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https://www.readbyqxmd.com/read/27882416/toward-more-efficient-surveillance-of-barrett-s-esophagus-identification-and-exclusion-of-patients-at-low-risk-of-cancer
#1
Mats Lindblad, Tim Bright, Ann Schloithe, George C Mayne, Gang Chen, Jeff Bull, Peter A Bampton, Robert J L Fraser, Piers A Gatenby, Louisa G Gordon, David I Watson
BACKGROUND: Endoscopic surveillance of Barrett's esophagus (BE) is probably not cost-effective. A sub-population with BE at increased risk of high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) who could be targeted for cost-effective surveillance was sought. METHODS: The outcome for BE surveillance from 2003 to 2012 in a structured program was reviewed. Incidence rates and incidence rate ratios for developing HGD or EAC were calculated. Risk stratification identified individuals who could be considered for exclusion from surveillance...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27868216/the-endoscopic-reference-score-shows-modest-accuracy-to-predict-either-clinical-or-histological-activity-in-adult-patients-with-eosinophilic-oesophagitis
#2
J Rodríguez-Sánchez, J Barrio-Andrés, O Nantes Castillejo, E Valdivieso-Cortazar, I Pérez-Martínez, A Boumidi, J A Olmos-Jérez, G Payeras-Llodra, N Alcaide-Suarez, L Ruiz-Rebollo, B Madrigal-Rubiales, E Gonzalez-Obeso, E de la Santa Belda, B López Viedma, J Molina-Infante
BACKGROUND: Conflicting results have been recently reported for the accuracy of the Endoscopic Reference Score (EREFS), an standardised endoscopic classification, to predict the histological activity of eosinophilic oesophagitis (EoE). AIM: To evaluate the accuracy of the EREFS to predict either histological or clinical activity of EoE. METHODS: Prospective multicentre study conducted in eight Spanish centres evaluating adult EoE patients, either naïve or after treatment...
November 20, 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27849511/hiatal-hernia-as-the-cause-of-g-induced-abdominal-pain
#3
Scott B Hughey, Lauren H Mattingly
Sliding hiatal hernias are common and affect approximately 10% to 80% of the general population. The condition typically presents with reflux-type symptoms and is diagnosed either with imaging or endoscopy. In this case, the hernia presented as G-induced abdominal pain. The patient was an F-18 pilot who experienced worsening epigastric abdominal pain proportionate to the amount of accelerative force experienced. The pain would occur at approximately 3 Gs and increase beyond that. The patient was asymptomatic at rest and denied any dysphagia or reflux symptoms...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27832555/driving-impairment-due-to-propofol-at-effect-site-concentrations-relevant-after-short-propofol-only-sedation
#4
J L Telles, S Agarwal, J Monagle, C Stough, R King, L Downey
Australian guidelines state "Following brief surgery or procedures with short acting anaesthetic drugs, the patient may be fit to drive after a normal night's sleep. After long surgery or procedures requiring longer lasting anaesthesia, it may not be safe to drive for 24 hours or more". The increasing use of the short-acting anaesthetic drug propofol as a solitary sedative medication for simple endoscopy procedures suggests a need to review this blanket policy. Thirty patients presenting for elective day surgery were recruited as volunteers for a pre-procedure driving simulation study and randomised to propofol or placebo arms...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27821032/small-bowel-capsule-endoscopy-for-the-investigation-of-obscure-gastrointestinal-bleeding-when-we-should-do-it-and-what-should-we-expect
#5
REVIEW
N Viazis, J Anastasiou, D G Karamanolis
Obscure gastrointestinal bleeding is defined as bleeding of unknown origin that persists or recurs (i.e. recurrent or persistent iron deficiency anemia, fecal occult blood test positivity or visible bleeding) after a negative initial workout that necessarily includes gastroscopy and colonoscopy. In clinical practice, small bowel capsule endoscopy is recommended as a third stage examination in these patients, since it is a simple, safe, non-invasive and reliable test. To date there are three available small bowel capsule systems that have gained FDA approval and their diagnostic yield has shown to be superior to other diagnostic modalities for the investigation of the small bowel in patients with obscure gastrointestinal bleeding...
July 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/27682148/gastrointestinal-transit-assessment-role-of-scintigraphy-where-are-we-now-where-are-we-going
#6
Harvey A Ziessman
The diagnostic imaging evaluation of patients with suspected esophagogastrointestinal transit disorders is changing. Anatomical methods, e.g., barium studies, endoscopy, manometry, radiopaque markers, have long been the techniques available and used for diagnosis. The one exception has been gastric emptying, where radionuclide scintigraphy has been the standard for decades. Esophageal transit scintigraphy is an old and reliable methodology but probably underutilized. The diagnostic use of small and large intestinal transit scintigraphy is increasing, in part, because of the limitations of the other methods but, most importantly, because it is truly physiologic, i...
