Doug Brunk

SAN DIEGO — The capsule urea breath test is more accurate than conventional endoscopic testing and serology for diagnosing Helicobacter pylori infection, results of a study of 100 patients showed.

The test “may become a good alternative to endoscopy for the diagnosis of H. pylori infection,” researchers led by Dr. Nan-Jing Peng wrote in a poster presented at the annual meeting of the Society of Nuclear Medicine.

Dr. Peng, of the department of nuclear medicine at Kaohsiung (Taiwan) Veterans General Hospital, and her associates compared the capsule urea breath test (UBT) with conventional endoscopic testing in 100 patients. They collected breath samples before and 15 minutes after consumption of capsules containing

The sensitivity of capsule UBT was 96.4%; endoscopy, 88.3%; and serology, 87.3%. The specificity of capsule UBT was 100%; conventional testing, 100%; and serology, 88.9%.

The accuracy of capsule UBT was 98%, which was higher than that of endoscopic testing (93%) and serology (88%).

SAN DIEGO — The capsule urea breath test is more accurate than conventional endoscopic testing and serology for diagnosing Helicobacter pylori infection, results of a study of 100 patients showed.

The test “may become a good alternative to endoscopy for the diagnosis of H. pylori infection,” researchers led by Dr. Nan-Jing Peng wrote in a poster presented at the annual meeting of the Society of Nuclear Medicine.

Dr. Peng, of the department of nuclear medicine at Kaohsiung (Taiwan) Veterans General Hospital, and her associates compared the capsule urea breath test (UBT) with conventional endoscopic testing in 100 patients. They collected breath samples before and 15 minutes after consumption of capsules containing

The sensitivity of capsule UBT was 96.4%; endoscopy, 88.3%; and serology, 87.3%. The specificity of capsule UBT was 100%; conventional testing, 100%; and serology, 88.9%.

The accuracy of capsule UBT was 98%, which was higher than that of endoscopic testing (93%) and serology (88%).

SAN DIEGO — The capsule urea breath test is more accurate than conventional endoscopic testing and serology for diagnosing Helicobacter pylori infection, results of a study of 100 patients showed.

The test “may become a good alternative to endoscopy for the diagnosis of H. pylori infection,” researchers led by Dr. Nan-Jing Peng wrote in a poster presented at the annual meeting of the Society of Nuclear Medicine.

Dr. Peng, of the department of nuclear medicine at Kaohsiung (Taiwan) Veterans General Hospital, and her associates compared the capsule urea breath test (UBT) with conventional endoscopic testing in 100 patients. They collected breath samples before and 15 minutes after consumption of capsules containing

The sensitivity of capsule UBT was 96.4%; endoscopy, 88.3%; and serology, 87.3%. The specificity of capsule UBT was 100%; conventional testing, 100%; and serology, 88.9%.

The accuracy of capsule UBT was 98%, which was higher than that of endoscopic testing (93%) and serology (88%).

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

“Therefore, a lot of people are not getting treatments that are needed,” Dr. Alavi added.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners.

The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

Dr. Alavi described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

At top, images show abnormal intense FDG uptake in the left proximal tibia. At bottom left, MRI T2 image shows abnormal signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee shows no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

“Therefore, a lot of people are not getting treatments that are needed,” Dr. Alavi added.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners.

The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

Dr. Alavi described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

At top, images show abnormal intense FDG uptake in the left proximal tibia. At bottom left, MRI T2 image shows abnormal signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee shows no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

“Therefore, a lot of people are not getting treatments that are needed,” Dr. Alavi added.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners.

The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

Dr. Alavi described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

At top, images show abnormal intense FDG uptake in the left proximal tibia. At bottom left, MRI T2 image shows abnormal signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee shows no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

LOS ANGELES — In patients at moderate risk for an ulcer who were on low-dose daily aspirin therapy, concomitant treatment with esomeprazole 20 mg once daily was significantly more effective than was placebo for preventing endoscopically confirmed gastroduodenal ulcers, a randomized, multicenter trial showed.

“Esomeprazole prevents the development of upper GI lesions and also lessens the occurrence of GI symptoms, and is a safe and well-tolerated therapy,” Dr. Angel Lanas said at the annual Digestive Disease Week.

In a study conducted at 80 centers in 11 countries, 991 patients aged 60 and older were randomized to receive either low-dose aspirin once daily plus esomeprazole (Nexium) 20 mg once daily (493 patients) or low-dose aspirin once daily plus placebo (498 patients). Low-dose aspirin was defined as a dose of 75–325 mg/day. Half of the patients were male, with a mean age of 80 years.

Patients were excluded if they had heartburn or other upper gastrointestinal symptoms that required treatment, or if they had erosive esophagitis. Endoscopy was performed at baseline, 2 months, and 6 months. The main study outcome was the incidence of gastroduodenal ulcers over the 6-month period.

At the study's end, 8 patients in the esomeprazole arm (1.6%) developed a gastroduodenal ulcer, compared with 27 patients (5.4%) in the placebo arm, a difference that was statistically significant.

Dr. Lanas of the gastroenterology department at University Hospital Clinic in Zaragoza, Spain, said that these results corresponded to a relative risk reduction of 70% among patients in the esomeprazole arm, compared with their counterparts in the placebo arm. He also noted that the average ulcer sizes in the esomeprazole arm ranged from 5 mm to 8 mm.

