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1

Gastrointestinal endoscopy in pregnancy  

PubMed Central

Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. PMID:25386072

Savas, Nurten

2014-01-01

2

Sedation Regimens for Gastrointestinal Endoscopy  

PubMed Central

Sedation allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces a patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. Sedation is therefore considered by many endoscopists to be an essential component of gastrointestinal endoscopy. Endoscopic sedation by nonanesthesiologists is a worldwide practice and has been proven effective and safe. Moderate sedation/analgesia is generally accepted as an appropriate target for sedation by nonanesthesiologists. This focused review describes the general principles of endoscopic sedation, the detailed pharmacology of sedatives and analgesics (focused on midazolam, propofol, meperidine, and fentanyl), and the multiple regimens available for use in actual practice. PMID:24765595

2014-01-01

3

Advanced Technologies for Gastrointestinal Endoscopy  

E-print Network

Abstract The gastrointestinal tract is home to some of the most deadly human dis- eases. Exacerbating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 398 1.1. Gastrointestinal Tract Anatomy, Pathologies, Diagnoses, and Therapies . . . . . . 399 1 or disorder of the gastrointestinal (GI) tract. Diagnosing and treating these maladies is challenging for many

Simaan, Nabil

4

Endoscopy for nonvariceal upper gastrointestinal bleeding.  

PubMed

Endoscopy for acute nonvariceal upper gastrointestinal bleeding plays an important role in primary diagnosis and management, particularly with respect to identification of high-risk stigmata lesions and to providing endoscopic hemostasis to reduce the risk of rebleeding and mortality. Early endoscopy, defined as endoscopy within the first 24 hours after presentation, improves patient outcome and reduces the length of hospitalization when compared with delayed endoscopy. Various endoscopic hemostatic methods are available, including injection therapy, mechanical therapy, and thermal coagulation. Either single treatment with mechanical or thermal therapy or a treatment that combines more than one type of therapy are effective and safe for peptic ulcer bleeding. Newly developed methods, such as Hemospray powder and over-the-scope clips, may provide additional options. Appropriate decisions and specific treatment are needed depending upon the conditions. PMID:25133117

Kim, Ki Bae; Yoon, Soon Man; Youn, Sei Jin

2014-07-01

5

Gastrointestinal endoscopy in the pregnant woman.  

PubMed

About 20000 gastrointestinal endoscopies are performed annually in America in pregnant women. Gastrointestinal endoscopy during pregnancy raises the critical issue of fetal safety in addition to patient safety. Endoscopic medications may be potentially abortifacient or teratogenic. Generally, Food and Drug Administration category B or C drugs should be used for endoscopy. Esophagogastroduodenoscopy (EGD) seems to be relatively safe for both mother and fetus based on two retrospective studies of 83 and 60 pregnant patients. The diagnostic yield is about 95% when EGD is performed for gastrointestinal bleeding. EGD indications during pregnancy include acute gastrointestinal bleeding, dysphagia > 1 wk, or endoscopic therapy. Therapeutic EGD is experimental due to scant data, but should be strongly considered for urgent indications such as active bleeding. One study of 48 sigmoidoscopies performed during pregnancy showed relatively favorable fetal outcomes, rare bad fetal outcomes, and bad outcomes linked to very sick mothers. Sigmoidoscopy should be strongly considered for strong indications, including significant acute lower gastrointestinal bleeding, chronic diarrhea, distal colonic stricture, suspected inflammatory bowel disease flare, and potential colonic malignancy. Data on colonoscopy during pregnancy are limited. One study of 20 pregnant patients showed rare poor fetal outcomes. Colonoscopy is generally experimental during pregnancy, but can be considered for strong indications: known colonic mass/stricture, active lower gastrointestinal bleeding, or colonoscopic therapy. Endoscopic retrograde cholangiopancreatography (ERCP) entails fetal risks from fetal radiation exposure. ERCP risks to mother and fetus appear to be acceptable when performed for ERCP therapy, as demonstrated by analysis of nearly 350 cases during pregnancy. Justifiable indications include symptomatic or complicated choledocholithiasis, manifested by jaundice, cholangitis, gallstone pancreatitis, or dilated choledochus. ERCP should be performed by an expert endoscopist, with informed consent about fetal radiation risks, minimizing fetal radiation exposure, and using an attending anesthesiologist. Endoscopy is likely most safe during the second trimester of pregnancy. PMID:24891928

Friedel, David; Stavropoulos, Stavros; Iqbal, Shahzad; Cappell, Mitchell S

2014-05-16

6

Magnetic manipulation with several mobile coils towards gastrointestinal capsular endoscopy.  

