The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Vaishali Sanchorawala - One of the best experts on this subject based on the ideXlab platform.
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amyloidosis of the Gastrointestinal Tract a 13 year single center referral experience
Haematologica, 2013Co-Authors: Andrew J Cowan, Martha Skinner, David C Seldin, John L Berk, David R Lichtenstein, Carl Ohara, Gheorghe Doros, Vaishali SanchorawalaAbstract:Amyloidosis of the Gastrointestinal Tract, with biopsy-proven disease, is rare. We reviewed a series of patients who presented with biopsy-proven Gastrointestinal amyloidosis and report their clinical characteristics, treatments, and survival. This is a retrospective review of data prospectively collected from January 1998 to December 2011 in a tertiary referral center; 2,334 patients with all types of amyloidosis were evaluated during this period. Seventy-six patients (3.2%) had biopsy-proven amyloid involvement of the Gastrointestinal Tract. Their median age was 61 years (range, 34-79). Systemic amyloidosis with dominant Gastrointestinal involvement was present in 60 (79%) patients, whereas the other 16 (21%) patients had amyloidosis localized to the Gastrointestinal Tract without evidence of an associated plasma cell dyscrasia or other organ involvement. Of the 60 systemic cases, 50 (83%) had immunoglobulin light-chain, five (8%) had familial lysozyme, three (5%) had wild-type transthyretin, and two (3%) had mutant transthyretin amyloidosis. The most frequent symptoms for all patients were weight loss in 33 (45%) and Gastrointestinal bleeding in 27 (36%). Incidental identification of amyloidosis on routine endoscopic surveillance played a role in the diagnosis of seven patients with systemic immunoglobulin light-chain, and four patients with immunoglobulin light-chain localized to the Gastrointestinal Tract. Amyloid protein subtyping was performed in 12 of the cases of localized disease, and all had lambda light chain disease. Of the 50 patients with systemic immunoglobulin light-chain amyloidosis, 45 were treated with anti-plasma cell therapy. The median survival has not been reached for this group. For the 16 patients with localized Gastrointestinal amyloidosis, supportive care was the mainstay of treatment; none received anti-plasma cell therapy. All 16 are alive at a median follow-up of 36 months (range, 1-143). Patients with biopsy-proven Gastrointestinal amyloidosis often present with weight loss and bleeding. In localized cases, all that underwent typing were due to lambda light chain amyloidosis and none progressed to systemic disease during the period of follow-up. Most patients with systemic disease had immunoglobulin light-chain, and their tolerance of therapy and median survival were excellent. Although a rare manifestation of amyloidosis, staining for amyloid should be considered in patients undergoing Gastrointestinal biopsy who have unexplained chronic Gastrointestinal symptoms.
Kenneth R Devault - One of the best experts on this subject based on the ideXlab platform.
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complications of endoscopy of the upper Gastrointestinal Tract a single center experience
Mayo Clinic proceedings, 2004Co-Authors: Herbert C Wolfsen, Lois L Hemminger, Sami R Achem, David S Loeb, Mark E Stark, Ernest P Bouras, Kenneth R DevaultAbstract:OBJECTIVE To evaluate prospectively the complications that occurred during consecutive endoscopies of the upper Gastrointestinal Tract. PATIENTS AND METHODS We evaluated all endoscopies of the upper Gastrointestinal Tract (except endoscopic retrograde cholangiopancreatography and endosonography) performed at the Ambulatory Surgical Center at the Mayo Clinic in Jacksonville, Fla, between January 1999 and June 2002. A staff gastroenterologist with or without a trainee performed these procedures. Therapeutic procedures included esophageal band ligation, injection sclerotherapy, botulinum toxin injection, extended upper endoscopy, pneumatic balloon dilation, endoscopic mucosal resection, and endoscopic ablation using thermal laser, argon beam coagulator, or photodynamic therapy. All complications were tabulated prospectively as per mandatory state licensure reporting. RESULTS Complications after diagnostic endoscopy of the upper Gastrointestinal Tract were related to anesthesia in 2 of the 12,841 patients. Perforations in 5 patients were associated with esophageal dilation (2), resection of duodenal lesions (2), or passage of a side-viewing instrument into the duodenum (1). No deaths occurred. CONCLUSIONS Diagnostic endoscopy of the upper Gastrointestinal Tract is safe, with a complication rate of less than 1 per 5000 cases. Therapeutic endoscopy increases the risk of complications. Compared with complication rates published previously, our results from a single center indicate a favorable reduction in complications related to endoscopy of the upper Gastrointestinal Tract.
