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New Minimally Invasive Outpatient Procedure Uses Radio Frequency Energy to Stop
Reflux 1. New Minimally Invasive Outpatient Procedure Uses Radio Frequency Energy to Stop Reflux Top Curon Medical, Inc. (formerly Conway Stuart Medical, Inc.) announced today that it has received clearance from the U.S. Food and Drug Administration (FDA) to market its Stretta(TM) System for the treatment of gastroesophageal reflux disease, more commonly referred to as GERD or chronic heartburn. The Stretta Procedure is a minimally invasive, outpatient procedure that uses radiofrequency energy to treat reflux. GERD afflicts more than 14 million adults in the U.S. alone. The most common symptoms GERD sufferers often endure are significant heartburn and acid regurgitation. Other symptoms include difficulty swallowing, cough, sore throat, hoarse voice, chest pain, sleep disturbance and breathing difficulties due to exacerbation of asthma. A study published in the New England Journal of Medicine recently found that those with at least one weekly occurrence of heartburn are eight times more likely to develop esophageal cancer. Worldwide, patients and insurers spend $14 billion for anti-heartburn medications each year. Most GERD sufferers must take daily doses of medication for a lifetime. "We are extremely pleased with the FDA's clearance today of the Stretta System," said John Morgan, President and Chief Executive Officer of Curon Medical. "In addition to chronic heartburn, GERD sufferers endure many other symptoms that impact all aspects of their lives. All of us at Curon Medical look forward to working with gastroenterologists around the country to make this much needed, outpatient procedure available to those who really need it." GERD is caused by a weakened lower esophageal sphincter (LES) between the esophagus and stomach that allows bile and acid from the stomach to reflux back up into the esophagus, causing heartburn and irritation of the esophagus. GERD symptoms can be triggered by certain acidic foods or simple exercise. The Stretta Procedure is a minimally invasive outpatient procedure performed by a gastroenterologist in 60 minutes or less. The Stretta Procedure applies controlled radiofrequency energy through a flexible catheter to the lower esophageal sphincter improving the barrier function of the valve to stop reflux. The Stretta Procedure was evaluated in a clinical study conducted at 16 centers in the U.S. with 130 patients. For the 47 study patients for whom 6-month follow up data is currently available, 70% were able to discontinue acid suppressing medications and 87% discontinued proton pump inhibitor medications. Stretta reduced the exposure of the esophagus to acid in the majority of patients, and significantly reduced heartburn and regurgitation. Most Stretta patients have now resumed normal diets and active exercise routines, which had been previously modified due to the symptoms of GERD. The most common treatment for GERD is daily over the counter and prescription medication for the lifetime of the patient. Some sufferers opt for a procedure called fundoplication, which can be performed laparoscopically or as an open abdominal procedure requiring a two to four day hospital stay and long recovery time. The Stretta Procedure offers patients a minimally invasive, outpatient solution that is quick and allows patients to return to normal activities the following day. "For GERD sufferers the symptoms are quite serious and the options have previously been limited to either lifetime medication or invasive surgery. The Stretta Procedure offers an attractive alternative treatment option for patients who may not want to stay on medications and do not want to undergo surgery," explains Neil Stollman, MD, Director of Clinical Gastroenterology, San Francisco General Hospital and Assistant Professor of Medicine, University of California, San Francisco, and a Stretta Procedure clinical investigator while at the University of Miami. "The results from the clinical study so far are promising, and we are seeing sustained improvement in patients six months out. That is very encouraging. Patients should discuss this option with their gastroenterologists." "Because of my reflux disease, I was forced to take daily medications to control my heartburn symptoms. I was forced to limit my diet, which was especially hard since my husband and I enjoyed travelling and trying out different cuisine. I was eating baby food at a point. I also curtailed exercise and hobbies since even the slightest movements triggered my heartburn symptoms. I stayed in an unfulfilling job simply because my symptoms drained my energies so much," explains Aline Humphrey, a registered nurse, and one of