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Melo TM, Cunha FLL, Bezerra LMR, Salemi M, de Albuquerque VA, de Alencar GG, de Siqueira GR. Abdominal and Diaphragmatic Mobility in Adults With Chronic Gastritis: A Cross-Sectional Study. J Chiropr Med 2023; 22:11-19. [PMID: 36844992 PMCID: PMC9947977 DOI: 10.1016/j.jcm.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this study was to assess abdominal and diaphragmatic mobility in adults with chronic gastritis compared with healthy individuals and to analyze the impact of chronic gastritis on musculoskeletal signs and symptoms of the cervical and thoracic spine. Methods This was a cross-sectional study conducted by the physiotherapy department at the Universidade Federal de Pernambuco in Brazil. Fifty-seven individuals participated, 28 with chronic gastritis (gastritis group [GG]) and 29 healthy individuals (control group [CG]). We assessed the following: restricted abdominal mobility in the transverse, coronal, and sagittal planes; diaphragmatic mobility; restricted cervical vertebral segmental mobility; restricted thoracic vertebral segmental mobility; and pain on palpation, asymmetry, and density and texture of the soft tissues on the cervical and thoracic spine. The measure of diaphragmatic mobility was assessed with ultrasound imaging. The Fisher exact and χ2 tests were applied to compare the groups (GG and CG) in relation to the restricted mobility of the abdominal tissues near the stomach on all planes and diaphragm, and the independent samples t test to compare the mobility measurements of the diaphragm. A significance level of 5% was considered for all tests. Results Restricted abdominal mobility in all directions (P < .05) was greater in GG when compared with CG except for the counterclockwise direction (P = .09). In GG, 93% of the individuals presented restricted diaphragmatic mobility, with a mean mobility of 3.1 ± 1.9 cm, and in the CG, 36.8% with a mean of 6.9 + 1.7 cm (P < .001). The GG presented a higher occurrence of restricted rotation and lateral glide mobility of the cervical vertebrae, pain to palpation, and density and texture dysfunction of the adjacent tissues when compared with CG (P < .05). In the thoracic region, there was no difference between GG and CG regarding musculoskeletal signs and symptoms. Conclusion Individuals with chronic gastritis presented greater abdominal restriction and lower diaphragmatic mobility, in addition to a higher occurrence of musculoskeletal dysfunction in the cervical spine when compared with healthy individuals.
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Affiliation(s)
- Thania Maion Melo
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | | | - Marianna Salemi
- Department of Physiotherapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Drake CE, Cheng LK, Paskaranandavadivel N, Alighaleh S, Angeli-Gordon TR, Du P, Bradshaw LA, Avci R. Stomach Geometry Reconstruction Using Serosal Transmitting Coils and Magnetic Source Localization. IEEE Trans Biomed Eng 2023; 70:1036-1044. [PMID: 36121949 PMCID: PMC10069741 DOI: 10.1109/tbme.2022.3207770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Bioelectric slow waves (SWs) are a key regulator of gastrointestinal motility, and disordered SW activity has been linked to motility disorders. There is currently a lack of practical options for the acquisition of the 3D stomach geometry during research studies when medical imaging is challenging. Accurately recording the geometry of the stomach and co-registering electrode and sensor positions would provide context for in-vivo studies and aid the development of non-invasive methods of gastric SW assessment. METHODS A stomach geometry reconstruction method based on the localization of transmitting coils placed on the gastric serosa was developed. The positions and orientations of the coils, which represented boundary points and surface-normal vectors, were estimated using a magnetic source localization algorithm. Coil localization results were then used to generate surface models. The reconstruction method was evaluated against four 3D-printed anatomically realistic human stomach models and applied in a proof of concept in-vivo pig study. RESULTS Over ten repeated reconstructions, average Hausdorff distance and average surface-normal vector error values were 4.7 ±0.2 mm and 18.7 ±0.7° for the whole stomach, and 3.6 ±0.2 mm and 14.6 ±0.6° for the corpus. Furthermore, mean intra-array localization error was 1.4 ±1.1 mm for the benchtop experiment and 1.7 ±1.6 mm in-vivo. CONCLUSION AND SIGNIFICANCE Results demonstrated that the proposed reconstruction method is accurate and feasible. The stomach models generated by this method, when co-registered with electrode and sensor positions, could enable the investigation and validation of novel inverse analysis techniques.
