APC and PDT are equally effective in eradicating Barrett's mucosa, with PDT being the more expensive treatment. However, PDT is more effective in eradicating dysplasia and the extra benefits of PDT are generated at an extra cost. The occurrence of buried columnar glands and carcinoma warrants caution. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium to justify these interventions.

No abstract

The diagnostic accuracy of the MBDB technique was superior to that of the random biopsy technique for identifying specialized intestinal metaplasia, but not dysplasia or carcinoma. The intensity of methylene blue staining has an influence on the detection of specialized intestinal metaplasia and dysplasia or carcinoma, which may help in targeting the biopsies. Although MBDB prolongs the endoscopy procedure slightly, it is a safe and well-tolerated procedure. Further clinical studies on the MBDB technique exclusively in endoscopically normal dysplastic Barrett's esophagus are needed.

No abstract

A 39-year-old woman presented for evaluation of severe hypomagnesemia of more than 10 years' duration (average serum magnesium concentration, 1.1; range, 0.5-2.8 mg/dL). She has a history of psychiatric disorders, including major depression, attention-deficit/ hyperactivity disorder, anorexia nervosa, and past laxative abuse. Hypokalemia has rarely accompanied the hypomagnesemia (average serum potassium concentration, 4.0; range, 3.4-4.8 mEq/L). There is no family history of renal or electrolyte disorders. She does not use tobacco, alcohol, or illicit substances. Based on psychiatric history, hypomagnesemia had previously been attributed to suspected surreptitious diuretic use. She denies vomiting, diuretic or laxative abuse, recent weight change, or diarrhea despite high-dose oral magnesium supplementation. Her concerns were diffuse myalgia and parasthesias of the upper extremities, upper back, neck, and thighs.