Fecal occult blood test in patients on low-dose aspirin, warfarin, clopidogrel, or non-steroidal anti-inflammatory drugs.

Aim: To determine the effect of anticoagulants and antiplatelet medications on the positive-predictive-value of fecal occult blood test (FOBT).

Methods: All patients who underwent a colonoscopy at our institution from 1995 to 2006 for a positive FOBT were identified. Medical records were searched, and patients were stratified into five groups selected a priori: low-dose aspirin, NSAIDs, warfarin, clopidogrel, or controls.

Plastic versus self-expanding metallic stents for malignant hilar biliary obstruction: a prospective multicenter observational cohort study.

Background: There are few comparative data as to whether plastic or self-expanding metallic stents are preferable for palliating malignant hilar biliary obstruction.

Methods: Thirty-day outcomes of consecutive endoscopic retrograde cholangiopancreatographies performed for malignant hilar obstruction at 6 private and 5 university centers were assessed prospectively.

Results: Patients receiving plastic (N=28) and metallic stents (N=34) were similar except that metallic stent recipients more often had: Bismuth III or IV tumors (16/34 vs.

Five-year colon surveillance after screening colonoscopy.

Background & Aims: Outcomes of colon surveillance after colorectal cancer screening with colonoscopy are uncertain. We conducted a prospective study to measure incidence of advanced neoplasia in patients within 5.5 years of screening colonoscopy.

Impact of preoperative endoscopic ultrasound on non-small cell lung cancer staging.

Aim: To determine if the addition of preoperative endoscopic ultrasound (EUS) to non-small cell lung cancer staging can reduce the proportion of patients in whom malignant mediastinal lymph nodes (inoperable disease) are discovered at surgery.

Methods: All patients with lung cancer who underwent mediastinoscopy or thoracotomy for cancer diagnosis, staging, or treatment from 1999 to 2005 were identified. Patients who had undergone preoperative EUS were designated as the EUS group.

Central intranodal blood vessel: a new EUS sign described in mediastinal lymph nodes.

Background: The vascular architecture of normal lymph nodes is composed of prominent centrally located blood vessels. In malignant nodes, this pattern is distorted because of tumor infiltration and neovascularization.

Objective: To determine whether EUS imaging of central intranodal blood vessels (CIV) can be used to differentiate benign from malignant subcarinal lymph nodes in lung cancer.

Microsatellite instability in interval colon cancers.

Background & Aims: Colon cancers that develop after a complete colonoscopy may be the result of "failure of colonoscopy" or rapid tumor growth. Tumors that develop via the mismatch repair gene pathway demonstrate rapid tumor growth. The aim of this study was to determine if interval colon cancers were more likely than noninterval cancers to result from the loss of function of mismatch repair genes and hence demonstrate microsatellite instability (MSI).

Should patients with anemia and low normal or normal serum ferritin undergo colonoscopy?

Background: Patients with unexplained iron deficiency anemia have a greater prevalence of colonic neoplasia, and should be evaluated for a colonoscopy. The approach to patients with anemia without iron deficiency remains unclear.

Objective: To compare the prevalence of colonic neoplasia in anemic patients with normal ferritin (>50 ng/mL), to those with ferritin < or =50 ng/mL, and nonanemic individuals.

Colorectal cancers found after a complete colonoscopy.

Background & Aims: The incidence of colorectal cancer in patients undergoing colonoscopic surveillance is higher than previously thought. A better understanding of interval cancers is needed to improve surveillance strategies. The objectives of this study were to determine whether interval colorectal cancers were associated with an inadequate earlier colonoscopy, incomplete polypectomy, or aggressive biologic behavior.

Current issues in endoscope reprocessing and infection control during gastrointestinal endoscopy.

The purpose of this article is to review the evidence regarding transmission of infection during gastrointestinal endoscopy, factors important in endoscope reprocessing and infection control, areas to focus on to improve compliance, and recent developments and advances in the field.

EUS-guided FNA for the diagnosis of advanced lung cancer.

Background: A majority of patients with lung cancer are incurable but are symptomatic and may benefit from palliative therapy. Currently available diagnostic methods are either too risky or unsuccessful in obtaining a tissue diagnosis in up to 30% of patients.

Objective: To evaluate the role of EUS-guided FNA in obtaining a tissue diagnosis in patients with advanced lung cancer.

Endoscopic ultrasound and positron emission tomography for lung cancer staging.

Background And Aims: Accurate assessment of mediastinal lymph nodes is vital for optimum treatment allocation in lung cancer patients. Currently available strategies fail to identify many patients with advanced mediastinal disease, resulting in unnecessary surgery. We prospectively compared 2 promising new modalities, positron emission tomography (PET) and endoscopic ultrasound (EUS), for staging mediastinal lymph nodes.

Recent advances in epidemiology and prevention of gastrointestinal endoscopy related infections.

Purpose Of Review: This article reviews recent publications relevant to endoscope reprocessing and the potential for transmission of infection during gastrointestinal endoscopy.

Recent Findings: There have been a number of established reprocessing failures of gastrointestinal endoscopes at various healthcare facilities across the US resulting in patient notifications. These episodes have been associated with user errors and reprocessing equipment failures, highlighting the need for increased compliance with established guidelines.

Acute GI bleeding in the setting of supratherapeutic international normalized ratio in patients taking warfarin: endoscopic diagnosis, clinical management, and outcomes.

Background: Acute GI bleeding is a life-threatening complication of warfarin therapy. Acute GI bleeding in patients with an international normalized ratio of 4.0 or greater (supratherapeutic) is often attributed to trivial mucosal lesions.