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https://www.readbyqxmd.com/read/28055990/dilation-of-pediatric-eosinophilic-esophagitis-adverse-events-and-short-term-outcomes
#1
Calies Menard-Katcher, Glenn T Furuta, Robert E Kramer
OBJECTIVES: Although several studies report the experience with adult eosinophilic esophagitis (EoE) related stricture, outcomes for pediatric patients with EoE associated fibrostenosis and stricture is even more limited. To address this, we aim to identify the adverse event rate and short-term outcomes of the largest reported cohort of children with EoE to undergo esophageal dilation for management of symptomatic esophageal narrowing. METHODS: A retrospective assessment of all children, 18 years and younger, who underwent esophageal dilation at an academic children's hospital over a 5-year period was conducted...
July 18, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28047625/su-f-j-129-verification-of-geometric-and-dosimetric-accuracy-of-respiratory-management-systems-using-homemade-phantom
#2
E Goksel, H Kucucuk, O Senkesen, E Tezcanli
PURPOSE: Different placements of Infrared Cameras (IRC) in CT and treatment rooms can cause gating window level (GWL) variations leading to differences between GWL used for planning and treatments. Although, Varian Clinac DHX-OBI sytem and CT are equipped with the same kind of IRC, Truebeam STx (TB) has a different type of IRC known as banana type. In this study; geometric and dosimetric accuracy of respiratory management system (RPM) for different machines were investigated with a special homemade phantom...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046715/tu-ab-bra-09-a-novel-method-of-generating-ultrafast-volumetric-cine-mri-vc-mri-using-prior-4d-mri-and-on-board-phase-skipped-encoding-acquisition-for-radiotherapy-target-localization
#3
C Wang, F Yin, W Harris, J Cai, Z Chang, L Ren
PURPOSE: To develop a technique generating ultrafast on-board VC-MRI using prior 4D-MRI and on-board phase-skipped encoding k-space acquisition for real-time 3D target tracking of liver and lung radiotherapy. METHODS: The end-of-expiration (EOE) volume in 4D-MRI acquired during the simulation was selected as the prior volume. 3 major respiratory deformation patterns were extracted through the principal component analysis of the deformation field maps (DFMs) generated between EOE and all other phases...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045773/the-association-between-celiac-disease-and-eosinophilic-esophagitis-mayo-experience-and-meta-analysis-of-the-literature
#4
Salim Hommeida, Mouaz Alsawas, Mohammad H Murad, David A Katzka, Rayna M Grothe, Imad Absah
BACKGROUND: The association between celiac disease (CD) and eosinophilic esophagitis (EoE) has been the focus of multiple studies with variable results. Both diseases are immune mediated, and dietary triggers play a role in their pathogenesis. OBJECTIVES: The aim of the study was to analyze the risk of EoE in children with CD, assess the magnitude of association between CD and EoE in children, and report the characteristics and outcomes of children with both conditions...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28042003/the-prevalence-of-eosinophilic-esophagitis-in-pediatric-patients-with-ige-mediated-food-allergy
#5
David A Hill, Jesse W Dudley, Jonathan M Spergel
BACKGROUND: Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients who underwent oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association. OBJECTIVE: We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE. METHODS: Using the analysis of electronic medical record data and manual chart review, we examined our subspecialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated and EoE food allergy...
December 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28041975/determination-of-esophageal-eosinophil-counts-and-other-histologic-features-of-eosinophilic-esophagitis-by-pathology-trainees-is-highly-accurate
#6
Spencer Rusin, Shannon Covey, Irina Perjar, Johnny Hollyfield, Olga Speck, Kimberly Woodward, John T Woosley, Evan S Dellon
Many studies of eosinophilic esophagitis (EoE) utilize expert pathology review, but it is unknown whether less experienced pathologists can reliably assess EoE histology. We aimed to determine whether trainee pathologists can accurately quantify esophageal eosinophil counts and identify associated histologic features of EoE, as compared to expert pathologists. We used a set of 40 digitized slides from patients with varying degrees of esophageal eosinophilia. Each of six trainee pathologists underwent a teaching session and used our validated protocol to determine eosinophil counts and associated EoE findings...
December 29, 2016: Human Pathology
https://www.readbyqxmd.com/read/28005266/enhanced-activation-of-eosinophils-in-peripheral-blood-and-implications-for-eosinophilic-esophagitis-diagnosis
#7
Valéria Botan, Tatiana Karla Dos Santos Borges, Erica Alessandra Rocha Alves, Shirley Claudino Pereira Couto, Heinrich Bender Kohnert Seidler, Maria Imaculada Muniz-Junqueira
BACKGROUND AND AIM: Eosinophils are markers of the eosinophilic esophagitis (EoE) disease, and this work aimed to assess whether activation of eosinophils could be a noninvasive test to contribute for EoE diagnosis. METHODS: The activation state of peripheral blood eosinophils in EoE patients (31) and control subjects (10) was assessed based on the morphological aspects of the eosinophil after adherence to slide. COX-2 and 5-LOX expressions were evaluated by means of immunofluorescence microscopy to verify if and which eicosanoid pathway is triggered in eosinophils in blood in EoE...
