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Gastrointestinal Endoscopy Clinics of North America

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https://www.readbyqxmd.com/read/28577775/new-directions-in-barrett-s-esophagus
#1
EDITORIAL
Nicholas J Shaheen
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577774/barrett-s-esophagus-and-the-prevention-of-esophageal-adenocarcinoma
#2
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577773/esophagectomy-for-superficial-esophageal-neoplasia
#3
REVIEW
Thomas J Watson
Endoscopic therapies have become the standard of care for most cases of Barrett's esophagus with high-grade dysplasia or intramucosal adenocarcinoma. Despite a rapid and dramatic evolution in treatment paradigms, esophagectomy continues to occupy a place in the therapeutic armamentarium for superficial esophageal neoplasia. The managing physician must remain cognizant of the limitations of endoscopic approaches and consider surgical resection when they are exceeded. Esophagectomy, performed at experienced centers for appropriately selected patients with early-stage disease can be undertaken with the expectation of cure as well as low mortality, acceptable morbidity, and good long-term quality of life...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577772/care-of-the-postablation-patient-surveillance-acid-suppression-and-treatment-of%C3%A2-recurrence
#4
REVIEW
Leila Kia, Srinadh Komanduri
Endoscopic eradication therapy is effective and durable for the treatment of Barrett's esophagus (BE), with low rates of recurrence of dysplasia but significant rates of recurrence of intestinal metaplasia. Identified risk factors for recurrence include age and length of BE before treatment and may also include presence of a large hiatal hernia, higher grade of dysplasia before treatment, and history of smoking. Current guidelines for surveillance following ablation are limited, with recommendations based on low-quality evidence and expert opinion...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577771/cryotherapy-for-barrett-s-esophagus
#5
REVIEW
Marcia Irene Canto
Cryotherapy or cryoablation involves the freezing of tissues to destroy unwanted tissue or to control bleeding. Endoscopic cryotherapy has been developed for gastrointestinal application by through-the-scope noncontact delivery of compressed carbon dioxide gas or liquid nitrogen (cryospray) or contact balloon cryoablation. The mechanism of cryotherapy ablative effects includes immediate injury as well as coagulation necrosis occurring over several hours and days, unlike heat-based thermal ablation. This article reviews the basis, technique, safety, efficacy, and durability for the use of endoscopic cryotherapy in Barrett's esophagus and esophageal adenocarcinoma...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577770/radiofrequency-ablation-of-barrett-s-esophagus-efficacy-complications-and-durability
#6
REVIEW
Kavel Visrodia, Liam Zakko, Kenneth K Wang
In the last decade, radiofrequency ablation in combination with endoscopic mucosal resection has simplified and improved the treatment of Barrett's esophagus. These treatments not only reduced the progression of dysplastic Barrett's esophagus to esophageal adenocarcinoma but also decreased treatment-related complications. More recent data from larger series with extended follow-up periods are emerging to refine expectations in patients treated with radiofrequency ablation. Although most patients achieve eradication of neoplasia and intestinal metaplasia, in the long-term a substantial portion of patients develop recurrent disease...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577769/radiofrequency-ablation-of-barrett-s-esophagus-patient-selection-preparation-and-performance
#7
REVIEW
Gene K Ma, Gregory G Ginsberg
Radiofrequency ablation (RFA) is a safe and effective thermal ablative therapy for dysplastic Barrett's esophagus (BE) and, to a lesser extent, nondysplastic BE. Before the utilization of RFA, there must be an appropriate indication, assessment of potential contraindications, discussion of risks and benefits with patients, and careful endoscopic planning. The ease of performance of the procedure along with its efficacy and low rate of adverse events have established RFA as a reliable technique for endoscopic management of dysplastic BE...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577768/the-role-of-endoscopic-ultrasound-in-the-management-of-patients-with-barrett-s-esophagus-and-superficial-neoplasia
#8
REVIEW
Bashar J Qumseya, Herbert C Wolfsen
Endoscopic ultrasound (EUS) is a minimally invasive advanced imaging procedure using high-frequency sound waves to produce detailed images of the esophageal wall with fine-needle aspiration to biopsy adjacent lymph nodes. The role of EUS is well established in patients with locally advanced Barrett esophagus neoplasia. The utility of EUS in the evaluation of Barrett esophagus patients is controversial. This is a review of the evidence using EUS in BE patients. The assessment is that EUS may be a powerful tool in managing patients with BE neoplasia...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577767/management-of-nodular-neoplasia-in-barrett-s-esophagus-endoscopic-mucosal-resection-and-endoscopic-submucosal-dissection
#9
REVIEW
Kamar Belghazi, Jacques J G H M Bergman, Roos E Pouw
Endoscopic resection has proven highly effective and safe in the removal of focal early neoplastic lesions in Barrett's esophagus and is considered the cornerstone of endoscopic treatment. Several techniques are available for endoscopic resection in Barrett's esophagus. The most widely used technique for piecemeal resection of early Barrett's neoplasia is the ligate-and-cut technique. Newer techniques such as endoscopic submucosal dissection may also play a role in the treatment of neoplastic Barrett's esophagus...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577766/beyond-dysplasia-grade-the-role-of-biomarkers-in-stratifying-risk
#10
REVIEW
Kerry B Dunbar, Rhonda F Souza
Gastroenterology society guidelines recommend endoscopic surveillance as a means to detect early stage cancer in Barrett's esophagus. However, the incidence of esophageal adenocarcinoma in Western countries continues to increase, suggesting that this strategy may be inadequate. Current surveillance methods rely on the endoscopist's ability to identify suspicious areas of Barrett's esophagus to biopsy, random biopsies, and on the histopathologic diagnosis of dysplasia. This review highlights the challenges of using dysplasia to stratify cancer risk and addresses the development and use of molecular biomarkers and in vivo molecular imaging to detect early neoplasia in Barrett's esophagus...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577765/the-role-of-adjunct-imaging-in-endoscopic-detection-of-dysplasia-in-barrett-s-esophagus
#11
REVIEW
Pujan Kandel, Michael B Wallace
Advances in imaging technologies have demonstrated promise in early detection of dysplasia and cancer in Barrett's esophagus (BE). Optical chromoendoscopy, dye-based chromoendoscopy, and novel technologies have provided the opportunity to visualize the cellular and subcellular structures. Only narrow-band imaging and acetic acid chromoendoscopy have reached benchmarks for clinical use. Volumetric laser endomicroscopy and molecular imaging are not established for routine use. Best practice in management of BE should be focused on careful endoscopic examination, resection, or ablation of the entire abnormal lesion, as well as the use of available imaging technique that has good diagnostic accuracy...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577764/effectiveness-and-cost-effectiveness-of-endoscopic-screening-and%C3%A2-surveillance
#12
REVIEW
Nina Saxena, John M Inadomi
Guidelines for the screening and surveillance of Barrett's esophagus continue to evolve as the incidence of esophageal adenocarcinoma increases, identification of individuals at highest risk for cancer improves, and management of dysplasia evolves. This article reviews related studies and economic analyses. Advances in diagnosis offer promising strategies to help focus screening efforts on those individuals who are most likely to develop esophageal adenocarcinoma.
