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183 results on '"Crookes, P. F."'

1. Obesity and Gastroesophageal Reflux: Quantifying the Association Between Body Mass Index, Esophageal Acid Exposure, and Lower Esophageal Sphincter Status in a Large Series of Patients with Reflux Symptoms

Author

Ayazi, Shahin, Hagen, Jeffrey A., Chan, Linda S., DeMeester, Steven R., Lin, Molly W., Ayazi, Ali, Leers, Jessica M., Oezcelik, Arzu, Banki, Farzaneh, Lipham, John C., DeMeester, Tom R., and Crookes, Peter F.

Subjects
Medicine & Public Health, Gastroenterology, Surgery, Obesity, Gastroesophageal reflux disease (GERD), BMI, Comorbidity, Ambulatory pH monitoring, Lower esophageal sphincter (LES)
Abstract

Obesity and gastroesophageal reflux disease (GERD) are increasingly important health problems. Previous studies of the relationship between obesity and GERD focus on indirect manifestations of GERD. Little is known about the association between obesity and objectively measured esophageal acid exposure. The aim of this study is to quantify the relationship between body mass index (BMI) and 24-h esophageal pH measurements and the status of the lower esophageal sphincter (LES) in patients with reflux symptoms.Data of 1,659 patients (50% male, mean age 51 ± 14) referred for assessment of GERD symptoms between 1998 and 2008 were analyzed. These subjects underwent 24-h pH monitoring off medication and esophageal manometry. The relationship of BMI to 24-h esophageal pH measurements and LES status was studied using linear regression and multiple regression analysis. The difference of each acid exposure component was also assessed among four BMI subgroups (underweight, normal weight, overweight, and obese) using analysis of variance and covariance.Increasing BMI was positively correlated with increasing esophageal acid exposure (adjusted R 2 = 0.13 for the composite pH score). The prevalence of a defective LES was higher in patients with higher BMI (p

Published
2009

3. Professionalism of surgery

Author

Rawlings, Arthur L., Shadduck, Phillip P., Sillin, Lelan F., Crookes, Peter F., MacFadyen, Jr., Bruce V., McDonald, Marian P., Forde, Kenneth A., and Mellinger, John D.

Published
2015
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36. Evolution of Esophageal Motility Testing: From Kronecker to Clouse

Author

Grubic, Andrew D. and Crookes, Peter F.

Abstract

Esophageal motility, the science of quantifying the mechanical function of the esophagus, was initiated by Hugo Kronecker in Germany in 1882. Little progress was made until after World War II, when motility studies began in the Mayo Clinic and Boston University. After 1960, several key figures promoted the science, including Lauran Harris, Don Castell, Jerry Dodds, Tom DeMeester, Peter Kahrilas, and Ray Clouse. All were inspirational teachers and mentors as well as scientists. The technical developments from balloons and perfused catheters to the current solid-state catheters and sophisticated software has provided insights which have helped physicians to treat patients with dysfunction of the esophagus with increasing success.

Published
2021
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41. Preoperative Pneumoperitoneum: Low-Risk Surgical Adjunct to the Surgical Management of Dense Abdominal Adhesions.

Author

Palmer, Suzanne L., Abdoli, Sherwin, and Crookes, Peter F.

Abstract

Surgical lysis of intra-abdominal adhesions is associated with a high rate of complications. This brief report presents 24 patients with dense intra-abdominal adhesions who underwent preoperative progressive pneumoperitoneum (PPP) prior to surgical lysis of adhesions. PPP was successfully performed in 23 patients, with few adverse events, resulting in subjectively improved ease of intraoperative tissue dissection. One patient withdrew due to intractable pain during insufflation. The results suggest that PPP is a low-risk technique with the potential to improve access to intra-abdominal structures in patients for whom conventional surgical therapy is predicted to carry a high rate of complications. [ABSTRACT FROM AUTHOR]

Published
2019
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43. Pharyngeal Swallowing

Author

Bremner, R. M., Hoeft, S. F., Costantin, M., Crookes, P. F., Bremner, C. G., Demeester, T. R., Little III, A. G., and Ritchie, Jr. W. P.

