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barrett's esophagus diagnosis

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https://www.readbyqxmd.com/read/28766563/editorial-the-effect-of-bias-on-estimation-of-improved-survival-after-diagnosis-of-barrett-s-esophagus
#1
Liam Zakko, Kavel Visrodia, Kenneth K Wang, Prasad G Iyer
Adjustments for lead and length time bias has been used when examining apparent survival advantages from screening procedures. However, these estimates depend on several assumptions and are modeled from malignancies that are fairly common and large cohorts are available. In smaller retrospective cohorts, adjustments themselves may be based on estimates that may not be biological nor statistically accurate, which can lead to divergent results as has been found in several recent studies of screening in Barrett's esophagus...
August 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28765700/endoscopy-is-of-low-yield-in-the-identification-of-gastrointestinal-neoplasia-in-patients-with-dermatomyositis-a-cross-sectional-study
#2
Trilokesh D Kidambi, Gabriela Schmajuk, Andrew J Gross, James W Ostroff, Jonathan P Terdiman, Jeffrey K Lee
AIM: To determine the prevalence of gastrointestinal neoplasia among dermatomyositis patients who underwent an esophagogastroduodenoscopy and/or colonoscopy. METHODS: A cross-sectional study examining the results of upper endoscopy and colonoscopy in adults with dermatomyositis at an urban, university hospital over a ten year period was performed. Chart review was performed to confirm the diagnosis of dermatomyositis. Findings on endoscopy were collected and statistical analyses stratified by age and presence of symptoms were performed...
July 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28753185/pediatric-gastroesophageal-reflux-disease-systematic-review-on-prognosis-and-prognostic-factors
#3
Maartje M J Singendonk, Merit M Tabbers, Marc A Benninga, Miranda W Langendam
In this systematic review, we summarize the evidence on prognosis and prognostic factors of pediatric GERD. A structured search of Embase and MEDLINE/PubMed (inception to April 2016) yielded 5365 references; four publications met our inclusion criteria (risk of bias moderate-high). Definitions and outcome measures varied widely between studies. The percentage of children with a diagnosis of GERD with esophagitis that had persisting symptoms and/or were on anti-reflux medication at follow-up (12 months to >5 years) ranged from 23% (weekly symptoms) to 68% (anti-reflux medication), depending on definition used...
July 27, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28752419/regional-variability-of-repeat-esophagogastroduodenoscopy-use-in-the-national-veteran-population
#4
Andrew J Gawron, Garrett Cole, Nan Hu, William K Thompson, John Fang, Matthew Samore
BACKGROUND: Esophagogastroduodenoscopy (EGD) procedures are performed frequently to evaluate gastrointestinal disease and symptoms. AIM: To determine regional practice variability of repeat EGDs in a national population. METHODS: The study sample included US Veterans with an outpatient index EGD from 1/1/2008 to 12/2010. We determined risk of repeat endoscopy from 1/2008 to 10/1/2014. A logistic regression model was used to assess the association between the odds of repeated EGD and patient demographics, ICD diagnostic codes, and geographic region...
July 31, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28577766/beyond-dysplasia-grade-the-role-of-biomarkers-in-stratifying-risk
#5
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/28577764/effectiveness-and-cost-effectiveness-of-endoscopic-screening-and%C3%A2-surveillance
#6
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
#7
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/28560244/toward-real-time-quantification-of-fluorescence-molecular-probes-using-target-background-ratio-for-guiding-biopsy-and-endoscopic-therapy-of-esophageal-neoplasia
#8
Yang Jiang, Yuanzheng Gong, Joel H Rubenstein, Thomas D Wang, Eric J Seibel
Multimodal endoscopy using fluorescence molecular probes is a promising method of surveying the entire esophagus to detect cancer progression. Using the fluorescence ratio of a target compared to a surrounding background, a quantitative value is diagnostic for progression from Barrett's esophagus to high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC). However, current quantification of fluorescent images is done only after the endoscopic procedure. We developed a Chan-Vese-based algorithm to segment fluorescence targets, and subsequent morphological operations to generate background, thus calculating target/background (T/B) ratios, potentially to provide real-time guidance for biopsy and endoscopic therapy...
