Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett’s esophagus: results from the U.S. RFA Registry

Little is known about differences in Barrett’s esophagus (BE) characteristics by sex, and race/ethnicity, or these differences in response to radiofrequency ablation (RFA)

Gastroscopic findings and fecal blood loss following aspirin administration

A study of 19 healthy young male subjects (Group 1) was made in which a correlation of aspirin ingestion, fecal blood loss, blood salicylate levels, prothrombin concentrations, and ABO blood groups was sought. An initial 4-day control period was followed by a 4-day test period during which subjects ingested 650 mg aspirin with each meal and at bedtime. Gastroscopy with photography was done on Day 1 and Day 7. Daily fecal blood loss was quantitated using the 51-chromium tagged erythrocyte method. Sixteen patients (Group 2) with a variety of upper gastrointestinal disorders underwent gastroscopy and photography before and after the acute ingestion of aspirin. Results reveal: (1) Aspirin produced petechiae in 4 of 18 subjects and a hemorrhagic gastritis in 1 of 18 in Group 1, (2) aspirin produced no visible lesions in the 16 subjects in Group 2, (3) the mean fecal blood loss during the control period was 0.38±0.35 g/24 hr and rose to 1.54±1.42 g/24 hr (P<0.01) during aspirin ingestion, (4) no correlation between normal or abnormal gastroscopic findings and fecal blood loss was apparent, and (5) no correlation between blood salicylate levels, prothrombin concentrations, and gastroscopic findings or fecal blood loss was detected.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44370/1/10620_2005_Article_BF02235965.pd

Biopsy depth after radiofrequency ablation of dysplastic Barrett's esophagus

After endoscopic radiofrequency ablation (RFA) of dysplastic Barrett's esophagus (BE), endoscopic biopsy samples are obtained to assess response to therapy. Whether these biopsies are of adequate depth to assess efficacy is unknown

Sex and race and/or ethnicity differences in patients undergoing radiofrequency ablation for Barrett\u27s esophagus: results from the U.S. RFA Registry.

BACKGROUND: Little is known about differences in Barrett\u27s esophagus (BE) characteristics by sex and race and/or ethnicity or these differences in response to radiofrequency ablation (RFA). OBJECTIVE: We compared disease-specific characteristics, treatment efficacy, and safety outcomes by sex and race and/or ethnicity in patients treated with RFA for BE. DESIGN: The U.S. RFA patient registry is a multicenter collaboration reporting processes and outcomes of care for patients treated with RFA for BE. PATIENTS: Patients enrolled with BE. INTERVENTIONS: RFA. MAIN OUTCOME MEASUREMENTS: We assessed safety (stricture, bleeding, perforation, hospitalization), efficacy (complete eradication of intestinal metaplasia [CEIM]), complete eradication of dysplasia, and number of treatments to CEIM by sex and race and/or ethnicity. RESULTS: Among 5521 patients (4052 men; 5126 white, 137 Hispanic, 82 African American, 40 Asian, 136 heritage not identified), women were younger (60.0 vs 62.1 years) and had shorter BE segments (3.2 vs 4.4 cm) and less dysplasia (37% vs 57%) than did men. Women were almost twice as likely to stricture (odds ratio 1.7; 95% confidence interval, 1.2-2.3). Although white patients were predominantly male, about half of African Americans and Asians with BE were female. African Americans and Asians had less dysplasia than white patients. Asians and African Americans had more strictures than did white patients. There were no sex or race differences in efficacy. LIMITATIONS: Observational study with non-mandated paradigms, no central laboratory for reinterpretation of pathology. CONCLUSION: In the U.S. RFA patient registry, women had shorter BE segments and less-aggressive histology. The usual tendency toward BE in men was absent in African Americans and Asians. Posttreatment stricture was more common among women and Asians. RFA efficacy did not differ by sex or race

Durability and Predictors of Successful Radiofrequency Ablation for Barrett’s Esophagus

Following radiofrequency ablation (RFA), patients may experience recurrence of Barrett’s esophagus (BE) after complete eradication of intestinal metaplasia (CEIM). Rates and predictors of recurrence after successful eradication are poorly described

Incidence of Esophageal Adenocarcinoma and Causes of Mortality After Radiofrequency Ablation of Barrett’s Esophagus

Radiofrequency ablation (RFA) is commonly used to treat Barrett's esophagus (BE). We assessed the incidence of esophageal adenocarcinoma (EAC) after RFA, predictors of EAC, and EAC-specific and all-cause mortality rates

Detection of Dysplasia in Barrett's Esophagus With In Vivo Depth-Resolved Nuclear Morphology Measurements

Patients with Barrett’s esophagus (BE) show increased risk for developing esophageal adenocarcinoma and are routinely examined using upper endoscopy with biopsy to search for neoplastic changes. Angle-resolved low coherence interferometry (a/LCI) uses in vivo depth-resolved nuclear morphology measurements to detect dysplasia. We assessed the clinical utility of a/LCI in the endoscopic surveillance of BE patients

Durability of Radiofrequency Ablation in Barrett's Esophagus With Dysplasia

Radiofrequency ablation (RFA) can eradicate dysplasia and intestinal metaplasia in patients with dysplastic Barrett’s esophagus (BE), and reduce rates of esophageal adenocarcinoma. We assessed long-term rates of eradication, durability of neosquamous epithelium, disease progression, and safety of RFA in patients with dysplastic BE

Results of Photodynamic Therapy in Barrett’s Esophagus: A Review

Barrett’s esophagus is associated with an increased occurrence of mucosal dysplasia and adenocarcinoma in the specialized glandular mucosa, with a 30- to 52-fold increase in the occurrence of esophageal cancer compared with the normal population. An alternative to esophagectomy as a treatment modality is needed because of the high morbidity and mortality associated with it. Photodynamic therapy offers an alternative nonsurgical therapy that eliminates dysplasia and superficial cancer, and reduces Barrett’s mucosa while reducing the risks and costs compared with those of esophagectomy. The use of photodynamic therapy in the ablation of Barrett’s mucosa is reviewed

Office endoscopy

xii, 200 p. : ill.; 25 cm