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Article ; Online: Proton pump inhibitors.

Jenkins, Danny / Modolell, Ines

2023 Volume 383, Page(s) e070752

MeSH term(s)	Humans ; Proton Pump Inhibitors/adverse effects
Chemical Substances	Proton Pump Inhibitors
Language	English
Publishing date	2023-11-13
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj-2022-070752
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Article ; Online: The effect of procedural time on dysplasia detection rate during endoscopic surveillance of Barrett's esophagus.

Vithayathil, Mathew / Modolell, Ines / Ortiz-Fernandez-Sordo, Jacobo / Pappas, Apostolos / Januszewicz, Wladyslaw / O'Donovan, Maria / Bianchi, Michele / White, Jonathan R / Kaye, Philip / Ragunath, Krish / di Pietro, Massimiliano

Endoscopy

2023 Volume 55, Issue 6, Page(s) 491–498

Abstract: BACKGROUND : Endoscopic surveillance of Barrett's esophagus (BE) with Seattle protocol biopsies is time-consuming and inadequately performed in routine practice. There is no recommended procedural time for BE surveillance. We investigated the duration of ...

Abstract	BACKGROUND : Endoscopic surveillance of Barrett's esophagus (BE) with Seattle protocol biopsies is time-consuming and inadequately performed in routine practice. There is no recommended procedural time for BE surveillance. We investigated the duration of surveillance procedures with adequate tissue sampling and effect on dysplasia detection rate (DDR). METHODS : We performed post hoc analysis from the standard arm of a crossover randomized controlled trial recruiting patients with BE (≥C2 and/or ≥M3) and no clearly visible dysplastic lesions. After inspection with white-light imaging, targeted biopsies of subtle lesions and Seattle protocol biopsies were performed. Procedure duration and biopsy number were stratified by BE length. The effect of endoscopy-related variables on DDR was assessed by multivariable logistic regression. RESULTS : Of 142 patients recruited, 15 (10.6 %) had high grade dysplasia/intramucosal cancer and 15 (10.6 %) had low grade dysplasia. The median procedural time was 16.5 minutes (interquartile range 14.0-19.0). Endoscopy duration increased by 0.9 minutes for each additional 1 cm of BE length. Seattle protocol biopsies had higher sensitivity for dysplasia than targeted biopsies (86.7 % vs. 60.0 %;
MeSH term(s)	Humans ; Barrett Esophagus/pathology ; Esophageal Neoplasms/pathology ; Esophagoscopy/methods ; Biopsy/methods ; Hyperplasia
Language	English
Publishing date	2023-01-19
Publishing country	Germany
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2015-8883
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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Article ; Online: Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic.

di Pietro, Massimiliano / Modolell, Ines / O'Donovan, Maria / Price, Catherine / Pilonis, Nastazja D / Debiram-Beecham, Irene / Fitzgerald, Rebecca C

The lancet. Gastroenterology & hepatology

2020 Volume 5, Issue 9, Page(s) 805–806

MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Barrett Esophagus/diagnosis ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Deglutition Disorders/etiology ; Esophageal Neoplasms/diagnosis ; Esophagoscopy ; Gastroscopy ; Humans ; Middle Aged ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Stomach Neoplasms/diagnosis ; Surgical Sponges ; Triage/methods
Keywords	covid19
Language	English
Publishing date	2020-07-30
Publishing country	Netherlands
Document type	Letter ; Research Support, Non-U.S. Gov't
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(20)30242-9
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Article: The effect of procedural time on dysplasia detection rate during endoscopic surveillance of Barrett’s esophagus

Vithayathil, Mathew / Modolell, Ines / Ortiz-Fernandez-Sordo, Jacobo / Pappas, Apostolos / Januszewicz, Wladyslaw / O’Donovan, Maria / Bianchi, Michele / White, Jonathan R. / Kaye, Philip / Ragunath, Krish / di Pietro, Massimiliano

Endoscopy

2023 Volume 55, Issue 06, Page(s) 491–498

Abstract: Background : Endoscopic surveillance of Barrett’s esophagus (BE) with Seattle protocol biopsies is time-consuming and inadequately performed in routine practice. There is no recommended procedural time for BE surveillance. We investigated the duration ... ...