When the researchers applied life-table estimates to the data, they determined that 1.8% of patients in the esomeprazole arm had a gastroduodenal ulcer at 6 months vs. 6.2% of patients in the placebo arm, a difference that also was statistically significant.

AstraZenecaPharmaceuticals LP, maker of Nexium, sponsored the trial. Dr. Lanas disclosed that he is a consultant for AstraZeneca and for Merck & Co.

LOS ANGELES — In patients at moderate risk for an ulcer who were on low-dose daily aspirin therapy, concomitant treatment with esomeprazole 20 mg once daily was significantly more effective than was placebo for preventing endoscopically confirmed gastroduodenal ulcers, a randomized, multicenter trial showed.

“Esomeprazole prevents the development of upper GI lesions and also lessens the occurrence of GI symptoms, and is a safe and well-tolerated therapy,” Dr. Angel Lanas said at the annual Digestive Disease Week.

In a study conducted at 80 centers in 11 countries, 991 patients aged 60 and older were randomized to receive either low-dose aspirin once daily plus esomeprazole (Nexium) 20 mg once daily (493 patients) or low-dose aspirin once daily plus placebo (498 patients). Low-dose aspirin was defined as a dose of 75–325 mg/day. Half of the patients were male, with a mean age of 80 years.

Patients were excluded if they had heartburn or other upper gastrointestinal symptoms that required treatment, or if they had erosive esophagitis. Endoscopy was performed at baseline, 2 months, and 6 months. The main study outcome was the incidence of gastroduodenal ulcers over the 6-month period.

At the study's end, 8 patients in the esomeprazole arm (1.6%) developed a gastroduodenal ulcer, compared with 27 patients (5.4%) in the placebo arm, a difference that was statistically significant.

Dr. Lanas of the gastroenterology department at University Hospital Clinic in Zaragoza, Spain, said that these results corresponded to a relative risk reduction of 70% among patients in the esomeprazole arm, compared with their counterparts in the placebo arm. He also noted that the average ulcer sizes in the esomeprazole arm ranged from 5 mm to 8 mm.

When the researchers applied life-table estimates to the data, they determined that 1.8% of patients in the esomeprazole arm had a gastroduodenal ulcer at 6 months vs. 6.2% of patients in the placebo arm, a difference that also was statistically significant.

AstraZenecaPharmaceuticals LP, maker of Nexium, sponsored the trial. Dr. Lanas disclosed that he is a consultant for AstraZeneca and for Merck & Co.

LOS ANGELES — In patients at moderate risk for an ulcer who were on low-dose daily aspirin therapy, concomitant treatment with esomeprazole 20 mg once daily was significantly more effective than was placebo for preventing endoscopically confirmed gastroduodenal ulcers, a randomized, multicenter trial showed.

“Esomeprazole prevents the development of upper GI lesions and also lessens the occurrence of GI symptoms, and is a safe and well-tolerated therapy,” Dr. Angel Lanas said at the annual Digestive Disease Week.

In a study conducted at 80 centers in 11 countries, 991 patients aged 60 and older were randomized to receive either low-dose aspirin once daily plus esomeprazole (Nexium) 20 mg once daily (493 patients) or low-dose aspirin once daily plus placebo (498 patients). Low-dose aspirin was defined as a dose of 75–325 mg/day. Half of the patients were male, with a mean age of 80 years.

Patients were excluded if they had heartburn or other upper gastrointestinal symptoms that required treatment, or if they had erosive esophagitis. Endoscopy was performed at baseline, 2 months, and 6 months. The main study outcome was the incidence of gastroduodenal ulcers over the 6-month period.

At the study's end, 8 patients in the esomeprazole arm (1.6%) developed a gastroduodenal ulcer, compared with 27 patients (5.4%) in the placebo arm, a difference that was statistically significant.

Dr. Lanas of the gastroenterology department at University Hospital Clinic in Zaragoza, Spain, said that these results corresponded to a relative risk reduction of 70% among patients in the esomeprazole arm, compared with their counterparts in the placebo arm. He also noted that the average ulcer sizes in the esomeprazole arm ranged from 5 mm to 8 mm.

When the researchers applied life-table estimates to the data, they determined that 1.8% of patients in the esomeprazole arm had a gastroduodenal ulcer at 6 months vs. 6.2% of patients in the placebo arm, a difference that also was statistically significant.

AstraZenecaPharmaceuticals LP, maker of Nexium, sponsored the trial. Dr. Lanas disclosed that he is a consultant for AstraZeneca and for Merck & Co.

LOS ANGELES — The sharp decline in the use of selective cyclo-oxygenase-2 inhibitors due to concerns about cardiovascular risks has created a “gastroprotection gap” among elderly arthritis patients who require NSAIDs, Dr. Gurkirpal Singh said at the annual Digestive Disease Week.

In California, the percentage of Medicaid participants with arthritis who did not receive concomitant gastroprotective agents with their NSAIDs rose from 14% in 2004 to 35% in 2005.