E-print Network

tract Traditional techniques for exploring the gastrointestinal tract are based on en- doscopyMagnetic manipulation with several mobile coils towards gastrointestinal capsular endoscopy manipulation, capsule endoscope, variable magnetic field 1 Introduction 1.1 Exploration of the gastrointestinal

Paris-Sud XI, Université de

7

Upper gastrointestinal endoscopy: Are preparatory interventions effective?  

Microsoft Academic Search

Background: This study was designed to examine the effects of preparatory cognitive and behavioral information on self-confidence, anxiety, and negative affect elicited by an impending upper gastrointestinal endoscopy. Methods: Forty-eight male and female out-patients, between 18 and 65 years of age, scheduled for a first-time, non-emergency, endoscopic examination were randomly assigned to receive one of four experimental interventions: cognitive, behavioral,

Maree L. Hackett; Dianne C. McCarthy

1998-01-01

8

Evaluation of a Virtual Endoscopy Simulator for Training in Gastrointestinal Endoscopy  

Microsoft Academic Search

Background and Study Aims: Skills in gastrointestinal endosco- py mainly depend on experience and practice. Training on endos- copy simulators may decrease the time needed to reach compe- tency in endoscopy. The purpose of the study was to determine whether the GI-Mentor, a virtual reality endoscopy simulator, can distinguish between beginners and experts in endoscopy and to assess whether training

A. Ferlitsch; P. Glauninger; A. Gupper; M. Schillinger; M. Haefner; A. Gangl; R. Schoefl

2002-01-01

9

Inhaled sevoflurane for lower gastrointestinal endoscopy with possible propofol anaphylaxis  

PubMed Central

Sedation with propofol is widely used for the outpatient examination. Although anaphylaxis to propofol is rare, there were some reports of anaphylaxis following propofol administration. We present a case of female patient under sedation for lower gastrointestinal endoscopy with possible propofol anaphylaxis. Then sevoflurane was successfully used for the examination and the following surgery. We discussed the possible feasibility of sevoflurane for the examination of lower gastrointestinal endoscopy. Propofol is widely used for the sedation of outpatient with lower gastrointestinal endoscopy. But it may cause some allergic reaction. Inhaled sevoflurane may provide a satisfactory and safe alternative for adult outpatients’ endoscopy. PMID:25419408

Ye, Ling; Liu, Yun-Fei; Zhu, Tao

2014-01-01

10

Upper gastrointestinal endoscopy in Zaria, northern Nigeria.  

PubMed

The indications for and findings in 431 consecutive patients who had upper gastrointestinal endoscopy in Zaria from June 1978 to August 1982 are reviewed. The major indications were dyspepsia (78.1%), upper gastro-intestinal bleeding (12.1%) and portal hypertension (4.2%). Other indications were persistent vomiting, dysphagia and abdominal masses. The mean age of the patients was 32 years. The male: female ratio (3:1) was not different from that in the hospital population. There were no abnormal findings in 32.7%. 26.6% had duodenal ulcers. Duodenitis was noted in 24.8%, oesophageal varices in 6.3%, gastritis in 6.3% and hiatus hernia in 4.6%. In those who presented with upper-gastrointestinal haemorrhage, oesophageal varices (34.6%) and peptic ulcer (17.3%) were the commonest findings. Complication seen commonly were soreness in the throat and thrombophlebitis at the site of valium injection. One death was recorded from the procedure over the period. PMID:2083205

Malu, A O; Wali, S S; Kazmi, R; Macauley, D; Fakunle, Y M

1990-01-01

11

Propofol alternatives in gastrointestinal endoscopy anesthesia  

PubMed Central

Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives.

Goudra, Basavana Gouda; Singh, Preet Mohinder

2014-01-01

12

Sedation-related complications in gastrointestinal endoscopy  

PubMed Central

Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient’s age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management. PMID:24255744

Amornyotin, Somchai

2013-01-01

13

Wireless capsule endoscopy: Perspectives beyond gastrointestinal bleeding  

PubMed Central

Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.

Redondo-Cerezo, Eduardo; Sanchez-Capilla, Antonio Damian; De La Torre-Rubio, Paloma; De Teresa, Javier

2014-01-01

14

Sedation in gastrointestinal endoscopy: Current issues  

PubMed Central

Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. PMID:23382625

Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

2013-01-01

15

Sedation in gastrointestinal endoscopy: current issues.  

PubMed

Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature. PMID:23382625

Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

2013-01-28

16

[Narrow band imaging: new paradigm in gastrointestinal video-endoscopy].  