the first patients treated with the Stretta Procedure in the clinical trial. "It's been a year since I had the Stretta Procedure and I feel great. I'm eating the foods I love again, and I'm back to biking, gardening and sculpting again. I've changed jobs and feel like a new person." About GERD Reflux disease, commonly referred to as GERD, is caused by a weakness in the lower esophageal sphincter (LES) that allows food and stomach acid to reflux back up into the esophagus. GERD sufferers often endure significant heartburn and acid regurgitation. Other symptoms include difficulty swallowing, cough, sore throat, hoarse voice, chest pain, sleep disturbance and breathing difficulties due to exacerbation of asthma. Most GERD patients must take daily doses of over the counter and prescription medications for a lifetime to control their symptoms. Some GERD sufferers opt for a surgical procedure called fundoplication. The fundoplication can be performed laparoscopically or in some cases as an open abdominal procedure often requiring a two to four day hospital stay and a substantial recovery period. About the Stretta Procedure The Stretta Procedure is a minimally invasive, outpatient procedure performed by a gastroenterologist in 60 minutes or less. A physician endoscopically delivers controlled radiofrequency (RF) energy to the lower esophageal sphincter (LES) muscle and gastric cardia to create thermal lesions. As the lesions heal, the barrier function of the LES is augmented, reducing the frequency of reflux events. Because there is no hospital stay involved with the Stretta Procedure, patients undergoing the procedure are able to participate in normal activities the following day. About Curon Medical Curon Medical, Inc. (formerly Conway Stuart Medical, Inc.) of Sunnyvale, Calif., is focused on developing cutting edge technology therapies using radiofrequency energy for the treatment of digestive system disorders. The Company's initial product offering, the Stretta(TM)System, is a minimally invasive treatment for gastroesophageal reflux disease or GERD. The Stretta Procedure has been cleared by the U.S. Food and Drug Administration for use in the U.S. and has CE Mark approval for use in Europe. The Stretta Procedure is performed on an outpatient basis in 60 minutes or less by a gastroenterologist. Most Stretta patients are able to return to normal activity the following day. Curon Medical can be found on the Web at www.curonmedical.com Stretta Procedure is a trademark of Curon Medical Inc. CONTACT: Schwartz Communications, Inc. Helen Shik/Jayme Maniatis, 781/684-0770 hshik@schwartz-pr.com jaymem@schwartz-pr.com or Curon Medical, Inc. Carol Chludzinski, 408/616-1830 2. New Option for Heartburn Fixes the Cause Instead of Just Blocking the Acid Top April 25, 2000 WASHINGTON (AP) -- Aline Humphrey was losing a 10-year battle with worsening heartburn: Medications didn't help, and she had resorted to eating only easy-to-digest baby food. Then doctors snaked a tiny tube down her throat to fix the faulty valve causing the problem. The California nurse celebrated several months later with an eight-course French meal and a bottle of Dom Perignon -- no more antacids, no more heartburn. Now other sufferers can try it, too: The Food and Drug Administration has approved the first non-drug treatments for acid reflux -- two different medical devices that send a tube down the throat to fix the actual cause of chronic heartburn instead of just suppressing painful stomach acid as medications do. The hourlong, outpatient procedures could significantly change the way heartburn is treated. One device is like a tiny sewing machine that puts a few stitches in the faulty valve causing heartburn, creating little pleated gathers to strengthen it. The other device, which Humphrey tried, zaps the faulty valve with radiofrequency energy, beams of heat. "Both rely on the fact that we think fixing the valve is a good long-term option rather than staying on medications for the rest of your life," explained Dr. Neil Stollman of San Francisco General Hospital, who tested the radiofrequency device, Curon Medical Inc.'s Stretta system. "I still practice medicine, and I know a lot of patients who are going to benefit," said Dr. Brian E. Harvey, the FDA senior medical officer who reviewed Stretta and competitor C.R. Bard Inc's Endoscopic Suturing System. The FDA approved both earlier this month. Some 14 million Americans suffer chronic heartburn, called "gastroesophageal reflux disease," or GERD. A valve where the esophagus meets the stomach, called the lower esophageal sphincter, relaxes at the wrong times, allowing acidic stomach contents to back up into the delicate esophagus -- a burning sensation. Spicy foods or overeating could give