“An increasing number of elderly patients on NSAID therapy are once again left without gastroprotection,” said Dr. Singh of Stanford University, Palo Alto, Calif. “We are going back to where we were before the advent of COX-2 inhibitors. We believe it is likely that this trend of decreased gastroprotection will result in the increased incidence of GI complications. … We haven't shown that yet, but we are currently working on this data analysis,” said Dr. Singh, who is on the speakers' bureau for Pfizer Inc. He and his associates defined the gastroprotection gap as “the proportion of patients who are elderly and at risk for GI bleeds but are exposed to nonselective NSAID therapy without concomitant protection with either a [proton-pump inhibitor] or misoprostol. These are the highest-risk patients who will get GI complications if they are not properly managed.”

Using Medi-Cal data, they analyzed prescription patterns in Californians older than 65 years who had physician-diagnosed arthritis and who were treated with NSAIDs for at least 30 days. From 1995 to mid-2005, there were 5,194,765 prescriptions for NSAIDs, including 2,634,345 (50.7%) for selective COX-2 inhibitors.

Of the 2,560,420 prescriptions for nonselective NSAIDs, only 1,215,762 (47.5%) had concomitant use of a proton-pump inhibitor or misoprostol. “The increasing implementation of gastroprotection strategies over the past several years reached a peak in 2004 when the percentage of patients not receiving gastroprotection decreased to 14% from 91% in 1995. However, this gap more than doubled to 35% in 2005,” they said.

LOS ANGELES — The sharp decline in the use of selective cyclo-oxygenase-2 inhibitors due to concerns about cardiovascular risks has created a “gastroprotection gap” among elderly arthritis patients who require NSAIDs, Dr. Gurkirpal Singh said at the annual Digestive Disease Week.

In California, the percentage of Medicaid participants with arthritis who did not receive concomitant gastroprotective agents with their NSAIDs rose from 14% in 2004 to 35% in 2005.

“An increasing number of elderly patients on NSAID therapy are once again left without gastroprotection,” said Dr. Singh of Stanford University, Palo Alto, Calif. “We are going back to where we were before the advent of COX-2 inhibitors. We believe it is likely that this trend of decreased gastroprotection will result in the increased incidence of GI complications. … We haven't shown that yet, but we are currently working on this data analysis,” said Dr. Singh, who is on the speakers' bureau for Pfizer Inc. He and his associates defined the gastroprotection gap as “the proportion of patients who are elderly and at risk for GI bleeds but are exposed to nonselective NSAID therapy without concomitant protection with either a [proton-pump inhibitor] or misoprostol. These are the highest-risk patients who will get GI complications if they are not properly managed.”

Using Medi-Cal data, they analyzed prescription patterns in Californians older than 65 years who had physician-diagnosed arthritis and who were treated with NSAIDs for at least 30 days. From 1995 to mid-2005, there were 5,194,765 prescriptions for NSAIDs, including 2,634,345 (50.7%) for selective COX-2 inhibitors.

Of the 2,560,420 prescriptions for nonselective NSAIDs, only 1,215,762 (47.5%) had concomitant use of a proton-pump inhibitor or misoprostol. “The increasing implementation of gastroprotection strategies over the past several years reached a peak in 2004 when the percentage of patients not receiving gastroprotection decreased to 14% from 91% in 1995. However, this gap more than doubled to 35% in 2005,” they said.

LOS ANGELES — The sharp decline in the use of selective cyclo-oxygenase-2 inhibitors due to concerns about cardiovascular risks has created a “gastroprotection gap” among elderly arthritis patients who require NSAIDs, Dr. Gurkirpal Singh said at the annual Digestive Disease Week.

In California, the percentage of Medicaid participants with arthritis who did not receive concomitant gastroprotective agents with their NSAIDs rose from 14% in 2004 to 35% in 2005.

“An increasing number of elderly patients on NSAID therapy are once again left without gastroprotection,” said Dr. Singh of Stanford University, Palo Alto, Calif. “We are going back to where we were before the advent of COX-2 inhibitors. We believe it is likely that this trend of decreased gastroprotection will result in the increased incidence of GI complications. … We haven't shown that yet, but we are currently working on this data analysis,” said Dr. Singh, who is on the speakers' bureau for Pfizer Inc. He and his associates defined the gastroprotection gap as “the proportion of patients who are elderly and at risk for GI bleeds but are exposed to nonselective NSAID therapy without concomitant protection with either a [proton-pump inhibitor] or misoprostol. These are the highest-risk patients who will get GI complications if they are not properly managed.”

Using Medi-Cal data, they analyzed prescription patterns in Californians older than 65 years who had physician-diagnosed arthritis and who were treated with NSAIDs for at least 30 days. From 1995 to mid-2005, there were 5,194,765 prescriptions for NSAIDs, including 2,634,345 (50.7%) for selective COX-2 inhibitors.

Of the 2,560,420 prescriptions for nonselective NSAIDs, only 1,215,762 (47.5%) had concomitant use of a proton-pump inhibitor or misoprostol. “The increasing implementation of gastroprotection strategies over the past several years reached a peak in 2004 when the percentage of patients not receiving gastroprotection decreased to 14% from 91% in 1995. However, this gap more than doubled to 35% in 2005,” they said.

LOS ANGELES — Between 1992 and 2002, only 70% of patients who underwent colorectal cancer resection received recommended surveillance at 3 years, results from a large analysis showed.

