Rebecca C Fitzgerald, Massimiliano di Pietro, Maria O'Donovan, Roberta Maroni, Beth Muldrew, Irene Debiram-Beecham, Marcel Gehrung, Judith Offman, Monika Tripathi, Samuel G Smith, Benoit Aigret, Fiona M Walter, Greg Rubin, Peter Sasieni
BACKGROUND: Treatment of dysplastic Barrett's oesophagus prevents progression to adenocarcinoma; however, the optimal diagnostic strategy for Barrett's oesophagus is unclear. The Cytosponge-trefoil factor 3 (TFF3) is a non-endoscopic test for Barrett's oesophagus. The aim of this study was to investigate whether offering this test to patients on medication for gastro-oesophageal reflux would increase the detection of Barrett's oesophagus compared with standard management. METHODS: This multicentre, pragmatic, randomised controlled trial was done in 109 socio-demographically diverse general practice clinics in England...
August 1, 2020: Lancet
Pavol Ďurč, Věra Dosedělová, František Foret, Jiří Dolina, Štefan Konečný, Markus Himmelsbach, Wolfgang Buchberger, Petr Kubáň
A fast, non-invasive, high-performance liquid chromatographic screening method with electrospray ionization mass spectrometric detection was developed for the analysis of three major glycine-conjugated bile acids in human saliva. Using a mobile phase composed of 80% methanol and 0.1% formic acid, glycocholic, glycodeoxycholic, and glycochenodeoxycholic acids were separated in less than 4 minutes with sensitivity in the low nM range. Bile acids are thought to contribute to the pathology of various complications in gastroesophageal reflux disease, for instance, Barrett's esophagus, which may eventually lead to esophageal carcinoma...
August 16, 2020: Journal of Chromatography. A
Daniela Cornelia Lazăr, Mihaela Flavia Avram, Alexandra Corina Faur, Adrian Goldiş, Ioan Romoşan, Sorina Tăban, Mărioara Cornianu
In the gastroenterology field, the impact of artificial intelligence was investigated for the purposes of diagnostics, risk stratification of patients, improvement in quality of endoscopic procedures and early detection of neoplastic diseases, implementation of the best treatment strategy, and optimization of patient prognosis. Computer-assisted diagnostic systems to evaluate upper endoscopy images have recently emerged as a supporting tool in endoscopy due to the risks of misdiagnosis related to standard endoscopy and different expertise levels of endoscopists, time-consuming procedures, lack of availability of advanced procedures, increasing workloads, and development of endoscopic mass screening programs...
July 21, 2020: Medicina
Wladyslaw Januszewicz, Vinod V Subhash, William Waldock, Daniel I Fernando, Giorgio Bartalucci, Hamza Chettouh, Ahmad Miremadi, Maria O'Donovan, Rebecca C Fitzgerald, Massimiliano di Pietro
BACKGROUND: Radiofrequency ablation (RFA) is an effective treatment for dysplastic Barrett's esophagus (BE), but recurrence can occur after initial response. Currently there is uncertainty about how to best define histological remission. A DNA methylation panel on esophageal samples was previously shown to have high diagnostic accuracy for BE. We aimed to investigate this biomarker panel in the assessment of response to RFA treatment. METHODS: We retrospectively analyzed esophageal and gastroesophageal junction (GEJ) biopsies from patients with BE before and after RFA treatment...
July 21, 2020: EBioMedicine
David J Saxby, Bryce Adrian Killen, C Pizzolato, C P Carty, L E Diamond, L Modenese, J Fernandez, G Davico, M Barzan, G Lenton, S Brito da Luz, E Suwarganda, D Devaprakash, R K Korhonen, J A Alderson, T F Besier, R S Barrett, D G Lloyd
Many biomedical, orthopaedic, and industrial applications are emerging that will benefit from personalized neuromusculoskeletal models. Applications include refined diagnostics, prediction of treatment trajectories for neuromusculoskeletal diseases, in silico design, development, and testing of medical implants, and human-machine interfaces to support assistive technologies. This review proposes how physics-based simulation, combined with machine learning approaches from big data, can be used to develop high-fidelity personalized representations of the human neuromusculoskeletal system...
July 16, 2020: Biomechanics and Modeling in Mechanobiology
Shraddha Gulati, Andrew Emmanuel, Mehul Patel, Sophie Williams, Amyn Haji, Bu'Hussain Hayee, Helmut Neumann
Artificial intelligence is a strong focus of interest for global health development. Diagnostic endoscopy is an attractive substrate for artificial intelligence with a real potential to improve patient care through standardisation of endoscopic diagnosis and to serve as an adjunct to enhanced imaging diagnosis. The possibility to amass large data to refine algorithms makes adoption of artificial intelligence into global practice a potential reality. Initial studies in luminal endoscopy involve machine learning and are retrospective...
