G C Harewood

..The purpose of the present paper was to determine if depth of invasion beyond MP, as assessed by preoperative endoscopic ultrasound (EUS), can predict tumor recurrence in patients with T3 rectal tumors...

..One of the major indications for terminal ileum intubation is to identify Crohn's disease. Signs and symptoms which raise a suspicion of Crohn's include abdominal pain/bloating, anaemia and diarrhoea...

..The aim of this pilot study was to assess the outcome in patients with non-resectable cholangiocarcinoma following endoscopic application of PDT directly into the biliary tract...

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..However, there is no consensus regarding what age is appropriate to stop screening. The aim of this study was to characterize neoplasia occurrence/recurrence in a large cohort of patients > or =70 years of age undergoing colonoscopy...

..Future prospective studies should provide data to support consensus guidelines recommending minimum annual procedure numbers required for maintenance of endoscopic competence among trained endoscopists...

..However, individual patients' risks may vary according to age and gender. This study aimed to characterize neoplasia recurrence in a large patient cohort undergoing surveillance colonoscopy...

..Recent legislation passed in July 2001 provides coverage for all Medicare beneficiaries for average-risk screening colonoscopy...

..The aim of the present study was to assess the impact of EUS FNA by comparing the clinical outcomes of patients with esophageal cancer before and after the introduction of this staging modality in our institution...

..Although, our findings put endoscopic practices into economic perspective, future perspective, future prospective trials are required to confirm the validity of these findings...

..Overall median polyp detection rate corresponded to a withdrawal time of 6.7 min. CONCLUSION: Our findings support a colonoscopy withdrawal time of at least 7 min, which correlates with higher colon polyp detection rates...

..41, P = 0.14) or mortality (hazard ratio, 0.96; 95% CI: 0.49-1.78, P = 0.91). CONCLUSIONS: The extent of invasion of T3 esophageal cancer beyond MP, as determined by EUS, is not a significant predictor of tumor recurrence or mortality...

..Colonoscopy is an operator-dependent procedure. The medical literature describes disparity in colonoscopy performance with respect to polyp detection, caecal intubation rates and procedural times...

..CONCLUSIONS: Our findings suggest that a protective effect is conferred by pancreatic stent placement in reducing postampullectomy pancreatitis. Future large-scale studies are required to confirm this benefit...

..EUS is more accurate than CT for determining T stage of rectal carcinoma...

..Use of EUS FNA biopsy minimizes the cost of diagnostic evaluation in most cases...

..These results support performing EUS in patients whose tumors are thought to be resectable on helical CT to enhance NPT LN assessment...

..The endoscopic approach is best practiced by experienced endoscopists who minimize precut complication rates...

..In conclusion, initial screening with endomysial antibody is the least costly strategy for diagnosing celiac disease in a low risk population. Antigliadin antibody becomes the cheaper strategy for higher risk populations...

..Digital image analysis (DIA) allows quantification of nuclear DNA content and may help distinguish benign and malignant strictures of the biliary tract...

..The clinical impact of EUS-guided FNA (EUS-FNA) in regional lymph-node staging in patients with unresectable hilar cholangiocarcinoma before liver transplantation has yet to be determined...

..The diagnosis of celiac sprue should be considered in such cases. Endoscopy provides an opportunity to obtain tissue to diagnose sprue, and should be strongly considered in this setting...

..The aim of this study was to determine whether the tissue obtained by endoscopic ultrasound-guided trucut biopsy (EUS TCB) is sufficient for histologic diagnosis of cystic pancreatic tumors (CPTs)...

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..Under certain circumstances, surgery is the preferred strategy...

..This will require further long-term outcome studies focusing on the endpoint of tumor recurrence and patient survival...

..CONCLUSION: The performance of EUS in staging rectal cancer may be overestimated in the literature due to publication bias. This inflated estimate of the capability of EUS may lead to unrealistic expectations of this technology...

..Inflammatory bowel disease associated with primary sclerosing cholangitis (PSC-IBD) may have a high prevalence of rectal sparing, backwash ileitis, and colorectal neoplasia...

..The knowledge of the patient's clinical information appears to clarify cytology interpretation resulting in fewer equivocal results. We did not detect any reliable predictors of cytology accuracy...