December 22, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27998193/update-on-dietary-therapy-for-eosinophilic-esophagitis-in-children-and-adults
#8
Javier Molina-Infante, Pedro Luis Gonzalez-Cordero, Angel Arias, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a chronic inflammatory esophageal disease triggered predominantly, but not excusively, by food antigens. Elimination diet thus remains the only therapy targeting the cause of the disease. Importantly, EoE is a unique form of non-IgE mediated food allergy, largely dependant upon delayed, cell-mediated hypersensitivity. Areas covered: A comprehensive review of literature to summarize and update the most relevant advances on dietary therapy for pediatric and adult EoE patients is conducted...
December 23, 2016: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27979389/eosinophilic-esophagitis-update-in-diagnosis-and-management-position-paper-by-the-italian-society-of-gastroenterology-and-gastrointestinal-endoscopy-sige
#9
REVIEW
Nicola de Bortoli, Roberto Penagini, Edoardo Savarino, Santino Marchi
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized by symptoms related to esophageal dysfunction, as well as significant esophageal eosinophilia. The entity exists worldwide but has been most extensively studied in Western countries. However, a wide range of symptoms has been noticed such as chest pain or gastro-esophageal reflux disease-like symptoms. Upper gastro-intestinal endoscopy and esophageal biopsies are crucial for the diagnosis. Endoscopy might be normal or reveal typical patterns such as rings, furrows, exudates, edema, and stricture...
December 2, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27956893/eosinophilic-disorders-of-the-gastro-intestinal-tract-an-update
#10
REVIEW
Erminia Ridolo, Valerie Melli, Gianluigi De' Angelis, Irene Martignago
Eosinophilic diseases of the gastrointestinal tract, including eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE), are rare chronic pathologies of the digestive system, with an immuno-mediated pathogenesis. Recent data suggest that, together with the "classic" IgE-response to allergens, also a delayed hypersensitivity mechanism could be involved in the development of eosinophilic disorders. EoE and EGE were studied only in the latest decades and as a consequence accurate data are not yet available, concerning not only pathogenesis, but also epidemiology, treatment and outcomes...
2016: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/27940272/cost-utility-analysis-of-topical-steroids-compared-to-dietary-elimination-for-treatment-of-eosinophilic-esophagitis
#11
Cary C Cotton, Daniel Erim, Swathi Eluri, Sarah H Palmer, Daniel J Green, W Asher Wolf, Thomas M Runge, Stephanie Wheeler, Nicholas J Shaheen, Evan S Dellon
BACKGROUND & AIMS: Topical corticosteroids or dietary elimination are recommended as first-line therapies for eosinophilic esophagitis (EoE), but data to directly compare these therapies are scant. We performed a cost utility comparison of topical corticosteroids and the 6 food elimination diet (SFED) in treatment of EoE, from the payer perspective. METHODS: We used a modified Markov model based on current clinical guidelines, in which transition between states depended on histologic response simulated at the individual cohort-member level...
December 7, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27926989/targeting-gm-csf-in-epithelial-and-vascular-remodeling-in-experimental-eosinophilic-esophagitis
#12
Eóin N McNamee, Kathryn A Biette, Juliet Hammer, Rachel Harris, Heather Miyazawa, James J Lee, Glenn T Furuta, Joanne C Masterson
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic antigen-mediated clinicopathologic disease of the esophagus characterized by an eosinophil-predominant inflammatory infiltrate. A clinical hallmark is extensive tissue remodeling including basal zone hyperplasia, fibrosis and angiogenesis. However, the cellular mechanisms responsible for these processes are not fully defined. We hypothesized that targeting GM-CSF (an agonist cytokine linked with eosinophil survival and activation) would be protective in a pre-clinical model of EoE...
December 7, 2016: Allergy
https://www.readbyqxmd.com/read/27921303/eosinophils-from-eosinophilic-oesophagitis-patients-have-t-cell-suppressive-capacity-and-express-foxp3
#13
C Lingblom, J Wallander, M Ingelsten, H Bergquist, M Bove, R Saalman, A Welin, C Wennerås
Eosinophilic esophagitis (EoE) is an antigen-driven T cell-mediated chronic inflammatory disease where food and environmental antigens are thought to have a role. Human eosinophils express the immunoregulatory protein galectin-10 and have T cell suppressive capacity similar to regulatory T cells (Tregs ). We hypothesized that one function of eosinophils in EoE might be to regulate the T cell-driven inflammation in the oesophagus. This was tested by evaluating the suppressive capacity of eosinophils isolated from the blood of adult EoE patients in a mixed lymphocyte reaction...