PubMed

Novel technologies in gastrointestinal endoscopy, such as magnification and high resolution endoscopy, have a clear aim in improving diagnostic accuracy of mucosal abnormalities. Narrow band imaging encompasses both of these by endoscopic display of gastric mucosa with bands of blue and green light. This enhances mucosal architecture and adjacent vasculature. Combined with optical magnification NBI enables recognition of subtle mucosal abnormalities, such as dysplasia in Barrett's oesophagus, early morphological changes of vasculature in inflammatory and malignant diseases of esophagus, stomach and colon. Before NBI becomes a routine diagnostic procedure, further investigations are needed especially in regard to standardisation and validation of findings, as well as their correlation with histopathological findings. PMID:20030289

Ivekovi?, Hrvoje; Brki?, Tomislav; Pulani?, Roland

2009-01-01

17

Progress in gastrointestinal tract surgery: the impact of gastrointestinal endoscopy  

Microsoft Academic Search

  Background: Gastrointestinal (GI) tract surgeons were challenged with the development of two revolutionary surgical specialities:\\u000a laparoscopic and endoscopic surgery. Minimal access surgery currently is the surgical speciality with the greatest impact\\u000a on patient care. Regarding the competitive treatment methods (open, laparoscopic, and intraluminal endoscopic management),\\u000a each new treatment must be evaluated on the evidence of the patient's benefit, surgical morbidity,

H. G. Beger; A. Schwarz; U. Bergmann

2003-01-01

18

Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.  

PubMed

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 Prophylactic colonic stent placement is not recommended. Colonic stenting should be reserved for patients with clinical symptoms and imaging evidence of malignant large-bowel obstruction, without signs of perforation (strong recommendation, low quality evidence). 2 Colonic self-expandable metal stent (SEMS) placement as a bridge to elective surgery is not recommended as a standard treatment of symptomatic left-sided malignant colonic obstruction (strong recommendation, high quality evidence). 3 For patients with potentially curable but obstructing left-sided colonic cancer, stent placement may be considered as an alternative to emergency surgery in those who have an increased risk of postoperative mortality, i.?e. American Society of Anesthesiologists (ASA) Physical Status???III and/or age?>?70 years (weak recommendation, low quality evidence). 4 SEMS placement is recommended as the preferred treatment for palliation of malignant colonic obstruction (strong recommendation, high quality evidence), except in patients treated or considered for treatment with antiangiogenic drugs (e.?g. bevacizumab) (strong recommendation, low quality evidence). PMID:25325682

van Hooft, Jeanin E; van Halsema, Emo E; Vanbiervliet, Geoffroy; Beets-Tan, Regina G H; DeWitt, John M; Donnellan, Fergal; Dumonceau, Jean-Marc; Glynne-Jones, Robert G T; Hassan, Cesare; Jiménez-Perez, Javier; Meisner, Søren; Muthusamy, V Raman; Parker, Michael C; Regimbeau, Jean-Marc; Sabbagh, Charles; Sagar, Jayesh; Tanis, Pieter J; Vandervoort, Jo; Webster, George J; Manes, Gianpiero; Barthet, Marc A; Repici, Alessandro

2014-10-01

19

Rebleeding rate after interventional therapy directed by capsule endoscopy in patients with obscure gastrointestinal bleeding  

PubMed Central

Background The precise role of capsule endoscopy in the diagnostic algorithm of obscure gastrointestinal bleeding has yet to be determined. Despite the higher diagnostic yield of capsule endoscopy, the actual impact on clinical outcome remains poorly defined. The aim of this study was to evaluate the follow-up results of patients with obscure gastrointestinal bleeding to determine which management strategies after capsule endoscopy reduced rebleeding. Methods All patients in whom the cause of obscure gastrointestinal bleeding was investigated between May 2004 and March 2007 were studied retrospectively. We evaluated the clinical outcome of patients with obscure gastrointestinal bleeding after capsule endoscopy using the rebleeding rate as the primary outcome. Results Seventy-seven patients with obscure gastrointestinal bleeding underwent capsule endoscopy. Capsule endoscopy identified clinically significant findings that were thought to be the sources of obscure gastrointestinal bleeding in 58.4% of the patients. The overall rebleeding rate was 36.4%. The rebleeding rate was significantly higher among patients with insignificant findings than among those with significant findings (p = 0.036). Among the patients in whom capsule endoscopy produced significant findings, the rebleeding rate of the patients who underwent therapeutic interventions was significantly lower than that in those who did not undergo intervention (9.5% vs 40.0%, p = 0.046). Conclusion Follow-up and further aggressive interventions are necessary for patients with obscure gastrointestinal bleeding and significant capsule endoscopy findings to reduce the chance of rebleeding. PMID:18430253

Endo, Hiroki; Matsuhashi, Nobuyuki; Inamori, Masahiko; Akimoto, Keiko; Ohya, Tomohiko; Yanagawa, Tatsuro; Asayama, Masako; Hisatomi, Kantaro; Teratani, Takuma; Fujita, Koji; Yoneda, Masato; Nakajima, Atsushi

2008-01-01

20

Highlights from the 50th seminar of the korean society of gastrointestinal endoscopy.  