Abstract	Background : Endoscopic surveillance of Barrett’s esophagus (BE) with Seattle protocol biopsies is time-consuming and inadequately performed in routine practice. There is no recommended procedural time for BE surveillance. We investigated the duration of surveillance procedures with adequate tissue sampling and effect on dysplasia detection rate (DDR). Methods : We performed post hoc analysis from the standard arm of a crossover randomized controlled trial recruiting patients with BE (≥C2 and/or ≥M3) and no clearly visible dysplastic lesions. After inspection with white-light imaging, targeted biopsies of subtle lesions and Seattle protocol biopsies were performed. Procedure duration and biopsy number were stratified by BE length. The effect of endoscopy-related variables on DDR was assessed by multivariable logistic regression. Results : Of 142 patients recruited, 15 (10.6 %) had high grade dysplasia/intramucosal cancer and 15 (10.6 %) had low grade dysplasia. The median procedural time was 16.5 minutes (interquartile range 14.0–19.0). Endoscopy duration increased by 0.9 minutes for each additional 1 cm of BE length. Seattle protocol biopsies had higher sensitivity for dysplasia than targeted biopsies (86.7 % vs. 60.0 %; P = 0.045). Longer procedural time was associated with increased likelihood of dysplasia detection on quadrantic biopsies (odds ratio [OR] 1.10, 95 %CI 1.00–1.20, P = 0.04), and for patients with BE > 6 cm also on targeted biopsies (OR 1.21, 95 %CI 1.04–1.40; P = 0.01). Conclusions : In BE patients with no clearly visible dysplastic lesions, longer procedural time was associated with increased likelihood of dysplasia detection. Adequate time slots are required to perform good-quality surveillance and maximize dysplasia detection.
Language	English
Publishing date	2023-01-19
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2015-8883
Database	Thieme publisher's database

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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Article ; Online: Image-Enhanced Endoscopy and Molecular Biomarkers Vs Seattle Protocol to Diagnose Dysplasia in Barrett's Esophagus.

Vithayathil, Mathew / Modolell, Ines / Ortiz-Fernandez-Sordo, Jacobo / Oukrif, Dahmane / Pappas, Apostolos / Januszewicz, Wladyslaw / O'Donovan, Maria / Hadjinicolaou, Andreas / Bianchi, Michele / Blasko, Adrienn / White, Jonathan / Kaye, Philip / Novelli, Marco / Wernisch, Lorenz / Ragunath, Krish / di Pietro, Massimiliano

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2022 Volume 20, Issue 11, Page(s) 2514–2523.e3

Abstract: Background & aims: Dysplasia in Barrett's esophagus often is invisible on high-resolution white-light endoscopy (HRWLE). We compared the diagnostic accuracy for inconspicuous dysplasia of the combination of autofluorescence imaging (AFI)-guided probe- ... ...

Abstract	Background & aims: Dysplasia in Barrett's esophagus often is invisible on high-resolution white-light endoscopy (HRWLE). We compared the diagnostic accuracy for inconspicuous dysplasia of the combination of autofluorescence imaging (AFI)-guided probe-based confocal laser endomicroscopy (pCLE) and molecular biomarkers vs HRWLE with Seattle protocol biopsies. Methods: Barrett's esophagus patients with no dysplastic lesions were block-randomized to standard endoscopy (HRWLE with the Seattle protocol) or AFI-guided pCLE with targeted biopsies for molecular biomarkers (p53 and cyclin A by immunohistochemistry; aneuploidy by image cytometry), with crossover to the other arm after 6 to 12 weeks. The primary end point was the histologic diagnosis from all study biopsies (trial histology). A sensitivity analysis was performed for overall histology, which included diagnoses within 12 months from the first study endoscopy. Endoscopists were blinded to the referral endoscopy and histology results. The primary outcome was diagnostic accuracy for dysplasia by real-time pCLE vs HRWLE biopsies. Results: Of 154 patients recruited, 134 completed both arms. In the primary outcome analysis (trial histology analysis), AFI-guided pCLE had similar sensitivity for dysplasia compared with standard endoscopy (74.3%; 95% CI, 56.7-87.5 vs 80.0%; 95% CI, 63.1-91.6; P = .48). Multivariate logistic regression showed pCLE optical dysplasia, aberrant p53, and aneuploidy had the strongest correlation with dysplasia (secondary outcome). This 3-biomarker panel had higher sensitivity for any grade of dysplasia than the Seattle protocol (81.5% vs 51.9%; P < .001) in the overall histology analysis, but not in the trial histology analysis (91.4% vs 80.0%; P = .16), with an area under the receiver operating curve of 0.83. Conclusions: Seattle protocol biopsies miss dysplasia in approximately half of patients with inconspicuous neoplasia. AFI-guided pCLE has similar accuracy to the current gold standard. The addition of molecular biomarkers could improve diagnostic accuracy.
MeSH term(s)	Humans ; Barrett Esophagus/complications ; Esophagoscopy/methods ; Tumor Suppressor Protein p53 ; Esophageal Neoplasms/pathology ; Microscopy, Confocal/methods ; Biopsy ; Hyperplasia ; Biomarkers/analysis ; Aneuploidy ; Randomized Controlled Trials as Topic
Chemical Substances	Tumor Suppressor Protein p53 ; Biomarkers
Language	English
Publishing date	2022-02-17
Publishing country	United States
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2022.01.060
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Zs.A 5836: Show issues

