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https://www.readbyqxmd.com/read/29460418/reliability-of-histologic-assessment-in-patients-with-eosinophilic-oesophagitis
#1
M J Warners, C A Ambarus, A J Bredenoord, J Verheij, G Y Lauwers, J C Walsh, D A Katzka, S Nelson, T van Viegen, G T Furuta, S K Gupta, L Stitt, G Zou, C E Parker, L M Shackelton, G R D Haens, W J Sandborn, E S Dellon, B G Feagan, M H Collins, V Jairath, R K Pai
BACKGROUND: The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. AIM: Formally assess the reliability of the EoEHSS and additional histologic features. METHODS: Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process...
February 20, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29460159/management-of-esophageal-food-impaction-varies-among-gastroenterologists-and-affects-identification-of-eosinophilic-esophagitis
#2
Girish Hiremath, Michael F Vaezi, Sandeep K Gupta, Sari Acra, Evan S Dellon
BACKGROUND AND AIMS: Esophageal food impaction (EFI) is a gastrointestinal emergency requiring immediate evaluation in the emergency room (ER) and an esophagogastroduodenoscopy (EGD) for disimpaction. EFI is also a distinct presenting feature of eosinophilic esophagitis (EoE). This study aimed at understanding the management of EFI among gastroenterologists (GIs) and estimated its impact on identification of EoE in USA. METHODS: GIs associated with three major gastroenterology societies based in USA were invited to participate in a web-based survey...
February 20, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29455359/eosinophilic-esophagitis-an-important-comorbid-condition-of-asthma
#3
REVIEW
Sandy R Durrani, Vincent A Mukkada, Theresa W Guilbert
Eosinophilic esophagitis and asthma are frequently found as comorbid conditions in children and adults along with other manifestations of atopic diathesis. These two conditions have similar T helper 2 responses-driven pathophysiology and share common management strategies such as using systemic corticosteroids and targeted anti-cytokine biologic therapies. Review of the literature finds that asthma is often a comorbid condition in eosinophilic esophagitis in both children and adults; however, the EoE-asthma relationship remains poorly characterized mechanistically and clinically...
February 18, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29435312/determinant-factors-of-quality-of-life-in-adult-patients-with-eosinophilic-esophagitis
#4
Alfredo J Lucendo, Laura Arias-González, Javier Molina-Infante, Ángel Arias
Background: Eosinophilic esophagitis (EoE) affects health-related quality of life (HRQoL). Data on determinant factors and the influence of dietary interventions are scarce. Objective: The objective of this article is to evaluate factors influencing HRQoL in adult EoE patients. Methods: We conducted a multicenter observational, cross-sectional study. A validated Spanish version of the self-administered Adult Eosinophilic Esophagitis Quality of Life (EoE-QoL-A) questionnaire and specific surveys were used...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29435311/rising-incidence-and-prevalence-of-adult-eosinophilic-esophagitis-in-midwestern-spain-2007-2016
#5
Javier Molina-Infante, Pedro Luis Gonzalez-Cordero, Hal Cliff Ferreira-Nossa, Pilar Mata-Romero, Alfredo J Lucendo, Angel Arias
Objectives: Epidemiologic studies on eosinophilic esophagitis (EoE) are scarce and patient responders to proton pump inhibitor (PPI) therapy have usually been excluded. We aimed to evaluate population-based incidence rates, prevalence and trends in adult EoE over the past decade, including responders to PPI therapy. Methods: We conducted an analysis of a prospectively established case registry in the health area of Cáceres, located in midwestern Spain. From the first EoE case diagnosed in 2007, endoscopy and pathology reports up to December 2016 were manually reviewed...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29427131/eosinophilic-esophagitis-through-the-flexible-endoscope-and-the-lens-of-a-photographer-in-the-amazon
#6
REVIEW
Amal Assa'ad
Eosinophilic esophagitis (EoE) is a disorder that has been identified recently, thus knowledge about it, its pathogenesis, and potential etiologies has spread in an era where the medical community and the public are receiving the information and discussing it as it appears in the medical literature. Because physiology, pathology, and pathophysiology are difficult to explain in layman terms, the author has used photographs taken in remote areas of the Amazon to create visual similes within a narrative that brings the scientific and medical concepts of the knowledge on EoE to a level that allows both medical and non-medical persons to grasp and discuss their significance...