PubMed

The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses. PMID:25133113

Kim, Eun Young; Choi, Il Ju; Kwon, Kwang An; Ryu, Ji Kon; Dong, Seok Ho; Hahm, Ki Baik

2014-07-01

21

Route selection for double-balloon endoscopy, based on capsule transit time, in obscure gastrointestinal bleeding  

Microsoft Academic Search

Background  Double-balloon endoscopy (DBE) utilizes both oral and anal routes. The proper selection of the initial route is important\\u000a for more rapid management of obscure gastrointestinal bleeding (OGIB). The aim of this retrospective study was to clarify\\u000a the accuracy of the transit time of video capsule endoscopy (VCE) to the lesion as a predictive indicator for the decision\\u000a on the initial

Masanao NakamuraNaoki; Naoki Ohmiya; Osamu Shirai; Hiroyuki Takenaka; Kenji Morishima; Ryoji Miyahara; Takafumi Ando; Osamu Watanabe; Hiroki Kawashima; Akihiro Itoh; Yoshiki Hirooka; Hidemi Goto

2010-01-01

22

Highlights of the 48th Seminar of Korean Society of Gastrointestinal Endoscopy  

PubMed Central

This special May issue of Clinical Endoscopy discusses the tutorial contents dealing with either the diagnostic or therapeutic gastrointestinal (GI) endoscopy that contain very fundamental and essential points in this filed. The seminar of Korean Society of Gastrointestinal Endoscopy (KSGE) had positioned as one of prime educational seminars covering the very beginner to advanced experts of GI endoscopy. Besides of four rooms allocated for each lecture, two additional rooms were open for either live demonstration or hands-on course, covering totally 20 sessions including one special lecture. Among these prestigious lectures, 12 lectures were selected for the current review articles in this special issue of Clinical Endoscopy journal. Basic course for beginner to advanced tips to expert were all covered in this seminar. This introductory review prepared by four associated editors of Clinical Endoscopy contained core contents divided into four sessions-upper gut, lower gut, pancreaticobiliary, and specialized topic session part-to enhance understandings not covered by enlisted review articles in this issue. PMID:23767027

Kwon, Kwang An; Choi, Il Ju; Kim, Eun Young; Dong, Seok Ho

2013-01-01

23

Infection control and its application to the administration of intravenous medications during gastrointestinal endoscopy  

Microsoft Academic Search

Several infection control practices and procedures crucial to the prevention of disease transmission in the health care setting are reviewed and discussed. Emphasis is placed on the importance of infection control to gastrointestinal endoscopy. Recommendations that minimize the risk of nosocomial infection during the preparation, handling, and administration of intravenous medications, particularly propofol, are provided. These recommendations include the labeling

Lawrence F Muscarella

2004-01-01

24

Should Capsule Endoscopy Be the First Test for Every Obscure Gastrointestinal Bleeding?  

PubMed Central

Obscure gastrointestinal bleeding (OGIB) refers to gastrointestinal (GI) bleeding of unclear origin that persists or recurs after negative findings on esophagogastroduodenoscopy and colonoscopy. OGIB accounts for approximately 5% of all types of GI bleeding. More than 80% of OGIB cases originate in the small bowel. The ability to detect OGIB in the small bowel has significantly advanced and been revolutionized since the introduction of the capsule endoscopy and double-balloon enteroscopy techniques in 2000 and 2001, respectively. With these new methods for small-bowel evaluation, new guidelines have been proposed for the diagnosis and management of OGIB. However, some issues remain unsolved. The purpose of this article is to review the various modalities used for evaluating OGIB, including capsule endoscopy and double-balloon enteroscopy, and to help guide clinicians in their decisions on which modality will be the most effective.

Tae, Chung Hyun

2014-01-01

25

Impact of nonsurgical, invasive endoscopy of the diagnosis and therapy of gastrointestinal diseases.  

PubMed

In the last 2 decades, endoscopy has become the most reliable means of diagnosing gut disorders. With the aid of magnifying endoscopy and staining methods, gastrointestinal cancers and malignant diseases can be detected in the early stages. Endoscopic ultrasonography is currently indicated for staging digestive cancers, assessing submucosal tumors, and diagnosing biliary and pancreatic diseases. During the past decade, endoscopy evolved from a solely diagnostic tool to a therapeutic modality. Endoscopic heater probes, bipolar electrocoagulation, and laser therapy are all of effective for achieving immediate hemostasis and preventing rebleeding in actively bleeding lesions. Various ligation methods and endoscopic injection sclerotherapy safely achieve high rates of hemostasis. Endoscopic mucosal resection allows curative treatment of gastrointestinal cancer in the mucosal layer, and removal of precancerous lesions. Endoscopic balloon dilators have been developed for dilating gut stenoses. Various endoprostheses are used for palliation of malignant stenoses. Endoscopic sphincterotomy, balloon dilation, lithotripsy, and endoprosthesis placement are alternatives for biliary tract and pancreatic disease therapy. Endoscopic photodynamic therapy is useful in palliation of esophageal cancer or in ablation of dysplastic lesions in Barrett's esophagus. With advances in modern biotechnology, endoscopy continues to show value in treating or preventing diseases, with less discomfort and lower cost than other methods. PMID:10705692

