Minor Disorders Research Articles

Evaluating the impact of an enhanced triage process on the performance and diagnostic yield of oesophageal physiology studies post COVID-19

ObjectivesThe COVID-19 pandemic significantly impacted on the provision of oesophageal physiology investigations. During the recovery phase, triaging tools were empirically recommended by national bodies for prioritisation of referrals amidst rising...

Vitamin D Supplementation and Cognition in Adults: A Systematic Review of Randomized Controlled Trials.

The role of vitamin D supplementation in improving cognition and slowing the incidence of minor and major neurocognitive disorders is a matter of debate. To our knowledge, no systematic review of randomized controlled trials (RCTs) has examined this question in adults. The purpose of this systematic review is to synthesize the evidence regarding the effects of vitamin D supplementation on cognitive performance and neurocognitive disorders in adults. A systematic search of scientific articles in English or French was conducted. The MEDLINE (PubMed), EMBASE (Ovid, EMBASE), PsychINFO, and Cochrane Central databases were searched for records without any limit on publication date in May 2021. Inclusion criteria were (1) human participants, (2) RCT, (3) participant age ≥ 18, (4) vitamin D supplementation as the intervention, and (5) cognition (i.e., cognitive performance or cognitive status such as cognitively healthy or minor and major neurocognitive disorder) as the primary outcome. Two independent reviewers both assessed all eligible studies' full texts and the risk of bias arising from methodological issues using a standardized procedure. Of the 2137 abstracts identified, 61 (2.9%) met screening inclusion criteria. After full text examination, 41 records (67.2%) were excluded. As a result, 20 RCTs (32.8%) were included in the systematic review. The review yielded mixed findings and, thus, failed to find evidence supporting cognitive benefits from vitamin D supplementation or suggesting a causal association between vitamin D and cognitive function. Half of the RCTs reported mixed results, one quarter negative results, and the last quarter positive effects for vitamin D supplementation on cognitive performance. The variability in serum 25-dihydroxyvitamin D concentration thresholds, the cognitive tests employed, the supplementation doses, and the samples' characteristics (i.e., ethnicity or number of participants) may explain these mixed findings. This systematic review of RCTs does not support a role for vitamin D supplementation in enhancing cognitionin adults.

Herbal Formulations as Lepa (External Application) in Vyanga - A Review

Vyanga is one of the Kshudra roga (minor disorder), characterized by the presence of Niruja (painless), Tanu (light) and Shyava varna mandala (bluish black patches) on face. It is one of the most common diseases as regards the face is concerned. Description of the disease Vyanga is available from Samhita kala onwards. Most of the Aacharya have mentioned Vyanga in the chapter of Kshudra Roga. According to Charaka, Vyanga is said to be manifested by the suppression of Chardi vega. The aggravated Vata and Pitta along with Rakta are responsible for its manifestation. The Manasika nidana like Soka, Krodha and Ayasa are also result in the disease Vyanga. The Ayurvedic management of Vyanga includes both Sodhana and Samana chikitsa and Samana comprises of both internal and external medications. As the disease is mainly concerned with the skin, external applications like Lepa is having a prime importance here. Drugs with Rakta prasadaka (blood purifying), Twachya (conducive to skin) and Varnya (improving complexion) properties are commonly used in the management of Vyanga. They help to pacify aggravated Vata & Pitta dosha, thus aid in disease cure. Here it is tried to include some of the simple herbal formulations as Lepa (external application) mentioned in Ayurvedic texts for the management of Vyanga.

A Traditional Review of Sickle Cell Disease and the Associated Onset of Dementia: Hematological and Neurocognitive Crossroads.

Sickle cell trait and disease are potential risk factors for dementia and cognitive dysfunction in African Americans, as are genetic variants. This illness affects around 300 million people globally. Due to its ability to defend against severe malaria, it represents an evolutionary survival advantage. It has been shown that sickle cell disease and trait are independent risk factors for the prevalence and incidence of albuminuria and chronic renal disease. Sickle cell anemia impairs cognitive performance in people with minimal or mild manifestations of the genetic blood disorder, owing mostly to its cerebrovascular implications. Similarly, various cerebral minor vascular disorders, such as silent cerebral infarcts, have been linked to the sickle cell trait, which is associated with impaired cognitive ability. It has been found that patients with sickle cell disease have a significantly decreased subcortical and cortical brain volume. Adults and children with sickle cell disease have been documented to have attention-related issues, particularly reduced sustained attention.