..A selective EUS-FNA approach reduced the cost by avoiding EUS-FNA in 42% of patients with esophageal carcinoma. These results require confirmation in future studies...

..Staging strategies incorporating EUS improve treatment allocation by achieving more accurate T staging, thereby optimizing the benefit of preoperative XRT to more advanced tumors...

..EUS-FNA errors during the initial learning phase are primarily due to inadequate specimens. Interpretation of pancreatic EUS-FNA specimens remained consistent before and after training...

..Future prospective studies assessing skill acquisition are required to define the minimum number of collection drainage procedures at which competence can be achieved...

..Complications were mild and infrequent (0.5%). CONCLUSION: EUS FNA of pancreatic masses safely and accurately diagnoses pancreatic malignancy when prior biopsy techniques have been unsuccessful...

..The need for precut sphincterotomy appears to decrease with increasing ERCP experience...

..There does not seem to be any difference in the preferences expressed by never-screened and screened patients with respect to the aspects of colonoscopy that they find objectionable...

..Our findings suggest that education enhances gastroenterologists' understanding of EUS. Future studies should seek to assess the impact of these improved knowledge levels on the appropriateness of EUS referral patterns...

..Outcomes differ depending on the type of pancreatic fluid collection drained. Further studies of endoscopic drainage of pancreatic fluid collections must use defined terminology to allow meaningful comparisons...

..5 years. More long-term follow-up data are required to determine the durability of the endotherapy benefit over time...

..Variation in biopsy practice exists among endoscopy site types and by gender. Clear guidelines are needed for the endoscopic approach to these patients...

..EUS use is associated with a recurrence-free survival advantage in patients, supporting its routine use in rectal cancer staging...

..The patient with pancreatitis has not experienced another episode. CONCLUSIONS: The possibility of a retained stent should be considered in patients presenting with steatorrhea or pancreatitis after pancreaticoduodenectomy...

..The uncertainty of any survival advantage that bilateral biliary stent placement confers over unilateral stent placement makes cost-effectiveness difficult to assess...

..The satisfaction levels of the responders may underestimate the overall satisfaction of the population being surveyed...

..Future educational initiatives should focus on applications of EUS in this category. Studies are required to assess the impact of this education on the appropriateness of EUS referral patterns...

..Further study of the utility and safety of this needle in humans is warranted...

..The aim of this study was to determine the prevalence of ARSA in patients undergoing upper endoscopic ultrasound (EUS) and to describe the EUS characteristics of ARSA...

..003). CONCLUSION: The HQT test detects occult upper GI tract blood loss significantly more frequently than the HO or HS test...

..Otherwise, review of existing abdominal CTs appears to have limited utility in predicting DPEJ outcome...

..Future studies should focus on the education of non-gastroenterologists regarding the role of EUS and assess the impact of such education on the appropriateness of EUS referral patterns...

..Conversely, a patient's fear that their preparation is suboptimal is also inaccurate. A colonoscopy should not be canceled on the basis of a patient's perception that the quality of their preparation is poor...

..One must be cautious in generalizing the findings of male patient studies from academic centers to the entire population...

..Further studies are required to determine whether this improved performance increases diagnostic yield...

..These results suggest that inadequate preparation quality only hinders detection of smaller lesions, while having negligible impact on detection of larger lesions. These results should be confirmed in prospective studies...

..Given the established benefit of Helicobacter pylori eradication, further study is needed to determine whether physicians are diagnosing and treating Helicobacter pylori infection adequately in patients with peptic ulcer...

..Doing so helps guide management and may help to avoid unnecessary surgery. Prospective studies are needed to verify these findings and to more clearly define the role of EUS TCB in these patients...

..CONCLUSIONS: Our results show that the practice of surveillance colonoscopy varies greatly among endoscopists, and longer procedure duration is significantly associated with the likelihood of dysplasia diagnosis...

..These results should prompt future prospective studies assessing the impact of colonoscopic withdrawal time on lesion detection...

..Neostigmine appears to be under-used in patients with ACPO who do not have a true contraindication to its use...

..An impacted meat bolus is more likely to require intervention for removal than other food types. These clinical predictors should be considered before administration of glucagon...

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..Although EPBD is theoretically attractive for use in young patients for biliary sphincter preservation, the rate of pancreatitis is higher with EPBD and cannot be routinely recommended at this time...