Lin, J T

1999-11-01

26

Time Trends in Colon Cancer Incidence and Distribution and Lower Gastrointestinal Endoscopy Utilization in Manitoba  

Microsoft Academic Search

OBJECTIVES:There are limited data on recent trends in subsite-specific colon cancer incidence and utilization of lower gastrointestinal endoscopy from Canada. The aim of our study was to determine the concomitant trends in right-sided colon cancer incidence and utilization of colonoscopy and flexible sigmoidoscopy (FS) in Manitoba.METHODS:Cases of colon cancer diagnosed from 1964 to 2004 were identified from the Manitoba Cancer

Harminder Singh; Alain A. Demers; Lin Xue; Donna Turner; Charles N. Bernstein

2008-01-01

27

Prevalence of celiac disease and its endoscopic markers among patients having routine upper gastrointestinal endoscopy  

Microsoft Academic Search

OBJECTIVE:The aim of this study was to determine the prevalence of duodenal villous atrophy (VA) among patients undergoing routine upper gastrointestinal (GI) endoscopy and the value of endoscopic markers for VA in selecting patients for duodenal biopsy.METHODS:One hundred and fifty adult patients with upper GI symptoms or iron-deficiency anemia had inspection and biopsy of the second part of the duodenum

William Dickey; Dermot Hughes

1999-01-01

28

Comfort, safety and quality of upper gastrointestinal endoscopy after 2 hours fasting: a randomized controlled trial  

PubMed Central

Background Upper gastrointestinal endoscopy has been performed after fasting 8 or more hours, which can be harmful to the patients. We assessed comfort, safety and quality of endoscopy under moderate sedation after 2 hours fasting for clear liquids. Methods In this clinical trial, patients referred for elective endoscopy were randomly assigned to a fasting period of 8 hours (F8) or a shorter fasting (F2), in which 200 ml of clear liquids were ingested 2 hours before the procedure. Endoscopists blinded to patients fasting status carried out the endoscopies. Comfort was rated by the patients, whereas safety and quality were determined by the endoscopists. Results Ninety-eight patients were studied (aging 48.5?±?16.5 years, 60% women): 50 patients (51%) in F2 and 48 in F8. Comfort was higher in F2 than F8 in regard to anxiety (8% vs. 25%; P?=?0.029), general discomfort (18% vs. 42%; P?=?0.010), hunger (44% vs. 67%; P?=?0.024), and weakness (22% vs. 42%; P?=?0.034). Regurgitation of gastric contents into the esophagus after endoscopic intubation did not differ between F2 and F8 (26% vs. 19%; P?=?0.471). There was no case of pulmonary aspiration. Gastric mucosal visibility was normal in most patients either in F2 or F8 (96% vs. 98%; P?=?0.999). Conclusions Elective upper GI endoscopy after 2 hours fasting for clear liquids was more comfortable and equally safe compared to conventional fasting. This preparation might be cautiously applied for patients in regular clinical conditions referred for elective endoscopy. Trial registration SAMMPRIS ClinicalTrial.gov number, NCT01492296 PMID:24209639

2013-01-01

29

Endoscopic Ultrasound-Guided Sampling in Gastroenterology: European Society of Gastrointestinal Endoscopy Technical Guidelines  

PubMed Central

At present, the European Society of Gastrointestinal Endoscopy (ESGE) guidelines on endoscopic ultrasound-guided sampling are almost complete and express state of the art developments. However, future developments are anticipated. This editorial focuses on a few recently published papers with some additional information and on two important additional techniques, elastography and contrast enhanced ultrasound (CEUS), which are mentioned, but not explained in detail in the current ESGE guidelines. Elastography and CEUS might be of importance in the near future to improve the biopsy techniques. PMID:24949378

Dietrich, Christoph F.; Jenssen, C.