anyone occasional heartburn. But GERD causes serious, repeated heartburn. The stomach acid can actually corrode the esophagus, causing inflammation or scarring that makes it hard to swallow. One recent study found people with severe reflux are eight times more likely to develop esophageal cancer. Acid-blocking medicines -- such as Prilosec, the world's best-selling drug -- are highly effective at relieving symptoms. But some people don't like taking daily medicine. Others don't have insurance to cover the drugs. Curon cites one estimate that patients and insurers worldwide spend $14 billion a year on anti-heartburn drugs. Still other patients get no relief from drugs, or suffer side effects. When acid blockers fail, patients have tried Propulsid, a drug that pushes food through the stomach faster so there's less to reflux -- but one drug the manufacturer is about to quit selling because it also can cause lethal irregular heartbeats. Until now, the only non-drug alternative was surgery to tighten the valve. The two new systems don't require cutting patients: Curon's Stretta has electrodes on an endoscope threaded down the throat. The electrodes burn spots on the muscle controlling the faulty valve. A flexible scar-like tissue forms. Doctors aren't sure if that tightens the valve, or if the heat zaps overactive nerves that made the valve malfunction. Regardless, in a study of 47 patients followed for six months after the procedure, 70 percent had quit taking all heartburn medicines. Bard's suturing device, developed by a physician at the Royal College of London, is like a miniature sewing machine on an endoscope. Tiny stitches tighten the valve. In a study of 64 patients, 67 percent had either no heartburn or only occasional, brief episodes six months later. No one knows how long the effects will last -- patients may need retreatment every few years, FDA's Harvey cautioned. Both procedures can cause mild chest or stomach pain that day, but studies found no serious side effects. However, physicians do need training to perform the procedures, something both companies are beginning. The procedures will cost $2,000 to $2,500. "If it turns out that this works as well as we think, it's going to be very appealing to physicians and our patients," said Emory University's Dr. Patrick Waring, who tested Bard's suturing system. "I think there's a lot of people ... who don't want to have an operation, who don't want medicine on a daily basis but still want relief from their heartburn." 3. Are There Links Between Heartburn and Esophageal Cancer? Top PITTSBURGH, May 8 /PRNewswire/ -- James D. Luketich, MD, co-director of the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery, UPMC Health System -- will answer questions about heartburn, gastroesophageal reflux disease (GERD), esophageal cancer, and the minimally invasive surgeries to treat these problems. The discussion will be broadcast live over the Internet on Friday, May 12, from 11 a.m. to noon EDT. To listen, log onto http://www.videonewswire.com/UPMC/051200/ or the UPMC Health System web site at http://www.upmc.edu. To ask Dr. Luketich a question, telephone him during the Webcast at the toll-free number 888-244-7406, conference ID number 512. To ask questions by e-mail, use the e-mail address luketichchat@msx.upmc.edu. Any e-mailed questions not answered during the event will receive a reply within 48 hours of the scheduled start time of the Webcast. Today, 40 million Americans suffer from GERD, a condition in which the acid and bile of the stomach find their way into the esophagus. Many people with GERD dismiss its most common symptom of burning pain -- they assume it is chronic heartburn and try to treat the problem with over-the-counter antacids. This approach may have significant limitations. GERD can lead to damage to the esophagus and serious complications. Medical treatment for GERD can yield prompt relief of symptoms in many cases. If medical treatment fails, minimally invasive surgery may be an option -- an option pioneered by Dr. Luketich and his colleagues at the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery. Minimally invasive procedures for GERD and esophageal cancer include photodynamic therapy (PDT) and minimally invasive esophagectomy. In addition to co-directing the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery, Dr. Luketich is an assistant professor of surgery at the University of Pittsburgh School of Medicine, section head of Thoracic Surgery, and co-director of the Lung Cancer Center at the University of Pittsburgh Cancer Institute. Dr. Luketich has been the principal investigator and co-investigator on numerous research grants and has published more than 100 papers, abstracts, and book chapters related to thoracic