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| 1 | Effect of electrical stimulation of the lower esophageal sphincter in gastroesophageal reflux disease patients refractory to proton pump inhibitors显示文摘AIM: To evaluate the efficacy of lower esophageal sphincter(LES)-electrical stimulation therapy(EST) in a subgroup of patients that reported only partial response to proton pump inhibitors(PPIs) therapy, compared to a group of patient with complete response.METHODS: Bipolar stitch electrodes were laparoscopically placed in the LES and connected to an implantable pulse generator(EndoS tim BV, the Hague, the Netherlands), placed subcutaneously in the anterior abdominal wall. Stimulation at 20 Hz, 215 μsec, 3-8 m Amp in 30 min sessions was delivered starting on day 1 post-implant. Patients were evaluated using gastroesophageal reflux disease(GERD)-HRQL, symptom diaries; esophageal p H and esophageal manometry before and up to 24 mo after therapy and results were compared between partial and complete responders.RESULTS: Twenty-three patients with GERD on LESEST were enrolled and received continuous per-protocol stimulation through 12 mo and 21 patients completed 24 mo of therapy. Of the 23 patients, 16(8 male, mean age 52.1 ± 12 years) had incomplete response to PPIs prior to LES-EST, while 7 patients(5 male, mean age 52.7 ± 4.7) had complete response to PPIs. In the sub-group with incomplete response to PPIs, median(IQR) composite GERD-HRQL score improved significantly from 9.5(9.0-10.0) at baseline on-PPI and 24.0(20.8-26.3) at baseline off-PPI to 2.5(0.0-4.0) at 12-mo and 0.0(0.0-2.5) at 24-mo follow-up(P < 0.05 compared to on-and off-PPI at baseline). Median(IQR) % 24-h esophageal pH < 4.0 at baseline in this sub-group improved significantly from 9.8%(7.8-11.5) at baseline to 3.0%(1.9-6.3) at 12 mo(P < 0.001) and 4.6%(2.0-5.8) at 24 mo follow-up(P < 0.01). At their 24-mo follow-up, 9/11 patients in this sub-group were completely free of PPI use. These results were comparable to the sub-group that reported complete response to PPI therapy at baseline. No unanticipated implantation or stimulation-related adverse events, or any untoward sensation due to stimulation were reported in either group and LES-EST was safely tolerated by both groups. CONCLUSION: LES-EST is safe and effective in controlling symptoms and esophageal acid exposure in GERD patients with incomplete response to PPIs. These results were comparable to those observed PPI responders. | Edy Soffer Leonardo Rodríguez Patricia Rodriguez Beatriz Gómez Manoel G Neto Michael D Crowell | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 4 |
| 2 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-induced angiogenesis显示文摘 | Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 3 | Vascular endothelial growth factor induced by hypoxia maymediate hypoxia-initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1993 | Nature(Lond)1993，359，： | 1 |
| 4 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis 显示文摘 | SWEIKI D ITIN A SOFFER D | 1992 | Nature1992，359，： | 1 |
| 5 | VaseuIar endothelial growth factor induced by hypoxia may mediate hypoxia initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，6398： | 1 |
| 6 | Vascular endothelial growth factor indeed by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，6398： | 1 |
| 7 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia initiated angiogenesis显示文摘 | Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 8 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 9 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | SHWEIKI D ITIN A SOFFER D | 1992 | Nature1992，359，3： | 1 |
| 10 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | Itin A Soffer L | 1992 | Nature1992，359，6398： | 1 |
| 11 | Vascular endotheial growth factor induced by hypoxia - initiated angiogensis 显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，2： | 1 |
| 12 | Vascular endothelial growth factor by hypoxia may mediate hypoxia-initiated angiogenesis 显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，6398： | 1 |
| 13 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-in tiuted angiogenesis显示文摘 | Shwelina D Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 14 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | Shweike D Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 15 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angingenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 16 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，： | 1 |
| 17 | Impact of angina class on inhibition of platelet aggregation following clopidogrel loading in patients undergoing coronary intervention:do we need more aggressive dosing regimens in unstable angina?显示文摘 | Soffer D Moussa I Harjai K J | 2003 | Catheter Cardiovasc Interv2003，59，1： | 1 |
| 18 | Vascular endothelial growth factor induced by hypoxia may mediate hypoxia initiated angiogenesis显示文摘 | Shweiki D Itin A Soffer D | 1992 | Nature1992，359，6398： | 1 |
| 19 | Impact of angina classon inhibition of platelet aggregation following clopidogrel loading in patients undergoing coronary intervention:Do we need more aggressive dosing regimens in unstable angina显示文摘 | Soffer D Moussa L Kishore J | 2003 | Catheterization and Cardiovascular Interventions2003，59，1： | 1 |
| 20 | A novel antigen-toxin chimeric protein:myelin basic protein-pseudomonas exotoxin (MBP-PE40) for treatment of experimental autoimmune encephalomyelitis显示文摘 | Brenner T Steinberger I Soffer D | 1999 | Immunol Lett1999，68，23： | 1 |
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