No abstract

Our data are the first to demonstrate a reduced quality of life in patients who develop GHD after cure of acromegaly compared to those who are GH sufficient. Further studies are warranted to determine whether GH replacement would improve quality of life for patients with GHD after cure from acromegaly.

Background & Aims Better criteria are needed to identify patients that should be screened for Barrett’s esophagus (BE), to reduce over-testing and improve the cost effectiveness. There is evidence that chemopreventive agents such as non-steroidal anti-inflammatory drugs—particularly aspirin—reduce the risk of esophageal adenocarcinoma (EAC), but little is known about their effects on BE. We analyzed characteristics of patients with BE for factors that might be used in screening and management. Methods In this case-controlled study, we identified 434 patients with BE diagnosed at the first endoscopy (incident cases) at a single institution (1997–2010). BE cases were matched with controls on the basis of indication for endoscopy, year of endoscopy, and endoscopist. Risk factors analyzed included age, gender, BMI, medical and social history, and medications. We performed a multivariate logistic regression analysis to identify clinical risk factors for BE. Results In a multivariate regression model, men had a greater risk for developing BE (odds ratio [OR]=3.2; 95% confidence interval [CI], 2.3–4.4), whereas current aspirin users had a lower risk than non-users (OR=0.56; 95% CI, 0.39–0.80). A subset analysis, limited to patients who had endoscopies for symptoms of gastroesophageal reflux disease, yielded similar findings. No interactions were found between aspirin use and smoking, or use of acid suppressive medications. Conclusions In a case-controlled study of 434 patients with BE, current aspirin use appeared to reduce the risk of BE; previous studies associated aspirin use with a reduced risk of EAC.. Although efforts were made to minimize biases in our analysis, the possibility of residual confounding remains.