January 2020: Therapeutic advances in gastrointestinal endoscopy
M R Struyvenberg, A J de Groof, A Kahn, B L A M Weusten, D E Fleischer, E K Ganguly, V J A Konda, C J Lightdale, D K Pleskow, A Sethi, M S Smith, A J Trindade, M B Wallace, H C Wolfsen, G J Tearney, S L Meijer, C L Leggett, J J G H M Bergman, W L Curvers
Volumetric laser endomicroscopy (VLE) has been shown to improve detection of early neoplasia in Barrett's esophagus (BE). However, diagnostic performance using histopathology-correlated VLE regions of interest (ROIs) has not been adequately studied. We evaluated the diagnostic accuracy of VLE assessors for identification of early BE neoplasia in histopathology-correlated VLE ROIs. In total, 191 ROIs (120 nondysplastic and 71 neoplastic) from 50 BE patients were evaluated in a random order using a web-based module...
July 1, 2020: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Matteo Ghisa, Brigida Barberio, Vincenzo Savarino, Elisa Marabotto, Mentore Ribolsi, Giorgia Bodini, Fabiana Zingone, Marzio Frazzoni, Edoardo Savarino
Gastroesophageal reflux disease (GERD) is a complex disorder with heterogeneous symptoms and a multifaceted pathogenetic basis, which prevent a simple diagnostic algorithm or any categorical classification. Clinical history, questionnaires and response to proton pump inhibitor (PPI) therapy are insufficient tools to make a conclusive diagnosis of GERD and further investigations are frequently required. The Lyon Consensus goes beyond the previous classifications and defines endoscopic and functional parameters able to establish the presence of GERD...
June 30, 2020: Journal of Neurogastroenterology and Motility
Thomas Kl Lui, Vivien Wm Tsui, Wai K Leung
BACKGROUND AND AIMS: Artificial intelligence (AI)-assisted detection is increasingly use in upper endoscopy. We performed a meta-analysis to determine the diagnostic accuracy of AI on detection of gastric and esophageal neoplastic lesions and Helicobacter pylori (HP) status. METHOD: We searched Embase, PubMed, Medline, Web of Science and Cochrane databases for studies on AI detection of gastric or esophageal neoplastic lesions and HP status. After assessment of study quality by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, a bivariate meta-analysis following a random effects model to summarize the data and plotted hierarchical summary receiver-operating characteristic (HSROC) curves...
June 17, 2020: Gastrointestinal Endoscopy
Pooja Dhorajiya, Rifat Mannan
We report an unusual case of Barrett's esophagus with prominent intramucosal Russell bodies, also known as Russell body Barrett's esophagus. We present this case to emphasize the importance of recognizing this unusual entity. It also represents a potential diagnostic pitfall because the distended plasma cells may be mistaken for signet ring cells of gastric adenocarcinoma or low-grade lymphoma. Hence, an awareness of this entity is important to avoid diagnostic confusion.
April 2020: ACG Case Reports Journal
Adriana Casas
ALA-mediated Photodynamic Therapy (ALA-PDT) is one of the most promising fields in Photodynamic therapy (PDT) research for cancer treatment. 5-aminolaevulinic acid (ALA) is the prodrug of the photosensitiser Protoporphyrin IX (PpIX). After ALA administration, cells generate PpIX through the haem biosynthetic pathway. Although the exact reasons for ALA/PpIX selectivity are unknown, it is believed that due to the special regulation of haem enzymes, PpIX is accumulated in the tumours. Both ALA and its derivative ALA Methyl ester, are mainly used in dermatology...
June 10, 2020: Cancer Letters
Azin Ahrari, Sierra S Barrett, Pari Basharat, Sherry Rohekar, Janet E Pope
INTRODUCTION: Autoantibody tests are commonly ordered when screening for rheumatic diseases. Rheumatoid factor (RF) and antinuclear antibody (ANA) have low positive predictive values in general practice. Overuse of diagnostic tests can result in an increase in unnecessary referrals, patient anxiety, and further costs. OBJECTIVE: The objective was to evaluate the utilization patterns, appropriateness, and associated costs of tests including ANA, extractable nuclear antibodies (ENA), anti-double stranded DNA (anti-dsDNA), RF, and HLA-B27 in patients referred to rheumatologists...
June 6, 2020: Joint, Bone, Spine: Revue du Rhumatisme
Camila Albo, Sanjiv Kumar, Michael Pope, Kyle Michael Kidwell, Hongyan Xu, Latanya Bowman, Leigh Wells, Nadine Barrett, Sabine Fields, Pritam Bora, Niren Patel, Abdullah Kutlar
OBJECTIVES: In this study, we investigated the evolution of chronic pain in sickle cell patients (SCD) as an age-dependent phenomenon, and studied the frequency of vaso-occlusive episode frequency, opioid use, quantitative sensory testing (QST) and biomarkers of chronic pain (CP). METHODS: We undertook a cross-sectional study of the evolution of CP in SCD. 72 subjects (age 15-66) were enrolled. VOE frequency, presence of CP hydroxyurea (HU) therapy, opioid use, and laboratory parameters were collected...