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Article ; Online: Initiative to improve detection of faecal incontinence in primary care: The GIFT Project.

Ribas, Yolanda / Coll, Meritxell / Espina, Avelina / Jiménez, Concepció / Chicote, Montserrat / Torné, Marta / Modolell, Ines

Family practice

2017 Volume 34, Issue 2, Page(s) 175–179

Abstract: Background: Faecal incontinence (FI) is a distressing condition with a significant impact on quality of life. The true prevalence of FI is unknown but probably underestimated. Identifying patients affected is of key importance because a significant ... ...

Abstract	Background: Faecal incontinence (FI) is a distressing condition with a significant impact on quality of life. The true prevalence of FI is unknown but probably underestimated. Identifying patients affected is of key importance because a significant proportion may improve with conservative treatments, and there are a number of other treatments available. Objectives: The aim of our project was to improve detection of FI in our primary care setting. Methods: A multidisciplinary working group was created in order to raise awareness and educate health professionals about FI. We designed a simple protocol and organized educational meetings at 7 primary care centres. The usual diagnostic computer-based tools used by nurses were modified, so that FI was systematically asked about. A proactive attitude among doctors and midwives regarding FI was recommended for high-risk patient groups. Results: The project was implemented in October 2014. Before the intervention, only 250 (<1%) patients with a diagnosis of FI were identified from the primary care register out of a population over 165000 people. Between October 2014 and February 2016, 17370 patients were questioned about anal continence in routine follow-ups. Of those questioned, 829 (4.8%) disclosed suffering from FI. Mean age was 78.5 ± 14 years (16-104), 565 (68.2%) were females, and 264 (31.8%) were males. The percentage of patients with FI increased with age and was higher in women. Conclusion: Our results show that a proactive approach with direct questions on FI may lead to a significant increase in FI detection in primary care.
MeSH term(s)	Aged ; Fecal Incontinence/diagnosis ; Fecal Incontinence/epidemiology ; Female ; Health Personnel/education ; Humans ; Male ; Mass Screening ; Prevalence ; Primary Health Care ; Quality of Life ; Risk Factors
Language	English
Publishing date	2017--01
Publishing country	England
Document type	Journal Article
ZDB-ID	605939-9
ISSN	1460-2229 ; 0263-2136
ISSN (online)	1460-2229
ISSN	0263-2136
DOI	10.1093/fampra/cmx004
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Article: Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic

di Pietro, Massimiliano / Modolell, Ines / O039, / Donovan, Maria / Price, Catherine / Pilonis, Nastazja D / Debiram-Beecham, Irene / Fitzgerald, Rebecca C

Lancet Gastroenterol Hepatol

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #688798
Database	COVID19

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Article ; Online: Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic.

Di Pietro, Massimiliano / Modolell, Ines / O'Donovan, Maria / Price, Catherine / Pilonis, Nastazja D / Debiram-Beecham, Irene / Fitzgerald, Rebecca

2020

Abstract: During the COVID-19 pandemic, endoscopy services have been severely curtailed—eg, in England, UK, a 30% reduction of diagnostic endoscopies has been reported for the period between January and April, 2020, compared with the same period in 2019, with an ... ...