2013-01-01

30

International Digestive Endoscopy Network 2014: Turnpike to the Future  

PubMed Central

Social networks are useful in the study of relationships between individuals or entire populations, and the ties through which any given social unit connects. Those represent the convergence of the various social contacts of that unit. Consequently, the term "social networking service" (SNS) became extremely familiar. Similar to familiar SNSs, International Digestive Endoscopy Network (IDEN) 2014 was based on an international network composed of an impressive 2-day scientific program dealing with a variety of topics for gastrointestinal (GI) diseases, which connects physicians and researchers from all over the world. The scientific programs included live endoscopic demonstrations and provided cutting-edge information and practice tips as well as the latest advances concerning upper GI, lower GI, and pancreatobiliary endoscopy. IDEN 2014 featured American Society for Gastrointestinal Endoscopy-Korean Society of Gastrointestinal Endoscopy (ASGE-KSGE)-joint sessions prepared through cooperation between ASGE and KSGE. Furthermore, IDEN 2014 provided a special program for young scientists called the 'Asian Young Endoscopist Award Forum' to foster networks, with many young endoscopists from Asian countries taking an active interest and participation. PMID:25324994

Kim, Eun Young; Kwon, Kwang An; Choi, Il Ju; Ryu, Ji Kon

2014-01-01

31

International digestive endoscopy network 2014: turnpike to the future.  

PubMed

Social networks are useful in the study of relationships between individuals or entire populations, and the ties through which any given social unit connects. Those represent the convergence of the various social contacts of that unit. Consequently, the term "social networking service" (SNS) became extremely familiar. Similar to familiar SNSs, International Digestive Endoscopy Network (IDEN) 2014 was based on an international network composed of an impressive 2-day scientific program dealing with a variety of topics for gastrointestinal (GI) diseases, which connects physicians and researchers from all over the world. The scientific programs included live endoscopic demonstrations and provided cutting-edge information and practice tips as well as the latest advances concerning upper GI, lower GI, and pancreatobiliary endoscopy. IDEN 2014 featured American Society for Gastrointestinal Endoscopy-Korean Society of Gastrointestinal Endoscopy (ASGE-KSGE)-joint sessions prepared through cooperation between ASGE and KSGE. Furthermore, IDEN 2014 provided a special program for young scientists called the 'Asian Young Endoscopist Award Forum' to foster networks, with many young endoscopists from Asian countries taking an active interest and participation. PMID:25324994

Kim, Eun Young; Kwon, Kwang An; Choi, Il Ju; Ryu, Ji Kon; Hahm, Ki Baik

2014-09-01

32

Use of endoscopy for management of acute upper gastrointestinal bleeding in the UK: results of a nationwide audit  

Microsoft Academic Search

ObjectivesTo examine the use of endoscopy in the UK for acute upper gastrointestinal bleeding (AUGIB) and compare with published standards.To assess the organisation of endoscopy services for AUGIB in the UK.To examine the relationship between outcomes and out of hours (OOH) service provision.DesignMulti-centre cross sectional clinical audit.SettingAll UK hospitals accepting admissions with AUGIB.PatientsAll adults (?16 yrs) presenting with AUGIB between

Sarah A Hearnshaw; Richard F A Logan; Derek Lowe; Simon P L Travis; Mike F Murphy; Kelvin R Palmer

2010-01-01

33

Fibreoptic endoscopy and the use of the Sengstaken tube in acute gastrointestinal haemorrhage in patients with portal hypertension and varices  

Microsoft Academic Search

The value of emergency upper gastrointestinal fibre-endoscopy, followed where required by the use of a modified Sengstaken tube, was studied during 84 episodes of acute bleeding in 75 patients who had evidence of portal hypertension with varices. The portal hypertension was due to alcoholic cirrhosis in 80% and to cryptogenic cirrhosis in 9% of the patients. By definition, varices were

B H Novis; P Duys; G O Barbezat; J Clain; S Bank; J Terblanche

1976-01-01

34

Capsule endoscopy  

Microsoft Academic Search

Video capsule endoscopy is a major innovation that provides high-resolution imaging of the entire small intestine in its entirety.\\u000a In the 4 years since its introduction, capsule endoscopy has demonstrated its viability as a first-line investigation in patients\\u000a with obscure gastrointestinal bleeding after a negative esophagogastroduodenoscopy and colonoscopy, and it has a positive\\u000a impact on the outcome. Video capsule endoscopy

G. S. Raju; Samir Kumar Nath

2005-01-01

35

New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy  

PubMed Central

Objective To evaluate the effect and acceptance of a new lidocaine lozenge compared with a lidocaine viscous oral solution as a pharyngeal anesthetic before upper gastrointestinal endoscopy (UGE), a diagnostic procedure commonly performed worldwide during which many patients experience severe discomfort mostly because of the gag reflex. Participants The single-blinded, randomized, controlled study involved 110 adult patients undergoing diagnostic UGE at the Department of Gastroenterology, Hvidovre University Hospital, Denmark. Methods The patients were randomized to receive either 100 mg lidocaine as a lozenge or 5 mL lidocaine viscous oral solution 2%. Intravenous midazolam was administered if needed. The effect of a lidocaine lozenge in reducing patient discomfort, including the gag reflex, during UGE compared with a lidocaine oral solution was assessed. Results Questionnaires from the patients showed that the gag reflex was acceptable for 64% in the lozenge group compared with 33% in the oral solution group (P = 0.0072). UGE was evaluated as acceptable by 69% in the lozenge group compared with 39% in the oral solution group (P = 0.0092). The taste was evaluated as good by 78% in the lozenge group (P < 0.0001), and 82% found the lozenge to have good texture (P < 0.0001). Conclusion The lozenge reduced the gag reflex, diminished patients’ discomfort during UGE, and was evaluated as having a good taste and texture. The lozenge improved patients’ acceptance of UGE. PMID:22915898