The surveillance rate at 1 year was much lower—26%—but that figure “can be deceiving because we looked specifically at [surveillance] 12 months post procedure. So if somebody got screened at 15 months, we're not necessarily going to pick that up,” lead study author Dr. Harry L. Reynolds said in an interview during a poster session at the annual Digestive Disease Week.

A more realistic number to look at would be the 3-year mark, he said. But even at 3 years, “we're not where we need to be in terms of screening or surveying our postop colectomy/proctectomy patients,” said Dr. Reynolds of the colorectal surgery division at University Hospitals of Cleveland.

He and his associates used a linked Surveillance Epidemiology and End Results Medicare database to identify patients with colorectal carcinoma who underwent colectomy and/or proctectomy between 1992 and 2002. Patients included in the analysis were age 65 or older, were not in an HMO, were enrolled in Medicare Part B, and underwent surgical resection for a stage I-III colorectal cancer.

The mean age of the patients was 77 years. Most (75%) had undergone surgery for colon cancer, while 25% had undergone surgery for rectal cancer. Dr. Reynolds and his associates reported that 62,882 patients survived 1 year after surgical resection and 35,784 survived through 3 years.

Fewer numbers of African Americans and Hispanics (63% and 66%, respectively) received surveillance at 3 years, compared with whites and Asians (71% and 70%, respectively). The differences were statistically significant “but the actual variations aren't huge,” Dr. Reynolds said. Reasons for the differences are not known, he added, but “there may be some regional differences in access to care, [and] there may be some economic issues.” Variation in the surveillance rates was also seen among the 13 different geographic regions used in the analysis, ranging from 23% to 33% at 1 year and 67% to 76% at 3 years.

The American Cancer Society and the National Cancer Institute supported the study.

LOS ANGELES — Between 1992 and 2002, only 70% of patients who underwent colorectal cancer resection received recommended surveillance at 3 years, results from a large analysis showed.

The surveillance rate at 1 year was much lower—26%—but that figure “can be deceiving because we looked specifically at [surveillance] 12 months post procedure. So if somebody got screened at 15 months, we're not necessarily going to pick that up,” lead study author Dr. Harry L. Reynolds said in an interview during a poster session at the annual Digestive Disease Week.

A more realistic number to look at would be the 3-year mark, he said. But even at 3 years, “we're not where we need to be in terms of screening or surveying our postop colectomy/proctectomy patients,” said Dr. Reynolds of the colorectal surgery division at University Hospitals of Cleveland.

He and his associates used a linked Surveillance Epidemiology and End Results Medicare database to identify patients with colorectal carcinoma who underwent colectomy and/or proctectomy between 1992 and 2002. Patients included in the analysis were age 65 or older, were not in an HMO, were enrolled in Medicare Part B, and underwent surgical resection for a stage I-III colorectal cancer.

The mean age of the patients was 77 years. Most (75%) had undergone surgery for colon cancer, while 25% had undergone surgery for rectal cancer. Dr. Reynolds and his associates reported that 62,882 patients survived 1 year after surgical resection and 35,784 survived through 3 years.

Fewer numbers of African Americans and Hispanics (63% and 66%, respectively) received surveillance at 3 years, compared with whites and Asians (71% and 70%, respectively). The differences were statistically significant “but the actual variations aren't huge,” Dr. Reynolds said. Reasons for the differences are not known, he added, but “there may be some regional differences in access to care, [and] there may be some economic issues.” Variation in the surveillance rates was also seen among the 13 different geographic regions used in the analysis, ranging from 23% to 33% at 1 year and 67% to 76% at 3 years.

The American Cancer Society and the National Cancer Institute supported the study.

LOS ANGELES — Between 1992 and 2002, only 70% of patients who underwent colorectal cancer resection received recommended surveillance at 3 years, results from a large analysis showed.

The surveillance rate at 1 year was much lower—26%—but that figure “can be deceiving because we looked specifically at [surveillance] 12 months post procedure. So if somebody got screened at 15 months, we're not necessarily going to pick that up,” lead study author Dr. Harry L. Reynolds said in an interview during a poster session at the annual Digestive Disease Week.

A more realistic number to look at would be the 3-year mark, he said. But even at 3 years, “we're not where we need to be in terms of screening or surveying our postop colectomy/proctectomy patients,” said Dr. Reynolds of the colorectal surgery division at University Hospitals of Cleveland.

He and his associates used a linked Surveillance Epidemiology and End Results Medicare database to identify patients with colorectal carcinoma who underwent colectomy and/or proctectomy between 1992 and 2002. Patients included in the analysis were age 65 or older, were not in an HMO, were enrolled in Medicare Part B, and underwent surgical resection for a stage I-III colorectal cancer.

The mean age of the patients was 77 years. Most (75%) had undergone surgery for colon cancer, while 25% had undergone surgery for rectal cancer. Dr. Reynolds and his associates reported that 62,882 patients survived 1 year after surgical resection and 35,784 survived through 3 years.

Fewer numbers of African Americans and Hispanics (63% and 66%, respectively) received surveillance at 3 years, compared with whites and Asians (71% and 70%, respectively). The differences were statistically significant “but the actual variations aren't huge,” Dr. Reynolds said. Reasons for the differences are not known, he added, but “there may be some regional differences in access to care, [and] there may be some economic issues.” Variation in the surveillance rates was also seen among the 13 different geographic regions used in the analysis, ranging from 23% to 33% at 1 year and 67% to 76% at 3 years.

