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5. Do children with dysphagia and normal esophageal motility according to Chicago Classification always have “normal” esophageal motility?

Author

Kovacic, Karlo, Kern, Mark, Li, B U.K., Vang, Mychoua, Noe, Joshua, and Shaker, Reza

Abstract

Background Methods Key Results Conclusion & Inferences Internationally adopted Chicago Classification (CC) criteria based on adult normative data have been used to diagnose children with esophageal motility disorders undergoing high‐resolution esophageal manometry (HREM). The aim of this study was to compare HREM parameters of children without dysphagia and children with dysphagia and normal findings according to CC.HREM metrics of 41 children (13.2 (9–18) years; 20 female) without dysphagia and 41 children (13.7 (8–18) years; 30 female) with dysphagia and normal diagnosis according to CC were compared. Analyzed data included resting and integrated relaxation pressures (IRP) of upper (UES) and lower (LES) esophageal sphincters, esophageal peristaltic contractile integrals, transition zone (TZ) gaps, distal latency (DL), and manometric esophageal length to height ratio (MELH). 95%ile normative cutoffs were calculated from the cohort without dysphagia.Proximal contractile integral (PCI), UES and LES mean resting and IRP were not significantly different between the cohorts (p > 0.3). On the contrary, distal contractile integral (DCI), TZ gap and MELH were notably different with p = 0.0002, p = 0.027, and p = 0.033 respectively. According to 95%ile normative cutoffs of DCI, TZ gap and MELH, in cohort with dysphagia 27%, 15%, and 22% of patients respectively were not normal.First study ever to compare HREM parameters of children without dysphagia to children with dysphagia. Considerable proportion of children with dysphagia may be underdiagnosed according to the adult criteria. This emphasizes the need for universally accepted child‐specific diagnostic protocols and norms. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Correlation of deglutitive striated esophagus motor function and pharyngeal phase swallowing biomechanical events.

Author

Shaker, Reza, Kern, Mark, Edeani, Francis, Mei, Ling, Yu, Elliot, and Sanvanson, Patrick

Abstract

Background: The functional relationship of striated esophagus (St.Eso) motor function with pharyngeal deglutitive biomechanical events has not been systematically studied. The aim of this study was to determine the spatio‐temporal characteristics of St.Eso function and its correlation with pharyngeal biomechanics and bolus transport. Methods: We studied 50 healthy volunteer subjects (age range: 21–82 years, 31 female) by digital videofluoroscopy. All subjects were studied in a seated, upright position. Thirteen of these 50 volunteers also underwent high‐resolution manometry (HRM) concurrent with fluoroscopy. We used laryngeal excursion as a surrogate for St.Eso excursion. Key Results: Median duration of St.Eso excursion was 2.35 [1.93,2.85, 5th and 95th percentile] seconds. Mean maximum extent of St.Eso excursion was 2.84 ± 0.72 cm. We identified four distinct periods in deglutitive St.Eso motor function: P1. Anterosuperior ascent without bolus or peristaltic activity, P2. Non‐peristaltic bolus receiving at the apogee of St.Eso excursion concurrent with UES opening and pharyngeal peristalsis P3. Peristaltic bolus transport as St.Eso descends and P4. Continued peristalsis in resting position. Conclusions and Inferences: 1. St.Eso motor function spans both pharyngeal and esophageal phases of swallowing for receiving and transporting the bolus, 2. Pressure signatures in HRM recordings currently attributed to St.Eso deglutitive motor activity does not represent the entirety of St.Eso peristalsis, only the part that occurs in its resting position. St.Eso peristalsis that occurs during its descent is recorded by pressure sensors initially in the pharynx. This finding needs to be considered when interpreting HRM recordings of the pharynx and proximal esophagus. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Parkinson's disease is associated with low striated esophagus contractility potentially contributing to the development of dysphagia.

Author

Kerschner, Alexander, Hassan, Hamza, Kern, Mark, Edeani, Francis, Mei, Ling, Sanvanson, Patrick, Shaker, Reza, and Yu, Elliot

Subjects
PARKINSON'S disease, MOVEMENT disorders, ESOPHAGUS, DEGLUTITION disorders
Abstract

Background: Parkinson's disease (PD) is the second most common neurodegenerative disorder, and more than 80% of PD patients will develop oropharyngeal dysphagia. Despite its striated histology, proximity to airway, and potential negative impact of its dysfunction on bolus transport and airway safety, the contractile function of the striated esophagus in PD patients has not been systematically studied. Methods: Using our repository of clinical manometry and the Milwaukee ManoBank, we analyzed high‐resolution manometry (HRM) studies of 20 PD patients, mean age 69.1 (range 38–87 years); 30 non‐PD patients with dysphagia, mean age 64.0 (44–86 years); and 32 healthy volunteers, mean age 65.3 (39–86 years). Patients with abnormal findings based on Chicago Classification 4.0 were identified. Repeat analysis was performed in 20% of the manometric tracings by a different investigator with inter‐rater concordance between 0.91 and 0.99. Key Results: The striated esophageal contractile integral in PD patients was significantly lower than that in non‐PD dysphagic patients and healthy controls (p = 0.03 and <0.01, respectively). This significant difference persisted after excluding patients with concurrent Chicago Classification motility disorders (p = 0.02 and 0.01, respectively). In both analyses, the distal esophageal contractile integral did not show any significant difference between groups (p = 0.58 and 0.93, respectively). Conclusions & Inferences: PD is associated with a significant decrease in striated esophagus contractility compared to non‐PD and healthy controls. This finding may play a pathophysiologic role in development of dysphagia in this patient population. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Chronic almond nut snacking alleviates perceived muscle soreness following downhill running but does not improve indices of cardiometabolic health in mildly overweight, middle-aged, adults

