Asunto(s)
Planes de Seguros y Protección Cruz Azul/economía , Mal Uso de los Servicios de Salud/economía , Servicios de Salud/economía , Seguro de Hospitalización/economía , Seguro de Servicios Médicos/economía , Control de Costos , Servicios de Salud/estadística & datos numéricos , Reembolso de Seguro de Salud , Estados UnidosAsunto(s)
Obesidad/terapia , Estómago/cirugía , Adulto , Peso Corporal , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Findings in this study correlated a low circulating gastrin level with an incompetent lower esophageal sphincter mechanism and abnormal reflux. Such reflux, in amounts causing esophagitis distally, was treated surgically by a mechanically simple method of fundoplication. The success of this reefing method of fundoplication was explained by using physiologically active sling fibers of the gastric fundus to augment the lower esophageal sphincter. Available gastrin was used more effectively in this manner. The high incidence of associated foregut diseases suggested an embryologic factor in the development of gastroesophageal reflux. The dilated hiatus and its attendant hernia had no apparent relationship to the development of reflux esophagitis. The term symptomatic sliding hiatal hernia, therefore, seemed to be a diagnostic and therapeutic misnomer.