The American Cancer Society and the National Cancer Institute supported the study.

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific. “Therefore, a lot of people are not getting treatments that are needed.”

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to do a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin.

“One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

Axial, coronal, and sagittal FDG-PET images (top, left to right) contrast with sagittal MRI image (bottom left) and plain radiograph (bottom right), lateral view, of a left knee without detectable bony abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific. “Therefore, a lot of people are not getting treatments that are needed.”

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to do a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin.

“One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

Axial, coronal, and sagittal FDG-PET images (top, left to right) contrast with sagittal MRI image (bottom left) and plain radiograph (bottom right), lateral view, of a left knee without detectable bony abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific. “Therefore, a lot of people are not getting treatments that are needed.”

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Among the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to do a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis and ulcerative colitis.

He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin.

“One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

Axial, coronal, and sagittal FDG-PET images (top, left to right) contrast with sagittal MRI image (bottom left) and plain radiograph (bottom right), lateral view, of a left knee without detectable bony abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Of the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis. He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

The lead author of the study was Dr. Wichana Chamroonrat, a research fellow at the Hospital of the University of Pennsylvania.

At top, images show abnormal intense FDG uptake in the left proximal tibia consistent with osteomyelitis. At bottom left, MRI T2 image shows abnormal nonspecific high signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee has no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Of the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis. He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

The lead author of the study was Dr. Wichana Chamroonrat, a research fellow at the Hospital of the University of Pennsylvania.

At top, images show abnormal intense FDG uptake in the left proximal tibia consistent with osteomyelitis. At bottom left, MRI T2 image shows abnormal nonspecific high signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee has no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

SAN DIEGO — Fluorodeoxyglucose PET scan results reflected a diagnosis of chronic osteomyelitis with 93% accuracy in a single-center study.

“Chronic osteomyelitis is a big area of morbidity for our society,” Dr. Abass Alavi said in an interview at the annual meeting of the Society of Nuclear Medicine. “A test that can accurately detect and monitor these patients is needed” because current modalities, including structural imaging and combined nuclear medicine techniques, are either insensitive or not specific.

He and his associates at the University of Pennsylvania Medical Center, Philadelphia, studied 57 patients with suspected chronic osteomyelitis who underwent fluorodeoxyglucose (FDG) PET imaging in full-ring PET scanners. The researchers then compared the images with the final diagnosis based on surgical findings, microbiology, and clinical follow-up.

Dr. Alavi, chief of the division of nuclear medicine at the medical center, reported that FDG-PET correctly diagnosed the presence or absence of chronic osteomyelitis in 53 of the 57 patients.

Of the 57 patients, 27 had chronic osteomyelitis and 30 were free of bone infection. The procedure correctly identified 26 of the 27 patients with chronic osteomyelitis, but there were false positives in 3 patients.

FDG-PET had a sensitivity of 96.3%, a specificity of 90%, and an accuracy of 93%. The positive predictive value was 90% and the negative predictive value was 96.4%, he reported.

The potential cost advantages of FDG-PET for diagnosing osteomyelitis “are clearly there, because we have a test that has an accuracy of better than 90%,” said Dr. Alavi, who was the first clinician to apply FDG-PET technology in humans. “Before I started this technique, we had to do white cell imaging, which costs about $2,000. Then we had to a bone scan [and] a bone marrow scan. A patient had to do these over 2 days. The cost of FDG-PET should not be more than $1,500.”

He predicted that FDG-PET will become the diagnostic tool of choice for other common inflammatory diseases, such as rheumatoid arthritis. He described a recent case in which FDG-PET was used in a patient who was in and out of the hospital for 6 weeks with a fever of unknown origin. “One single FDG-PET showed an infection in the mediastinum,” he said. “It looks like FDG-PET is going to be the way to go whenever there's infection.”

The lead author of the study was Dr. Wichana Chamroonrat, a research fellow at the Hospital of the University of Pennsylvania.

At top, images show abnormal intense FDG uptake in the left proximal tibia consistent with osteomyelitis. At bottom left, MRI T2 image shows abnormal nonspecific high signal intensity in the proximal left tibia. At bottom right, plain radiograph of the left knee has no detectable abnormality. Courtesy Dr. Wichana Chamroonrat and Dr. Abass Alavi

PALM SPRINGS, CALIF. — Routine vaginal cytology as a surveillance test for endometrial cancer recurrence is costly, inefficient, and benefits less than 1% of patients, Dr. Robert E. Bristow and his associates reported in a poster session at the annual meeting of the Society of Gynecologic Oncologists.

“The rationale for intensive surveillance of endometrial cancer patients in clinical remission is based on the premise that early detection of an asymptomatic recurrence will translate into improved survival outcomes,” the researchers of the Kelly Gynecologic Oncology Service at Johns Hopkins Medical Institutions, Baltimore, wrote in their poster.

Although this premise is widely held, studies have not demonstrated a significant survival advantage for patients whose recurrences are detected during routine follow-up, compared with symptomatic patients presenting for interval evaluation, they noted.

The researchers reviewed the medical records of 377 endometrial cancer patients who were treated at the Kelly Gynecologic Oncology Service between July of 1997 and June of 2005. They calculated the total number of Pap tests performed during surveillance or until the time of recurrence. Costs were based on 2005 Pap test costs adjusted retroactively via the consumer price index.