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Steinsvik EK, Hausken T, Fluge Ø, Mella O, Gilja OH. Gastric dysmotility and gastrointestinal symptoms in myalgic encephalomyelitis/chronic fatigue syndrome. Scand J Gastroenterol 2023:1-8. [PMID: 36728717 DOI: 10.1080/00365521.2023.2173533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge gap in the literature concerning gastrointestinal motility features and detailed symptom description. OBJECTIVE In this study, we aimed to characterize gastric motility and gastric symptoms in response to a liquid meal. METHODS We included 20 patients with ME/CFS with abdominal complaints who were recruited to a double-blind randomized placebo-controlled trial of Rituximab. The patients of this sub study were examined with an ultrasound drink test, and gastrointestinal symptoms were evaluated using the Rome III questionnaire and Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS) questionnaire. RESULTS We found that patients commonly reported fullness/bloating (75%), abdominal pain (45%) and nausea (35%). Ultrasound measurements revealed lower proximal measurements of the stomach after a meal (p < 0.01) and larger fasting antral area (p = 0.019) compared to healthy controls. The patients had a stronger symptomatic response to the liquid meal compared to healthy controls regarding epigastric pain, discomfort and nausea (p < 0.05).Ninety percent of the patients reported bowel movement frequencies within the normal range but scored high on bowel habit dissatisfaction and life disruption. CONCLUSION The patients presented with fullness/bloating, nausea and epigastric pain, showed signs of impaired gastric accommodation and visceral hypersensitivity, showing that the gastrointestinal symptoms of ME/CFS patients are similar to functional dyspepsia.Key summary Gastrointestinal symptoms are common in ME/CFS, but there is a knowledge gap in the literature concerning gastrointestinal motility features and detailed symptom description. • In this study, patients with ME/CFS had signs of impaired gastric accommodation after a liquid meal. • Out of 20 patients, 15 patients reported fullness/bloating, 9 reported abdominal pain, and 7 reported nausea. The patients showed signs of visceral hypersensitivity on a drink test. • Our findings suggest that patients with ME/CFS share many similarities with patients with Functional Dyspepsia. The findings were not typical for Irritable Bowel Syndrome.
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Affiliation(s)
- Elisabeth K Steinsvik
- National Centre for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway.,National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - Trygve Hausken
- National Centre for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway.,National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Øystein Fluge
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway.,Institute of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Olav Mella
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway.,Institute of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Liu X, Esser D, Wagstaff B, Zavodni A, Matsuura N, Kelly J, Diller E. Capsule robot pose and mechanism state detection in ultrasound using attention-based hierarchical deep learning. Sci Rep 2022; 12:21130. [PMID: 36476715 PMCID: PMC9729303 DOI: 10.1038/s41598-022-25572-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Ingestible robotic capsules with locomotion capabilities and on-board sampling mechanism have great potential for non-invasive diagnostic and interventional use in the gastrointestinal tract. Real-time tracking of capsule location and operational state is necessary for clinical application, yet remains a significant challenge. To this end, we propose an approach that can simultaneously determine the mechanism state and in-plane 2D pose of millimeter capsule robots in an anatomically representative environment using ultrasound imaging. Our work proposes an attention-based hierarchical deep learning approach and adapts the success of transfer learning towards solving the multi-task tracking problem with limited dataset. To train the neural networks, we generate a representative dataset of a robotic capsule within ex-vivo porcine stomachs. Experimental results show that the accuracy of capsule state classification is 97%, and the mean estimation errors for orientation and centroid position are 2.0 degrees and 0.24 mm (1.7% of the capsule's body length) on the hold-out test set. Accurate detection of the capsule while manipulated by an external magnet in a porcine stomach and colon is also demonstrated. The results suggest our proposed method has the potential for advancing the wireless capsule-based technologies by providing accurate detection of capsule robots in clinical scenarios.
