The American journal of gastroenterology
-
Am. J. Gastroenterol. · Nov 1997
Dysplasia in short-segment Barrett's esophagus: a prospective 3-year follow-up.
Short segments of intestinal metaplasia in the distal esophagus are being recognized with increasing frequency. Both long and short segments of Barrett's esophagus can progress to dysplasia and cancer. However, the risk of short-segment Barrett's esophagus (SSBE) for the development of dysplasia and adenocarcinoma of the esophagus is not yet known. Our purpose, therefore, was to determine the frequency with which dysplasia occurs in patients with SSBE. ⋯ The prevalence of dysplasia was 8.5% with an incidence of 5.7% per year in this group of SSBE patients, followed prospectively. Although dysplastic changes may not be identified on follow-up examination, some patients progress to adenocarcinoma. Therefore, we recommend surveillance endoscopy and biopsy in patients with SSBE just as in those with long-segment Barrett's esophagus.
-
Am. J. Gastroenterol. · Nov 1997
Comparative StudyStudy of prevalence, severity, and etiological factors associated with acute pancreatitis in patients infected with human immunodeficiency virus.
Patients with the human immunodeficiency virus (HIV) disease can develop pancreatic gland inflammation from HIV infection and related causes, or from factors totally independent of it. The incidence and severity acute pancreatitis in patients with HIV diseases and the frequency of associated etiological factors have not been examined in any detail. The purpose of this study was to (a) determine the prevalence of acute pancreatitis, (b) evaluate severity of pancreatic gland inflammation, (c) identify commonly associated etiological factors with acute pancreatitis, and (d) examine the relationship between CD4 lymphocyte counts and serum pancreatic enzyme levels (amylase and lipase) in patients with HIV disease. ⋯ A detailed review of medical records of patients with HIV disease seen in a community hospital in 1 yr (1993-1994) suggests a high incidence (14%) of mild to moderately severe acute pancreatitis. In this group of patients, pancreatic gland inflammation is commonly associated with gallstones, intravenous drug abuse, pentamidine intake, and Pneumocystis carinii and Mycobacterium avium intracellulare infections. In addition, marked reduction in CD4 lymphocyte count is associated with increase in serum pancreatic enzyme levels (amylase, lipase activity) suggesting pancreatic gland inflammation or altered pancreatic enzyme turnover.