oncology and GERD. He is frequently a guest lecturer at seminars throughout the world. To listen to the Webcast on May 12, the minimum requirements are RealPlayer software -- downloadable free from http://www.real.com/products/player/index.html -- and an Internet connection of 14.4Kbps. If you have problems listening to the Webcast, help will be available; send an e-mail to webmaster@vdat.com. After the Webcast on May 12, the transcript of the event will be available on the UPMC Health System web site at http://www.upmc.edu. The e-mail address for sending questions to Dr. Luketich will remain active until Sunday, May 14, 11 a.m. EDT. Contact: Heather Szafranski, UPMC Health System News Bureau, at 412-624-2607 or szafranskihl@msx.upmc.edu. SOURCE UPMC Health System 4. Heartburn -- Not Just an Adult Problem Top Television News Service/Medical Breakthroughs According to the American College of Gastroenterology, heartburn affects about 40 percent of adults on a monthly basis. A recent study indicates it's not just an adult problem. We'll tell you why it should be taken more seriously in children. Seven years ago, at the age of four, Bradley Pierce started having stomach problems. "I get these weird tastes in my mouth, and it just doesn't feel good," he says. He was diagnosed with gastroesophageal reflux disease or GERD. Unlike regular heartburn that comes and goes, GERD is a more chronic problem. Symptoms include frequent acid regurgitation, trouble swallowing, stomachaches and not eating well. A new study by Suzanne Nelson, M.D., found the condition often goes undiagnosed in children. "About 20 percent of children complain of weekly abdominal pain. So I think it's often difficult for a parent to distinguish just plain abdominal pain or stomachaches from gastroesophageal reflux," says Dr. Nelson, a pediatric gastroenterologist at Children's Hospital in Chicago, Illinois. Dr. Nelson says complaints of chest pains or heartburn-like symptoms on a weekly basis or more frequently could be a warning sign. Bradley's condition was recognized early. Now a low-fat diet and medication help. A relief for his mother, Debbie. "But I worry about what it's doing to the inside of him," she says. "You know that it's acid, and it's coming up, and acid burns." Bradley still has some troubles, but doctors say he may outgrow the condition. For now, he's happy to be able to eat without pain. If treatment starts early, complications can be avoided. Complications from GERD include an irritated esophagus and ulcerations in the esophagus. 5. Esophageal Cancer -- Is Heartburn to Blame? Top Television News Service/Medical Breakthroughs Some call it the American disease, because so many Americans have it. The American College of Gastroenterology estimates 40 percent of adults have heartburn at least once a month. While many use medications to relieve their symptoms, could they be ignoring something more serious? Medical studies show heartburn can lead to Barrett's esophagus, which can lead to esophageal cancer, but doctors disagree on the reasons why. The Fleming family is preparing for a big day. Reid and Providence's only daughter, Colette, is getting married. As father of the bride, Reid is doing his part. "I write the checks and keep my mouth shut. That's my role," he says with a smile. While he jokes now, it wasn't always that way. Reid says, "I guess I probably did think occasionally, would I ever see that day?"He was diagnosed with esophageal cancer in 1996. After chemotherapy and surgery, he beat the deadly disease -- a disease that began with something millions of Americans suffer from. "I never knew that that could lead to cancer," says Reid. That is heartburn, also called gastroesophageal reflux disease or GERD. A 1999 study in The New England Journal of Medicine found people who have severe heartburn are 43 times more likely to develop esophageal cancer. James Luketich, M.D., a thoracic surgeon at the University of Pittsburgh Medical Center in Pennsylvania, says, "The rate of rise is worrisome, and the association is worrisome." Dr. Luketich believes there is a connection between heartburn medications and esophageal cancer. "We just need to be a little more cautious in recommending chronic medical therapy that might be ongoing for our patients," he says. Gastroenterologist Joel Richter, M.D., disagrees. "I'm very, very comfortable that the medicines have nothing at all, 100 percent confident it has nothing to do with the rise of this cancer," says Dr. Richter, a gastroenterologist at the Cleveland Clinic Foundation in Ohio. He says while esophageal cancer only makes up one percent of cancers diagnosed, the increase is more than any other cancer. "The numbers are going straight up like a rocket," says Dr. Richter. However, he