Predictive value of brain MRI at term-equivalent age in extremely preterm children on neurodevelopmental outcome at school-age.

This study's objective was to correlate the abnormalities in brain MRIs performed at corrected-term age for minor or moderate neurocognitive disorders in children school-age born extremely premature (EPT) and without serious sequelae such as autism, cerebral palsy, mental impairment. Data were issued from a cross-sectional multicenter study (GP-Qol study, number NCT01675726). Clinical examination and psychometric assessments were performed when the children were between 7 and 10years old during a day-long evaluation. Term-equivalent age brain MRIs on EPT were analyzed with a standardized scoring system. There were 114 children included in the study. The mean age at the time of evaluation, was 8.47years old (± 0.70). 59% of children with at least one cognitive impairment and 53% who had a dysexecutive disorder. Only ten EPT (8.7%) presented moderate to severe white and grey matter abnormalities. These moderate to severe grey matter abnormalities were associated with at least two abnormal executive functions [OR 3.08 (95% CI 1.04-8.79), p = 0.04] and language delay [OR 3.25 (95% CI 1.03-9.80), p = 0.04]. These results remained significant in the multivariate analysis. Moderate to severe ventricular dilatation abnormalities (15%, n = 17) were associated with ideomotor dyspraxia [OR 7.49 (95% CI 1.48-35.95), p = 0.02] and remained significant in multivariate analysis [OR 11.2 (95% CI 1.45-131.4), p = 0.02]. Biparietal corrected diameters were moderate abnormal in 20% of cases (n = 23) and were associated to visuo spatial integration delay [OR 4.13 (95% CI 1.23-13.63), p = 0.02]. Cerebral MRI at term-equivalent age with scoring system analysis can provide information on long-term neuropsychological outcomes at school-age in EPTs children having no severe disability.

A CLINICAL STUDY TO EVALUATE AN EFFECT OF DHANYAKADI LEPA AS - BAHIRPARIMARJANA CHIKITSA AND CHANDANA CHURNA WITH MADHU AS ANTHAPARIMARJANA CHIKITSA IN YAVANAPIDAKA

Yavanapidika is one among the Kshudra roga (minor disorder) 1explained in Classical texts. However, Sushruta has described this disease under the name of Mukhadushika2. Kapha, Vata & Rakta are considered as causative factors of Mukhdushika. Pidika (eruptions), Saruja(pain), Ghana (thick), Medagarbha (fat in eruption) are considered clinical features as mentioned in Samhitas. Yavana Pidaka can be correlated with Acne vulgaris. Acne is the most common skin problem which commonly affects Teenagers. According to the global burden of disease study, Acne Vulgaris affects about 85% of the age group of 12-25 years, Acne consistently represents the top three most prevalent skin conditions in the general population as found in large studies3. In this context, Dhanyakadi Lepa4 is applied externally as Bahirparimarjana Chikitsa in the form of lepa and Chandana Churna (Santalum album, Linn)5 with Madhu (honey)6 is used internally as Anthaparimarjana chikitsa on Yavanapidaka. Thirty patients suffering from Yavanapidika were randomly selected and the above-mentioned treatment was administeredfor thirty days. It is concluded that Dhanyakadi Lepa as Bahir parimarjana chikitsa and Chandana Churna and Madhu as Anthaparimarjana Chikitsa are effective in the treatment of Yavanapidaka. Keywords: Yavanapidika, Mukhadushika, Kshudra rogas, Acne vulgaris, Dhanyakadi lepa, Chandana churna, Madhu.

200 - Neuropsychiatric symptoms influence performance of activities of daily living in symptomatic Alzheimer’s Disease