September 28, 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27562355/systematic-review-with-meta-analysis-prevalent-vs-incident-oesophageal-adenocarcinoma-and-high-grade-dysplasia-in-barrett-s-oesophagus
#7
REVIEW
K Visrodia, S Singh, R Krishnamoorthi, D A Ahlquist, K K Wang, P G Iyer, D A Katzka
BACKGROUND: The proportion of oesophageal adenocarcinoma that is detected concurrently with initial Barrett's oesophagus diagnosis is not well studied. AIM: To compare the proportion of prevalent adenocarcinoma vs. incident adenocarcinoma found during surveillance of Barrett's. METHODS: We performed a systematic search of MEDLINE, EMBASE and Web of Science (from their inception to 31 May 2015) for cohort studies in adults with Barrett's (nondysplastic Barrett's ± Barrett's with low-grade dysplasia) with minimum average follow-up of 3 years, and providing numbers of prevalent adenocarcinoma detected (concurrently with Barrett's diagnosis and up to 1 year afterwards) vs...
October 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27503924/rna-sequencing-identifies-transcriptionally-viable-gene-fusions-in-esophageal-adenocarcinomas
#8
Andrew E Blum, Srividya Venkitachalam, Yan Guo, Ann Marie Kieber-Emmons, Lakshmeswari Ravi, Apoorva K Chandar, Prasad G Iyer, Marcia I Canto, Jean S Wang, Nicholas J Shaheen, Jill S Barnholtz-Sloan, Sanford D Markowitz, Joseph E Willis, Yu Shyr, Amitabh Chak, Vinay Varadan, Kishore Guda
Esophageal adenocarcinoma is a deadly cancer with increasing incidence in the United States, but mechanisms underlying pathogenesis are still mostly elusive. In addressing this question, we assessed gene fusion landscapes by comprehensive RNA sequencing (RNAseq) of 55 pretreatment esophageal adenocarcinoma and 49 nonmalignant biopsy tissues from patients undergoing endoscopy for Barrett's esophagus. In this cohort, we identified 21 novel candidate esophageal adenocarcinoma-associated fusions occurring in 3...
October 1, 2016: Cancer Research
https://www.readbyqxmd.com/read/27465667/azithromycin-for-the-treatment-of-eosinophilic-nasal-polyposis-clinical-and-histologic-analysis
#9
Isamara Simas de Oliveira, Paulo Fernando Tormin Borges Crosara, Geovanni Dantas Cassali, Diego Carlos Dos Reis, Danilo Santana Rodrigues, Flavio Barbosa Nunes, Roberto Eustáquio Santos Guimarães
INTRODUCTION: Macrolides used as immunomodulators are a promising tool for chronic inflammatory airway diseases. Eosinophilic nasal polyposis (ENP) is still considered a disease that is difficult to control with the currently standardized treatments. OBJECTIVES: To evaluate prolonged treatment with low-dose azithromycin for ENP based on clinical and histopathologic variables. METHODS: The present investigation was a self-paired case study of 33 patients with ENP...
January 2016: Allergy & Rhinology
https://www.readbyqxmd.com/read/27464708/deep-mural-injury-and-perforation-after-colonic-endoscopic-mucosal-resection-a-new-classification-and-analysis-of-risk-factors
#10
Nicholas G Burgess, Milan S Bassan, Duncan McLeod, Stephen J Williams, Karen Byth, Michael J Bourke
OBJECTIVES: Perforation is the most serious complication associated with endoscopic mucosal resection (EMR). We propose a new classification for the appearance and integrity of the muscularis propria (MP) after EMR including various extents of deep mural injury (DMI). Risk factors for these injuries were analysed. DESIGN: Endoscopic images and histological specimens of consecutive patients undergoing EMR of colonic laterally spreading lesions ≥20 mm at a large Australian tertiary referral endoscopy unit were retrospectively analysed using our new DMI classification system...
