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

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.

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.

[Acute and chronic diarrhea in AIDS: study of 435 (HIV+) patients, in Buenos Aires]. / Diarrea aguda y crónica en SIDA: estudio de 435 pacientes HIV(+), en Buenos Aires.

OBJECTIVE: Assessment of the rate of Diarrhoea in an infected HIV population of our medium. Assessment of its etiology, risk factors and response to treatment in both presentation of disease (Acute and chronic). DESIGN: This is a retrospective analysis of HIV and/or AIDS patients and diarrhea. The analytic points were: the clinical pattern of diarrhea (acute or chronic), risk factors, age, sex, etiology, stage of the disease, and response rate to treatment. PLACE: Hospital Prof. A. Posadas, that is situated in the greater Buenos Aires, and that functions as a referral centre for AIDS patients. PATIENTS AND METHODS: 435 case records that were followed up through June 1987/ March 1994 were reviewed; 109 of the total number suffered from diarrhea. RESULTS: The rate of diarrhoea in the studied population was 25% (109/435). This represented the first symptom of HIV infection in 18.3% of the patients (20/109), 49% had acute diarrhea and 51% had chronic diarrhea. An etiologic agent was established in 52.3% of the chronic diarrhoeas and in the 17.7% of the acute ones, with a 35.4% of a global isolation when basic stool test were made. Sixty three percent of the patients with chronic diarrhoea were in stage IV of HIV infection. The 78.3% of the acute diarrhoeas and 46% of the chronic ones were responsive to specific or symptomatic treatment. CONCLUSIONS: HIV antibodies determinations should be included in the study protocol of diarrhea, especially in young patients. Chronic diarrhea could be related to final stages of the disease, with lower response to treatment. Endoscopy studies should be useful when the stool tests are negative, specially in the Cytomegalovirus (CMV) and Mycobacterium complex avium intracellulare (MAI) search.