relapse, and patients with grade IV mega-esophagus according to Resano-Malenchini's classification.

Argentina↗
PubMed2000

[Barrett s epithelium: clinical review].

In this paper we review the literature about regarding etiology, natural history, methods of study and treatment of Barrett's esophagus. Likewise we review our personal experience as well as the one at national level.

Barrett Esophagus↗
PubMed1998

Foreign body impaction in the esophagus: are there underlying motor disorders?

UNLABELLED: We observed in our practice several cases of impaction with meat boluses without bony edges, in patients with patent esophageal lumen. The aim of this study was to search for eventual underlying motor disorders which could be responsible for this impaction. We included 19 patients who attended the endoscopy service for meat bolus impaction without organic esophageal stenosis. This group was compared with 18 control volunteers. Both groups underwent UGI series, UGI endoscopy and low-compliance perfusion standard esophageal manometry. RESULTS: Compared with the control group, the impacted subjects presented marked reduction in amplitude and duration of esophageal contraction in the proximal esophagus. CONCLUSIONS: These motor disorders could be responsible for the foreign body impaction in the esophagus. However, we believe this patient group should be further studied by 24-hour esophageal manometry to reach a more accurate diagnosis by studying each patient's entire circadian cycle.

Adolescent↗
PubMed1997

Esophageal perforation after pneumatic dilatation for achalasia: why?

UNLABELLED: A retrospective study was performed to asses risk factors in patients with esophageal achalasia undergoing pneumatic dilatation. Of 140 patients who underwent 159 dilatations, 7 sustained esophageal perforation (4.4%). They were matched with a group of 52 non perforated, dilated achalasia patients. History of prior pneumatic dilatation and small esophageal diameter were found to be risk factors by chi square and ANOVA. CONCLUSIONS: 1) Pneumatic dilatation for esophageal achalasia is a procedure with 4.4% risk of perforation and 0.6% mortality rate. 2) The risk of developing an esophageal perforation is increased by previous pneumatic dilatation and small esophageal diameter. Another risk factor such as a possible anatomical weakness of the esophageal wall (and the likelihood of it being evaluated by ultrasonography) at the site of perforation is suggested.

Adult↗
PubMed1997

[Gastroesophageal reflux disease refractory to medical treatment. Which approach: the pill or the scalpel?].

We analyze the modern literature regarding natural history, clinical picture and treatment of gastroesophageal reflux disease. The characteristics of a small group of patients with tendency to relapse are emphasized, analyzing the possibilities offered by pharmacological as well as surgical treatment. Finally, we analyse the current literature of our country situation.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1997

[Esophageal achalasia: what to do, the balloon or the scalpel?].

In this paper we review the different options published in the world literature regarding the treatment of achalasia of the esophagus. It is concluded that pneumatic dilatation and Heller's operation are the only valid possibilities for primary treatment of the disease. The specific indications for each procedure are also being set. The cost analysis in our country is determined, arriving to the conclusion that pneumatic dilation has a direct cost of A$968 (expectant cost up to A$1.144); and laparoscopic Heller's operation A$2.250. Our personal experience on 120 pneumatic dilatations is analyzed and compared with that of the literature, arriving to the conclusion that our results are similar to the ones of the main available papers.

Catheterization↗
PubMed1994

[Predictive factors in the treatment of esophageal achalasia].

With aim of determining if there are predictive factors in the treatment of achalasia of the esophagus, we analyzed in a group of 119 patients variables such as age, gender, X-Rays, Chagas' disease serology and esophageal manometry before and after treatment. The only significant factor was the LES pressure post-treatment but, since the sampling was heterogeneous, and the differences where the same between bad and good results, we believe it has no predictive value in the treatment of achalasia of the esophagus.

Adolescent↗
PubMed1991

[Esophageal achalasia: 20 years' experience with non surgical treatment].

The purpose of this paper is to report the experience acquired in pneumatic dilatation in achalasia of the esophagus up to 1990. Two hundred and six patients were studied in that period (X 50, 7 years, M/F 1:1). According to X Rays the distribution was: grade I 17.4%, grade II 54.8%, grade III 14% and grade IV 13.5%. The associated esophageal pathology was: hiatus hernia 9.7%, esophagitis 5.8%, benign stenosis 2.4%, cancer 1.4%, ulcer and diverticula 0.9% and Schatzki's ring and leiomyoma 0.4% respectively Serology for Chagas disease was positive in 23% Chagasic megacolon was more frequent than chagasic heart disease (4.3% Vs. 1.4%). Out of these, one hundred and twenty patients were treated by pneumatic dilatation. To this group we shall refer in more detail. One hundred ant two patients were dilated once and the remaining 18 twice. Esophageal manometry showed a vigorous pattern in 7.7%. The LES' pressure pre-treatment was 24.5 mm Hg and post-dilatation 13.7 mm Hg in 75.8% of the cases the result was good. The morbidity was 5% and the mortality 0.7%. Relapse was seen in 25.8% of the cases. The follow-up was X 38 months. We conclude that pneumatic dilatation is the election procedure in the treatment of achalasia since it offers good results with low morbimortality. Surgery is indicated after failure of 2 dilatations, in children, and association with esophageal neoplasms, hiatus hernia and esophageal diverticula.

Adolescent↗