February 9, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29424023/integrin-%C3%AE-m-activation-and-upregulation-on-esophageal-eosinophils-and-periostin-mediated-eosinophil-survival-in-eosinophilic-esophagitis
#7
Praveen Vimalathas, Alexandra Farris, Dorothea Letner, Vikram Deshpande, Vijay Yajnik, Wayne Shreffler, John Garber
Eosinophilic esophagitis (EoE) is increasingly recognized allergic disease associated with dysphagia and esophageal fibrosis. We aimed to determine expression patterns of specific eosinophil integrins that promote eosinophilic infiltration of the esophageal epithelium, and to determine how key EoE-related cytokines influence eosinophil activation and survival. Esophageal and peripheral eosinophils were isolated from 20 adult subjects with EoE for immunophenotyping and integrin profiling using multicolor flow cytometry and immunohistochemistry...
February 9, 2018: Immunology and Cell Biology
https://www.readbyqxmd.com/read/29422678/clinical-translation-of-tethered-confocal-microscopy-capsule-for-unsedated-diagnosis-of-eosinophilic-esophagitis
#8
Nima Tabatabaei, DongKyun Kang, Minkyu Kim, Tao Wu, Catriona N Grant, Mireille Rosenberg, Norman S Nishioka, Paul E Hesterberg, John Garber, Qian Yuan, Aubrey J Katz, Guillermo J Tearney
Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level...
February 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29422238/eosinophilic-oesophagitis-current-evidence-based-diagnosis-and-treatment
#9
Alfredo J Lucendo, Javier Molina-Infante
Eosinophilic oesophagitis (EoE) is a disease caused by an immune response to food antigens in contact with the oesophageal mucosa. Its diagnosis is defined by the combination of oesophageal dysfunction symptoms and inflammation of the oesophageal mucosa predominantly by eosinophils. Its chronic course and frequent progression to subepithelial fibrosis and oesophageal strictures indicate the need for treatment. The information provided by recent clinical trials and systematic reviews has led to the development of new clinical guidelines, endorsed by several European scientific societies...
February 5, 2018: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/29399613/ankylosaurus-back-sign-novel-endoscopic-finding-in-esophageal-eosinophilia-patients-indicating-proton-pump-inhibitor-response
#10
Norihisa Ishimura, Shohei Sumi, Mayumi Okada, Daisuke Izumi, Hironobu Mikami, Eiko Okimoto, Nahoko Ishikawa, Yuji Tamagawa, Tsuyoshi Mishiro, Naoki Oshima, Kotaro Shibagaki, Shunji Ishihara, Riruke Maruyama, Yoshikazu Kinoshita
Background and study aims : Characteristic endoscopic findings, such as linear furrows, rings, and whitish exudates, indicate the presence of esophageal eosinophilia (EE), though no specific findings are known to distinguish eosinophilic esophagitis (EoE) from proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE). Here, we present a novel endoscopic finding in some EE patients possessing a linear longitudinal arrangement of whitish nodules with the appearance of the back of an Ankylosaurus dinosaur, termed Ankylosaurus back sign (ABS), and evaluations of its significance in affected patients...