July 27, 2016: Gut
https://www.readbyqxmd.com/read/27439975/a-multi-centred-randomised-trial-of-radical-surgery-versus-adjuvant-chemoradiotherapy-after-local-excision-for-early-rectal-cancer
#11
W A A Borstlap, P J Tanis, T W A Koedam, C A M Marijnen, C Cunningham, E Dekker, M E van Leerdam, G Meijer, N van Grieken, I D Nagtegaal, C J A Punt, M G W Dijkgraaf, J H De Wilt, G Beets, E J de Graaf, A A W van Geloven, M F Gerhards, H L van Westreenen, A W H van de Ven, P van Duijvendijk, I H J T de Hingh, J W A Leijtens, C Sietses, E J Spillenaar-Bilgen, R J C L M Vuylsteke, C Hoff, J W A Burger, W M U van Grevenstein, A Pronk, R J I Bosker, H Prins, A B Smits, S Bruin, D D Zimmerman, L P S Stassen, M S Dunker, M Westerterp, P P Coene, J Stoot, W A Bemelman, J B Tuynman
BACKGROUND: Rectal cancer surgery is accompanied with high morbidity and poor long term functional outcome. Screening programs have shown a shift towards more early staged cancers. Patients with early rectal cancer can potentially benefit significantly from rectal preserving therapy. For the earliest stage cancers, local excision is sufficient when the risk of lymph node disease and subsequent recurrence is below 5 %. However, the majority of early cancers are associated with an intermediate risk of lymph node involvement (5-20 %) suggesting that local excision alone is not sufficient, while completion radical surgery, which is currently standard of care, could be a substantial overtreatment for this group of patients...
2016: BMC Cancer
https://www.readbyqxmd.com/read/27367977/simple-risk-factors-to-predict-urgent-endoscopy-in-nonvariceal-upper-gastrointestinal-bleeding-pre-endoscopically
#12
Jianzong Wang, Duanming Hu, Wen Tang, Chuanyin Hu, Qin Lu, Juan Li, Jianhong Zhu, Liming Xu, Zhenyu Sui, Mingjie Qian, Shaofeng Wang, Guojian Yin
The goal of this study is to evaluate how to predict high-risk nonvariceal upper gastrointestinal bleeding (NVUGIB) pre-endoscopically. A total of 569 NVUGIB patients between Match 2011 and January 2015 were retrospectively studied. The clinical characteristics and laboratory data were statistically analyzed. The severity of NVUGIB was based on high-risk NVUGIB (Forrest I-IIb), and low-risk NVUGIB (Forrest IIc and III). By logistic regression and receiver-operating characteristic curve, simple risk score systems were derived which predicted patients' risks of potentially needing endoscopic intervention to control bleeding...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27272012/electromagnetic-guided-bedside-placement-of-nasoenteral-feeding-tubes-by-nurses-is-non-inferior-to-endoscopic-placement-by-gastroenterologists-a-multicenter-randomized-controlled-trial
#13
Arja Gerritsen, Thijs de Rooij, Marcel G Dijkgraaf, Olivier R Busch, Jacques J Bergman, Dirk T Ubbink, Peter van Duijvendijk, G Willemien Erkelens, Mariël Klos, Philip M Kruyt, Dirk Jan Bac, Camiel Rosman, Adriaan C Tan, I Quintus Molenaar, Jan F Monkelbaan, Elisabeth M Mathus-Vliegent, Marc G Besselink
OBJECTIVES: Electromagnetic (EM)-guided bedside placement of nasoenteral feeding tubes by nurses may improve efficiency and reduce patient discomfort and costs compared with endoscopic placement by gastroenterologists. However, evidence supporting this task shift from gastroenterologists to nurses is limited. We aimed to compare the effectiveness of EM-guided and endoscopic nasoenteral feeding tube placement. METHODS: We performed a multicenter randomized controlled non-inferiority trial in 154 adult patients who required nasoenteral feeding and were admitted to gastrointestinal surgical wards in five Dutch hospitals...
August 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27249440/-breath-test-with-locally-produced-13%C3%B0-urea-tbilisi-georgia-in-diagnostics-of-helicobacter-pylori-infection
#14
A Girdaladze, B Mosidze, G Elisabedashvili, D Kordzaia
Comparative assessment of results of detection of Helicobacter pylori (Hp) infection by breath tests with standard and locally produced 13С urea was done in 213 patients with gastric and duodenal pathology, including those who already were undergone the surgery. Invasive endoscopic biopsy test including rapid urease test (RUT), smear cytology and histology were also performed (tissue samples were obtained after endoscopy or surgery). RUT was carried out with the help of URE-HP test kit. Serological test for Hp antibodies was performed by IFA using kit ELISA...