speculates that increase has more to do with a bacteria in the stomach or obesity than with medications. "As the American population has become more obese, we have more reflux, and therefore if you have more reflux, you can develop the Barrett's and the cancer," he says. While these doctors disagree on the cause, they do agree that heartburn cannot be ignored. Dr. Luketich says, "Anybody with heartburn on chronic medications should be seen by a specialist and consider endoscopy to see what their esophagus looks like." Dr. Richter says, "Simple test, you give them a little medicine to make you sleepy, the instrument is about the size of my little finger, takes about 15 minutes to do it." A test that can catch the cancer early and give patients a chance to survive. Reid says, "I've always wanted a German shepherd for years, years. I said if I get through this that will be the first thing we do is go out and buy the damn dog." And the second thing Reid did --- walk his daughter down the aisle. For more information about heartburn or GERD, UPMC Health System 3708 Fifth Ave., Suite 201 Pittsburgh, PA 15213 (412) 624-2607 [Clinician Reviews] Tell patients who complain of a very sore throat associated with postnasal drip to take a teaspoon of a liquid antacid before they go to sleep. Stress that they should not "wash it down" by drinking anything because the antacid is meant to coat the serosal layer. This coating works by neutralizing the acidic mucus as it drips down during sleep -- and also neutralizes the acid in the stomach that sometimes causes morning nausea during a sinus infection. The antacid also makes the throat less sore. Terry L. Lewis, PA-C Minneapolis, Minn 7. Healthology Launches Webcast Series with Jim Palmer as He Discusses His Battle Top New Video Webcast to Premiere Every Tuesday Night in May on GERDawareness.com NEW YORK, May 9 /PRNewswire/ -- Healthology, Inc. (http://healthology.com) announced today the launch of a new series of video webcasts featuring Baseball Hall of Fame Pitcher Jim Palmer, speaking out about his struggle with GERD, Gastrointestinal Esophageal Reflux Disease, which affects more than 21 million Americans. This four part webcast series which features leading gastroenterologists, will premiere live at 9 p.m. ET, May 9, 2000, and will continue every Tuesday night at the same time throughout the month of May. These webcasts can be viewed at http://gerdawareness.com, as well as on a number of health, fitness, sports, and news Web sites. The webcast series and a special live chat with Jim Palmer will take place on May 16, to raise the awareness of GERD, a serious condition often mistaken as ordinary heartburn. Many people suffer silently, blaming their symptoms on lifestyle or eating habits, which may not be the causes of the problem. GERD is associated with harsh stomach acid backing up into the esophagus, or food tube, that often causes a rising burning sensation behind the breastbone. It may be a chronic and potentially serious condition, and if left untreated, can lead to a more serious condition known as erosive esophagitis. Jim Palmer, former pitcher for the Baltimore Orioles, continues to pursue a very active professional career as a TV commentator, spokesperson, and author. The only American League Hall of Fame pitcher to win the Cy Young Award three times, Jim Palmer ended his 21-year career with the Baltimore Orioles holding numerous club records including most wins, completed games, strikeouts, walks, and shut-outs. "I can think of no one better than Jim Palmer to bring the messages home about this condition and to motivate people to reevaluate their symptoms. We hope that this program will encourage people who have been suffering from GERD to visit their physician and get appropriate care," says Steven Haimowitz, MD, President and CEO of Healthology. Viewers will have the unique opportunity to email questions to Jim Palmer and the participating gastroenterologists both before and during the premiere webcast. All four segments will also be available for on-demand viewing on GERDawareness.com (http://gerdawareness.com). About Healthology Founded in 1997, Healthology (http://healthology.com) is a New York based online health media company, formed and managed by physicians. Healthology was founded on the principle that credible, practical online health information of the highest quality can only be produced through direct involvement of health professionals with extensive clinical experience and expertise. Healthology is a leading producer of streaming health content, offering daily webcasts addressing some of today's most important health issues. These webcasts provide the Internet audience with direct access to the nation's top health experts from