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barrett's esophagus diagnosis

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https://www.readbyqxmd.com/read/29135518/substantial-interobserver-agreement-in-the-diagnosis-of-dysplasia-in-barrett-esophagus-upon-review-of-a-patient-s-entire-set-of-biopsies
#1
Marcela A Salomao, Dora Lam-Himlin, Rish K Pai
The pathologic diagnosis of dysplasia in Barrett esophagus (BE) suffers from interobserver disagreement. Many of the studies demonstrating disagreement in the diagnosis of dysplasia have pathologists review individual biopsy slides in isolation. To more closely mimic daily practice, 3 pathologists reviewed hematoxylin and eosin slides made from 549 individual biopsy jars obtained from 129 unique patients with a diagnosis of BE. Each pathologist reviewed the entirety of a given patient's biopsy material. The grade of dysplasia present in each biopsy jar was given as well as an overall highest grade of dysplasia from the patient's entire set of biopsies...
November 9, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/29133255/high-prevalence-of-barrett-s-esophagus-and-esophageal-squamous-cell-carcinoma-after-repair-of-esophageal-atresia
#2
Floor W T Vergouwe, Hanneke IJsselstijn, Katharina Biermann, Nicole S Erler, René M H Wijnen, Marco J Bruno, Manon C W Spaander
BACKGROUND & AIMS: Esophageal atresia is rare, but improved surgical and intensive care techniques have increased rates of survival in children, so there are now many adults with this disorder. Many patients with esophageal atresia develop gastroesophageal reflux (GER), raising concerns about increased risk of Barrett's esophagus (BE; prevalence of 1.3%-1.6% in general population) and esophageal carcinoma. We assessed the prevalence of BE and esophageal carcinoma in this population. METHODS: We performed a prospective study of 289 patients with esophageal atresia at the Department of Gastroenterology and Hepatology at Erasmus MC University Medical Center in The Netherlands, from May 2012 through March 2017...
November 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29132520/gastroesophageal-reflux-disease
#3
REVIEW
Rick Kellerman, Thomas Kintanar
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity resulting in symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. GERD affects quality of life and may cause erosive esophagitis, esophageal strictures, and Barrett esophagus, a precursor to esophageal adenocarcinoma. GERD is a clinical diagnosis and is most effectively treated with proton-pump inhibitors (PPIs)...
December 2017: Primary Care
https://www.readbyqxmd.com/read/29103533/diagnosis-and-management-of-barrett-related-neoplasia-in-the-modern-era
#4
REVIEW
Lysandra Voltaggio, Elizabeth A Montgomery
Whereas in the past, pathologists were hesitant to diagnose high-grade dysplasia in patients with Barrett esophagus, because this diagnosis prompted esophagectomy, current international consensus is that endoscopic treatment is the management for high-grade dysplasia and intramucosal carcinoma. Furthermore, many centers advocate endoscopic ablation for low-grade dysplasia. As such, establishing a diagnosis of dysplasia has become the key step; separation between the grades of dysplasia is less critical. This article offers some criteria for separating dysplasia from reactive changes, discusses pitfalls in interpreting endoscopic mucosal resection specimens, and outlines management strategies...
December 2017: Surgical Pathology Clinics
https://www.readbyqxmd.com/read/29078688/endoscopic-mucosal-ablation-and-resection-of-barrett-s-esophagus-and-related-diseases
#5
REVIEW
Juan A Muñoz-Largacha, Virginia R Litle
The prevalence of gastroesophageal reflux disease as well as the incidence of Barrett's esophagus (BE) has increased in the Western world over the last decades. The chronic reflux of gastric secretions injuries the esophageal mucosa and triggers cellular and molecular changes inducing the transformation of the normal squamous mucosa into columnar metaplastic epithelium. BE is a premalignant condition that can progress to low-grade dysplasia, high-grade dysplasia and ultimately esophageal adenocarcinoma. An early diagnosis of dysplastic changes and the adoption of appropriate therapeutic approaches are essential to improve patient outcomes and survival...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29066320/detection-of-genetic-alterations-in-cfdna-as-a-possible-strategy-to-monitor-the-neoplastic-progression-of-barrett-s-esophagus
#6
Enrica Rumiato, Elisa Boldrin, Sandro Malacrida, Stefano Realdon, Matteo Fassan, Tiziana Morbin, Giorgio Battaglia, Alberto Amadori, Massimo Rugge, Daniela Saggioro
Barrett's esophagus (BE) is associated with an increased risk of developing esophageal adenocarcinoma. Despite the low absolute risk of neoplastic progression of BE, probability increases with the diagnosis of dysplasia. For this reason, BE patients undergo an endoscopy-based surveillance that is, however, burdensome for patients, subject to inter-observer subjectivity, and expensive for national health systems. Thus, less invasive and low-cost diagnostic tools are needed. This study is aimed at finding a simple and reliable method to detect the circulating cell-free DNA (cfDNA) in BE patients as evidence of the molecular instability that accompanies BE carcinogenesis...