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Affiliation(s)
- Xiaoyun Liu
- grid.17063.330000 0001 2157 2938Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S1A8 Canada
| | - Daniel Esser
- grid.152326.10000 0001 2264 7217Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235 USA
| | - Brandon Wagstaff
- grid.17063.330000 0001 2157 2938University of Toronto Institute of Aerospace Studies, University of Toronto, Toronto, ON M5S1A8 Canada
| | - Anna Zavodni
- grid.17063.330000 0001 2157 2938Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON M5S1A8 Canada
| | - Naomi Matsuura
- grid.17063.330000 0001 2157 2938Department of Materials Science and Engineering and Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S1A8 Canada
| | - Jonathan Kelly
- grid.17063.330000 0001 2157 2938University of Toronto Institute of Aerospace Studies, University of Toronto, Toronto, ON M5S1A8 Canada
| | - Eric Diller
- grid.17063.330000 0001 2157 2938Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S1A8 Canada
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Liao D, Mark EB, Nedergaard RB, Jensen LR, Bertoli D, Frøkjær JB, Yu D, Zhao J, Brock C, Drewes AM. Indentation of a pressurized silicon stomach model - A non-invasive study of gastric wall stiffness and pressurized gastric content stiffness. J Mech Behav Biomed Mater 2022; 135:105449. [PMID: 36108417 DOI: 10.1016/j.jmbbm.2022.105449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/23/2022] [Accepted: 09/01/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Evaluation of gastric wall stiffness and intragastric pressure is essential for detailed assessments of gastric accommodation. However, non-invasive assessments are needed for large scale clinical studies and none of the existing methods takes abdominal wall effect into the calculation. This study aimed to assess gastric wall stiffness and gastric content stiffness as a proxy for intragastric pressure using novel mechanical modeling and non-invasive indentation tests on a silicon stomach model. METHODS A silicon stomach model (scaling 1:1 with the human stomach) was indented using a pressure algometer at intragastric pressures from 0 to 0.8 kPa. Wall thicknesses and luminal cross-sectional areas along the stomach were measured with ultrasound images. The gastric wall stiffness was compared between measurements from tensile tests on strips cut from the silicon stomach and estimations from a shell indentation model. The pressurized gastric content stiffness was predicted from a bonded two-layer axisymmetric half-space indentation model. RESULTS The gastric wall stiffness estimated from the shell indentation model showed no difference to measurements from the mechanical tests on the cutting strips (p = 0.14). The predicted gastric content stiffness was strongly associated with the intragastric pressure (r > 0.83, p < 0.001). CONCLUSIONS The mechanical model developed in this study can simultaneously predict the gastric wall stiffness and the pressurized gastric content stiffness. In future studies, the method can be applied to reveal intragastric pressure conditions non-invasively via the pressurized gastric content stiffness during gastric accommodation and emptying such as with magnetic resonance imaging.
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Affiliation(s)
- Donghua Liao
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
| | - Esben Bolvig Mark
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
| | - Rasmus Bach Nedergaard
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
| | | | - Davide Bertoli
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark.
| | - Jens Brøndum Frøkjær
- Mech-Sense, Department of Radiology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Donghong Yu
- Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark.
| | - Jingbo Zhao
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; LBP (Chongqing) Pathological Diagnosis Center, Chongqing, China.
| | - Christina Brock
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Steno Diabetes Center North Denmark, Aalborg, Denmark.
| | - Asbjørn Mohr Drewes
- Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Steno Diabetes Center North Denmark, Aalborg, Denmark.
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Eichler CE, Cheng LK, Paskaranandavadivel N, Angeli-Gordon TR, Du P, Bradshaw LA, Avci R. Anatomically Constrained Gastric Slow Wave Localization using Biomagnetic Data. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:3935-3938. [PMID: 36086461 DOI: 10.1109/embc48229.2022.9871485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Detection of dysrhythmic gastric slow wave (SW) activity could have significant clinical utility because dysrhyth-mias have been linked to gastric motility disorders. The elec-trogastrogram (EGG) and magnetogastrogram (MGG) enable the non-invasive assessment of SW activity, but most analysis methods can only resolve frequency and velocity. Improved characterization of dysrhythmic propagation patterns from non-invasive measurements is important for the diagnosis of motility disorders and could allow early treatment stratification. In this study, we demonstrate the use of a penalized linear regression framework to localize SW events on the longitudinal stomach axis using simulated MGG data. Priors relating to spatial sparsity, the organization of wavefronts into complete circumferential rings, and the local distribution of depolar-ization and repolarization phases were used to constrain the inverse solution. This method was applied to MGG computed for a single wavefront case and a multiple wavefront case that were constructed from simulated 3 cycle-per-minute normal SW activity. Propagation patterns along the longitudinal stomach axis were identifiable from reconstructed SW activity for both cases. Localization error was 5.7 ± 0.1 mm and 7.7 ± 0.1 mm for each respective case within the distal stomach when the signal-to-noise ratio was 10 dB. Results indicate that penalized linear regression can successfully localize SW events provided the 3D geometry of the stomach and torso were acquired. Clinical Relevance- This method could help to improve the efficiency and accuracy of diagnosing gastric motility disorders from non-invasive measurements.
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Gregersen H. Bionic devices and measurements in the digestive tract. Physiol Meas 2021; 42. [PMID: 34140432 DOI: 10.1088/1361-6579/ac0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/19/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Hans Gregersen
- California Medical Innovations Institute, San Diego, CA, United States of America
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