institutions around the country. Healthology distributes its original content through the sites of its distribution partners. For more information about Healthology, Inc., please visit http://healthology.com or call 212-431-5100. SOURCE Healthology, Inc. 8. Heartburn Defense in DUI Case Top 4/26/2000 The Associated Press GREELEY, Colo. (AP) - A judge wants to know more about heartburn so he can rule on an unusual defense being used by a co-owner of the Colorado Rockies baseball team in a drunken-driving case. Charlie Monfort was charged with driving under the influence last summer after a test showed his blood-alcohol level was .209 percent - more than twice the state's legal limit. Monfort contends he had heartburn that brought alcohol up from his stomach and skewed the results of the breath test. His attorneys hope to present expert witnesses to bolster the claim. Prosecutors say the heartburn defense is not generally accepted in the scientific community. Judge Lynn Karowsky on Tuesday demanded that both sides provide him published articles, reports or journals supporting or refuting the defense claim. He gave both sides until Friday to submit the articles and said he would rule on the defense Monday. 9. Eradication of H. pylori May Induce Reflux? Top April 25, 2000 WESTPORT (Reuters Health) - A team of Canadian researchers has published additional data supporting the theory that patients with Helicobacter pylori infection may be protected against gastroesophageal reflux disease (GERD) and that eradication of H. pylori may induce reflux. Dr. Carlo A. Fallone, of Victoria Hospital, in Montreal, Quebec, and a multicenter team followed 87 patients enrolled in a clinical trial of H. pylori eradication for 1 year. At the end of follow-up, 29% of the patients with successful eradication had GERD symptoms alone and 21% had endoscopic esophagitis alone, compared with 8% and 4% of patients with treatment failure, respectively. Factors such as smoking, weight gain and H. pylori genotype were unrelated to the development of reflux in this population, the research team reports in the April issue of The American Journal of Gastroenterology. "Our study provides another piece of evidence that supports the possible association between H. pylori and gastroesophageal reflux disease," Dr. Fallone and colleagues say. They note that H. pylori infection may protect against reflux via any one of several mechanisms, including inhibition of gastric acid secretion, acid neutralization by H. pylori's urease enzyme or alteration of gastroesophageal motility. The investigators note that their findings require confirmation by prospective studies. "Further studies will also need to address whether this increased incidence of reflux disease is present only in the short term or persists after several years posttreatment," they add. Am J Gastroenterol 2000;95:914-920. 10. People With Barrett's Esophagus at High Risk of Developing Esophageal Cancer Top More People With Barrett's Esophagus at High Risk of Developing Esophageal Cancer Than Previously Thought SEATTLE, April 18 /PRNewswire/ -- Significantly more people who suffer from Barrett's esophagus, a precancerous condition often associated with frequent heartburn, may be at high risk of developing esophageal cancer than previously thought, according to researchers at the Fred Hutchinson Cancer Research Center in Seattle. These findings, by Rebecca Rudolph, M.D., M.P.H., and colleagues, appear today in the Annals of Internal Medicine. An estimated 20 million Americans experience chronic heartburn that goes well beyond the occasional misery of having one too many chili dogs. About 2 million of these people have Barrett's esophagus, a premalignant condition of the esophagus, the tube that carries food from the mouth to the stomach. While the condition is most prevalent in middle-aged white men, the incidence of Barrett's esophagus is rising in women and African Americans. A physician may suspect that the condition is present if part of the inner lining of the esophagus is red rather than the usual light pink. This is determined through a procedure called endoscopy, in which a tubelike instrument is used to view the esophageal lining. However, a definite diagnosis cannot be made unless small samples of the red lining are biopsied, or removed and examined under a microscope, and found to have cellular changes typical of this disorder. People with "long-segment" Barrett's esophagus, in which the red lining is 3 cm or more in length, are about 40 times more likely than those in the general population to develop esophageal cancer. As a result, they typically undergo regular endoscopic screening and biopsies to ensure their condition has not progressed to cancer. Substantially more