June 4, 2020: European Journal of Haematology
Anthony Villani, Rebecca McClure, Michelle Barrett, David Scott
AIM: We aimed to compare diagnostic differences for identification of sarcopenia using the original operational definition developed by the European Working Group on Sarcopenia in Older People (EWGSOP1) and the most recently revised EWGSOP2 definition in community dwelling older adults with type 2 diabetes mellitus (T2DM). METHODS: Appendicular Lean Mass (ALM) corrected for height (ALM/m2 ) was assessed by dual energy X-ray absorptiometry. Muscle strength was assessed using hand-grip strength (HGS) or chair stands, and the Short Physical Performance Battery (SPPB) and gait speed were used to evaluate lower extremity physical function...
April 21, 2020: Archives of Gerontology and Geriatrics
Matthew Barrett Innes, Amber Reck Atwater
Orthopedic implant hypersensitivity reactions (IHRs) are known to occur but are uncommon. Clinical presentations include local and generalized cutaneous reactions and noncutaneous complications. Pathogenesis traditionally was believed a type IV delayed hypersensitivity reaction, but there is evidence that innate immunity plays a role. Orthopedic implants are made predominantly of metals, and nonmetal components, such as bone cement, plastics, and ceramics, also may be utilized. Several diagnostic tests are available, and patch testing is considered the gold standard...
July 2020: Dermatologic Clinics
Bridget M Crawford, Hsin-Neng Wang, Christina Stolarchuk, Richard J von Furstenberg, Pietro Strobbia, Dadong Zhang, Xiaodi Qin, Kouros Owzar, Katherine S Garman, Tuan Vo-Dinh
MicroRNAs (miRNAs) play an important role in the regulation of biological processes and have demonstrated great potential as biomarkers for the early detection of various diseases, including esophageal adenocarcinoma (EAC) and Barrett's esophagus (BE), the premalignant metaplasia associated with EAC. Herein, we demonstrate the direct detection of the esophageal cancer biomarker, miR-21, in RNA extracted from 17 endoscopic tissue biopsies using the nanophotonics technology our group has developed, termed the inverse molecular sentinel (iMS) nanobiosensor, with surface-enhanced Raman scattering (SERS) detection...
May 21, 2020: Analyst
Barrett Boody, Jesse Caballero, Caleb Macadaeg, Robert Funk, Kevin Macadaeg
Sacroiliac (SI) joint pathology has been an increasingly discussed pathology as a potential etiology for significant low back and lower extremity pain. While patient history and examination maneuvers can assist with identifying the SI joint as a potential cause of pain, an intra-articular SI joint injection is critical to properly diagnose the SI joint as a clinically relevant pain generator. In addition to the diagnostic information from the injection, SI joint intra-articular injections can be performed for therapeutic benefit as part of a multi-modal, conservative treatment approach for SI joint pathology...
May 19, 2020: Clinical Spine Surgery
Maarten de Rooij, Bas Israël, Marcia Tummers, Hashim U Ahmed, Tristan Barrett, Francesco Giganti, Bernd Hamm, Vibeke Løgager, Anwar Padhani, Valeria Panebianco, Philippe Puech, Jonathan Richenberg, Olivier Rouvière, Georg Salomon, Ivo Schoots, Jeroen Veltman, Geert Villeirs, Jochen Walz, Jelle O Barentsz
OBJECTIVES: This study aims to define consensus-based criteria for acquiring and reporting prostate MRI and establishing prerequisites for image quality. METHODS: A total of 44 leading urologists and urogenital radiologists who are experts in prostate cancer imaging from the European Society of Urogenital Radiology (ESUR) and EAU Section of Urologic Imaging (ESUI) participated in a Delphi consensus process. Panellists completed two rounds of questionnaires with 55 items under three headings: image quality assessment, interpretation and reporting, and radiologists' experience plus training centres...
May 19, 2020: European Radiology
Kali S Thomas, Margot L Schwartz, Eric Boyd, Dolly P White, Angela B Mariotto, Michael J Barrett, Joan L Warren
BACKGROUND: This article describes characteristics of patients receiving home health following an initial cancer diagnosis, comparing those enrolled in Medicare Advantage (MA) and Traditional Medicare (TM), using the newly linked 2010-2014 National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare and home health Outcome and Assessment Information Set (OASIS) data. METHODS: We identified SEER-Medicare beneficiaries with at least one OASIS assessment within 3 months of cancer diagnosis in 2010-2014, and summarized their demographic and clinical characteristics...
May 1, 2020: Journal of the National Cancer Institute. Monographs
Mazen R Al-Mansour, Antonio Caycedo-Marulanda, Brian R Davis, Abdulrahim Alawashez, Salvatore Docimo, Alia Qureshi, Shawn Tsuda
BACKGROUND: Confocal laser endomicroscopy (CLE) is a novel endoscopic adjunct that allows real-time in vivo histological examination of mucosal surfaces. By using intravenous or topical fluorescent agents, CLE highlights certain mucosal elements that facilitate an optical biopsy in real time. CLE technology has been used in different organ systems including the gastrointestinal tract. There has been numerous studies evaluating this technology in gastrointestinal endoscopy, our aim was to evaluate the safety, value, and efficacy of this technology in the gastrointestinal tract...
May 13, 2020: Surgical Endoscopy
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