Hamidreza Kianifar; Saeedeh Talebi
Abstract
Introduction: Epidermolysis bullosa is a genetic condition with skin fragility that leads to blister formation and erosion following minor trauma. This disease also involves the gastrointestinal tract by way of esophageal stricture and dysphasia. Some studies have recommended oral budesonide liquid therapy ...
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Introduction: Epidermolysis bullosa is a genetic condition with skin fragility that leads to blister formation and erosion following minor trauma. This disease also involves the gastrointestinal tract by way of esophageal stricture and dysphasia. Some studies have recommended oral budesonide liquid therapy to decrease the need for balloon endoscopy and other aggressive treatments. The aim of the study was to evaluated clinical symptoms of patients who consumed oral budesonide in their daily routine therapies.
Methods: This cross-sectional study was conducted in Akbar Hospital of the Mashhad University of Medical Sciences. All enrolled patients were followed between July and October 2021. Ten milliliter oral budesonide (0.5 milligram) liquid was administrated one hour before eating. They were followed up to determine and document any side effects after treatment, and any improvement of clinical symptoms such as amelioration of dysphasia, volume of food intake, duration of food consumption, and kind of food consumed (solid versus liquid).Results: About fifteen patients were studied. The mean duration + SD of using budesonide was 9.66±15.76 weeks. The mean percentage + SD was 41.33±34.61 for improvement in the volume of food intake, and the mean for improving dysphasia + SD was 42±33.63%. Three patients suffered from complications (i.e., mucositis and gastric fullness). Also, two patients did not want to continue treatment because they did not like the drug taste.Conclusion: Oral budesonide liquid could be recommended for epidermolysis bollusa patients to improve clinical symptoms.
Mitra Ahadi; Negin Masoudifar
Abstract
Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires ...
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Eosinophilic esophagitis (EoE) is a chronic immune condition affecting children and adults. Dysphagia and food impaction are the main symptoms; however, reflux-like symptoms may also be present. The diagnosis of EoE is made with endoscopic evaluation for dysphagia, and its definitive diagnosis requires biopsy confirmation. The criteria for active EoE are defined as the symptoms of esophageal dysfunction, eosinophilic tissue infiltration (eosinophil count of at least 15 eosinophils per high-power field), and exclusion of other possible causes of esophageal eosinophilia. EoE is more prevalent in patients suffering from atopic conditions; therefore, allergic conditions may play an important role in the development of the disease. However, the etiology and pathophysiology of the disease are not completely understood. Elimination diets are considered as the first-line therapy in children; nevertheless, this approach appears to be less effective in adults, who often require steroids. Despite medical treatments, EoE is complicated in some cases by esophageal stricture and stenosis that require additional endoscopic treatments.
Kavian Ghandehari; Marjan Erfani; Elnaz Kiadarbandsari; Meysam Pourgholami
Abstract
Introduction: The aim of this research was to systematically review all the randomized controlled trials that have evaluated the effect of transcranial direct current stimulation (tDCS) on post-stroke dysphagia. Methods: Three electronic databases were searched for relevant articles that were uploaded ...
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Introduction: The aim of this research was to systematically review all the randomized controlled trials that have evaluated the effect of transcranial direct current stimulation (tDCS) on post-stroke dysphagia. Methods: Three electronic databases were searched for relevant articles that were uploaded from their inception to March 2015: PubMed, Cochrane Library (Cochrane Central Register of Controlled Trials), and Scopus. All data was that was related to the location of the cerebrovascular accident (CVA), the parameters of tDCS, post-stroke time to commencement of tDCS, the stimulated hemisphere, stimulation dose, any outcome measurements, and follow-up duration were extracted and assessed. Finally, a number of observations were generated through a qualitative synthesis of the extracted data.Result: Three eligible randomized controlled trials were included in the systematic review. All three trials reported that, in comparison to a placebo, tDCS had a statistically significant effect on post-stroke dysphagia.Discussion: The results of our systematic review suggest that tDCS may represent a promising novel treatment for post-stroke dysphagia. However, to date, little is known about the optimal parameters of tDCS for relieving post-stroke dysphagia. Further studies are warranted to refine this promising intervention by exploring the optimal parameters of tDCS.Conclusion: Since brainstem swallowing centers have bilateral cortical innervations, measures that enhance cortical input and sensorimotor control of brainstem swallowing may facilitate recovery from dysphagia.