Abstract	During the COVID-19 pandemic, endoscopy services have been severely curtailed—eg, in England, UK, a 30% reduction of diagnostic endoscopies has been reported for the period between January and April, 2020, compared with the same period in 2019, with an estimated 750 oesophagogastric cancers going undiagnosed. A delay in oesophageal cancer diagnosis could adversely affect outcomes, such as has previously been seen with low endoscopy referral rates being linked with poor outcomes from oesophageal cancer.
Keywords	covid19
Language	English
Publisher	Elsevier
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Use of Cytosponge as a triaging tool to upper gastrointestinal endoscopy during the COVID-19 pandemic

di Pietro, Massimiliano / Modolell, Ines / O'Donovan, Maria / Price, Catherine / Pilonis, Nastazja D / Debiram-Beecham, Irene / Fitzgerald, Rebecca C

The Lancet Gastroenterology & Hepatology

2020 Volume 5, Issue 9, Page(s) 805–806

Keywords	Hepatology ; Gastroenterology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ISSN	2468-1253
DOI	10.1016/s2468-1253(20)30242-9
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Proton-pump inhibitors in sleep-related breathing disorders: clinical response and predictive factors.

Modolell, Inés / Esteller, Eduard / Segarra, Francesc / Mearin, Fermín

European journal of gastroenterology & hepatology

2011 Volume 23, Issue 10, Page(s) 852–858

Abstract: Background and aim: Gastroesophageal reflux is frequently associated with sleep-related breathing disorders. We aimed to evaluate the prevalence of acid reflux in patients with sleep-related breathing disorders, their clinical response to proton-pump ... ...

Abstract	Background and aim: Gastroesophageal reflux is frequently associated with sleep-related breathing disorders. We aimed to evaluate the prevalence of acid reflux in patients with sleep-related breathing disorders, their clinical response to proton-pump inhibitor (PPI) treatment, and to identify predictive response factors to this treatment. Methods: Prospective study among patients attending a sleep clinic. Evaluation of typical and atypical gastroesophageal reflux symptoms, simultaneous 24 h dual-channel pH monitoring and polysomnography were performed in all patients. Patients were treated with pantoprazole. After 3-6 months clinical response was evaluated, and pHmetry and polysomnography repeated. Clinical response was defined in terms of snore, apnea and somnolence grading. Improvement in polysomnography was defined by the Stanford criteria. Results: One hundred and ninety-nine patients were included. Abnormal reflux levels were detected in the distal esophagus in 72% of patients, and in the proximal esophagus in 46%. Clinical or polysomnographic response to PPI treatment was found in 78% of patients. Pretreatment pHmetry was a significant predictor of success: 67% of responders had pathological proximal pHmetry (vs. 33% of nonresponders; P<0.001), and 55% also had pathological distal pHmetry (P<0.05). Age, sex, BMI, alcohol or tobacco abuse, typical or atypical gastroesophageal reflux symptoms, severity of sleeping disorder, and polysomnography were not predictive of outcome. Conclusions: Patients with sleep-related breathing disorders have an increased prevalence of gastroesophageal reflux disease. They may be successfully treated with PPIs, particularly in patients with an abnormal proximal esophageal pHmetry.
MeSH term(s)	2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Adult ; Aged ; Esophageal pH Monitoring ; Female ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/drug therapy ; Humans ; Male ; Manometry/methods ; Middle Aged ; Polysomnography/methods ; Prognosis ; Proton Pump Inhibitors/therapeutic use ; Severity of Illness Index ; Sleep Apnea Syndromes/etiology ; Treatment Outcome ; Young Adult
Chemical Substances	2-Pyridinylmethylsulfinylbenzimidazoles ; Proton Pump Inhibitors ; pantoprazole (D8TST4O562)
Language	English
Publishing date	2011-10
Publishing country	England
Document type	Clinical Trial ; Journal Article
ZDB-ID	1034239-4
ISSN	1473-5687 ; 0954-691X
ISSN (online)	1473-5687
ISSN	0954-691X
DOI	10.1097/MEG.0b013e328349d093
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