February 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29394460/a-fast-4d-imrt-vmat-planning-method-based-on-segment-aperture-morphing
#11
Slade J Klawikowski, An Tai, Ozgur Ates, Ergun Ahunbay, X Allen Li
PURPOSE: Four-dimensional volumetric modulated arc therapy (4D VMAT) and four-dimensional intensity modulated radiotherapy (4D IMRT) are developing radiation therapy treatment strategies designed to maximize dose conformality, minimize normal tissue dose, and deliver the treatment as efficiently as possible. The patient's entire breathing cycle is captured through 4D imaging modalities and then separated into individual breathing phases for planning purposes. Optimizing multi-phase VMAT and IMRT plans is computationally demanding and currently impractical for clinical application...
February 2, 2018: Medical Physics
https://www.readbyqxmd.com/read/29394215/practice-differences-in-the-diagnosis-and-management-of-eosinophilic-esophagitis-among-adult-and-pediatric-gastroenterologists-in-israel
#12
Eyal Zifman, Hagar Banai, Raanan Shamir, Tamar Ringel-Kulka, Noam Zevit
OBJECTIVES: Eosinophilic esophagitis (EoE) guidelines call for similar practices in adults and children with EoE. We compared the diagnostic and management practices of gastroenterologists treating adult and pediatric patients suspected of having, or diagnosed with, EoE. METHODS: A 19 question multiple choice questionnaire was given to gastroenterologists treating either adults or children. Questions explored four areas of interest: Physician demographics, diagnosis and tissue sampling practices, management, and the need for societal publications on EoE...
February 1, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29390993/efficient-strategy-for-the-molecular-diagnosis-of-intractable-early-onset-epilepsy-using-targeted-gene-sequencing
#13
John Hoon Rim, Se Hee Kim, In Sik Hwang, Soon Sung Kwon, Jieun Kim, Hyun Woo Kim, Min Jung Cho, Ara Ko, Song Ee Youn, Jihun Kim, Young Mock Lee, Hee Jung Chung, Joon Soo Lee, Heung Dong Kim, Jong Rak Choi, Seung-Tae Lee, Hoon-Chul Kang
BACKGROUND: We intended to evaluate diagnostic utility of a targeted gene sequencing by using next generation sequencing (NGS) panel in patients with intractable early-onset epilepsy (EOE) and find the efficient analytical step for increasing the diagnosis rate. METHODS: We assessed 74 patients with EOE whose seizures started before 3 years of age using a customized NGS panel that included 172 genes. Single nucleotide variants (SNVs) and exonic and chromosomal copy number variations (CNVs) were intensively examined with our customized pipeline and crosschecked with commercial or pre-built software...
February 1, 2018: BMC Medical Genomics
https://www.readbyqxmd.com/read/29381255/airborne-and-food-sensitization-patterns-in-children-and-adults-with-eosinophilic-esophagitis
#14
Yu Ting He, Paul J Christos, William R Reisacher
BACKGROUND: The pathogenesis of eosinophilic esophagitis (EoE) is currently unknown, but evidence suggests that allergic sensitization to food and airborne allergens may play a key role. This retrospective study examines the rate of sensitization to both food and airborne allergens in EoE patients, and compares their sensitivity patterns to control groups. METHODS: We identified 103 patients with a diagnosis of EoE via esophageal eosinophilia (≥15 eosinophils/high-power field [hpf]), who had undergone comprehensive food and/or airborne allergen testing through either skin or in vitro methods...
January 30, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29380175/combined-and-alternating-topical-steroids-and-food-elimination-diet-for-the-treatment-of-eosinophilic-esophagitis
#15
Craig C Reed, Anca M Safta, Shadi Qasem, M Angie Almond, Evan S Dellon, Elizabeth T Jensen
BACKGROUND: Few studies have examined combined or alternating treatment algorithms in eosinophilic esophagitis. AIMS: We conducted a retrospective cohort study to ascertain the efficacy and adherence to a combined and alternating treatment approach with topical corticosteroids and 2-food elimination diet for pediatric EoE. METHODS: Patients were prescribed a 2-food elimination diet (milk and soy) and topical corticosteroid (fluticasone or oral viscous budesonide) for 3 months, after which the steroid was discontinued and 2-food elimination diet continued for 3 months...
