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Gastrointestinal Endoscopy Clinics of North America

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https://www.readbyqxmd.com/read/29129305/eosinophilic-esophagitis
#1
EDITORIAL
David A Katzka
No abstract text is available yet for this article.
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129304/eosinophilic-esophagitis-new-insights-and-management
#2
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129303/endoscopic-treatment-of-eosinophilic-esophagitis
#3
REVIEW
Joel E Richter
In eosinophilic esophagitis, the main cause of solid-food dysphagia is tissue remodeling resulting in strictures and narrowed esophagus. Endoscopy and biopsies help to identify the degree of inflammation but often miss the fibrosis. Although initially considered dangerous, esophageal dilation has evolved into an extremely effective and safe treatment in fibrostenotic disease. The key is starting low with small-diameter bougies or balloons, and gradually dilating the esophagus and strictures to 16 to 18 mm. Results in more than 1000 adults and children have shown low rates of complications, especially perforations, and no deaths, but postprocedure chest pain is common...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129302/dietary-therapy-in-eosinophilic-esophagitis
#4
REVIEW
Nirmala Gonsalves
Eosinophilic esophagitis is characterized by dense mucosal eosinophilia with symptoms of esophageal dysfunction. Because the incidence and prevalence are increasing, understanding the available treatments is imperative. This article highlights evolution and advancements in dietary treatment, supports the notion that food antigens drive this disease, and discusses the advantages, limitations, and future of dietary therapy. Medical and dietary therapies are effective treatments and the optimal approach should be individualized based on patient goals and available local resources...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129301/pharmacologic-treatment-of-eosinophilic-esophagitis-an-update
#5
REVIEW
Alain M Schoepfer, Alex Straumann, Ekaterina Safroneeva
Eosinophilic esophagitis (EoE) is defined as a chronic, immune-medicated or antigen-mediated, esophageal disease, characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Food allergens are identified in most patients. Treatment strategies include elimination diets, drugs, and esophageal dilation. This article focuses on pharmacologic treatment. Currently, there is no pharmacologic treatment that has been approved by regulatory authorities...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129300/eosinophilic-esophagitis-in-children-and-adults
#6
REVIEW
Jonathan E Markowitz, Steven B Clayton
Adults and children with eosinophilic esophagitis (EoE) have distinct clinical and endoscopic presentations. Recognition of clinical signs, along with laboratory and endoscopic findings, is critical for the identification of patients with EoE because delay in diagnosis has been associated with esophageal remodeling and stricture formation. Clinical presentation varies considerably between adults and children. This is less due to differences in the disease and more due to patient differences. This article describes the similarities and differences in clinical presentation of children and adults with EoE, including areas of epidemiology, clinical and endoscopic presentation, pathophysiology, and treatment...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129299/endoscopic-and-radiologic-findings-in-eosinophilic-esophagitis
#7
REVIEW
Jeffrey A Alexander
Eosinophilic esophagitis (EoE) was first described by Landis in 1978. The disease is characterized by esophageal symptoms, primarily dysphagia in adult patients, and esophageal eosinophilic infiltration. The disease is associated with characteristic endoscopic findings, including edema, rings, furrows, exudates, and strictures. The typical radiographic findings of this disorder are rings, strictures, and small-caliber esophagus. The endoscopic and radiographic findings of EoE are the topic of this review.
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129298/latest-insights-on-the-relationship-between-symptoms-and-biologic-findings-in-adults-with-eosinophilic-esophagitis
#8
REVIEW
Ekaterina Safroneeva, Alex Straumann, Alain M Schoepfer
Patients with eosinophilic esophagitis (EoE) present with symptoms accompanied by behavioral adaptions to living with this condition. These include swallowing- and nonswallowing-associated pain in adulthood. In children, EoE symptoms vary with age and include vomiting, abdominal pain, and dysphagia. Studies using validated patient-reported outcome measures have demonstrated that symptoms in EoE are associated with severe biologic alterations and that patients on the low biologic severity spectrum have few symptoms...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129297/demographic-features-of-eosinophilic-esophagitis
#9
REVIEW
Anna Maria Lipowska, Robert T Kavitt
Eosinophilic esophagitis (EoE) is an increasingly prevalent chronic condition characterized by eosinophilic infiltration of the esophageal epithelium accompanied by esophageal symptoms. The number of new diagnoses is growing worldwide in both pediatric and adult populations. Differences in disease distribution and presentation have been found, varying by gender, race, and other characteristics. This review examines the existing literature and provides insight into the demographic features of EoE.
