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David Sanders - One of the best experts on this subject based on the ideXlab platform.

  • Routine duodenal bulb biopsy in coeliac disease: time to change clinical practice?
    Gut, 2011
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of villous atrophy in the duodenal bulb. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 461 Patients were prospectively recruited. Biopsies were graded using the Marsh criteria by a single pathologist blinded to the clinical information. Results 461 Patients, (300 female, 161 male) median age 50 years (range 16–89) were analysed. 24 Patients had VA in the bulb only, 6 had VA in distal duodenum only (p=0.001) (table 1). 1 Control Patient with HIV enteropathy had VA at both sites. CD in remission showed greater histological variability than new diagnosis CD (p=0.0018) and Controls (p=0.0001) Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 11/126 (9%) of new diagnosis CD and 12/85 (14%) of CD in remission demonstrated VA in the bulb alone. We recommend taking a biopsy from the bulb as well as the distal duodenum to diagnose suspected coeliac disease and reassess known cases.

  • pth 087 routine duodenal bulb biopsy in coeliac disease a paradigm shift in our clinical practice abstract pth 087
    Gut, 2010
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of duodenal bulb biopsies. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 215 Patients were prospectively accrued. Biopsies were graded using the Marsh criteria by a single pathologist. Results 215 Patients, (150 female, 65 male) median age 48 years (range 16-89) were analysed. 17 Patients demonstrated VA in the bulb only. 1 had VA in distal duodenum only. 1 Control Patient with HIV enteropathy had VA in the bulb and distal duodenum. Both new diagnosis CD (8%, p Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 7/91 (8%) of new diagnosis CD and 9/59 (15%) of CD in remission demonstrated VA in the bulb alone. When looking at CD in remission, 41% of Patients have a discrepancy in severity of the histological lesion between the bulb and the duodenum; in this group the most severe lesion is nearly always in the bulb. This is the first study to demonstrate that optimal assessment of both new diagnosis CD and those in remission requires a duodenal bulb biopsy in addition to distal duodenal biopsies.

Kate E Evans - One of the best experts on this subject based on the ideXlab platform.

  • Routine duodenal bulb biopsy in coeliac disease: time to change clinical practice?
    Gut, 2011
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of villous atrophy in the duodenal bulb. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 461 Patients were prospectively recruited. Biopsies were graded using the Marsh criteria by a single pathologist blinded to the clinical information. Results 461 Patients, (300 female, 161 male) median age 50 years (range 16–89) were analysed. 24 Patients had VA in the bulb only, 6 had VA in distal duodenum only (p=0.001) (table 1). 1 Control Patient with HIV enteropathy had VA at both sites. CD in remission showed greater histological variability than new diagnosis CD (p=0.0018) and Controls (p=0.0001) Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 11/126 (9%) of new diagnosis CD and 12/85 (14%) of CD in remission demonstrated VA in the bulb alone. We recommend taking a biopsy from the bulb as well as the distal duodenum to diagnose suspected coeliac disease and reassess known cases.

  • pth 087 routine duodenal bulb biopsy in coeliac disease a paradigm shift in our clinical practice abstract pth 087
    Gut, 2010
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of duodenal bulb biopsies. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 215 Patients were prospectively accrued. Biopsies were graded using the Marsh criteria by a single pathologist. Results 215 Patients, (150 female, 65 male) median age 48 years (range 16-89) were analysed. 17 Patients demonstrated VA in the bulb only. 1 had VA in distal duodenum only. 1 Control Patient with HIV enteropathy had VA in the bulb and distal duodenum. Both new diagnosis CD (8%, p Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 7/91 (8%) of new diagnosis CD and 9/59 (15%) of CD in remission demonstrated VA in the bulb alone. When looking at CD in remission, 41% of Patients have a discrepancy in severity of the histological lesion between the bulb and the duodenum; in this group the most severe lesion is nearly always in the bulb. This is the first study to demonstrate that optimal assessment of both new diagnosis CD and those in remission requires a duodenal bulb biopsy in addition to distal duodenal biopsies.

Dianne Bryant - One of the best experts on this subject based on the ideXlab platform.

  • a randomized clinical trial to compare the effectiveness of rotator cuff repair with or without augmentation using porcine small intestine submucosa for Patients with moderate to large rotator cuff tears a pilot study
    Journal of Shoulder and Elbow Surgery, 2016
    Co-Authors: Dianne Bryant, Richard Holtby, Kevin Willits, Robert Litchfield, Darren S Drosdowech, Alison Spouge, David White, Gordon H Guyatt
    Abstract:

    Background The rate of rotator cuff repair failure is between 13% and 67%. Porcine small intestine submucosa (SIS) may be suitable to augment the repair. Methods There were 62 Patients with moderate and large cuff tears randomized to repair alone (Control) or augmentation with SIS (Restore Orthobiologic Implant; DePuy, Warsaw, IN, USA). Primary outcome was repair failure using magnetic resonance arthrography. Randomization occurred on completion of the repair. Patients and assessors were blind to group. Assessments occurred preoperatively and postoperatively at 2 and 6 weeks and 3, 6, 12, and 24 months. Results There were 62 Patients randomized (34 SIS, 28 Control). Patient demographics, rotator cuff tear characteristics, and repair details were similar between groups. At 1 year, risk of failure was 52.9% (18/34) in the SIS group and 65.4% (17/26) in the Control group for a risk difference of 12% (80% confidence interval, −7% to 32%) or relative risk of 0.81 (95% confidence interval, 0.53-1.24, P  = .33) in favor of SIS. At 1 and 2 years, the mean difference between groups for Patient-reported outcomes was small and consistent with chance but did not exclude the possibility of a clinically important difference. There was no statistically significant difference ( P  = .50) between the SIS group (59.6 ± 38.9; range, 3-112) and the Control group (52.7 ± 38.6; range, 5-112) in number of days to being narcotic and pain free ( Conclusion We found no evidence that SIS-augmented rotator cuff repair provides superior outcomes in Patients with moderate rotator cuff tears.