Background:The triad of symptom groups of Alzheimer’s disease (AD) encompasses cognitive impairment (e.g. impaired memory or orientation), neuropsychiatric symptoms like apathy, depressive mood, delusions, hallucinations or anxiety, and functional impairment exclusively in complex activities of daily living (cADL, e.g. preparing meals, managing finances) in minor neurocognitive disorder due to AD and both in complex and basic ADL (bADL, e.g. dressing, toileting) in major neurocognitive disorder due to AD. These functional impairments are widely thought to be exclusively attributable to the cognitive deficits of the disease. Of note, mounting evidence indicates that neuropsychiatric symptoms are very common in AD and pose a heavy burden to both patients and their caregivers.Research objective:To unravel potential associations between neuropsychiatric symptoms and cADL and bADL in individuals with neurocognitive disorder due to AD by means of machine learning (ML).Methods:The study included 189 cognitively intact older individuals (CI) and 130 with either minor or major neurocognitive disorder due to AD. Neuropsychiatric symptoms were captured with the Neuropsychiatric Inventory (NPI), covering delusions, hallucinations, aggression, depression, anxiety, apathy, elation, disinhibition, irritability, motor disturbance, nighttime behavioural disturbances and appetite disturbances; cognitive function was assessed with the Cognitive Telephone Screening Instrument (COGTEL); The Bristol ADL scale, an informant-rated measure, was employed for tapping performance of ADL. A variety of ML-models was constructed and trained/tested using a 5-fold cross validation, with SMOTE employed as a remedy for class imbalances. In all cases the features had been selected beforehand based on LASSO technique. The dependent variable was either cADL or bADL (after their discretization based on kMeans quantization). Additionally, the modelling of the diagnosis was also attempted within our ML framework.Results:Gradient Boosting models performed superiorly. cADL and bADL levels are predicted based on both deficits in cognitive domains and NPI variables with an accuracy of 82.3% and 84.8% respectively.In addition, diagnosis can be predicted, with an accuracy of 83.5%, based on a model in which NPI and Bristol ADL variables were significant predictors.Conclusions:cADL- and bADL performance in patients with AD is influenced by both cognitive deficits and neuropsychiatric symptoms.

Современные тенденции в архитектурном проектировании инклюзивных школ

Introduction. The co-authors address current trends in the architectural design of inclusive schools. Their mission is to maximize the social involvement and integration of disabled children into groups of kids. The purpose of this research is to identify guidelines for designing inclusive schools and to make recommendations for the design of inclusive schools that conduct adaptation events. Materials and methods. The co-authors have used methods of comparative analysis and synthesis of foreign and Russian research, literary and design materials; findings of sociological surveys; a multidisciplinary approach that encompasses medicine, social science, and legal norms, that influence the guidelines for designing inclusive schools. Results. The research is focused on developing guidelines for designing inclusive schools and recommendations on the design of inclusive schools whose administration conducts adaptation events for children with minor disabilities and a normal level of intelligence, the vision acuity of, at least, 0.4 diopters, the hearing impairment of 26 to 40 dB, minor muscle-skeleton disorders, including wheelchair users, capable of getting around on their own. These results may be taken advantage of by architects, designing inclusive schools; they can also be taught at universities of architecture. Conclusions. The co-authors make recommendations for the design of inclusive schools designated for particular categories of disabled persons. The analysis of problems in the context of architectural and space-planning design of inclusive school buildings will allow to improve their structure and study their typology with a view to further development. The deve­lopment of inclusive education, which is also regarded from the standpoint of architectural and space-planning design, draws human attention to the problem of responsibility for disabled children that must be be assumed by the society and the state.

Sexual Disorders in Women with Overactive Bladder and Urinary Stress Incontinence Compared to Controls: A Prospective Study.

Introduction and Hypothesis Female urinary incontinence (UI) has a negative impact on sexual function and sexual quality of life (QoL) in women. But there is still no consensus on the type of UI or the prevalence of sexual dysfunction (SD). The aim of the study was to evaluate sexual disorders in women with overactive bladder (OAB) compared to patients with urinary stress incontinence (SUI) and healthy controls. Materials and Methods 106 women presenting to a urogynecological outpatient clinic (referral clinic) were investigated using standardized questionnaires and the Female Sexual Function Index (FSFI-d). All 65 incontinent women underwent a full urodynamic examination; the controls (31) were non-incontinent women in the same age range who came for routine check-ups or minor disorders not involving micturition or pelvic floor function. Women with mixed urinary incontinence, a history of previous medical or surgical treatment for UI, recurrent urinary tract infections, previous radiation therapy or pelvic organ prolapse of more than stage 2 on the Pelvic Organ Prolapse Quantification (POP-Q) system were excluded. Results 100 questionnaires could be evaluated (94.3%). Thirty-four women had urinary stress incontinence, 35 had OAB, 31 were controls. Mean age was 56 years, with no significant differences between groups. The scores of the questionnaire ranged from 2 to 35.1 points. The median score of OAB patients was significantly lower (17.6) than the median score of the controls (26.5; p = 0,004). The stress-incontinent women had a score of 21.95, which was lower than that of the controls but statistically non-significant (p = 0.051). In all subdomains, the OAB patients had lower scores than the stress-incontinent women and significantly lower values than the control group. Most striking was the impairment of “sexual interest in the last 4 weeks”. The figure for “none or almost no sexual activity” was 80% for the OAB group, 64.7% for the group of stress-incontinent women and 48% for the control group. Incontinence during intercourse was reported by one OAB patient and 4 stress-incontinent women but did not occur in the control group. Conclusions There is a high prevalence of SD in women with urinary incontinence. Patients with OAB reported a greater negative impact on sexual function and had significantly lower scores for the FSFI questionnaire than patients with stress incontinence or controls.

