The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Evan S Dellon - One of the best experts on this subject based on the ideXlab platform.
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distribution and variability of esophageal Eosinophilia in patients undergoing upper endoscopy
Modern Pathology, 2015Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Nicholas J Shaheen, Shannon Covey, Spencer Rusin, John T WoosleyAbstract:The variability of eosinophilic infiltrates in eosinophilic esophagitis is not well described. This study aimed to determine the distribution of esophageal Eosinophilia and the utility of histologic cut-points for eosinophilic esophagitis diagnosis in subjects undergoing endoscopy. We performed a prospective study of adults undergoing outpatient endoscopy. Research protocol esophageal biopsies were obtained from all subjects. Incident cases of eosinophilic esophagitis were diagnosed per consensus guidelines. Biopsies were interpreted following a validated protocol, and maximum eosinophil counts (eosinophils per high-power field; eos/hpf) were determined. Histologic analyses were performed on a per-patient, per-biopsy, and per-hpf basis. There were 213 patients, yielding 923 esophageal biopsies with 4588 hpfs. Overall, 48 patients (23%), 165 biopsy fragments (18%), and 449 hpfs (10%) had ≥15 eos/hpf; most subjects had no or low levels of eosinophils. In the eosinophilic esophagitis cases, 119 biopsy fragments (63%) and 332 hpfs (36%) had ≥15 eos/hpf. There was a mean 104-fold difference between the lowest and highest hpf eosinophil count for the eosinophilic esophagitis patients; 85% of the biopsies from eosinophilic esophagitis cases also had at least one hpf with <15 eos/hpf. The cut-point of 15 eos/hpf had a sensitivity of 100% and a specificity of 96% for diagnosis of eosinophilic esophagitis. In conclusion, most patients have little to no esophageal Eosinophilia. In patients with eosinophilic esophagitis, there was marked variability in the eosinophil counts by biopsy and by hpf within a given biopsy. Additionally, the 15 eos/hpf cut-point was highly sensitive and specific for eosinophilic esophagitis. Multiple esophageal biopsies from different locations should be obtained to optimize eosinophilic esophagitis diagnosis.
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clinical and endoscopic characteristics do not reliably differentiate ppi responsive esophageal Eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy a prospective cohort study
The American Journal of Gastroenterology, 2013Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Jessica H Gebhart, Ryan D Madanick, Sidney Levinson, Karen J Fritchie, John T Woosley, Nicholas J ShaheenAbstract:Clinical and Endoscopic Characteristics do Not Reliably Differentiate PPI-Responsive Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients Undergoing Upper Endoscopy: A Prospective Cohort Study
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acg clinical guideline evidenced based approach to the diagnosis and management of esophageal Eosinophilia and eosinophilic esophagitis eoe
The American Journal of Gastroenterology, 2013Co-Authors: Evan S Dellon, Nirmala Gonsalves, Ikuo Hirano, Glenn T Furuta, Chris A Liacouras, David A KatzkaAbstract:5Esophageal Eosinophilia and eosinophilic esophagitis (EoE) are increasingly recognized and prevalent conditions, which now represent common clinical problems encountered by gastroenterologists, pathologists, and allergists. The study of EoE has become a dynamic fi eld with an evolving understanding of the pathogenesis, diagnosis, and treatment. Although there are limited data supporting management decisions, clinical parameters are needed to guide the care of patients with eosinophilic ‐ esophageal disorders. In this evidence-based review, recommendations developed by adult and pediatric gastroenterologists are provided for the evaluation and management of these patients. New terminology is emphasized, particularly the concepts of esophageal Eosinophilia and proton-pump inhibitor-responsive esophageal Eosinophilia (PPI-REE) as entities distinct from EoE.
Nicholas J Shaheen - One of the best experts on this subject based on the ideXlab platform.
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distribution and variability of esophageal Eosinophilia in patients undergoing upper endoscopy
Modern Pathology, 2015Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Nicholas J Shaheen, Shannon Covey, Spencer Rusin, John T WoosleyAbstract:The variability of eosinophilic infiltrates in eosinophilic esophagitis is not well described. This study aimed to determine the distribution of esophageal Eosinophilia and the utility of histologic cut-points for eosinophilic esophagitis diagnosis in subjects undergoing endoscopy. We performed a prospective study of adults undergoing outpatient endoscopy. Research protocol esophageal biopsies were obtained from all subjects. Incident cases of eosinophilic esophagitis were diagnosed per consensus guidelines. Biopsies were interpreted following a validated protocol, and maximum eosinophil counts (eosinophils per high-power field; eos/hpf) were determined. Histologic analyses were performed on a per-patient, per-biopsy, and per-hpf basis. There were 213 patients, yielding 923 esophageal biopsies with 4588 hpfs. Overall, 48 patients (23%), 165 biopsy fragments (18%), and 449 hpfs (10%) had ≥15 eos/hpf; most subjects had no or low levels of eosinophils. In the eosinophilic esophagitis cases, 119 biopsy fragments (63%) and 332 hpfs (36%) had ≥15 eos/hpf. There was a mean 104-fold difference between the lowest and highest hpf eosinophil count for the eosinophilic esophagitis patients; 85% of the biopsies from eosinophilic esophagitis cases also had at least one hpf with <15 eos/hpf. The cut-point of 15 eos/hpf had a sensitivity of 100% and a specificity of 96% for diagnosis of eosinophilic esophagitis. In conclusion, most patients have little to no esophageal Eosinophilia. In patients with eosinophilic esophagitis, there was marked variability in the eosinophil counts by biopsy and by hpf within a given biopsy. Additionally, the 15 eos/hpf cut-point was highly sensitive and specific for eosinophilic esophagitis. Multiple esophageal biopsies from different locations should be obtained to optimize eosinophilic esophagitis diagnosis.
