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ABSTRACT: BackgroundBarrett’s Esophagus (BE) is a pre-malignant condition. Limited data on BE dysplasia prevalence exists among United States
ethnic groups.
AimThe purpose of this study was to determine if the frequency of BE with dysplasia varies among the major ethnic groups presenting
to our institution.
MethodsThe University of Florida-Jacksonville endoscopy database was searched for all cases of endoscopic BE from September 2002
to August 2007. Histologic BE was diagnosed if salmon colored esophageal mucosa was endoscopically seen at least 1cm above
the top of the gastric folds and biopsy revealed intestinal metaplasia with Alcian blue-containing goblet cells. Demographic
data collected for all included: age at diagnosis, ethnicity, sex, previous history of esophageal reflux, atypical manifestations
(chronic cough, aspiration), endoscopic length of BE, presence or absence of hiatal hernia, esophageal stricture or ulcer,
and presence or absence of dysplasia.
ResultsSalmon colored esophageal mucosa was observed in 405 of 7,308 patients (5.5%) and histologically confirmed in 115 of 405 patients
(28%) reflecting an overall prevalence of BE of 115/7308 (1.6%) in this cohort. Ethnic distribution of histologic BE patients
was as follows: 95 (83%) non-Hispanic white (nHw), 16 (14%) African American (AA) and 4 (3%) other. Long segment BE (LSBE)
and any form of dysplasia was observed less frequently in AA than nHw (LSBE: 12% vs. 26% and dysplasia: 0% vs. 7%).
ConclusionsLSBE and dysplasia are less frequent in AA than nHw. Studies in AA with BE may illustrate factors limiting dysplasia and LSBE
risk.
KeywordsBarrett’s esophagus–Dysplasia–Demographics–Ethnicity–African American
Digestive Diseases and Sciences 04/2012; 57(2):419-423. · 2.12 Impact Factor
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ABSTRACT: To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications.
A retrospective search of the endoscopy database at the University of Florida Health Science Center/Jacksonville for all cases of reflux esophagitis and its complications from January 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classification, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication.
The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001).
Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture and hiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.
World Journal of Gastroenterology 06/2009; 15(23):2878-81. · 2.47 Impact Factor
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ABSTRACT: Esophageal variceal bleeding can be serious or life threatening. Drug-induced thrombocytopenia can further complicate such bleeding episodes. Thrombocytopenia because of sandostatin has been reported in the literature only once previously. We describe a case of sandostatin-induced reversible thrombocytopenia with a positive rechallenge. Platelet count decreased during administration of sandostatin and recovered only when the infusion was halted. The proposed mechanism of thrombocytopenia during both episodes is immunologic. Physician awareness of sandostatin-induced thrombocytopenia can prevent unnecessary complication during episodes of esophageal variceal bleeding and is rapidly reversed with discontinuation of the drug.
European journal of gastroenterology & hepatology 03/2009; 21(4):474-5. · 1.66 Impact Factor
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Chest 02/2009; 135(1):228-32. · 5.25 Impact Factor