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129296/eosinophilic-esophagitis-incidence-and-prevalence
#10
REVIEW
Fouad J Moawad
Eosinophilic esophagitis (EoE) is a rapidly emerging allergy-mediated condition encountered frequently in clinical practice. It presents with failure to thrive, nausea, and vomiting in children and is a common reason for dysphagia and food impaction in adults. Several institution-based and population-based studies have reported the frequency of EoE over the past few years. The incidence and prevalence of EoE vary depending on the method of data collection. In population-based studies using national registries, the incidence appears to be increasing, currently estimated to be approximately 10 cases/100,000 persons annually, whereas the prevalence is reported between 10 and 57 cases/100,000 persons...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129295/future-directions-in-eosinophilic-esophagitis
#11
REVIEW
Ikuo Hirano
Eosinophilic esophagitis advances parallel the increased prevalence. Developments include refining the diagnostic criteria, identifying risk factors, appreciating the contribution of inflammatory pathways, recognizing the importance of subepithelial remodeling, validating trial endpoints, defining a role for biological therapies, and optimizing dietary therapy. Endoscopic outcomes have emerged as endpoints in trials of novel therapeutics. Expanding efforts seek to develop less-invasive methods to assess disease activity thereby reducing the burden of repeated endoscopic procedures during elimination diets...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/29129294/eosinophilic-esophagitis-pathophysiology-and-definition
#12
REVIEW
Frederic Clayton, Kathryn Peterson
Eosinophilic esophagitis is an adaptive immune response to patient-specific antigens, mostly foods. Eosinophilic esophagitis is not solely IgE-mediated and is likely characterized by Th2 lymphocytes with an impaired esophageal barrier function. The key cytokines and chemokines are thymic stromal lymphopoeitin, interleukin-13, CCL26/eotaxin-3, and transforming growth factor-β, all involved in eosinophil recruitment and remodeling. Chronic food dysphagia and food impactions, the feared late complications, are related in part to dense subepithelial fibrosis, likely induced by interleukin-13 and transforming growth factor-β...
January 2018: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918813/progress-in-endoscopic-ultrasonography
#13
EDITORIAL
Frank G Gress
No abstract text is available yet for this article.
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918812/endoscopic-ultrasound-becomes-a-major-interventional-tool
#14
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918811/future-directions-for-endoscopic-ultrasound-where-are-we-heading
#15
REVIEW
Sahin Coban, Omer Basar, William R Brugge
Endoscopic ultrasound (EUS) plays an important role as a diagnostic and therapeutic modality in gastroenterology. New developments have emerged, especially in the last decade, and are being introduced to endoscopists. The ability to readily visualize and access organs in the gastrointestinal tract has allowed endoscopists to perform new interventional procedures. EUS procedures have taken the place of conventional approaches for the treatment of various gastrointestinal diseases, including pancreatic cystic lesions...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918810/progress-in-endoscopic-ultrasonography-training-in-therapeutic-or-interventional-endoscopic-ultrasonography
#16
REVIEW
Monica Saumoy, Michel Kahaleh
Therapeutic endoscopic ultrasound is a rapidly expanding field, requiring training beyond the 3-year gastroenterology fellowship and at least an additional year in a structured advanced endoscopy fellowship program with mentorship from an expert at a sufficiently high-volume center. Simulation models can provide initial instruction on technique and increase familiarity with the rapidly changing devices. Trainees must also be given a graduated level of independence to perform each step and, eventually, be able to practice on a variety of endoscopic targets...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918809/endoscopic-ultrasonography-guided-hemostasis-techniques
#17
REVIEW
Everson Luiz de Almeida Artifon, Fernando Pavinato Marson, Muhammad Ali Khan
Endoscopic ultrasonography (EUS)-guided hemostasis is an evolving technique that has the potential to improve the care of patients with refractory variceal and nonvariceal gastrointestinal bleeding. EUS-guided treatment of fundal varices with coil and/or cyanoacrylate seems to be highly effective in active bleeding, as well as for primary and secondary bleeding prophylaxis. Reports of EUS-guided treatment of refractory nonvariceal sources of bleeding are more scarce, but show high success rates. The procedures involve a medium to high technical difficulty level, and this has been replicated worldwide...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918808/endoscopic-ultrasound-guided-drainage-of-pelvic-fluid-collections
#18
REVIEW
SriHari Mahadev, David S Lee
Pelvic fluid collections can be challenging and often inaccessible because of their location and close proximity to adjacent organs and spine. This causes an increased risk for morbidity and poor outcomes. Recent advances in endoscopic ultrasound and therapeutic devices provide an effective, safe, and minimally invasive option to surgery or interventional radiology. These devices offer a relatively pain-free method that has shown good outcomes with minimal risk in recent case series, and has increasingly become the first-line treatment of choice...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918807/endoscopic-ultrasonography-guided-drainage-of-pancreatic-collections-including-the-role-of-necrosectomy
#19
REVIEW
Ryan Law, Todd H Baron
In recent years, the management of symptoms of pancreatic fluid collections has shifted from surgical and percutaneous interventions to endoscopic techniques. Available data show that endoscopic drainage can be achieved with minimal morbidity and procedural-related mortality, a high degree of technical and clinical success, and acceptable risk of adverse events. Although endoscopic management of walled-off necrosis provides a durable, minimally invasive treatment option, it is still generally performed only in tertiary care medical centers because of the overall complexity of this clinical scenario...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28918806/endoscopic-ultrasound-guided-gastrojejunostomy
#20
REVIEW
Sunil Amin, Amrita Sethi
Gastric outlet obstruction is a common complication of advanced upper gastrointestinal and pancreatic malignancies. Endoscopic ultrasound (EUS)-guided gastrojejunostomy is a new option that may provide a more durable solution than enteral stenting with shorter recovery time and less cost than surgical gastrojejunostomy. Techniques to perform this procedure include direct EUS-guided puncture and balloon-assisted and free-hand methods. Use of cautery-tipped lumen-apposing metal stent results in higher rates of technical success and shorter procedure times...
October 2017: Gastrointestinal Endoscopy Clinics of North America
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