Andrew D. Hopper - One of the best experts on this subject based on the ideXlab platform.

  • Routine duodenal bulb biopsy in coeliac disease: time to change clinical practice?
    Gut, 2011
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of villous atrophy in the duodenal bulb. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 461 Patients were prospectively recruited. Biopsies were graded using the Marsh criteria by a single pathologist blinded to the clinical information. Results 461 Patients, (300 female, 161 male) median age 50 years (range 16–89) were analysed. 24 Patients had VA in the bulb only, 6 had VA in distal duodenum only (p=0.001) (table 1). 1 Control Patient with HIV enteropathy had VA at both sites. CD in remission showed greater histological variability than new diagnosis CD (p=0.0018) and Controls (p=0.0001) Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 11/126 (9%) of new diagnosis CD and 12/85 (14%) of CD in remission demonstrated VA in the bulb alone. We recommend taking a biopsy from the bulb as well as the distal duodenum to diagnose suspected coeliac disease and reassess known cases.

  • pth 087 routine duodenal bulb biopsy in coeliac disease a paradigm shift in our clinical practice abstract pth 087
    Gut, 2010
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of duodenal bulb biopsies. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 215 Patients were prospectively accrued. Biopsies were graded using the Marsh criteria by a single pathologist. Results 215 Patients, (150 female, 65 male) median age 48 years (range 16-89) were analysed. 17 Patients demonstrated VA in the bulb only. 1 had VA in distal duodenum only. 1 Control Patient with HIV enteropathy had VA in the bulb and distal duodenum. Both new diagnosis CD (8%, p Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 7/91 (8%) of new diagnosis CD and 9/59 (15%) of CD in remission demonstrated VA in the bulb alone. When looking at CD in remission, 41% of Patients have a discrepancy in severity of the histological lesion between the bulb and the duodenum; in this group the most severe lesion is nearly always in the bulb. This is the first study to demonstrate that optimal assessment of both new diagnosis CD and those in remission requires a duodenal bulb biopsy in addition to distal duodenal biopsies.

Marios Hadjivassiliou - One of the best experts on this subject based on the ideXlab platform.

  • Routine duodenal bulb biopsy in coeliac disease: time to change clinical practice?
    Gut, 2011
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of villous atrophy in the duodenal bulb. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 461 Patients were prospectively recruited. Biopsies were graded using the Marsh criteria by a single pathologist blinded to the clinical information. Results 461 Patients, (300 female, 161 male) median age 50 years (range 16–89) were analysed. 24 Patients had VA in the bulb only, 6 had VA in distal duodenum only (p=0.001) (table 1). 1 Control Patient with HIV enteropathy had VA at both sites. CD in remission showed greater histological variability than new diagnosis CD (p=0.0018) and Controls (p=0.0001) Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 11/126 (9%) of new diagnosis CD and 12/85 (14%) of CD in remission demonstrated VA in the bulb alone. We recommend taking a biopsy from the bulb as well as the distal duodenum to diagnose suspected coeliac disease and reassess known cases.

  • pth 087 routine duodenal bulb biopsy in coeliac disease a paradigm shift in our clinical practice abstract pth 087
    Gut, 2010
    Co-Authors: Kate E Evans, Simon S. Cross, G R Sahota, Andrew D. Hopper, Marios Hadjivassiliou, David Sanders
    Abstract:

    Introduction Historically Brunner9s glands were thought to interfere with interpretation of duodenal bulb biopsies. Recent reports suggest that the duodenal bulb may be the only site to demonstrate villous atrophy (VA) in coeliac disease (CD). There are few data on the prevalence of lesions in non-coeliac Patients. Methods We aimed to compare the histological findings in the duodenal bulb and distal duodenum of Patients with CD against Controls having gastroscopy with duodenal biopsy. Indications included positive coeliac serology, family history, diarrhoea, and iron deficiency anaemia. A total of 215 Patients were prospectively accrued. Biopsies were graded using the Marsh criteria by a single pathologist. Results 215 Patients, (150 female, 65 male) median age 48 years (range 16-89) were analysed. 17 Patients demonstrated VA in the bulb only. 1 had VA in distal duodenum only. 1 Control Patient with HIV enteropathy had VA in the bulb and distal duodenum. Both new diagnosis CD (8%, p Conclusion Villous atrophy may be present only in the duodenal bulb. In this study 7/91 (8%) of new diagnosis CD and 9/59 (15%) of CD in remission demonstrated VA in the bulb alone. When looking at CD in remission, 41% of Patients have a discrepancy in severity of the histological lesion between the bulb and the duodenum; in this group the most severe lesion is nearly always in the bulb. This is the first study to demonstrate that optimal assessment of both new diagnosis CD and those in remission requires a duodenal bulb biopsy in addition to distal duodenal biopsies.