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577763/alternatives-to-traditional-per-oral-endoscopy-for-screening
#13
REVIEW
Judith Offman, Rebecca C Fitzgerald
Barrett's esophagus (BE) predisposes patients to esophageal adenocarcinoma. 3 to 6% of individuals with gastro-esophageal reflux disease are estimated to have BE but only 20 to 25% of BE patients are currently diagnosed. The current gold standard for diagnosis of BE is per-oral upper GI endoscopy. As this is not suitable for large-scale screening, a number of alternative methods are currently being investigated: transnasal and video capsule endoscopy, endomicroscopy, cell collection devices like the cytosponge and biomarkers...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577762/who-deserves-endoscopic-screening-for-esophageal-neoplasia
#14
REVIEW
Christopher H Blevins, Prasad G Iyer
Despite the availability of safe and effective endoscopic treatment of Barrett's esophagus (BE)-related dysplasia and neoplasia, the incidence and mortality from esophageal adenocarcinoma (EAC) have continued to increase. This likely stems from the large population of patients that develop EAC outside of a BE screening and surveillance program. Identification of BE with screening followed by enrollment in an appropriate surveillance/risk stratification program could be a strategy to address both the incidence of and mortality from EAC...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28577761/the-troublesome-epidemiology-of-barrett-s-esophagus-and-esophageal-adenocarcinoma
#15
REVIEW
Jennifer L Schneider, Douglas A Corley
Barrett's esophagus and esophageal adenocarcinoma diagnoses have increased markedly in recent decades. Recent research with patients diagnosed with Barrett's esophagus (the only known precursor for esophageal adenocarcinoma) and esophageal adenocarcinoma has identified several modifiable and nonmodifiable potential risk factors. Consistent risk factors for both disorders include increasing age, male sex, white non-Hispanic race/ethnicity, gastroesophageal reflux disease, lack of infection with Helicobacter pylori, smoking, abdominal obesity, and a Western diet...
July 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292413/bariatric-and-metabolic-endoscopy
#16
EDITORIAL
Richard I Rothstein
No abstract text is available yet for this article.
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292412/bariatric-and-metabolic-endoscopy-new-approaches-to-obesity-and-diabetes
#17
EDITORIAL
Charles J Lightdale
No abstract text is available yet for this article.
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292411/reimbursement-for-endoscopic-bariatric-therapies
#18
REVIEW
Joel V Brill
Intragastric devices may be of benefit to patients who are unable to achieve weight loss through lifestyle modification and pharmaceuticals. With the help of every member of a multidisciplinary team and ongoing commitment from patients, small, practical steps and goals can lead to long-lasting, healthy weight loss.
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292410/the-regulatory-perspectives-on-endoscopic-devices-for-obesity
#19
REVIEW
April K Marrone, Mark J Antonino, Joshua S Silverstein, Martha W Betz, Priya Venkataraman-Rao, Martin Golding, Diane Cordray, Jeffrey W Cooper
The recent increase in US Food and Drug Administration-approved weight-loss devices has diversified obesity treatment options. The regulatory pathways for endoscopically placed weight-loss devices and considerations for clinical trials are discussed, including the benefit-risk paradigm intended to aid in weight-loss-device trial development. Also discussed is the benefit-risk analysis of recently approved endoscopic devices. A strategic priority of the FDA Center for Devices and Radiological Health is to increase the use of patient input in decision making...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292409/therapeutic-options-to-treat-pediatric-obesity
#20
REVIEW
Allen F Browne
Obesity in children and adolescents is a severe health, psychosocial, and economic problem. Treatment of obesity should be based on the physiology, biochemistry, and genetics of the disease. Treatment is designed to prevent the comorbidities of obesity and allow a healthy, high-quality, and productive life. Treatment is based on healthy living and usually involves tools such as pharmacotherapy, medical device therapy, and bariatric surgery. Bariatric surgery is not acceptable to most patients, parents, primary care providers, and payers...
April 2017: Gastrointestinal Endoscopy Clinics of North America
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