AIMTo determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population. METHODSPathology and endoscopy databases at an academic medical center were reviewed t...AIMTo determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population. METHODSPathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed. RESULTSFour hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05, P = 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56, P P = 0.015), gastric dysplasia (OR = 6.11, P = 0.038), and gastric cancer (OR = 6.53, P = 0.027). Histologic findings of Barrett’s esophagus (OR = 0.28, P = 0.003) and esophageal dysplasia (OR = 0.11, P = 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73, P = 0.005) was associated with gastric IM. CONCLUSIONPatients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.展开更多
AIM: To investigate whether pretreatment with pressurelowering medication prior to anti-vascular endothelial factor(VEGF) injections had an effect on glaucomatous progression in patients with preexisting glaucoma or o...AIM: To investigate whether pretreatment with pressurelowering medication prior to anti-vascular endothelial factor(VEGF) injections had an effect on glaucomatous progression in patients with preexisting glaucoma or ocular hypertension(OHT).METHODS: A total of 66 eyes from 54 patients with a preexisting diagnosis of glaucoma or OHT, treated with six or more anti-VEGF injections were selected for chart review. Primary outcome measures were rate of visual field loss in d B/year, rate of change in retinal nerve fiber layer(RNFL) thickness in microns/year, and need for additional glaucoma intervention.RESULTS: The number of eyes requiring additional glaucoma medication was 5 of 20(25.0%) and 14 of 46(30.4%) for the pretreated and non-pretreated groups, respectively. The number of eyes requiring glaucoma laser or surgery was 4 of 20(20.0%) and 13 of 46(28.3%) for the pretreated and non-pretreated groups, respectively. Estimated mean rate of pattern standard deviation decline was not significant in either group(P>0.073), with no difference between groups(P=0.332). Although both groups showed significant RNFL change from baseline(P<0.011), no difference was detected between groups(P=0.467).CONCLUSION: Pretreatment has no detectable effect on structural or functional glaucomatous progression. Patients receiving repeated injections may be at risk for glaucomatous complications requiring invasive intervention.展开更多
文摘AIMTo determine which clinical factors might be associated with gastric intestinal metaplasia (IM) in a North American population. METHODSPathology and endoscopy databases at an academic medical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed. RESULTSFour hundred and sixty-eight patients with gastric IM (mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM (mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology (OR = 2.05, P = 0.051). Gastric IM was associated with histologic findings of chronic gastritis (OR = 2.56, P P = 0.015), gastric dysplasia (OR = 6.11, P = 0.038), and gastric cancer (OR = 6.53, P = 0.027). Histologic findings of Barrett’s esophagus (OR = 0.28, P = 0.003) and esophageal dysplasia (OR = 0.11, P = 0.014) were inversely associated with gastric IM. Tobacco use (OR = 1.73, P = 0.005) was associated with gastric IM. CONCLUSIONPatients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy (EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable.
文摘AIM: To investigate whether pretreatment with pressurelowering medication prior to anti-vascular endothelial factor(VEGF) injections had an effect on glaucomatous progression in patients with preexisting glaucoma or ocular hypertension(OHT).METHODS: A total of 66 eyes from 54 patients with a preexisting diagnosis of glaucoma or OHT, treated with six or more anti-VEGF injections were selected for chart review. Primary outcome measures were rate of visual field loss in d B/year, rate of change in retinal nerve fiber layer(RNFL) thickness in microns/year, and need for additional glaucoma intervention.RESULTS: The number of eyes requiring additional glaucoma medication was 5 of 20(25.0%) and 14 of 46(30.4%) for the pretreated and non-pretreated groups, respectively. The number of eyes requiring glaucoma laser or surgery was 4 of 20(20.0%) and 13 of 46(28.3%) for the pretreated and non-pretreated groups, respectively. Estimated mean rate of pattern standard deviation decline was not significant in either group(P>0.073), with no difference between groups(P=0.332). Although both groups showed significant RNFL change from baseline(P<0.011), no difference was detected between groups(P=0.467).CONCLUSION: Pretreatment has no detectable effect on structural or functional glaucomatous progression. Patients receiving repeated injections may be at risk for glaucomatous complications requiring invasive intervention.