Screening of minor psychiatric disorders and burnout among a sample of medical students in St. Petersburg, Russia: a descriptive study

BackgroundDespite the general interest of researchers around the world, there are few studies on the psychological wellbeing and burnout among medical students in Russia. The aim of this study was to perform screening for minor psychiatric disorders, burnout, problematic alcohol use, and quantify the psychological issues and stress among a sample of medical students in St. Petersburg, Russia.ResultsAccording to the GHQ-12, screening for minor mental disorders was positive in 140 students (85%). Screening for burnout using the OLBI showed positive results in 121 (73%) students for disengagement and 132 (80%) students for exhaustion. Screening with the CAGE tool identified a risk of alcohol consumption in 33 students (20%). Most students reported academic studies as the main source of stress in their life (n = 147; 89.1%).ConclusionsThis study identified very high levels of stress, burnout, risk of minor mental disorders, and problematic alcohol use among medical students in St. Petersburg, Russia. These findings suggest more attention is needed to the poor mental wellbeing and health in medical students in Russia.

Revisiting Treatment Options for Depressed Patients with Generalised Anxiety Disorder.

Symptoms of anxiety and depression often coexist, and evidence suggests that this has a genetic basis, among other possible causes. However, the current classification of comorbid generalised anxiety disorder (GAD) and depression (anxious depression) in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5) does not fully reflect the high prevalence of anxiety symptoms in people with depression and the International Classification of Diseases (10th and 11th revisions) has tended to identify anxious depression with minor disorders seen in primary care. As a result, few dedicated therapeutic trials have been conducted in patients with anxious depression, and specific treatment guidelines and recommendations are lacking. Fortunately, there is considerable therapeutic overlap between anxiety and depression, such that many agents with antidepressant efficacy are also effective for symptoms of GAD. The initial treatment of a patient with depression and symptoms of anxiety should be with an agent that is approved for both major depressive disorder and GAD, such as a selective serotonin reuptake inhibitor. There is an obvious need for greater recognition of anxious depression in order to boost the volume of high-quality clinical data, which should translate over time into better, more specific treatment recommendations and improved outcomes.

Pilot Study: The Queen Square Screening Test for Visual Deficits in Dementia

ABSTRACT The Queen Square Screening Test for Visual Deficits (QS test) screens for changes in visual processing. Our pilot study aimed to review the applicability of the QS test in individuals with dementia compared with those with normal cognition. Participants with major and minor neurocognitive disorder scored 50/71 (n=12) and 61/71 (n=10) respectively on the QS test, compared to 65/71 for age-matched healthy controls (n=11). The QS test score correlated with cognitive impairment as measured using the Rowland Universal Dementia Assessment Scale (r = 0.74). The QS test is an affordable and easy bedside screening test for visual processing changes.

Effectiveness of Structured Teaching Programme (STP) on knowledge Regarding Selected Minor Ailments of Newborn among Primipara Mothers Admitted in PNC ward, AIIMS Raipur

Newborn babies constitute the foundation of life. The birth of a baby is one of the most awe inspiring and emotional events that can occur in one’s life time. In India most the mothers are not aware of management regarding minor disorder of newborn (vomiting, diarrhea, physiological jaundice conjunctivitis, umbilical cord infection, skin rashes etc). Mother plays an important role in the identifying minor developmental deviation and early evidences of the disease process because she is constantly and closely watching her baby. Methodology: pre experimental (one group pretest and posttest) design was adopted for this study. The study was conducted at postnatal ward AIIMS Raipur with sample size of 30 primipara mothers. Non probability convenient sampling technique was adopted to select the sample. The data was collected by means of self-structured questionnaire to assess the knowledge among primipara mothers. Result: The mean score of pre-test was 15.36 and mean score of post-test was 22.4 and the mean improvement was 7.04, which is 45.83% of total primipara mothers. The paired ‘t’ value obtained for knowledge was 10.41 which was found significant at 0.05 level (p<0.05) which is 2.05. Which result shows that significantly an improvement in the knowledge of the primipara mothers after the structured teaching programme (STP) on selected minor ailments of newborn.