April 2017: Journal of Medical Imaging
https://www.readbyqxmd.com/read/28551084/barrett-s-esophagus-ten-years-of-experience-at-a-tertiary-care-hospital-center-in-mexico
#9
F Valdovinos-Andraca, A R Bernal-Méndez, R Barreto-Zúñiga, D Briseño-García, J A Martínez-Lozano, A F Romano-Munive, J Elizondo-Rivera, F I Téllez-Ávila
INTRODUCTION: The prevalence of Barrett's esophagus has been calculated at between 1.3 and 1.6%. There is little information with respect to this in Mexico. AIM: To determine the frequency and characteristics of Barrett's esophagus in patients that underwent endoscopy at a national referral center, within a 10-year time frame. MATERIAL AND METHODS: The databases of the pathology and gastrointestinal endoscopy departments of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" were analyzed, covering the period of January 2002 to December 2012...
May 24, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28546793/current-management-of-low-grade-dysplasia-in-barrett-esophagus
#10
Gary W Falk
Low-grade dysplasia in Barrett esophagus remains an ongoing challenge in clinical management. Recent studies suggest an increased risk in progression of low-grade dysplasia to high-grade dysplasia and/or adenocarcinoma. This is especially seen when 1 or more expert gastrointestinal pathologist confirms the diagnosis and in the setting of low-grade dysplasia that persists on more than 1 endoscopy. In the setting of confirmed and persistent low-grade dysplasia, level 1 evidence supports endoscopic ablation as a treatment option for these patients, although continued surveillance remains a viable option...
April 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28501084/barrett-esophagus-and-intramucosal-esophageal-adenocarcinoma
#11
REVIEW
Shanmugarajah Rajendra, Prateek Sharma
Barrett esophagus (BE) is a precursor lesion for esophageal adenocarcinoma (EAC). Developments in imaging and molecular markers, and endoscopic eradication therapy, are available to curb the increase of EAC. Endoscopic surveillance is recommended, despite lack of data. The cancer risk gets progressively downgraded, raising questions about the understanding of risk factors and molecular biology involved. Recent data point to at least 2 carcinogenic pathways operating in EAC. The use of p53 overexpression and high-risk human papillomavirus may represent the best chance to detect progressors...
June 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/28475729/ceacam-6-a-novel-marker-for-the-diagnosis-of-barrett-s-esophagus
#12
N Sharma, S Srivastava, F Kern, W Xian, K G Yeoh, T Ming, F McKeon, K Y Ho
Barrett's esophagus (BE) is a premalignant condition associated with the development of esophageal adenocarcinoma (EAC). Despite the low risk of progression to EAC, evidence highlights the notably poor survival rates of this malignancy. The mainstay form of diagnosis of BE is endoscopy and biopsy sampling. However, research emphasizes limitations with regards to the histological detection of BE and associated dysplasia. The aim of this study is to evaluate the clinical significance of CEACAM6 as a potential biomarker for the diagnosis of BE and beyond...
July 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28469359/probe-confocal-laser-endomicroscopy-in-the-therapeutic-endoscopic-management-of-barrett-s-dysplasia
#13
Fabrice Caillol, Sebastien Godat, Flora Poizat, Aurélie Auttret, Christian Pesenti, Erwan Bories, Jean Phillipe Ratone, Marc Giovannini
BACKGROUND: Endoscopic management of Barrett's esophagus (BE) depends on the histological stage of BE and includes the following: follow up, endotherapy with thermal ablation, and piecemeal or monobloc endoscopic resection (ER). We know that biopsies are unreliable in 20-75% of cases. The aim of our study was to evaluate the efficiency of probe confocal laser endomicroscopy (pCLE) in the diagnosis of the histological stage of BE, compared with the final histological results after ER. METHODS: This retrospective study was based on a prospective registry of patients referred for management of BE-associated dysplasia...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28446978/optimizing-the-diagnosis-and-therapy-of-barrett-s-esophagus
#14
REVIEW
Juan A Muñoz-Largacha, Hiran C Fernando, Virginia R Litle
The incidence of Barrett's esophagus (BE) in the Western world has increased over the last decades. BE is considered a premalignant lesion that can progress to esophageal adenocarcinoma (EAC), a highly aggressive malignancy with poor survival rates. The close association between BE and EAC highlights the need for an early diagnosis in order to improve survival and outcomes in this group of patients. Although the evidence for BE screening with conventional endoscopy is controversial and limited by cost-effectiveness studies, screening can be suggested in patients with chronic gastroesophageal reflux disease (GERD) and two or more risk factors for EAC...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28425652/endoscopic-findings-of-esophagogastric-junction-in-children
#15
Yoshiko Nakayama, Shinobu Ida
Esophagogastric landmarks are recognizable in the same way both in children and in adults, and palisade-shaped vessels can be observed at the distal position of esophageal mucosa, even in infants. Few studies have been done in respect to Barrett's esophagus (BE) in children. Incidence of endoscopically suspected BE among all children undergoing esophagogastroduodenoscopy (EGD) is approximately 0.25-1.4%, but can be up to 9.7% in patients with gastroesophageal reflux disease (GERD). Some data suggest that BE is an acquired disorder and point to the possibility of a congenital component in combination with severe mucosal injury...
