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Waqar A Qureshi

Publications and source records attributed to Waqar A Qureshi.

17 recordsLinked to original sources
PubMed2006

Esophageal dilation.

Explore the source record for details and available documents.

Deglutition Disorders↗
PubMed2006

Approach to the patient who has suspected acute bacterial cholangitis.

Table 4 gives summary recommendations concerning the major decisions that are related to the diagnosis and management of suspected acute bacterial cholangitis. All of these decisions have to be made within the context of disease severity, degree of diagnostic uncertainty, and associated comorbidity. Although these recommendations are based on evidence, there are few randomized controlled trials. Antibiotics that cover gram negatives and anaerobes, along with fluid and electrolyte correction, frequently stabilize the patient. Imaging studies frequently confirm the diagnosis and identify the location and etiology of the obstruction. With or without a definitive diagnosis, ERCP or PTC can be done emergently to establish drainage to control sepsis. Although endoscopic and percutaneous drainage techniques have lower morbidity and mortality than does emergent surgical decompression, optimal management of this potentially life-threatening condition requires close cooperation between the gastroenterologist, radiologist, and surgeon.

Acute Disease↗
PubMed2005

ASGE guideline: the management of low-molecular-weight heparin and nonaspirin antiplatelet agents for endoscopic procedures.

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.

Clinical Trials as Topic↗
PubMed2005

ASGE guideline: complications of EUS.

This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of experts. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement and revision needed to clarify aspects of this statement and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to the recommendations.

Autonomic Nerve Block↗
PubMed2005

Visible small-intestinal mucosal injury in chronic NSAID users.

BACKGROUND & AIMS: Patients who regularly take nonsteroidal anti-inflammatory drugs (NSAIDs) have an increased risk for small-intestinal mucosal ulceration and bleeding, which may present as anemia of undetermined gastrointestinal origin or protein loss. The prevalence and severity of small-intestinal lesions remains unclear. Our aim was to assess the frequency of NSAID-induced small-bowel injury among chronic NSAID users. METHODS: Ambulatory patients with various types of arthritides who took NSAIDs daily (>3 mo duration) or took either acetaminophen alone or nothing were enrolled in the study. All patients fasted overnight and underwent wireless video capsule endoscopy. Two investigators, blind to therapy, reviewed each video beginning after the pylorus. Lesions were scored as normal, red spots, small erosions, large erosions, or ulcers. An ulcer was defined as a larger lesion with apparent depth and a definite rim. RESULTS: Forty-one patients, 36 men and 5 women, ages ranging from 22 to 66 years (mean age, 49.8 y) were analyzed including 21 chronic NSAID users and 20 control patients. Small-bowel injury was seen in 71% of NSAID users compared with 10% of controls (P < .001). Injury was mild (few or no erosions, absence of large erosions/ulcers) in 10 NSAID users compared with 2 controls. Five NSAID users had major (>4 erosions or large ulcers/ulcers) damage compared with none in the control group. There were no complications or problems with the capsule endoscopy procedure. CONCLUSIONS: Endoscopically evident small-intestinal mucosal injury is very common among chronic NSAID users. The role of endoscopically evident injury in unexplained iron-deficiency anemia and hypoalbuminemia among chronic NSAID users remains undetermined.

Adult↗
PubMed2004

Schatzki's ring: to cut or break an unresolved problem.

Symptom assessment has been proven to be less reliable than barium pill testing for success of dilation of peptic strictures. Schatzki's ring also has a high recurrence rate. Our aim here was to compare the efficacy of single dilatation with a 54-F Savary dilator and electrosurgical ring incision for symptomatic Schatzki's rings. Schatzki's ring patients who failed to pass a 12.7-mm barium pill were randomized to dilatation with a 54-F Savary dilator or four quadrant incisions with a needle knife. All received lansoprazole (30 mg) for 30 days posttreatment. Follow-up at 1, 3, 6, and 12 months used the pill test and a dysphagia score. Eleven patients (mean age, 62; median, 64) were randomized and received therapy, six with dilatation and five with incision. The ring diameter pretherapy was 9.8 +/- 1.3 mm. One patient with dilatation had a procedure-related esophageal perforation. The dysphagia score decreased (from 2.7 +/- 1.1 predilatation and 3.0 +/- 0.4 preincision) to 0 after treatment, suggesting that both therapies were equally successful. In contrast, using objective measurements with the barium pill showed that the pill failed to pass the ring in 60% at 1 month after therapy. The failure rate by 1 year was 100%. Use of an objective measure of effectiveness of treatment of symptomatic Schatzki's rings showed that neither single large-dilator dilatation nor four quadrant ring incision was a reliable and effective therapy. In the future studies, repeated dilatation may be needed to define success before long-term outcome can be accurately assessed.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2002

NSAID gastric ulceration: predictive value of gastric pH, mucosal density of polymorphonuclear leukocytes, or levels of IL-8 or nitrite.

NSAID use and Helicobacter pylori both cause damage to the gastric mucosa and can cause peptic ulcers. Our aim was to test the relationship between gastric mucosal polymorphonuclear leukocyte (PMN) infiltration and the severity of NSAID-induced gastric injury. H. pylori density, mucosal interleukin-8 (IL-8), and nitrite levels were assessed after receiving placebo and again after receiving 1000 mg of naproxen daily for three days. Histology was graded using a visual analog scale (0-5). IL-8 levels were assayed by ELISA and nitrite levels by Griess reaction. Eleven healthy volunteers with H. pylori infection entered. All had normal-appearing gastric mucosa after placebo. Postnaproxen gastric damage included three with none, one with mild, three with moderate, two with severe, and three were very severe mucosal injury (including one with an ulcer >5 mm). There was an inverse correlation between endoscopic score and the pH of the gastric juice post-therapy (R = -0.77, P = 0.004). There was no significant change in histologic or biochemical parameters from pretreatment levels. And none of the parameters (eg, PMN density) predicted endoscopic outcome. In conclusion, there was no relation between mucosal PMN density and endoscopic mucosa injury. PMN infiltration, while not predictive, may be a surrogate for an H. pylori infection-related increased risk of NSAID ulcers.

Adult↗
PubMed2002

Gastrointestinal uses of botulinum toxin.

Botulinum toxin was initially used in medicine to produce a potent neuromuscular blockade. It was later found to interfere with acetylcholine release in the myenteric plexus and inhibit contraction in gastrointestinal smooth muscle, leading to its use in the treatment of various conditions. It is frequently used in the treatment of achalasia in elderly patients who may be poor surgical candidates. It has been used successfully in the management of various conditions, including anal fissure and biliary dyskinesia. Large controlled trials are needed to establish the role of botulinum toxin and its safety in gastroenterology.

Anti-Dyskinesia Agents↗