April 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27236824/depth-of-anaesthesia-monitoring-during-procedural-sedation-and-analgesia-a-systematic-review-and-meta-analysis
#15
Aaron Conway, Joanna Sutherland
OBJECTIVES: Processed electroencephalogram-based depth of anaesthesia monitoring devices provide an additional method to monitor level of consciousness during procedural sedation and analgesia. The objective of this systematic review was to determine whether using a depth of anaesthesia monitoring device improves the safety and efficacy of sedation. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Electronic databases (CENTRAL; Medline; CINAHL) were searched up to May 2015...
May 24, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27134668/the-new-kid-on-the-block-for-advanced-imaging-in-barrett-s-esophagus-a-review-of-volumetric-laser-endomicroscopy
#16
REVIEW
Arvind J Trindade, Michael S Smith, Douglas K Pleskow
Advanced imaging techniques used in the management of Barrett's esophagus include electronic imaging enhancement (e.g. narrow band imaging, flexible spectral imaging color enhancement, and i-Scan), chromoendoscopy, and confocal laser endomicroscopy. Electronic imaging enhancement is used frequently in daily practice, but use of the other advanced technologies is not routine. High-definition white light endoscopy and random four quadrant biopsy remain the standard of care for evaluation of Barrett's esophagus; this is largely due to the value of advanced imaging technologies not having been validated in large studies or in everyday practice...
May 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27123071/%C3%AE-fetoprotein-producing-gastric-carcinoma-a-case-report-of-a-rare-subtype-and-literature-review
#17
Ningbo Sun, Qing Sun, Qun Liu, Tianxiao Zhang, Qiang Zhu, Wei Wang, Ming Cao, Q I Zang
α-fetoprotein (AFP)-producing gastric carcinoma is a rare type of gastric cancer, and the characteristics have not yet been fully elucidated. The present study reports the case of a patient with this type of gastric cancer. A 66-year-old male was referred to the Department of Gastrointestinal Surgery, Qianfoshan Hospital, Shandong University (Jinan, China) with a 20-day history of retrosternal pain. A computed tomography (CT) scan revealed a thickening of the wall of the cardia and massive lymph node swelling in the region of the lesser curvature of the stomach...
May 2016: Oncology Letters
https://www.readbyqxmd.com/read/27102832/a-comparison-of-endoscopy-versus-pathology-sizing-of-colorectal-adenomas-and-potential-implications-for-surveillance-colonoscopy
#18
Jennifer L Taylor, Helen G Coleman, Ronan T Gray, Paul J Kelly, R Iain Cameron, Ciaran J O'Neill, Rajeev M Shah, Tracy A Owen, William Dickey, Maurice B Loughrey
BACKGROUND AND AIMS: The aim of this study was to compare endoscopy and pathology sizing in a large population-based series of colorectal adenomas and to evaluate the implications for patient stratification into surveillance colonoscopy. METHODS: Endoscopy and pathology sizes available from intact adenomas removed at colonoscopies performed as part of the Northern Ireland Bowel Cancer Screening Programme, from 2010 to 2015, were included in this study. Chi-squared tests were applied to compare size categories in relation to clinicopathologic parameters and colonoscopy surveillance strata according to current American Gastroenterology Association and British Society of Gastroenterology guidelines...
August 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27085847/utilizing-uncoded-consultation-notes-from-electronic-medical-records-for-predictive-modeling-of-colorectal-cancer
#19
Mark Hoogendoorn, Peter Szolovits, Leon M G Moons, Mattijs E Numans
OBJECTIVE: Machine learning techniques can be used to extract predictive models for diseases from electronic medical records (EMRs). However, the nature of EMRs makes it difficult to apply off-the-shelf machine learning techniques while still exploiting the rich content of the EMRs. In this paper, we explore the usage of a range of natural language processing (NLP) techniques to extract valuable predictors from uncoded consultation notes and study whether they can help to improve predictive performance...
May 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/26987042/management-of-peptic-pyloroduodenal-stenosis-in-sylvanus-olympio-teaching-hospital-in-lome-togo
#20
I Kassegne, E V Sewa, K K Kanassoua, F Alassani, K Adabra, K Amavi, K G Azialey, K Attipou
This study's aim was to describe the management of ulcerous pyloroduodenal stenosis in Sylvanus Olympio teaching hospital of Lomé (Togo). It was a retrospective study of medical files of all patients managed for peptic pyloroduodenal stenosis at the visceral surgery department of Sylvanus Olympio teaching hospital in Lomé (Togo) from january 1(st), 2002 to december 31(th), 2011. Twenty-five patients were selected. Mean age was 38 ± 7.4 years. Sex-ratio was 5. Twenty four patients underwent upper digestive tract endoscopy, completed by upper gastrointestinal series in 18 cases...
May 1, 2016: Médecine et Santé Tropicales
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