January 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29377264/understanding-fibrosis-in-eosinophilic-esophagitis-are-we-there-yet
#16
REVIEW
Jennifer Armbruster-Lee, Cary P Cavender, Jay A Lieberman, Amali E Samarasinghe
Eosinophilic esophagitis (EoE) is an immune/antigen-mediated, progressive fibrostenotic disease characterized by symptoms of esophageal dysfunction and abnormal eosinophilic infiltration in the esophagus. Despite current treatment modalities of dietary antigen elimination or topical corticosteroids, a subset of patients do not have clinical or histologic response. Even with resolution of superficial epithelial eosinophilia, patients may still have progressive subepithelial fibrosis, which may lead to esophageal strictures over time...
January 29, 2018: Journal of Leukocyte Biology
https://www.readbyqxmd.com/read/29372536/biological-therapies-for-eosinophilic-esophagitis-where-do-we-stand
#17
REVIEW
Emily Ko, Mirna Chehade
Eosinophilic esophagitis (EoE) is an immune-mediated, chronic esophageal disease characterized by esophageal symptoms and esophageal eosinophilia. It is triggered by foods and possibly by environmental allergens. Currently, there are no FDA-approved therapies for EoE. Commonly used treatments include dietary restrictions and topical corticosteroids. Many of these therapies are suboptimal in their efficacy, have side effects, or diminish patients' quality of life. Biologic therapies for EoE have therefore been sought as an alternative...
January 25, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29357016/new-developments-in-the-diagnosis-therapy-and-monitoring-of-eosinophilic-esophagitis
#18
REVIEW
Ronak Vashi Patel, Ikuo Hirano
PURPOSE OF REVIEW: Eosinophilic esophagitis (EoE) has transformed over the past two decades from a little-known entity to a significant cause of morbidity in the adult and pediatric population. We reviewed the most recent advancements in the diagnosis, therapy, and long-term monitoring of EoE. RECENT FINDINGS: Based on clinical, endoscopic, histologic, immunologic, and genetic similarities, there is growing consensus to move away from distinguishing proton pump inhibitor responsive esophageal eosinophilia as an entity distinct from EoE...
January 22, 2018: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29356936/does-aeroallergen-sensitization-cause-or-contribute-to-eosinophilic-esophagitis
#19
REVIEW
Jesus R Guajardo, Melissa A Zegarra-Bustamante, Edward G Brooks
Eosinophilic esophagitis is an atopic disease defined clinically by esophageal symptoms in combination with a dense esophageal eosinophilia. EoE is triggered and maintained by exposure to certain foods and it is known that dietary modification controls symptoms and achieves disease remission. Recently, aeroallergens have been implicated in the pathogenesis of EoE. To examine the role of aeroallergens in EoE, we reviewed the published literature. Sensitization and production of IgE antibodies to foods and aeroallergens in subjects with EoE has been demonstrated...
January 22, 2018: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29350339/emerging-insights-into-the-esophageal-microbiome
#20
REVIEW
Michael May, Julian A Abrams
PURPOSE OF REVIEW: Analysis of the esophageal microbiome remains a relatively new field of research, and most studies to date have focused on characterizing the esophageal microbiome in states of health and disease. Microbiome alterations have been implicated in the pathogenesis of inflammatory and neoplastic conditions in the colon and elsewhere in the gastrointestinal tract. The epidemiology of various esophageal conditions including Barrett's esophagus (BE), esophageal adenocarcinoma (EAC), esophageal squamous cell carcinoma (ESCC), and eosinophilic esophagitis (EoE) point to the microbiome as a potential co-factor in disease pathogenesis, and the possibility exists that these microbiome alterations could contribute directly to the inflammatory environments necessary for the carcinogenesis or atopy involved in these conditions...
January 19, 2018: Current Treatment Options in Gastroenterology
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