Rapid salivary pepsin test: blinded assessment of test performance in gastroesophageal reflux disease.

Objective/hypothesis: Pepsin lateral flow device (LFD) is a rapid noninvasive test to detect salivary pepsin as a surrogate marker for gastroesophageal reflux disease (GERD). We aimed to establish the test sensitivity, specificity, positive and negative predictive values (PPV, NPV) in patients with symptomatic and objective evidence of GERD compared to healthy controls.

Study Design: Prospective, blinded, controlled cohort study.

Targeted cyst wall puncture and aspiration during EUS-FNA increases the diagnostic yield of premalignant and malignant pancreatic cysts.

Background: Characterization of pancreatic cysts by using EUS-FNA includes chemical and cytologic analysis.

Objective: To evaluate whether material obtained from FNA of the cyst wall increases diagnostic yield.

Design: Prospective series.

Relationship of pancreatic mass size and diagnostic yield of endoscopic ultrasound-guided fine needle aspiration.

Background: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is central to discerning the diagnosis of solid pancreatic tumors through tissue acquisition. Test performance is affected by a number of factors including location of mass within the pancreas, presence of onsite cytology technologist, and number of passes with the needle. The influence of tumor size has not been well studied.

Increased expression and cellular localization of spermine oxidase in ulcerative colitis and relationship to disease activity.

Background: Polyamines are important in cell growth and wound repair, but have also been implicated in inflammation-induced carcinogenesis. Polyamine metabolism includes back-conversion of spermine to spermidine by the enzyme spermine oxidase (SMO), which produces hydrogen peroxide that causes oxidative stress. In ulcerative colitis (UC), levels of spermine are decreased compared to spermidine.

Increased serum levels of L-arginine in ulcerative colitis and correlation with disease severity.

Background: L-arginine (L-Arg) is a semi-essential amino acid that is the substrate for both nitric oxide and polyamine synthesis. Cellular uptake of L-Arg is an active transport process that is subject to competitive inhibition by L-ornithine (L-Orn) and L-lysine (L-Lys). We investigated L-Arg utilization in patients with ulcerative colitis (UC).

Gastroesophageal reflux monitoring: pH (catheter and capsule) and impedance.

Diagnostic testing for GERD has evolved to include multi esophageal sites (distal, proximal and hypopharyngeal monitoring), wireless pH, and oropharyngeal devices. The versatility of the devices has increased our ability to better understand the role of acid reflux in various disorders involving reflux of acid. Wireless pH monitoring improves patient comfort and allows monitoring for gastroesophageal reflux events over several days.