Of the 337 patients, most (63.7%) had stage I cancer; 10.1% had stage II; 18.8% had stage III, and 7.4% had stage IV. The median follow-up was 30 months. A median of five Pap samples per patient were collected during the study period, for a total of 2,134 Pap tests.

The researchers found that endometrial cancer recurred in 61 patients (16.2%), while 11 (2.9%) had an isolated vaginal recurrence. Of the isolated recurrences, seven were detected by physical examination alone, two were detected by interval CT, and two asymptomatic vaginal recurrences were detected by routine vaginal cytology, for a rate of 0.5%.

“Detection of each asymptomatic vaginal recurrence required 1,067 Pap tests, generating $44,049 in cumulative charges,” the researchers noted in their poster.

They concluded that “elimination or reduction in the use of vaginal cytology for this purpose offers an opportunity for significant cost savings in gynecologic oncology health care.”

Dr. Bristow directs the Kelly Gynecologic Oncology Service.

PALM SPRINGS, CALIF. — Routine vaginal cytology as a surveillance test for endometrial cancer recurrence is costly, inefficient, and benefits less than 1% of patients, Dr. Robert E. Bristow and his associates reported in a poster session at the annual meeting of the Society of Gynecologic Oncologists.

“The rationale for intensive surveillance of endometrial cancer patients in clinical remission is based on the premise that early detection of an asymptomatic recurrence will translate into improved survival outcomes,” the researchers of the Kelly Gynecologic Oncology Service at Johns Hopkins Medical Institutions, Baltimore, wrote in their poster.

Although this premise is widely held, studies have not demonstrated a significant survival advantage for patients whose recurrences are detected during routine follow-up, compared with symptomatic patients presenting for interval evaluation, they noted.

The researchers reviewed the medical records of 377 endometrial cancer patients who were treated at the Kelly Gynecologic Oncology Service between July of 1997 and June of 2005. They calculated the total number of Pap tests performed during surveillance or until the time of recurrence. Costs were based on 2005 Pap test costs adjusted retroactively via the consumer price index.

Of the 337 patients, most (63.7%) had stage I cancer; 10.1% had stage II; 18.8% had stage III, and 7.4% had stage IV. The median follow-up was 30 months. A median of five Pap samples per patient were collected during the study period, for a total of 2,134 Pap tests.

The researchers found that endometrial cancer recurred in 61 patients (16.2%), while 11 (2.9%) had an isolated vaginal recurrence. Of the isolated recurrences, seven were detected by physical examination alone, two were detected by interval CT, and two asymptomatic vaginal recurrences were detected by routine vaginal cytology, for a rate of 0.5%.

“Detection of each asymptomatic vaginal recurrence required 1,067 Pap tests, generating $44,049 in cumulative charges,” the researchers noted in their poster.

They concluded that “elimination or reduction in the use of vaginal cytology for this purpose offers an opportunity for significant cost savings in gynecologic oncology health care.”

Dr. Bristow directs the Kelly Gynecologic Oncology Service.

PALM SPRINGS, CALIF. — Routine vaginal cytology as a surveillance test for endometrial cancer recurrence is costly, inefficient, and benefits less than 1% of patients, Dr. Robert E. Bristow and his associates reported in a poster session at the annual meeting of the Society of Gynecologic Oncologists.

“The rationale for intensive surveillance of endometrial cancer patients in clinical remission is based on the premise that early detection of an asymptomatic recurrence will translate into improved survival outcomes,” the researchers of the Kelly Gynecologic Oncology Service at Johns Hopkins Medical Institutions, Baltimore, wrote in their poster.

Although this premise is widely held, studies have not demonstrated a significant survival advantage for patients whose recurrences are detected during routine follow-up, compared with symptomatic patients presenting for interval evaluation, they noted.

The researchers reviewed the medical records of 377 endometrial cancer patients who were treated at the Kelly Gynecologic Oncology Service between July of 1997 and June of 2005. They calculated the total number of Pap tests performed during surveillance or until the time of recurrence. Costs were based on 2005 Pap test costs adjusted retroactively via the consumer price index.

Of the 337 patients, most (63.7%) had stage I cancer; 10.1% had stage II; 18.8% had stage III, and 7.4% had stage IV. The median follow-up was 30 months. A median of five Pap samples per patient were collected during the study period, for a total of 2,134 Pap tests.

The researchers found that endometrial cancer recurred in 61 patients (16.2%), while 11 (2.9%) had an isolated vaginal recurrence. Of the isolated recurrences, seven were detected by physical examination alone, two were detected by interval CT, and two asymptomatic vaginal recurrences were detected by routine vaginal cytology, for a rate of 0.5%.

“Detection of each asymptomatic vaginal recurrence required 1,067 Pap tests, generating $44,049 in cumulative charges,” the researchers noted in their poster.

They concluded that “elimination or reduction in the use of vaginal cytology for this purpose offers an opportunity for significant cost savings in gynecologic oncology health care.”

Dr. Bristow directs the Kelly Gynecologic Oncology Service.

LOS ANGELES — The rate of small-bowel findings on capsule endoscopy was the same whether or not patients were on anticoagulation or antiplatelet therapy, results from a single-center study showed.