April 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28374815/the-impact-of-a-prior-diagnosis-of-barrett-s-esophagus-on-esophageal-adenocarcinoma-survival
#16
Angela C Tramontano, Deirdre F Sheehan, Jennifer M Yeh, Chung Yin Kong, Emily C Dowling, Joel H Rubenstein, Julian A Abrams, John M Inadomi, Deborah Schrag, Chin Hur
OBJECTIVES: Endoscopic surveillance of patients with Barrett's Esophagus (BE) is recommended to detect esophageal adenocarcinoma (EAC) and its dysplasia precursors, but survival benefits are unclear. Using Surveillance, Epidemiology, and End Results (SEER) and linked Medicare data, we sought to determine the impact of a prior BE diagnosis on survival in patients with EAC. METHODS: Our analysis focused on patients over age 65 with primary EAC diagnosed in a SEER region from 2000-2011 and enrolled in Medicare...
August 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28374813/predictors-of-progression-in-barrett-s-esophagus-with-low-grade-dysplasia-results-from-a-multicenter-prospective-be-registry
#17
MULTICENTER STUDY
Rajesh Krishnamoorthi, Jason T Lewis, Murli Krishna, Nicholas J Crews, Michele L Johnson, Ross A Dierkhising, Brenda F Ginos, Kenneth K Wang, Herbert C Wolfsen, David E Fleischer, Francisco C Ramirez, Navtej S Buttar, David A Katzka, Prasad G Iyer
OBJECTIVES: Low-grade dysplasia (LGD) is a risk factor for progression in Barrett's esophagus (BE). Progression estimates however vary and predictors of progression are not well established. We aimed to assess predictors of progression in a multicenter BE-LGD cohort. METHODS: All subjects with LGD (diagnosed by a GI pathologist) in a prospective BE registry were identified. Progression was defined development of HGD/EAC more than 12 months after index date of LGD diagnosis...
June 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28338484/the-importance-of-biopsy-sampling-practices-in-the-pathologic-evaluation-of-gastrointestinal-disorders
#18
Nicole C Panarelli, Rhonda K Yantiss
PURPOSE OF REVIEW: To summarize the literature regarding appropriate endoscopic sampling and surveillance protocols for common inflammatory diseases of the digestive tract. Gastroenterologists increasingly use endoscopy with mucosal biopsy to detect inflammatory diseases, assess response to therapy, and monitor for progression to dysplasia. RECENT FINDINGS: Many diseases show a patchy distribution in the digestive tract and there may be poor correlation between the endoscopic appearance and presence of histologic abnormalities...
September 2016: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28317452/recent-advances-in-diagnostic-testing-for-gastroesophageal-reflux-disease
#19
Rishi D Naik, Michael F Vaezi
Gastroesophageal reflux disease (GERD) has a large economic burden with important complications that include esophagitis, Barrett's esophagus, and adenocarcinoma. Despite endoscopy, validated patient questionnaires, and traditional ambulatory pH monitoring, the diagnosis of GERD continues to be challenging. Areas covered: This review will explore the difficulties in diagnosing GERD with a focus on new developments, ranging from basic fundamental changes (histology and immunohistochemistry) to direct patient care (narrow-band imaging, impedance, and response to anti-reflux surgery)...
March 27, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28280615/the-frequency-of-histologically-confirmed-barrett-s-esophagus-varies-by-the-combination-of-ethnicity-and-gender
#20
Sian S Chisholm, Joe E Khoury, M Mazen Jamal, Carlos Palacio, Sunitha Pudhota, Kenneth J Vega
BACKGROUND: Barrett's esophagus (BE) is the primary risk factor for esophageal adenocarcinoma (EAC). Limited data exists regarding the frequency of histologically confirmed BE by both gender and ethnicity in the United States. The study aim was to determine whether the frequency of histologically confirmed BE varies by ethnicity and gender. METHODS: The University of Florida-Jacksonville endoscopy database was reviewed for all cases of salmon colored esophageal mucosa from September 2002 to August 2007...
February 2017: Journal of Gastrointestinal Oncology
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