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The gastrointestinal tract
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
Christopher F.D. Li Wai Suen, Peter De Cruz
Sphincters also occur at various points in the GI tract. These circular muscles act as gateways that regulate the passage of food products. By contracting, they stop the flow of content whereas by relaxing, they allow the passage of contents. The pyloric sphincter (or pylorus), for example, is at the exit end of the stomach and regulates passage of food into the duodenum (the first part of the small intestine connected to the stomach).
The Role of Evacuation Proctography (Defecography) in the Evaluation of Fecal Incontinence
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
Philip Shorvon, Giles Stevenson
Despite the useful overview and unique information obtained at proctography, there are several limitations to the technique and it should never be considered in isolation from clinical and physiological data. The main limitations are The wide range of normality and the overlap in appearance between normal subjects and patients.The lack of data on the changes of the appearances with age.The inability to detect specific sphincter defects accurately.A relatively high radiation dose, which is a particular consideration in those patients still hoping to have children and also for those subjected to repeated studies to monitor therapy.The lack of data on the variation of proctographic appearances that different stool consistencies produce and the difficulty in making and inserting a sufficiently viscous contrast to simulate normal stool.Only the posterior compartment of the pelvis is well visualized and the interrelations of the different pelvic compartments in pelvic floor descent and prolapse are not demonstrated.
The digestive system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Gastrointestinal sphincters are formed where the circular layer of smooth muscle is thickened. Sphincters occur at several points along the tract. Their function is to limit the movement of food materials from one region to another. For example, the pyloric sphincter is found between the stomach and the duodenum of the small intestine. This sphincter plays an important role in limiting the rate of gastric emptying. Sphincters undergo tonic contractions, which may be sustained for minutes or hours.
Association between anticholinergic medication uses and the risk of pneumonia in elderly adults: a meta-analysis and systematic review
Published in Annals of Medicine, 2023
Mindan Wu, Zhixuan Li, Wenchuan Zheng, Jia Zhuang, Shuhan Wu, Qipeng Zhou, Junfu Cai, Houzhen Zheng, Guixing Zeng, Weilin Zhang, Shengbin Zhang, Maohuang Lin, Xianyang Zhong, Qichuan Zhang
Anticholinergic drugs have some adverse effects including central (e.g. cognitive, drowsiness, sedation, delirium, confusion) and peripheral (e.g. dry mouth, constipation) adverse effects. Several potential hypotheses were made to explain the increased risk of pneumonia with anticholinergic medication uses based on adverse effects [20]. Firstly, dryness of mouth could impair oropharyngeal and oesophageal bolus transport which may result in aspiration pneumonia [6,9,21,22]. Second, low levels of thick mucosal secretion could increase the bacterial growth. Depression of mucociliary transport could prolong bacterial stay in the lungs. Both of them may finally lead to respiratory infection [23]. Third, low oesophageal sphincter pressure might lead to acid reflux which could cause aspiration [24]. At last, sedation and altered mental status, one of the anticholinergic drugs central adverse effects, were related with poor pulmonary hygiene, atelectasis and aspiration which might contribute to pneumonia [25]. However, the possible mechanisms still remain speculate with regard to molecular mechanisms.
Current development and clinical applications of artificial anal sphincter
Published in Expert Review of Medical Devices, 2023
Minghui Wang, Yunlong Liu, Qingjun Nong, Hongliu Yu
Animal studies on artificial anal sphincter are preliminary and have some limitations. For example, the reality of animals and humans is different. However, animal models are useful for studying the mechanism of action of artificial anal sphincter in biological tissues. Prior to clinical trials, the interaction between artificial sphincter and surrounding biological tissue is simulated in animal models, which is helpful to avoid tissue damage caused by the interaction between implant and biological tissue. Therefore, these preliminary studies can provide necessary information for subsequent clinical studies. In terms of evaluating the safety and effectiveness of the device, animal experimental study is of great significance for further clinical experimental research. Both the animal studies and clinical studies are able of the introduction on market of new devices, but further, a priori evaluation could strongly improve the devices themselves and the clinical outcomes.
Efficacy of pelvic floor muscle exercise or therapy with or without duloxetine: a systematic review and network Meta-analysis
Published in The Aging Male, 2022
Jae Joon Park, Allison Kwon, Tae Il Noh, Yong Nam Gwon, Sung Ryul Shim, Jae Heon Kim
Causes of PPUI include removal of the proximal urethral sphincter during prostatectomy, detrusor overactivity, sphincter injury, nerve damage, and shortening of the urethra length. Which of these factors is most critical for the risk of PPUI remains controversial [11]. A high rate of postoperative sphincter weakness has been confirmed via a urodynamic study in patients with PPUI, and detrusor overactivity was observed in 30–60% of patients with PPUI [16]. Also, during prostatectomy, the proximal urethral sphincter is removed, which increases the risk of sphincter damage due to ischemia and immobilization [17,18]. Mostwin reported the role of multiple factors in PPUI, including direct pudendal nerve damage by prostatectomy and shortening of the urethra above a threshold [11,19].