Author

Siegel, Leah, primary, Rooney, Jessica, additional, Marjoram, Lindsey, additional, Mason, Lauren, additional, Bowles, Elena, additional, van Keulen, Thomas Valente, additional, Helander, Carina, additional, Rayo, Vernon, additional, Hong, Mee Young, additional, Liu, Changqi, additional, Hooshmand, Shirin, additional, Kern, Mark, additional, and Witard, Oliver C., additional

Published
2024
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10. The Role Of Almonds In Exercise Recovery

Author

Rayo, Vernon U., primary, Hooshmand, Shirin, additional, Okamoto, Lauren, additional, North, Elise, additional, Storm, Svitlana, additional, Jason, Nathaniel, additional, Cervantes, Maricarmen, additional, Liu, Changqi, additional, Hong, Mee Young, additional, Witard, OIiver C., additional, and Kern, Mark, additional

Published
2023
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13. Pistachios as a recovery food following downhill running exercise in recreational team‐sport individuals

Author

Philpott, Jordan, primary, Kern, Mark, additional, Hooshmand, Shirin, additional, Carson, Imogene, additional, Rayo, Vernon, additional, North, Elise, additional, Okamoto, Lauren, additional, O’Neil, Timothy, additional, Hong, Mee Young, additional, Liu, Changqi, additional, Dreczkowski, Gillian, additional, Rodriguez‐Sanchez, Nidia, additional, Witard, Oliver C., additional, and Galloway, Stuart D., additional

Published
2023
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26. Effects of Short-term Pistachio Consumption Before and Throughout Recovery from an Intense Exercise Bout on Cardiometabolic Markers in Healthy Men

Author

North, Elise, Carson, Imogene, Galloway, Stuart D.R., Hong, Mee Young, Hooshmand, Shirin, Liu, Changqi, Okamoto, Lauren, O'Neal, Timothy, Philpott, Jordan D., Rayo, Vernon, Witard, Oliver, and Kern, Mark

Abstract

Although pistachios have been shown to improve cardiometabolic biomarkers in diseased and at-risk populations, less research has been conducted on young, healthy individuals. Furthermore, some but not all research indicates that exercise acutely improves cardiometabolic markers; however, it remains unclear as to why outcomes vary among studies. This research evaluated secondary aims of a study designed to assess the impacts of pistachios on recovery from vigorous eccentrically-biased exercise. Here we examined the short-term (two weeks) effects of two different doses (1.5 oz/d and 3.0 oz/d) of pistachios and a water-only control on the biomarkers of metabolic health in young adult men. This was followed by daily blood collection for three consecutive days after a 40-min downhill run. Twenty-seven participants completed each of three conditions in a counterbalanced randomized order. Plasma biomarkers (lipid profile, glucose, and insulin) were measured at the end of each 2-week feeding period immediately before the exercise bout and again 24, 48, and 72 h thereafter. Two weeks of pistachio consumption failed to elicit changes in any biomarker (p < .05).. Exercise reduced LDL-cholesterol at the end of the recovery period; however, positive effects were limited to when subjects were consuming the higher dose of pistachios. Follow up t-tests revealed significant reductions in LDL-C in the high dose group at 72-H compared to that at 0-H (8.2 ± 19.4; p < .04), 24-H (8.0 ± 18.6; p < .04), and 48-H (9.3 ± 15.8; p < .005) post exercise within the same trial. Overall, in healthy young men with normal blood lipid and glucose metabolism, little effect of either pistachios or intense exercise on cardiometabolic risk indicators was detected. More research is needed to determine the influence of usual diet consumption on outcomes following an acute exercise bout.

Published
2022

27. Influence Of Pistachios On Sports Performance And Oxidative Stress Following Exercise-induced Muscle Damage

Author

Rayo, Vernon, primary, Buono, Michael, additional, Carson, Imogene, additional, Galloway, Stuart, additional, Hong, Mee Young, additional, Hooshmand, Shirin, additional, Liu, Changqi, additional, North, Elise, additional, Okamoto, Lauren, additional, O'Neal, Timothy, additional, Philpott, Jordan, additional, Witard, Olly, additional, and Kern, Mark, additional

Published
2022
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28. Effects Of Short-term Pistachio Consumption Before And Throughout Recovery From Intense Exercise On Cardiometabolic Markers

Author

North, Elise, primary, Buono, Michael, additional, Carson, Imogene, additional, Galloway, Stuart, additional, Hong, Mee Young, additional, Hooshmand, Shirin, additional, Liu, Changqi, additional, Okamoto, Lauren, additional, O'Neal, Timothy, additional, Philpott, Jordan, additional, Rayo, Vernon, additional, Witard, Olly, additional, and Kern, Mark, additional

Published
2022
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