October 6, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28969923/diagnosis-and-endoscopic-management-of-barrett-s-esophagus-an-italian-experts-opinion-based-document
#7
Guido Costamagna, Giorgio Battaglia, Alessandro Repici, Roberto Fiocca, Massimo Rugge, Cristiano Spada, Vincenzo Villanacci
BACKGROUND: Barrett's esophagus (BE) is recognized as a risk factor for esophageal adenocarcinoma. An expert panel was organized in Italy with the aim of drafting a series of statements on BE to guide diagnosis and management of patients with BE. METHODS: The working Group Coordinators worked on a literature search to identify key topics regarding critical steps of the endoscopic approach to BE. Based on the search and their expert opinion, a list of most meaningful questions was prepared and emailed to all members who were asked to vote the questions...
September 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28954045/low-prevalence-of-barrett-s-esophagus-in-a-risk-area-for-esophageal-cancer-in-south-of-brazil
#8
Diego Michelon DE Carli, Amanda Faria de Araujo, Renato Borges Fagundes
BACKGROUND: Barrett's esophagus a complication of gastroesophageal reflux disease (GERD) is a precursor of esophageal adenocarcinoma. The incidence of esophageal adenocarcinoma has been increasing in most Western countries. Rio Grande do Sul (RS), the Southernmost state of Brazil has the highest rates of esophageal cancer with low prevalence of esophageal adenocarcinoma. OBJECTIVE: To investigate the prevalence of Barrett's esophagus among patients underwent to upper gastrointestinal endoscopy in the last 5 years...
September 21, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28922442/volumetric-laser-endomicroscopy-for-barrett-s-esophagus-looking-at-the-fine-print
#9
REVIEW
Deepanshu Jain, Sanna Fatima, Shilpa Jain, Shashideep Singhal
Barrett's esophagus (BE) is a premalignant condition. The incidence of adenocarcinoma in BE has been reported to be between 0.1-3%. Dysplasia in BE is patchy and extensive biopsy sampling is labor intensive, low yield and does not eliminate the sampling error completely. Volumetric laser endomicroscopy (VLE) is expected to enable endoscopists to do targeted biopsy of dysplastic/cancerous lesions (not visible on white light endoscopy) among patients with BE. We reviewed 7 studies with a total of 62 subjects who had undergone VLE...
September 2017: Journal of Gastrointestinal and Liver Diseases: JGLD
https://www.readbyqxmd.com/read/28905803/diagnosis-and-treatment-of-gastroesophageal-reflux-disease-complicated-by-barrett-s-esophagus
#10
Andriy Stasyshyn
The aim of the study was to evaluate the effectiveness of a diagnostic and therapeutic algorithm for gastroesophageal reflux disease complicated by Barrett's esophagus in 46 patients. MATERIALS AND METHODS: A diagnostic and therapeutic algorithm for complicated GERD was developed. To describe the changes in the esophagus with reflux esophagitis, the Los Angeles classification was used. Intestinal metaplasia of the epithelium in the lower third of the esophagus was assessed using videoendoscopy, chromoscopy, and biopsy...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28881340/additional-benefits-of-routine-drugs-on-gastrointestinal-cancer-statins-metformin-and-proton-pump-inhibitors
#11
Moon Kyung Joo, Jong-Jae Park, Hoon Jai Chun
BACKGROUND: Commonly used medications including statins, metformin, and proton pump inhibitors (PPIs) effectively reduce the risk of esophageal, gastric, and colorectal cancer (CRC). SUMMARY: A number of observational studies and meta-analyses have shown that long-term statin use significantly reduces the incidence of gastrointestinal (GI) cancer. Moreover, statin use after GI cancer diagnosis has been significantly associated with better prognosis in large-scale cohort studies...
2018: Digestive Diseases
https://www.readbyqxmd.com/read/28870046/-the-chinese-consensus-for-screening-diagnosis-and-management-of-barrett-s-esophagus-and-early-adenocarcinoma-2017-wanning
#12
(no author information available yet)
Patients with Barrett's esophagus (BE)/columnar lined esophagus (CLE) and adenocarcinoma are increasing, in whom 0.61% BE/CLE would develop to adenocarcinoma. The prognosis of esophageal cancer is related to the tumor stage at diagnosis. To standardize the screening, diagnosis and therapy of BE and adenocarcinoma in China, 31 digestive diseases and digestive endoscopy experts and digestive histologists drafted the consensus on the basis of clinical experience and references. The consensus defined BE as a complication of gastroesophageal reflux disease...
September 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28766563/editorial-the-effect-of-bias-on-estimation-of-improved-survival-after-diagnosis-of-barrett-s-esophagus
#13
COMMENT
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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