ABSTRACT
AIM: The aim of the study was to evaluate the prevalence of gastroesophageal reflux and abnormalities of esophageal motility in a population of neonates referred for apparently life threatening event (ALTE) and presenting vagal hyperreflectivity. POPULATION AND METHODS: The study included 17 infants, who were examined after an ALTE. They were admitted at a mean age of 11.7 weeks (range 1-40 weeks). Vagal hyperreflectivity was confirmed in each infant by oculocardiac reflex. Before treatment, 24-hour intraesophageal pH-monitoring and esophageal manometry were performed. RESULTS: pH-monitoring and esophageal manometry were both normal in only two patients. pH-monitoring showed pathological reflux (% of time with pH < 4 more than 4.8%) in 10/17 (59%) patients. Manometric studies showed esophageal dysmotility in 12/17 (71%) of patients. Hypertensive lower sphincter was noted in 11/17 (65%) infants. Patients with normal manometry were older than patients presenting with esophageal dysmotility (P < 0.05). CONCLUSION: This study shows a high frequency of gastroesophageal reflux and dysmotility in infants with vagal hyperreflectivity. Hypertensive lower esophageal sphincter as well as vagal hyperreflectivity may correspond to dysmaturity of autonomous nervous system and facilitate the occurrence of ALTE.
Subject(s)
Esophageal Motility Disorders/complications , Gastroesophageal Reflux/complications , Reflex , Syncope/complications , Vagus Nerve/physiopathology , Esophagus/physiopathology , Female , Humans , Hydrogen-Ion Concentration , Male , Manometry , Prospective StudiesSubject(s)
Manuals as Topic , Mental Disorders/diagnosis , Psychiatry , Canada , Humans , Research , Schools, Medical , TeachingABSTRACT
Seven fresh cadaveric forearms were studied to investigate the effects of medial and lateral positioning of the pisiform bone on pressure within the carpal tunnel. The wick catheter, a device used to transmit interstitial fluid pressure, was inserted into the carpal tunnels of the cadavers. Pressures in the tunnel with the pisiform in a resting position, medial position, and lateral position were measured via a water manometer. A significant increase in pressure was noted between the resting position and both the medial and lateral positions ( p = 0.001). No significant difference was found between the medial and lateral positions ( p > 0.05). Findings suggest that the use of movement of the pisiform as a conservative treatment in carpal tunnel syndrome is questionable. J Orthop Sports Phys Ther 1982;4(1):47-50.