Mogensen, Stine; Treldal, Charlotte; Feldager, Erik; Pulis, Sylvia; Jacobsen, Jette; Andersen, Ove; Rasmussen, Mette

2012-01-01

36

The Changing Pattern of Upper Gastrointestinal Disorders by Endoscopy: Data of the Last 40 Years  

PubMed Central

Objectives. We have investigated the changes in the incidence of various diagnoses that have been made in the endoscopy unit throughout the last 40 years. Methods. In this study, changes in the incidence of endoscopic diagnosis in upper gastrointestinal system between 1970 and 2010 were evaluated. Their diagnosis, age, and gender data were entered into the Excel software. Results. Of the 52816 cases who underwent esophagogastroduodenoscopy in the 40-year time period, the mean age was 48.17 ± 16.27 (mean ± SD). Although overall more than half of the patients were male (54.3%), in 1995 and after a marked increase was seen in the proportion of female gender (51–55%). The presence of hiatal hernia, reflux esophagitis, and the number of Barrett's esophaguses significantly increased. Erosive gastritis showed gradual increase, while the number of gastric ulcers decreased significantly. The presence of gastric and esophageal cancer significantly decreased. The number of duodenal ulcers significantly decreased. Conclusion. We detected that the incidences of esophagitis, Barrett's esophagus, and erosive gastritis significantly increased while the incidences of gastric/duodenal ulcer and gastric/esophageal cancer decreased throughout the last 40 years.

Caglar, Erkan; Baysal, Birol; Dobrucal?, Ahmet

2014-01-01

37

Procedural sedation and analgesia for gastrointestinal endoscopy in infants and children: how, with what, and by whom?  

PubMed

Endoscopic procedures involving the gastrointestinal tract have been successfully developed in paediatric practice over the last two decades, improving both diagnosis and treatment in many children's gastrointestinal diseases. In this group of patients, experience and co-operation between paediatricians/endoscopists and paediatric anaesthesiologists should help to guarantee the quality and safety of a procedure and should additionally help to minimise the risk of adverse events which are greater the smaller the child is. This principle is more and more important especially since the announcement of the Helsinki Declaration on Patient Safety in Anaesthesiology in 2010, emphasising the role of anaesthesiology in promoting safe perioperative care. The Helsinki Declaration has been endorsed by all European anaesthesiology institutions as well as the World Health Organisation's 'Safe Surgery Saves Lives' initiative including the 'Surgical Safety Checklist'. Although most of these procedures could be performed by paediatricians under procedural sedation and analgesia, children with congenital defects and serious coexisting diseases (ASA ? III) as well as the usage of anaesthetics (e.g. propofol) must be managed by paediatric anaesthesiologists. We have reviewed the specific principles employed during qualification and performance of procedural sedation and analgesia for gastrointestinal endoscopy in paediatrics. We have also tried to answer the questions as to how, with what, and by whom, procedural sedation for gastrointestinal endoscopy in children should be performed. PMID:24858971

Bartkowska-?niatkowska, Alicja; Rosada-Kurasi?ska, Jowita; Zieli?ska, Marzena; Grze?kowiak, Ma?gorzata; Bienert, Agnieszka; Jenkins, Ian A; Igny?, Iwona

2014-01-01

38

Risk of transmission of carbapenem-resistant Enterobacteriaceae and related "superbugs" during gastrointestinal endoscopy  

PubMed Central

To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae (CRE) and their related superbugs during gastrointestinal (GI) endoscopy. Reports of outbreaks linked to GI endoscopes contaminated with different types of infectious agents, including CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE’s emergence, these reports were obtained by searching the peer-reviewed medical literature (via the United States National Library of Medicine’s “MEDLINE” database); the Food and Drug Administration’s Manufacturer and User Facility Device Experience database, or “MAUDE”; and the Internet (via Google’s search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at “Hospital X” located in the suburbs of Chicago (IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital’s patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Control and Prevention (CDC), which published a report about this outbreak in Morbidity and Mortality Weekly Report (MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X’s infection control practices following this CRE outbreak, were also reviewed. While this article focuses primarily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infectious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently associated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospital X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer’s labeling, supplemented as needed with professional organizations’ published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including bronchoscopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endoscopy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind and near the forceps elevator located at the distal end of the ERCP endoscope, are recommended. If the ERCP endoscope features a narrow and exposed channel that houses a wire connecting the GI endoscope’s control head to this forceps elevator, then this channel’s complete reprocessing, including its flushing with a detergent using a procedure validated for effectiveness, is also emphasized.

