Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification Tập 45 Số 2 - Trang 172-180 - 1999
Lars Lundell, John Dent, J R Bennett, A. L. Blum, David Armstrong, Jean Paul Galmiche, Frank B. Johnson, Michio Hongo, Joel E. Richter, Stuart J. Spechler, G. N. J. Tytgat, L Wallin
BACKGROUNDEndoscopic oesophageal changes are diagnostically helpful and identify patients exposed to the risk of disease chronicity. However, there is a serious lack of agreement about how to describe and classify the appearance of reflux oesophagitis
AIMSTo examine the reliability of criteria that describe the circumferential extent of mucosal breaks and to evaluate the functional and clinical correlates of patients with reflux disease whose oesophagitis was graded according to the Los Angeles system.
METHODSForty six endoscopists from different countries used a detailed worksheet to evaluate endoscopic video recordings from 22 patients with the full range of severity of reflux oesophagitis. In separate studies, Los Angeles system gradings were correlated with 24 hour oesophageal pH monitoring (178 patients), and with clinical trials of omeprazole treatment (277 patients).
RESULTSEvaluation of circumferential extent of oesophagitis by the criterion of whether mucosal breaks extended between the tops of mucosal folds, gave acceptable agreement (mean κ value 0.4) among observers. This approach is used in the Los Angeles system. An alternative approach of grouping the circumferential extent of mucosal breaks as occupying 0–25%, 26–50%, 51–75%, 76–99%, or 100% of the oesophageal circumference, gave unacceptably high interobserver variation (mean κ values 0–0.15) for all but the lowest category of extent (mean κ value 0.4). Severity of oesophageal acid exposure was significantly (p<0.001) related to the severity grade of oesophagitis. Preteatment oesophagitis grades A–C were related to heartburn severity (p<0.01), outcomes of omeprazole (10 mg daily) treatment (p<0.01), and the risk for symptom relapse off therapy over six months (p<0.05).
CONCLUSIONSResults add further support to previous studies for the clinical utility of the Los Angeles system for endoscopic grading of oesophagitis.
Management ofHelicobacter pyloriinfection—the Maastricht IV/ Florence Consensus Report Tập 61 Số 5 - Trang 646-664 - 2012
Peter Malfertheiner, Françis Mégraud, Colm O’Morain, J. Atherton, Anthony Axon, Franco Bazzoli, Gian Franco Gensini, Javier P. Gisbert, David Y. Graham, Theodore Rokkas, Emad El‐Omar, Ernst J. Kuipers
The gut microbiota and host health: a new clinical frontier Tập 65 Số 2 - Trang 330-339 - 2016
Julian R. Marchesi, David Adams, Francesca Fava, Gerben D. A. Hermes, Gideon M. Hirschfield, Georgina L. Hold, Mohammed Nabil Quraishi, James Kinross, Hauke Smidt, Kieran Tuohy, L. Thomas, Erwin G. Zoetendal, Ailsa Hart
Akkermansia muciniphilaand improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology Tập 65 Số 3 - Trang 426-436 - 2016
Ming Dao, Amandine Everard, Judith Aron‐Wisnewsky, Nataliya Sokolovska, Edi Prifti, Eric O. Verger, Brandon D. Kayser, Florence Levenez, Julien Chilloux, Lesley Hoyles, Marc‐Emmanuel Dumas, Salwa Rizkalla, Joël Doré, Patrice D. Cani, Karine Clément
Secukinumab, a human anti-IL-17A monoclonal antibody, for moderate to severe Crohn's disease: unexpected results of a randomised, double-blind placebo-controlled trial Tập 61 Số 12 - Trang 1693-1700 - 2012
Wolfgang Hueber, Bruce E. Sands, Steve Lewitzky, Marc Vandemeulebroecke, Walter Fries, Peter Higgins, Jan Wehkamp, Brian G. Feagan, Michael Yao, Marek Karczewski, Jakub Karczewski, Nicole Pezous, Stephan Bek, Gerard Bruin, Bjoern Mellgard, C Berger, Marco Londei, Arthur P. Bertolino, Gervais Tougas, Simon Travis
