The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
David A Lieberman - One of the best experts on this subject based on the ideXlab platform.
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serious Gastrointestinal Pathology found in patients with serum ferritin values 50 ng ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
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Serious Gastrointestinal Pathology found in patients with serum ferritin values ≤ 50 ng/ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
Geronimo Sahagun - One of the best experts on this subject based on the ideXlab platform.
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serious Gastrointestinal Pathology found in patients with serum ferritin values 50 ng ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
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Serious Gastrointestinal Pathology found in patients with serum ferritin values ≤ 50 ng/ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
Megan Oehlke - One of the best experts on this subject based on the ideXlab platform.
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serious Gastrointestinal Pathology found in patients with serum ferritin values 50 ng ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
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Serious Gastrointestinal Pathology found in patients with serum ferritin values ≤ 50 ng/ml
The American Journal of Gastroenterology, 1998Co-Authors: Geronimo Sahagun, Megan Oehlke, David A LiebermanAbstract:Abstract Objective: Our aim was to evaluate the Gastrointestinal tract in patients with serum ferritin values ≤ 50 ng/ml for the presence of serious Gastrointestinal Pathology, including neoplasia and acid peptic disease. Methods: In this prospective observational study, patients with serum ferritin values ≤ 50 ng/ml who did not have an obvious cause of iron deficiency underwent colonoscopy and/or esophagogastroduodenoscopy. Results: Between October 1, 1994, and February 29, 1996, 725 of 3015 patients who had serum ferritin determinations were found to have values ≤ 50 ng/ml. To date, 143 patients have been fully evaluated and 77 were found to have serious Gastrointestinal Pathology including acid peptic disease (N = 46), cancer (N = 15), and large adenomas (N = 6). Colon cancer was discovered in five asymptomatic patients. The prevalences of serious Gastrointestinal Pathology did not differ between patients with serum ferritin values ≤ 20 ng/ml and those with values between 21–50 ng/ml (63% vs 48%, p = 0.07). However, multivariate analysis showed that the presence of upper or lower Gastrointestinal symptoms and serum ferritin value ≤ 20 ng/ml is predictive of finding serious Pathology (p = 0.0002 for the whole model), with odds ratios of 3.8 (95% confidence interval of 1.84–7.70) for presence of Gastrointestinal symptoms and 2.2 (95% confidence interval of 1.09–4.57) for serum ferritin value ≤ 20 ng/ml. Conclusions: Endoscopic examination is warranted in patients with serum ferritin values ≤ 50 ng/ml to detect serious Gastrointestinal Pathology, present in 54% of such patients.
Wilfred M Weinstein - One of the best experts on this subject based on the ideXlab platform.
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association of infection due to helicobacter pylori with specific upper Gastrointestinal Pathology
Clinical Infectious Diseases, 1991Co-Authors: Martin J Blaser, Guillermo I Perezperez, John Lindenbaum, Daria Schneidman, Gary Van Deventer, Myriam Marinsorensen, Wilfred M WeinsteinAbstract:: The association of infection with Helicobacter pylori and antral (type B) gastritis now is clear, and the development of sensitive and specific serologic assays for IgA and IgG allows for diagnosis of this infection by noninvasive means. With use of these assays, we studied the association of infection with H. pylori and four other upper Gastrointestinal inflammatory conditions: Barrett's esophagus, pernicious anemia (which accompanies type A gastritis), and duodenal and gastric ulcers. H. pylori was present in only 39% of 41 patients with Barrett's esophagus whose gastric biopsy specimens were examined histologically. Each serologic assay correctly categorized 39 (95.1%) of the 41 patients. For both assays the frequency of seropositivity noted for 58 patients with Barrett's esophagus was not different from that noted for age- and sex-matched healthy controls. Among 40 patients with pernicious anemia, the results of assays for IgA and IgG were positive for 17.5% and 0%, respectively; these prevalences were significantly less than the 50% (IgA) and 40% (IgG) positivities noted for matched controls (P less than .01 for each; McNemar's test). Among 57 patients with documented duodenal or gastric ulcers, the results of assays for IgG and IgA were positive for 100% and 98.2%, respectively; these prevalences were significantly higher than the rate noted for matched controls (P less than .001 for duodenal ulcers and P = .02 for gastric ulcers for IgA assay). These data suggest that infection with H. pylori is strongly associated with duodenal and gastric ulcers, negatively associated with pernicious anemia, and independent of Barrett's esophagus.
Peter W Hamilton - One of the best experts on this subject based on the ideXlab platform.
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digital slide viewing for primary reporting in Gastrointestinal Pathology a validation study
Virchows Archiv, 2015Co-Authors: Maurice B Loughrey, Paul J Kelly, Oisin P Houghton, Helen G Coleman, Joseph Houghton, Anne Carson, Manuel Saltotellez, Peter W HamiltonAbstract:Despite the increasing availability of digital slide viewing, and numerous advantages associated with its application, a lack of quality validation studies is amongst the reasons for poor uptake in routine practice. This study evaluated primary digital Pathology reporting in the setting of routine subspecialist Gastrointestinal Pathology, commonplace in most tissue Pathology laboratories and representing one of the highest volume specialties in most laboratories. Individual digital and glass slide diagnoses were compared amongst three pathologists reporting in a Gastrointestinal subspecialty team, in a prospective series of 100 consecutive diagnostic cases from routine practice in a large teaching hospital laboratory. The study included a washout period of at least 6 months. Discordant diagnoses were classified, and the study evaluated against recent College of American Pathologists (CAP) recommendations for evaluating digital Pathology systems for diagnostic use. The study design met all 12 of the CAP recommendations. The 100 study cases generated 300 pairs of diagnoses, comprising 100 glass slide diagnoses and 100 digital diagnoses from each of the three study pathologists. 286 of 300 pairs of diagnoses were concordant, representing intraobserver concordance of 95.3 %, broadly comparable to rates previously published in this field. In ten of the 14 discordant pairs, the glass slide diagnosis was favoured; in four cases, the digital diagnosis was favoured, but importantly, the 14 discordant intraobserver diagnoses were considered to be of minor clinical significance. Interobserver, or viewing modality independent, concordance was found in 94 of the total of 100 study cases, providing a comparable baseline discordance rate expected in any second viewing of Pathology material. These overall results support the safe use of digital Pathology in primary diagnostic reporting in this setting.
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The Place of Quantitation in Diagnostic Gastrointestinal Pathology
Current topics in pathology. Ergebnisse der Pathologie, 1990Co-Authors: James M Sloan, Peter W Hamilton, D. C. Allen, P. C. H. WattAbstract:Diagnosis based on histopathological or cytopathological assessment frequently shows considerable interobserver variation. More efficient exchange of information over recent decades has improved diagnostic standards but the subjective nature of the interpretation involved means that the standardisation available in other branches of laboratory medicine cannot easily be achieved. For example despite detailed and widely publicised attempts to achieve more uniform assessment of dysplasia in gastric (Morson et al. 1980; Ming et al. 1984) and in colonic mucosa (Riddell et al. 1983) there is still widespread variation even among histopathologists experienced in this field.
