Single-probe pH monitoring of the hypopharynx and esophagus was feasible. Adding a hypopharyngeal pH sensor increased the detection of abnormal acid reflux more often than traditional dual-sensor esophageal pH monitoring.

Background: The direct effect of the COVID-19 pandemic on patients with intestinal failure (IF) has not been described. Methods: We conducted a nationwide study of U.K. IF centres to evaluate the infection rates, presentations and outcomes in patients with types 2 and 3 IF. Results: A total of 45 patients with IF contracted COVID-19 between March and August 2020; this included 26 of 2191 (1.2%) Home Parenteral Nutrition (HPN)-dependent adults and 19 of 298 (6.4%) adults hospitalized with type 2 IF. The proportion of patients receiving nursing care for HPN administration was higher in those with community-acquired COVID-19 (66.7%) than the proportion in the entire HPN cohort (26.1%; p<0.01). Two HPN-dependent and 1 hospitalised patient with type 2 IF died as a direct consequence of the virus (6.7% of 45 patients with types 2 or 3 infected). Conclusion: This is the first study to describe the outcomes of COVID-19 in a large cohort of patients of requiring long term PN. Methods to reduce hospital and community nosocomial spread would likely be beneficial. Clinical relevancy statement 1.2% of 2191 HPN-dependent adults and 6.4% of 298 hospitalized adults with acute severe IF contracted COVID-19 during the first wave of the pandemic in the U.K. 6.7% of adults with types 2 or 3 IF infected with COVID-19 during the study period died as a direct result of viral infection. Methods to reduce hospital and community nosocomial spread would be beneficial.

SUMMARY The effects on the oesophagus of an aromatic oil, guaiacol, has been examined in a group of 20 patients with reflux oesophagitis and also normal volunteers. This agent produced a rapid and sustained rise in resting lower oesophageal sphincter pressures and the peristaltic pressures induced in response to swallowing liquids. This compound may prove useful in the treatment of patients with reflux oesophagitis and other disorders of oesophageal motility.Aromatic oils or substances containing them have been used as internal medicinal agents from the earliest times. The therapeutic aims have been numerous but probably the most frequent has been to produce the 'carminative' effect. Carminatives are agents which produce a sensation of abdominal warmth and relieve gastrointestinal distension when ingested orally, probably by increasing gut mucosal blood flow and acting as antispasmodics.1-3 Indeed, it may have been these properties which prompted Hippocrates (460-361 BC), for example, to use oil of rue as an antispasmodic, stimulant, and rubefacient in the treatment of childhood colic.Pharmacological studies performed on isolated preparations of mammalian smooth muscle, using known constituents of volatile oils and other chemically related agents, have demonstrated that many of these compounds decrease muscle tone and spontaneous contractility; properties which are characteristic of antispasmodics and spasmolytics.4 We have identified one aromatic oil, however, which increases spontaneous activity of isolated muscle strips in vitro and the canine colon in vivo. 5 6 We have further examined the efficacy of this compound in the human oesophagus in normal individuals and patients suffering from gastrooesophageal reflux complicated by oesophagitis. Diminution in oesophageal peristalsis and resting tone of the lower oesophageal sphincter (LOS) are believed to contribute to the pathophysiology of reflux oesophagitis and it is likely that a topically-

No abstract

No abstract