The Relationship between Motor Self-Motivation and Symptoms of Attention-Deficit Hyperactivity in Adhd Children

Background: The growth and development of the child are essential and inevitable, and the growth of every child requires motor development. Purpose: This study examines the relationship between motor self-motivation and attention-deficit hyperactivity disorder's symptoms in children with attention-deficit hyperactivity disorder. 40 people were selected by the convenience sampling method from the psychology centers of the province. The research method was descriptive-correlational. A questionnaire was used to collect data. Data were analyzed using Pearson correlation and linear regression. Results: The results showed that there is a significant negative relationship between motor self-motivation and symptoms of attention-deficit hyperactivity disorder. The results of regression analysis also showed that motor self-motivation is able to predict the symptoms of attention-deficit hyperactivity disorder in children. Conclusion: In general, the more children's motor motivation, the more minor attention-deficit hyperactivity disorder's symptoms. Keywords: Hyperactivity, motor self-motivation, motor development, preschool

Deep learning for tracing esophageal motility function over time

Background and Objective: Esophageal high-resolution manometry (HRM) is widely performed to evaluate the representation of manometric features in patients for diagnosing normal esophageal motility and motility disorders. Clinicians commonly assess esophageal motility function using a scheme termed the Chicago classification, which is difficult, time-consuming and inefficient with large amounts of data. Methods: Deep learning is a promising approach for diagnosing disorders and has various attractive advantages. In this study, we effectively trace esophageal motility function with HRM by using a deep learning computational model, namely, EMD-DL, which leverages three-dimensional convolution (Conv3D) and bidirectional convolutional long-short-term-memory (BiConvLSTM) models. More specifically, to fully exploit wet swallowing information, we establish an efficient swallowing representation method by localizing manometric features and swallowing box regressions from HRM. Then, EMD-DL learns how to identify major motility disorders, minor motility disorders and normal motility. To the best of our knowledge, this is the first attempt to use Conv3D and BiConvLSTM to predict esophageal motility function over esophageal HRM. Results: Test experiments on HRM datasets demonstrated that the overall accuracy of the proposed EMD-DL model is 91.32% with 90.5% sensitivity and 95.87% specificity. By leveraging information across swallowing motor cycles, our model can rapidly recognize esophageal motility function better than a gastroenterologist and lays the foundation for accurately diagnosing esophageal motility disorders in real time. Conclusions: This approach opens new avenues for detecting and identifying esophageal motility function, thereby facilitating more efficient computer-aided diagnosis in clinical practice.

A review of crime prevention activities in a Japanese local government area since 2008: Beautiful Windows Movement in Adachi Ward

There have been limited reports on crime prevention policies by local governments in Japan, which is one of the safest countries in the world. This article reviews crime prevention policies in Adachi Ward, which used to have the highest crime rates in Tokyo. The government of Adachi Ward introduced the “Beautiful Windows Movement” (BWM) in 2008. Based on BWM, Adachi Ward implemented various programs and interventions based on two different aspects: the aspect of preventing minor crimes and disorder in partnership with the police referring to the Broken Windows Theory and the aspect of literally making the Ward beautiful in cooperation with citizen volunteers. After 11 years of implementing BWM, the number of recorded crimes in Adachi Ward declined the most in Tokyo and residents’ sense of security improved significantly. This case study highlights the advantage of the duality of BWM to both reduce crimes and improve residents’ sense of security.

Cognitive functions in late life depression

Cognitive disorders are frequently found during late-life depression. Many cognitive functions may be concerned and can be explained by fronto-striatal brain circuits and hippocampus dysfunctions partly through abnormalities related to cerebrovascular diseases. It seems important to distinguish between early and late onset depression whose cognitive characterisation and etiopathogenia differ in some aspects. Cognitive impairment may represent markers of depression but it is still unclear whether one should consider potential biomarkers of disease state or trait or risk factor. These disorders may precede depression and persist despite symptomatic remission. Moreover, the interest of specifying these disorders is multiple because they can have pejorative consequences such as the modification of emotional content, promote suicidal act, limit the effectiveness of psychotherapy, be a risk factor for poor response to antidepressants. or be a potential risk factor for progression to a minor or major neurocognitive disorder, especially Alzheimer's disease.