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clinical and endoscopic characteristics do not reliably differentiate ppi responsive esophageal Eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy a prospective cohort study
The American Journal of Gastroenterology, 2013Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Jessica H Gebhart, Ryan D Madanick, Sidney Levinson, Karen J Fritchie, John T Woosley, Nicholas J ShaheenAbstract:Clinical and Endoscopic Characteristics do Not Reliably Differentiate PPI-Responsive Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients Undergoing Upper Endoscopy: A Prospective Cohort Study
Frederick E Hargreave - One of the best experts on this subject based on the ideXlab platform.
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Induced Sputum, Eosinophilic Bronchitis, and Chronic Obstructive Pulmonary Disease
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Frederick E Hargreave, Richard LeighAbstract:AM J RESPIR CRIT CARE MED 1999;160:S53−S57.The application of sputum induction and refined methods of sputum examination has provided the opportunity to examine cell and molecular markers of airway inflammation in asthma, COPD, and other airway diseases. The measurements are relatively noninvasive and can be applied safely, with care, even in more severe exacerbations of asthma and severe COPD. Induced sputum examination can be applied at random and repeatedly and gives results that are reproducible, valid, and responsive to changes in treatment. An eosinophilic bronchitis, defined as sputum Eosinophilia, is typical of asthma but can also occur in patients with a chronic cough without asthma, and in some patients with COPD in whom the classic inflammatory response is neutrophilic without Eosinophilia. When Eosinophilia occurs in COPD, it has been considered to be the result of cigarette smoking but it may be due to other causes. The clinical importance of eosinophilic bronchitis is that it responds to tre...
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Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.
American journal of respiratory and critical care medicine, 1999Co-Authors: Frederick E Hargreave, Richard LeighAbstract:The application of sputum induction and refined methods of sputum examination has provided the opportunity to examine cell and molecular markers of airway inflammation in asthma, COPD, and other airway diseases. The measurements are relatively noninvasive and can be applied safely, with care, even in more severe exacerbations of asthma and severe COPD. Induced sputum examination can be applied at random and repeatedly and gives results that are reproducible, valid, and responsive to changes in treatment. An eosinophilic bronchitis, defined as sputum Eosinophilia, is typical of asthma but can also occur in patients with a chronic cough without asthma, and in some patients with COPD in whom the classic inflammatory response is neutrophilic without Eosinophilia. When Eosinophilia occurs in COPD, it has been considered to be the result of cigarette smoking but it may be due to other causes. The clinical importance of eosinophilic bronchitis is that it responds to treatment with corticosteroid. In contrast, there is increasing evidence that an absence of sputum Eosinophilia is associated with steroid resistance. Hargreave FE, Leigh R. Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.
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a case for serial examination of sputum inflammatory cells
European Respiratory Journal, 1996Co-Authors: A G Wong, Ian D Pavord, Malcolm R Sears, Frederick E HargreaveAbstract:In the case reported, serial evaluation of sputum inflammatory cell counts made it possible to identify an unusual series of events in a man with eosinophilic bronchitis. The patient initially presented with a productive cough, which did not respond to treatment with antibiotics or high-dose inhaled corticosteroids. A diagnosis of eosinophilic bronchitis was made after demonstration of intense sputum Eosinophilia. When inhaled corticosteroids were stopped, symptoms and sputum Eosinophilia became worse and airway hyperresponsiveness developed. Both abnormalities were reversed by a course of prednisone. When the prednisone was stopped the productive cough recurred but on this occasion sputum examination suggested a different disease process and the symptoms resolved after a course of co-trimoxazole. The patient has subsequently remained well on no treatment with little or no sputum Eosinophilia.
John T Woosley - One of the best experts on this subject based on the ideXlab platform.