common, however, is "short-segment" Barrett's, in which the patch of affected tissue is no more than 3 cm long. Until recently, esophageal-cancer risk in people with shorter segments was largely unknown because such patients often were excluded from studies because their condition was more difficult to diagnose through endoscopy, and because researchers initially were uncertain whether short-segment Barrett's indeed was a cancer risk factor at all. Rudolph and colleagues at the Hutchinson Center and the University of Washington have found that, contrary to popular belief, the risk of esophageal cancer in patients with short-segment Barrett's is not substantially lower than in patients with longer patches of affected tissue. "The general feeling among gastroenterologists has been that people with short-segment Barrett's are probably at a much lower risk of developing esophageal cancer, and so it is possible that these people aren't being monitored as aggressively as they should," says Rudolph, the lead author of the study. Barrett's-related esophageal cancer strikes about 10,000 people a year, and for unknown reasons, the incidence is rising faster than that of any other cancer in the United States. Barrett's-related cancers tripled between 1976 and 1990, and more than doubled in the past decade. If not diagnosed early, the outlook is grim; more than 90 percent of patients with invasive esophageal adenocarcinoma die within five years of diagnosis. The study, the largest single-center trial of its kind, involved 309 Barrett's patients, primarily from the Puget Sound area, who were followed and closely monitored for four years. Currently, the recommended screening frequency for Barrett's esophagus ranges from once every three to six months to once every two to three years, depending on segment length and the degree of dysplasia, or cellular abnormality, detected under the microscope upon biopsy. "Until more data are available, the frequency of endoscopic surveillance should be determined without regard to the patient's segment length," says Rudolph, a clinical specialist in the Center's Public Health Sciences Division. "For now, people with short-segment Barrett's should be treated exactly the same as people with long-segment Barrett's." Senior authorship of the study was shared by Brian Reid, M.D., Ph.D., a member of the Center's Clinical, Human Biology and Public Health Sciences divisions and a professor of gastroenterology at UW; and Thomas Vaughan, M.D., M.P.H., a member of the Center's Public Health Sciences Division and a professor of epidemiology at the UW School of Public Health and Community Medicine. This research was supported by grants from the National Institutes of Health. CONTACT: Kristen Woodward of Fred Hutchinson Cancer Research Center, 206-667-5095 SOURCE Fred Hutchinson Cancer Research Center CO: Fred Hutchinson Cancer Research Center 11. Surgery Effective in Reflux-Associated Asthma Top WESTPORT, Feb 24 (Reuters Health) - Antireflux surgery may be more effective than other approaches in the treatment of asthma associated with gastroesophageal reflux disease (GERD), according to a review in the February issue of the Annals of Surgery. Dr. David J. Bowrey and colleagues from the University of Southern California, Los Angeles, observe that "despite the...documented association between asthma and GERD, controversy remains regarding the value of antireflux therapy." The researchers therefore examined studies of GERD and asthma. They found that in seven of nine identified trials, use of histamine-receptor antagonists led to a treatment-related improvement in asthma symptoms in half of the patients. However, only one study showed an improvement in respiratory function, that being an 8% increase in nocturnal peak expiratory flow. In three of six trials of proton pump inhibitors, there was an improvement in asthma symptoms, on average in 25% of the patients. In addition, half of the studies showed a significant improvement in pulmonary function, but when the effect was seen it occurred in fewer than 15% of the patients. Pooling of results from trials of antireflux surgery, including five studies of children and 14 studies of adults, showed that "almost 90% of children and 70% of adults had improvement in respiratory symptoms, with approximately one third experiencing improvements in objective measures of pulmonary function." The researchers note that only one medical study that used "what would currently be considered optimal antisecretory therapy" obtained success comparable to that consistently found with surgery. Although optimal medical therapy may be as effective as surgery, they conclude, "large-scale studies providing support for this assertion are lacking." Ann Surg 2000;231:161-172. Top |