Ineffective esophageal motility assessment in patients with and without pathological esophageal acid reflux.

Ineffective esophageal motility (IEM), defined as minor esophageal motility disorder, is also the most common esophageal motility disorder. The relationship between gastro-esophageal reflux disease is still controversial. Our aim in this study is to evaluate whether there are differences in terms of demographic, endoscopic, or motility findings between IEM patients with pathological esophageal acid reflux and physiological reflux.Patients diagnosed with IEM according to the Chicago classification v3 with high-resolution manometry (HRM) before acid monitoring constituted the study group of our investigation. The patients were divided into 2 groups as patients with pathological esophageal reflux and patients with physiological reflux according to 24-hour acid monitoring. Demographic data, endoscopic findings, and HRM findings were compared between 2 groups.A total of 62 patients who were diagnosed with IEM according to the Chicago classification v3 were included in the study. Patients in the physiological reflux group were 7 years younger on average than the pathological reflux group. Esophagitis rates were significantly higher in the pathological reflux group (P = .033). Lower esophageal sphincter resting pressure, integrated relaxation pressure, and the presence of hernia were found to be similar in the 2 groups (P = 392, P = 182, P = 657, respectively). The rate of severe IEM was also similar between the 2 groups (P = .143).The fact that the physiological reflux patient group is younger may suggest that the IEM develops in the early period and then reflux accompanies the picture with advancing age.

Synthesis and crystal structures of 3,6-di-hydroxy-picolinic acid and its labile inter-mediate dipotassium 3-hy-droxy-6-(sulfonato-oxy)pyridine-2-carboxyl-ate monohydrate.

A simplified two-step synthesis of 3,6-di-hydroxy-picolinic acid (3-hy-droxy-6-oxo-1,6-di-hydro-pyridine-2-carb-oxy-lic acid), C6H5NO4 (II), an inter-mediate in the metabolism of picolinic acid, is described. The crystal structure of II, along with that of a labile inter-mediate, dipotassium 3-hy-droxy-6-(sulfonato-oxy)pyridine-2-carboxyl-ate monohydrate, 2K+·C6H3NO7S2-·H2O (I), is also described. Compound I comprises a pyridine ring with carboxyl-ate, hydroxyl (connected by an intra-molecular O-H⋯O hydrogen bond), and sulfate groups at the 2-, 3-, and 6-positions, respectively, along with two potassium cations for charge balance and one water mol-ecule of crystallization. These components are connected into a three-dimensional network by O-H⋯O hydrogen bonds arising from the water mol-ecule, C-H⋯O inter-actions and π-π stacking of pyridine rings. In II, the ring nitro-gen atom is protonated, with charge balance provided by the carboxyl-ate group (i.e., a zwitterion). The intra-molecular O-H⋯O hydrogen bond observed in I is preserved in II. Crystals of II have unusual space-group symmetry of type Abm2 in which extended planar networks of O-H⋯O and N-H⋯O hydrogen-bonded mol-ecules form sheets lying parallel to the ac plane, constrained to b = 0.25 (and 0.75). The structure was refined as a 50:50 inversion twin. A minor disorder component was modeled by reflection of the major component across a mirror plane perpendicular to c.

High resolution manometry in esophageal disorders

Esophageal manometry is one of the main axes in diagnostic armamentarium that deals with esophageal motility disorders, next to endoscopic and radiological methods. Traditional, conventional manometry, has greatly been replaced by a modern technique, high resolution manometry which enables not only better spatiotemporal signal resolution and compatibility, but also shortens the time of the procedure which is extremely important for patients undergoing it. Two catheters are being used, solid state and water perfused. Both record pressures within the esophageal lumen and both esophageal sphincters. Contemporary technology has also enabled incorporation of impedance sensors into the catheter. Impedance is based on resistance changes to liquid or food boluses.These changes help in bolus transit evaluation, reducing the need for ionization procedures. Each examined bolus (liquid or solid) is evaluated according to Chicago classification criteria and parameters that are within these criteria. According to the third version of the Classification, functional esophageal disorders are divided into EGJ outflow obstruction disorders, major peristaltic and minor peristaltic disorders. Introduction of this methodology, but also the continuous update of Chicago classification, help in timely diagnosis and further treatment of all the more frequently diagnosed functional esophageal disorders.