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distribution and variability of esophageal Eosinophilia in patients undergoing upper endoscopy
Modern Pathology, 2015Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Nicholas J Shaheen, Shannon Covey, Spencer Rusin, John T WoosleyAbstract:The variability of eosinophilic infiltrates in eosinophilic esophagitis is not well described. This study aimed to determine the distribution of esophageal Eosinophilia and the utility of histologic cut-points for eosinophilic esophagitis diagnosis in subjects undergoing endoscopy. We performed a prospective study of adults undergoing outpatient endoscopy. Research protocol esophageal biopsies were obtained from all subjects. Incident cases of eosinophilic esophagitis were diagnosed per consensus guidelines. Biopsies were interpreted following a validated protocol, and maximum eosinophil counts (eosinophils per high-power field; eos/hpf) were determined. Histologic analyses were performed on a per-patient, per-biopsy, and per-hpf basis. There were 213 patients, yielding 923 esophageal biopsies with 4588 hpfs. Overall, 48 patients (23%), 165 biopsy fragments (18%), and 449 hpfs (10%) had ≥15 eos/hpf; most subjects had no or low levels of eosinophils. In the eosinophilic esophagitis cases, 119 biopsy fragments (63%) and 332 hpfs (36%) had ≥15 eos/hpf. There was a mean 104-fold difference between the lowest and highest hpf eosinophil count for the eosinophilic esophagitis patients; 85% of the biopsies from eosinophilic esophagitis cases also had at least one hpf with <15 eos/hpf. The cut-point of 15 eos/hpf had a sensitivity of 100% and a specificity of 96% for diagnosis of eosinophilic esophagitis. In conclusion, most patients have little to no esophageal Eosinophilia. In patients with eosinophilic esophagitis, there was marked variability in the eosinophil counts by biopsy and by hpf within a given biopsy. Additionally, the 15 eos/hpf cut-point was highly sensitive and specific for eosinophilic esophagitis. Multiple esophageal biopsies from different locations should be obtained to optimize eosinophilic esophagitis diagnosis.
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clinical and endoscopic characteristics do not reliably differentiate ppi responsive esophageal Eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy a prospective cohort study
The American Journal of Gastroenterology, 2013Co-Authors: Evan S Dellon, Olga Speck, Kimberly Woodward, Jessica H Gebhart, Ryan D Madanick, Sidney Levinson, Karen J Fritchie, John T Woosley, Nicholas J ShaheenAbstract:Clinical and Endoscopic Characteristics do Not Reliably Differentiate PPI-Responsive Esophageal Eosinophilia and Eosinophilic Esophagitis in Patients Undergoing Upper Endoscopy: A Prospective Cohort Study
Richard Leigh - One of the best experts on this subject based on the ideXlab platform.
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Induced Sputum, Eosinophilic Bronchitis, and Chronic Obstructive Pulmonary Disease
American Journal of Respiratory and Critical Care Medicine, 1999Co-Authors: Frederick E Hargreave, Richard LeighAbstract:AM J RESPIR CRIT CARE MED 1999;160:S53−S57.The application of sputum induction and refined methods of sputum examination has provided the opportunity to examine cell and molecular markers of airway inflammation in asthma, COPD, and other airway diseases. The measurements are relatively noninvasive and can be applied safely, with care, even in more severe exacerbations of asthma and severe COPD. Induced sputum examination can be applied at random and repeatedly and gives results that are reproducible, valid, and responsive to changes in treatment. An eosinophilic bronchitis, defined as sputum Eosinophilia, is typical of asthma but can also occur in patients with a chronic cough without asthma, and in some patients with COPD in whom the classic inflammatory response is neutrophilic without Eosinophilia. When Eosinophilia occurs in COPD, it has been considered to be the result of cigarette smoking but it may be due to other causes. The clinical importance of eosinophilic bronchitis is that it responds to tre...
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Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.
American journal of respiratory and critical care medicine, 1999Co-Authors: Frederick E Hargreave, Richard LeighAbstract:The application of sputum induction and refined methods of sputum examination has provided the opportunity to examine cell and molecular markers of airway inflammation in asthma, COPD, and other airway diseases. The measurements are relatively noninvasive and can be applied safely, with care, even in more severe exacerbations of asthma and severe COPD. Induced sputum examination can be applied at random and repeatedly and gives results that are reproducible, valid, and responsive to changes in treatment. An eosinophilic bronchitis, defined as sputum Eosinophilia, is typical of asthma but can also occur in patients with a chronic cough without asthma, and in some patients with COPD in whom the classic inflammatory response is neutrophilic without Eosinophilia. When Eosinophilia occurs in COPD, it has been considered to be the result of cigarette smoking but it may be due to other causes. The clinical importance of eosinophilic bronchitis is that it responds to treatment with corticosteroid. In contrast, there is increasing evidence that an absence of sputum Eosinophilia is associated with steroid resistance. Hargreave FE, Leigh R. Induced sputum, eosinophilic bronchitis, and chronic obstructive pulmonary disease.