Robert D Odze - One of the best experts on this subject based on the ideXlab platform.
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pathology of diseases that cause upper Gastrointestinal Tract bleeding
Gastrointestinal Endoscopy Clinics of North America, 2011Co-Authors: Joanna Gibson, Robert D OdzeAbstract:: Acute and chronic bleeding from the upper Gastrointestinal Tract is a common indication for endoscopy and hospitalization and is associated with significant morbidity and mortality. The causes of upper Gastrointestinal bleeding are numerous and can result in both acute and chronic hemorrhage. The aim of this article is to examine the pathologic features of various diseases associated with upper Gastrointestinal Tract bleeding.
Herbert C Wolfsen - One of the best experts on this subject based on the ideXlab platform.
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complications of endoscopy of the upper Gastrointestinal Tract a single center experience
Mayo Clinic proceedings, 2004Co-Authors: Herbert C Wolfsen, Lois L Hemminger, Sami R Achem, David S Loeb, Mark E Stark, Ernest P Bouras, Kenneth R DevaultAbstract:OBJECTIVE To evaluate prospectively the complications that occurred during consecutive endoscopies of the upper Gastrointestinal Tract. PATIENTS AND METHODS We evaluated all endoscopies of the upper Gastrointestinal Tract (except endoscopic retrograde cholangiopancreatography and endosonography) performed at the Ambulatory Surgical Center at the Mayo Clinic in Jacksonville, Fla, between January 1999 and June 2002. A staff gastroenterologist with or without a trainee performed these procedures. Therapeutic procedures included esophageal band ligation, injection sclerotherapy, botulinum toxin injection, extended upper endoscopy, pneumatic balloon dilation, endoscopic mucosal resection, and endoscopic ablation using thermal laser, argon beam coagulator, or photodynamic therapy. All complications were tabulated prospectively as per mandatory state licensure reporting. RESULTS Complications after diagnostic endoscopy of the upper Gastrointestinal Tract were related to anesthesia in 2 of the 12,841 patients. Perforations in 5 patients were associated with esophageal dilation (2), resection of duodenal lesions (2), or passage of a side-viewing instrument into the duodenum (1). No deaths occurred. CONCLUSIONS Diagnostic endoscopy of the upper Gastrointestinal Tract is safe, with a complication rate of less than 1 per 5000 cases. Therapeutic endoscopy increases the risk of complications. Compared with complication rates published previously, our results from a single center indicate a favorable reduction in complications related to endoscopy of the upper Gastrointestinal Tract.
Mohammadreza Mohebbi - One of the best experts on this subject based on the ideXlab platform.
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geographical spread of Gastrointestinal Tract cancer incidence in the caspian sea region of iran spatial analysis of cancer registry data
BMC Cancer, 2008Co-Authors: Mohammadreza Mohebbi, Mahmood Mahmoodi, Rory Wolfe, Keramat Nourijelyani, Kazem Mohammad, Hojjat Zeraati, Akbar FotouhiAbstract:High incidence rates of Gastrointestinal Tract cancers have been reported in the Caspian region of Iran. This study aimed to: 1) describe the geographical spatial patterns of Gastrointestinal Tract cancer incidence based on cancer registry data and, 2) determine whether geographical clusters of statistical significance exist. The Babol Cancer Registry, which covers the two major northern Iranian provinces of Mazandaran and Golestan (total population = 4,484,622) was used to identify new Gastrointestinal Tract cancer cases during 2001 to 2005. Age-specific cancer incidence rates were calculated for 7 Gastrointestinal Tract cancer sites in 26 wards of the Mazandaran and Golestan provinces. Spatial autocorrelation indices, hierarchical Bayesian Poisson models, and spatial scan statistics were used in measuring the geographic pattern and clusters. There were non-random spatial patterns in esophageal and stomach cancers that were similar for both sexes. Clusters of high incidence were identified in esophageal, stomach, colorectal and liver cancer for both sexes, as well as a possible cluster of pancreas cancer in males. Gastrointestinal Tract cancers exhibit significant spatial clustering of risk in northern Iran. Further work is needed to relate these geographical patterns to information on potential life-style and environmental factors.
