Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia

Abstract

Steady‐state and oscillatory shear behavior of three neat syndiotactic polypropylene (s‐PP) resins and a s‐PP resin (s‐PP#8) filled with CaCO3 particles of varying content, size, and type of surface modification were investigated. All of the neat s‐PP resins investigated exhibited the expected shear‐thinning behavior. Both the storage and loss moduli increased with decreasing temperature. The shift factors used to construct the master curves were fitted well with both the Arrhenius and the Williams–Landel–Ferry (WLF) equations. The inclusion of CaCO3 particles of varying content, size, and type of surface modification, to a large extent, affected both the steady‐state and oscillatory shear behavior of s‐PP/CaCO3 compounds, with the property values being found to increase with increasing content, decreasing size, and surface coating of the CaCO3 particles. Lastly, the effects of melt‐annealing and crystallization temperatures on isothermal crystallization behavior of s‐PP#8 filled with CaCO3 particles of varying content, size, and type of surface modification were also investigated. The half‐time of crystallization of neat s‐PP#8 exhibited a strong correlation with the choice of the melt‐annealing temperature (Tf) when Tf was less than about 160 °C, while it became independent of Tf when Tf was greater than about 160 °C. On the other hand, the half‐time of crystallization of s‐PP#8/CaCO3 compounds did not vary much with the Tf. Generally, the observed half‐time of crystallization decreased with increasing CaCO3 content and increased with increasing CaCO3 particle size. Finally, coating the surface of CaCO3 particles with either stearic acid or paraffin reduced the ability of the particles to effectively nucleate s‐PP#8. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 100: 4515–4525, 2006

Esophageal and Esophagogastric Junction Cancers

“…21 Age, male gender, long-standing GERD, hiatal hernia size, and the length of the Barrett's esophagus are strongly associated with higher grades of dysplasia. 24,25 These preliminary results warrant further prospective evaluation as predictors of risk for the development of high-grade dysplasia (HGD) and esophageal adenocarcinoma in patients with Barrett's esophagus.…”

“…111 Age, male sex, longstanding GERD, hiatal hernia size, and the length of the Barrett's esophagus are strongly associated with the progression of Barrett's esophagus to adenocarcinoma of the esophagus. 24,25,112 Biomarkers such as aneuploidy and p53 loss of heterozygosity have been associated with increased risk of progression to HGD and/or adenocarcinoma of the esophagus. 112 These preliminary results warrant further prospective evaluation as predictors of risk for the development of HGD and esophageal adenocarcinoma in patients with Barrett's esophagus.…”

Endoscopic risk factors for neoplastic progression in patients with Barrett’s oesophagus

“…Up to 65-87% of BO patients have a hiatal hernia upon endoscopy. 15,[19][20][21] A case-control study comparing endoscopic findings in BO patients with HGD/OAC to patients with non-dysplastic BO found that Barrett's patients with HGD/OAC more often had a hiatal hernia (84%) than non-dysplastic patients (65%), p ¼ 0.000. Using multivariate logistic regression, the length of the hiatal hernia increased the risk of neoplastic progression with an OR of 1.2 (95% CI 1.04-1.39, p ¼ 0.013) per centimetre.…”

To whom and when the upper gastrointestinal endoscopy is indicated in gastroesophageal reflux disease? What is the role of routine esophageal biopsy? Which endoscopic esophagitis classification should be used?

“…In a cohort study consisting of 1058 patients, the frequency and duration of heartburn symptom increase risk of BE development; presence of heartburn for more than 5 years (OR: 1.5, 95% CI 1.07-209) and the presence of daily GERD symptoms (OR: 2.33, 95% CI 1.34-4.05) were reported risk factors (19,20). The increase in the risk of detection of high-grade dysplasia is notable in long-term GERD and BE; in a cohort study consisting of 109 patients, the average was found to be 5.66 in those having complaints for more than 20 years (21). In a population-based case-control study (FINBAR) in which the relationship between GERD and BE or esophageal AC was investigated, the presence of GERD was found to be strongly associated with BE (OR: 12.0) and esophageal AC (OR: 3.48).…”