The findings are important because many patients who undergo capsule endoscopy are on anticoagulation and/or antiplatelet agents, and “the findings and yield in these patients compared to others is not well documented,” a team of researchers from the University of Illinois Medical Center at Chicago wrote in a poster presented at the annual Digestive Disease Week.

They studied 196 patients referred to the medical center for capsule endoscopy between April 2004 and March 2006. Of the 196 patients, 26 (13%) had gastric bleeding as shown on capsule endoscopy. Of these 26 patients, 17 (65%) had the following gastric lesions: 8 had gastropathy, 7 had erosions, 1 had an ulcer, and 1 had an arteriovenous malformation (AVM).

In addition, 18 patients (69%) had either no small-bowel lesion or a single, small, nonbleeding AVM. This suggests that the gastric site was the primary cause of the bleeding.

No significant difference was seen in the prevalence of gastric blood in patients using antiplatelet or anticoagulation agents, compared with those who were not using these drugs (11% vs. 15%, respectively). Also, the prevalence of small-bowel lesions was similar in these two groups, regardless of the combination of agents used.

The researchers did note a significantly higher frequency of gastric bleeding in patients who underwent capsule endoscopy between April 2004 and March 2006, compared with those who underwent the procedure between April 2002 and March 2004 (20% vs. 5%, respectively).

LOS ANGELES — The rate of small-bowel findings on capsule endoscopy was the same whether or not patients were on anticoagulation or antiplatelet therapy, results from a single-center study showed.

The findings are important because many patients who undergo capsule endoscopy are on anticoagulation and/or antiplatelet agents, and “the findings and yield in these patients compared to others is not well documented,” a team of researchers from the University of Illinois Medical Center at Chicago wrote in a poster presented at the annual Digestive Disease Week.

They studied 196 patients referred to the medical center for capsule endoscopy between April 2004 and March 2006. Of the 196 patients, 26 (13%) had gastric bleeding as shown on capsule endoscopy. Of these 26 patients, 17 (65%) had the following gastric lesions: 8 had gastropathy, 7 had erosions, 1 had an ulcer, and 1 had an arteriovenous malformation (AVM).

In addition, 18 patients (69%) had either no small-bowel lesion or a single, small, nonbleeding AVM. This suggests that the gastric site was the primary cause of the bleeding.

No significant difference was seen in the prevalence of gastric blood in patients using antiplatelet or anticoagulation agents, compared with those who were not using these drugs (11% vs. 15%, respectively). Also, the prevalence of small-bowel lesions was similar in these two groups, regardless of the combination of agents used.

The researchers did note a significantly higher frequency of gastric bleeding in patients who underwent capsule endoscopy between April 2004 and March 2006, compared with those who underwent the procedure between April 2002 and March 2004 (20% vs. 5%, respectively).

LOS ANGELES — The rate of small-bowel findings on capsule endoscopy was the same whether or not patients were on anticoagulation or antiplatelet therapy, results from a single-center study showed.

The findings are important because many patients who undergo capsule endoscopy are on anticoagulation and/or antiplatelet agents, and “the findings and yield in these patients compared to others is not well documented,” a team of researchers from the University of Illinois Medical Center at Chicago wrote in a poster presented at the annual Digestive Disease Week.

They studied 196 patients referred to the medical center for capsule endoscopy between April 2004 and March 2006. Of the 196 patients, 26 (13%) had gastric bleeding as shown on capsule endoscopy. Of these 26 patients, 17 (65%) had the following gastric lesions: 8 had gastropathy, 7 had erosions, 1 had an ulcer, and 1 had an arteriovenous malformation (AVM).

In addition, 18 patients (69%) had either no small-bowel lesion or a single, small, nonbleeding AVM. This suggests that the gastric site was the primary cause of the bleeding.

No significant difference was seen in the prevalence of gastric blood in patients using antiplatelet or anticoagulation agents, compared with those who were not using these drugs (11% vs. 15%, respectively). Also, the prevalence of small-bowel lesions was similar in these two groups, regardless of the combination of agents used.

The researchers did note a significantly higher frequency of gastric bleeding in patients who underwent capsule endoscopy between April 2004 and March 2006, compared with those who underwent the procedure between April 2002 and March 2004 (20% vs. 5%, respectively).

SAN DIEGO – Parkinson's disease patients who have undergone subthalamic nucleus deep brain stimulation have higher rates of completed and attempted suicide than do others with the disease, Dr. Valerie Voon reported at the annual meeting of the American Academy of Neurology.

The rate of completed suicides following deep brain stimulation (DBS) for Parkinson's disease was found to be 0.4% and the rate of attempted suicides 0.9% in the largest multicenter study of its kind, said Dr. Voon, a psychiatrist with the National Institute of Neurological Disorders and Stroke, Bethesda, Md.

The researchers noted that the suicide rate among Parkinson's patients within the first year after undergoing subthalamic DBS was 11- 37 times higher than the suicide rate in the general population, based on World Health Organization data. The rate was 4–13 times higher in postoperative year 2 and dropped to baseline in postoperative years 3 and 4.

The rate of suicide is 10 times lower in Parkinson's disease patients who have not undergone DBS, when compared with the World Health Organization's general population data, she said.