November 5, 2016: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/27920662/possible-noninvasive-biomarker-of-eosinophilic-esophagitis-clinical-and-experimental-evidence
#14
Sathisha Upparahalli Venkateshaiah, Murli Manohar, Alok K Verma, Uwe Blecker, Anil Mishra
Eosinophilic esophagitis (EoE) diagnosis and follow-up response to therapy is based on repeated endoscopies and histological examination for eosinophils/HPF. The procedure is invasive and risky in particular for the pediatric population. Presently, there is no highly sensitive and specific noninvasive blood test available to monitor the disease pathogenesis. Reports indicate the expression of PDL1 (CD274) on the eosinophils in allergic patients. Herein, we report that CD274-expressing and -nonexpressing eosinophils were detected in both examined pediatric and adult EoE patients...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27906799/diet-and-stress-in-pediatric-eosinophilic-esophagitis
#15
Christine Case, Glenn T Furuta, Dan Atkins, Zhaozing Pan, Jane Robinson
Clinical experiences and recent studies suggest that Eosinophilic Esophagitis (EoE) has the potential to induce caregiver (CG) and child stress. The specific sources of CG EoE-related stress remain uncertain. To address this, we performed a survey of CGs and youth attending an EoE patient education symposium that measured potential stressful elements in their daily life. Our results indicated that CGs experienced most stress associated with purchasing, preparation and completion of meals. We conclude that providers should consider this in choosing therapeutic approaches for children with EoE...
November 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27900765/the-role-of-the-otolaryngologist-in-the-evaluation-and-diagnosis-of-eosinophilic-esophagitis
#16
Mark Kubik, Prasad Thottam, Amber Shaffer, Sukgi Choi
OBJECTIVE: To describe the clinical presentation and role of the otolaryngologist in the evaluation of eosinophilic esophagitis (EoE) at a tertiary pediatric hospital. STUDY DESIGN: Retrospective review. METHODS: Records from pediatric patients with a diagnosis of EoE from 2003 to 2015 were reviewed. Study variables were analyzed to compare patients presenting to different specialties. RESULTS: Two hundred and fifty-one patients with EoE were evaluated...
November 30, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27896821/clinical-symptom-tool-that-raises-the-index-of-suspicion-for-eosinophilic-oesophagitis-in-adults-and-drives-earlier-biopsy-for-definitive-diagnosis
#17
U von Arnim, F-W Röhl, S Miehlke, D Jechorek, D Reinhold, T Wex, P Malfertheiner
BACKGROUND: Eosinophilic oesophagitis (EoE) and gastro-oesophageal reflux disease (GERD) present with overlapping symptomatology and it is challenging to distinguish EoE from GERD clinically before endoscopy. AIM: To investigate the prognostic value of a set of clinical symptoms and laboratory values in patients with EoE and GERD. METHODS: In this prospective, single-centre, observational study, we compared clinical and laboratory data from 202 patients with EoE or GERD (10 relevant characteristics)...
February 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27889574/budesonide-oral-suspension-improves-symptomatic-endoscopic-and-histologic-parameters-compared-with-placebo-in-patients-with-eosinophilic-esophagitis
#18
Evan S Dellon, David A Katzka, Margaret H Collins, Mohamed Hamdani, Sandeep K Gupta, Ikuo Hirano
BACKGROUND & AIMS: Pharmacologic treatment of eosinophilic esophagitis (EoE) is limited to off-label use of corticosteroids not optimized for esophageal delivery. We performed a randomized, controlled phase 2 trial to assess the ability of budesonide oral suspension (BOS), a novel muco-adherent topical steroid formulation, to reduce symptoms and esophageal eosinophilia in adolescents and adults with EoE. METHODS: In this multicenter, randomized, double-blind, placebo-controlled, parallel-group trial, 93 EoE patients between the ages of 11 and 40 years with dysphagia and active esophageal eosinophilia were randomized to receive either BOS 2 mg or placebo twice daily for 12 weeks...
November 23, 2016: Gastroenterology
https://www.readbyqxmd.com/read/27878833/presence-of-intraepithelial-food-antigen-in-patients-with-active-eosinophilic-oesophagitis
#19
E V Marietta, D M Geno, T C Smyrk, A Becker, J A Alexander, M Camilleri, J A Murray, D A Katzka
BACKGROUND: Although eosinophilic oesophagitis (EoE) is putatively mediated by an abnormal response to food antigen, the oesophagus is considered relatively impermeable to large molecules. AIM: To assess whether food antigens penetrate the oesophageal mucosa in patients with EoE. METHODS: Anti-gliadin staining was performed in three groups: active EoE, inactive EoE and EoE patients on a low or gluten free diet. To appraise the specificity of our results, we also performed gliadin staining on six patients without oesophageal disease who were consuming gluten...
February 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27868307/effects-of-eosinophilic-oesophagitis-on-quality-of-life-in-an-adult-uk-population-a-case-control-study
#20
R Hewett, C Alexakis, A D Farmer, J Ainley, V Chhaya, J O Hayat, A Poullis, J-Y Kang
Eosinophilic oesophagitis (EoE) is a chronic immune-mediated esophageal disease, characterized by symptoms related to esophageal dysfunction and histologically by eosinophil predominant inflammation. Current evidence for an adverse impact on quality of life (QoL) is conflicting and there are no data from a UK population regarding QoL. We conducted a prospective cross-sectional observational study using the Short Form-36 Health Survey, Hospital Dysphagia/Odynophagia Questionnaire, and the EoE Adult Quality of Life Questionnaire to assess QoL and severity of dysphagia in EoE patients, compared to age and gender matched healthy control subjects...
November 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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