Subjects
Adult, medicine.medical_specialty, Supine position, Monitoring, Adolescent, Motility, Gastroenterology, Internal medicine, 80 and over, medicine, Humans, Physiologic, Aged, Monitoring, Physiologic, Aged, 80 and over, Esophageal disease, business.industry, digestive, oral, and skin physiology, Pharynx, Pharyngeal swallowing, Reflux, Hydrogen-Ion Concentration, Middle Aged, medicine.disease, Deglutition, medicine.anatomical_structure, Ambulatory, Gastroesophageal Reflux, Peristalsis, Surgery, Sleep, Esophageal reflux, business, Research Article
Abstract

OBJECTIVE: This study defined the clearance mechanisms of naturally occurring reflux episodes in normal subjects and patients with gastroesophageal reflux disease. SUMMARY BACKGROUND: Previous studies on acid clearance have been performed in the laboratory setting in supine subjects using acid instillation and stationary motility. The mechanisms of clearance have not been studied using ambulatory pH and motility monitoring. METHODS: A new system capable of monitoring simultaneously for 24 hours pharyngeal pressure, esophageal motility, and pH was used to study the clearance of naturally occurring reflux episodes in 10 normal subjects and 18 patients with gastroesophageal reflux disease. Esophageal contraction waves were classified as primary (i.e., initiated by a pharyngeal swallow) and secondary (i.e., unrelated to a pharyngeal swallow). RESULTS: A total of 1288 reflux episodes were analyzed, during which 2781 contraction waves occurred. Clearance (i.e., restoration of pH to > 4) occurred after primary peristalsis in 83% of reflux episodes. An additional 11% were cleared by pharyngeal swallows without an esophageal body response. Secondary waves were rare and when they occurred, only 19% were peristaltic. Secondary peristalsis cleared only 9 of the 1288 reflux episodes. Patients and normal subjects cleared reflux episodes similarly. Baseline swallowing frequency was 0.87/min during the daytime and increased to 2.59/min (p < 0.01) during daytime reflux episodes. Swallowing frequency in response to nighttime reflux episodes was less (1.42/min; p < 0.05). CONCLUSIONS: Pharyngeal swallowing is the most important mechanism for esophageal acid clearance. Secondary waves are rare, usually disorganized, and unimportant in clearing a reflux episode. During sleep, the mechanisms of clearance are depressed.

Published
1993
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44. Normal esophageal body function: a study using ambulatory esophageal manometry

Author

Bremner, R. M., Costantini, M., Demeester, T. R., Bremner, C. G., Hoeft, S. F., Crookes, P. F., Peters, J. H., and Hagen, J. A.

Subjects
Adult, Monitoring, Hepatology, Manometry, Gastroenterology, Monitoring, Ambulatory, Hydrogen-Ion Concentration, Middle Aged, Esophagus, Humans, Peristalsis, Pressure, Reference Values, Ambulatory
Abstract

The objective of this study was to establish normative ambulatory manometric data for contractions and contraction propagation in three levels of the esophagus.Twenty-five healthy volunteers underwent simultaneous ambulatory 24 h manometry. Concomitant 24 h pH studies were performed to exclude the presence of increased esophageal acid exposure. Pressures were recorded over a complete circadian cycle while patients continued with their normal lifestyles including eating and sleeping. Data were analyzed with a software program that was previously modified and validated and that enables quantitation of contractions in terms of efficacy.The frequency of contractions was lowest during sleep, was increased when awake, and was highest during meals. Contraction amplitude increased during meals, providing a greater propulsive force for bolus transport. Similarly, the prevalence of peristaltic waves varied according to different physiologic states, ie., while eating, upright, awake, and sleeping. An increased amplitude and prevalence of peristalsis resulted in an increase in manometric efficacy during meals.This study provides normative data for ambulatory manometry for comparison when studying patients with disease.

Published
1998

45. Manual verification of computer analysis of 24-hour esophageal motility

Author

Bremner, R M, Costantini, M, Hoeft, S F, Yasui, A, Crookes, P F, Shibberu, H, Peters, J H, Nicholas, K, and Demeester, T R

Subjects
Monitoring, Manometry, Transducers, Reproducibility of Results, Circadian Rhythm, Diagnosis, Computer-Assisted, Esophageal Motility Disorders, Esophagus, Humans, Monitoring, Physiologic, Peristalsis, Software, Transducers, Pressure, Computer-Assisted, Diagnosis, Pressure, Physiologic
Abstract

The application of solid-state technology to intraesophageal pressure monitoring over an entire circadian cycle has resulted in large amounts of data that require computer analysis. Recently available commercial software has yet to be validated. The aim of this study was to compare the analysis of ambulatory esophageal manometry by an automated computer program with manual analysis and make the software modifications necessary to validate the automated system for clinical use. Computer-aided analysis of a large number of esophageal contractions recorded during ambulatory esophageal manometry was compared with manual analysis by four experienced physicians. Good correlations were found between manual and computerized measurements of contraction amplitude and duration (r = 0.99 and r = 0.73, respectively). Software modifications resulted in correct identification of 94% of contractions and correct classification of 93.3% of these waves as peristaltic or simultaneous. These results demonstrate that the evaluated program for automated analysis of ambulatory esophageal manometry is accurate and reliable for research and clinical applications.

Published
1993

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