Dr. Voon and her associates surveyed 75 movement disorders centers in North America and Europe to locate Parkinson's patients who underwent subthalamic nucleus DBS and subsequently attempted or completed suicide. Participating centers had published medical literature on DBS and had operated on more than 100 DBS patients.

Of the 75 centers, 55 responded and provided data on 5,255 Parkinson's disease patients who underwent subthalamic nucleus DBS. After DBS, 22 of the patients completed suicide (0.4%) between 1 month and 4 years.

The researchers also found that 47 patients attempted suicide (0.9%). The attempted suicides took place between approximately 1 week and 8 years following DBS.

Preoperatively, three completed and three attempted suicides were reported. These patients were on DBS wait lists. “The highest risk period is in the first 10 months to 1.5 years” after DBS, she said. “At 10 months time, 50% of the events had already occurred. At 17 months, 75% of the events had occurred.”

Logistic regression analysis based on a study of 70 controls showed that these factors were independently associated with an increased risk of suicide: past history of impulse control disorder or substance abuse, being single, or having postoperative depression.

Suicide is potentially preventable, so patients and families should be aware of this risk, Dr. Voon said.

SAN DIEGO – Parkinson's disease patients who have undergone subthalamic nucleus deep brain stimulation have higher rates of completed and attempted suicide than do others with the disease, Dr. Valerie Voon reported at the annual meeting of the American Academy of Neurology.

The rate of completed suicides following deep brain stimulation (DBS) for Parkinson's disease was found to be 0.4% and the rate of attempted suicides 0.9% in the largest multicenter study of its kind, said Dr. Voon, a psychiatrist with the National Institute of Neurological Disorders and Stroke, Bethesda, Md.

The researchers noted that the suicide rate among Parkinson's patients within the first year after undergoing subthalamic DBS was 11- 37 times higher than the suicide rate in the general population, based on World Health Organization data. The rate was 4–13 times higher in postoperative year 2 and dropped to baseline in postoperative years 3 and 4.

The rate of suicide is 10 times lower in Parkinson's disease patients who have not undergone DBS, when compared with the World Health Organization's general population data, she said.

Dr. Voon and her associates surveyed 75 movement disorders centers in North America and Europe to locate Parkinson's patients who underwent subthalamic nucleus DBS and subsequently attempted or completed suicide. Participating centers had published medical literature on DBS and had operated on more than 100 DBS patients.

Of the 75 centers, 55 responded and provided data on 5,255 Parkinson's disease patients who underwent subthalamic nucleus DBS. After DBS, 22 of the patients completed suicide (0.4%) between 1 month and 4 years.

The researchers also found that 47 patients attempted suicide (0.9%). The attempted suicides took place between approximately 1 week and 8 years following DBS.

Preoperatively, three completed and three attempted suicides were reported. These patients were on DBS wait lists. “The highest risk period is in the first 10 months to 1.5 years” after DBS, she said. “At 10 months time, 50% of the events had already occurred. At 17 months, 75% of the events had occurred.”

Logistic regression analysis based on a study of 70 controls showed that these factors were independently associated with an increased risk of suicide: past history of impulse control disorder or substance abuse, being single, or having postoperative depression.

Suicide is potentially preventable, so patients and families should be aware of this risk, Dr. Voon said.

SAN DIEGO – Parkinson's disease patients who have undergone subthalamic nucleus deep brain stimulation have higher rates of completed and attempted suicide than do others with the disease, Dr. Valerie Voon reported at the annual meeting of the American Academy of Neurology.

The rate of completed suicides following deep brain stimulation (DBS) for Parkinson's disease was found to be 0.4% and the rate of attempted suicides 0.9% in the largest multicenter study of its kind, said Dr. Voon, a psychiatrist with the National Institute of Neurological Disorders and Stroke, Bethesda, Md.

The researchers noted that the suicide rate among Parkinson's patients within the first year after undergoing subthalamic DBS was 11- 37 times higher than the suicide rate in the general population, based on World Health Organization data. The rate was 4–13 times higher in postoperative year 2 and dropped to baseline in postoperative years 3 and 4.

The rate of suicide is 10 times lower in Parkinson's disease patients who have not undergone DBS, when compared with the World Health Organization's general population data, she said.

Dr. Voon and her associates surveyed 75 movement disorders centers in North America and Europe to locate Parkinson's patients who underwent subthalamic nucleus DBS and subsequently attempted or completed suicide. Participating centers had published medical literature on DBS and had operated on more than 100 DBS patients.

Of the 75 centers, 55 responded and provided data on 5,255 Parkinson's disease patients who underwent subthalamic nucleus DBS. After DBS, 22 of the patients completed suicide (0.4%) between 1 month and 4 years.

The researchers also found that 47 patients attempted suicide (0.9%). The attempted suicides took place between approximately 1 week and 8 years following DBS.

Preoperatively, three completed and three attempted suicides were reported. These patients were on DBS wait lists. “The highest risk period is in the first 10 months to 1.5 years” after DBS, she said. “At 10 months time, 50% of the events had already occurred. At 17 months, 75% of the events had occurred.”

Logistic regression analysis based on a study of 70 controls showed that these factors were independently associated with an increased risk of suicide: past history of impulse control disorder or substance abuse, being single, or having postoperative depression.

Suicide is potentially preventable, so patients and families should be aware of this risk, Dr. Voon said.