Muscarella, Lawrence F

2014-01-01

39

Risk of transmission of carbapenem-resistant Enterobacteriaceae and related "superbugs" during gastrointestinal endoscopy.  

PubMed

To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae (CRE) and their related superbugs during gastrointestinal (GI) endoscopy. Reports of outbreaks linked to GI endoscopes contaminated with different types of infectious agents, including CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature (via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manufacturer and User Facility Device Experience database, or "MAUDE"; and the Internet (via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the suburbs of Chicago (IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Control and Prevention (CDC), which published a report about this outbreak in Morbidity and Mortality Weekly Report (MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's infection control practices following this CRE outbreak, were also reviewed. While this article focuses primarily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infectious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently associated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospital X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including bronchoscopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related superbugs, with associated patient morbidity and mortality. Thorough reprocessing of these complex reusable instruments is necessary to prevent disease transmission and ensure patient safety during GI endoscopy. Enhanced training and monitoring of reprocessing staffers to verify the proper cleaning and brushing of GI endoscopes, especially the area around, behind and near the forceps elevator located at the distal end of the ERCP endoscope, are recommended. If the ERCP endoscope features a narrow and exposed channel that houses a wire connecting the GI endoscope's control head to this forceps elevator, then this channel's complete reprocessing, including its flushing with a detergent using a procedure validated for effectiveness, is also emphasized. PMID:25324917

Muscarella, Lawrence F

2014-10-16

40

Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.  

PubMed

This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures. Main recommendations 1 ESGE recommends that each center implements a written policy regarding the management of iatrogenic perforation, including the definition of procedures that carry a high risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 In the case of an endoscopically identified perforation, ESGE recommends that the endoscopist reports: its size and location with a picture; endoscopic treatment that might have been possible; whether carbon dioxide or air was used for insufflation; and the standard report information. 3 ESGE recommends that symptoms or signs suggestive of iatrogenic perforation after an endoscopic procedure should be carefully evaluated and documented, possibly with a computed tomography (CT) scan, in order to prevent any diagnostic delay. 4 ESGE recommends that endoscopic closure should be considered depending on the type of perforation, its size, and the endoscopist expertise available at the center. A switch to carbon dioxide insufflation, the diversion of luminal content, and decompression of tension pneumoperitoneum or tension pneumothorax should also be done. 5 After closure of an iatrogenic perforation using an endoscopic method, ESGE recommends that further management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of the iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical consultation are recommended. PMID:25046348

Paspatis, Gregorios A; Dumonceau, Jean-Marc; Barthet, Marc; Meisner, Søren; Repici, Alessandro; Saunders, Brian P; Vezakis, Antonios; Gonzalez, Jean Michel; Turino, Stine Ydegaard; Tsiamoulos, Zacharias P; Fockens, Paul; Hassan, Cesare

2014-08-01

41

Long-term outcome in patients with obscure gastrointestinal bleeding after negative capsule endoscopy  

PubMed Central

AIM: To investigate long-term outcome in obscure gastrointestinal bleeding (OGIB) after negative capsule endoscopy (CE) and identify risk factors for rebleeding. METHODS: A total of 113 consecutive patients underwent CE for OGIB from May 2003 to June 2010 at Seoul National University Hospital. Ninety-five patients (84.1%) with a subsequent follow-up after CE of at least 6 mo were enrolled in this study. Follow-up data were obtained from the patients’ medical records. The CE images were reviewed by two board-certified gastroenterologists and consensus diagnosis was used in all cases. The primary outcome measure was the detection of rebleeding after CE, and factors associated with rebleeding were evaluated using multivariate analysis. RESULTS: Of the 95 enrolled patients (median age 61 years, range 17-85 years), 62 patients (65.3%) were male. The median duration of follow-up was 23.7 mo (range 6.0-89.4 mo). Seventy-three patients (76.8%) underwent CE for obscure-overt bleeding. Complete examination of the small bowel was achieved in 77 cases (81.1%). Significant lesions were found in 38 patients (40.0%). The overall rebleeding rate was 28.4%. The rebleeding rate was higher in patients with positive CE (36.8%) than in those with negative CE (22.8%). However, there was no significant difference in cumulative rebleeding rates between the two groups (log rank test; P = 0.205). Anticoagulation after CE examination was an independent risk factor for rebleeding (hazard ratio, 5.019; 95%CI, 1.560-16.145; P = 0.007), regardless of CE results. CONCLUSION: Patients with OGIB and negative CE have a potential risk of rebleeding. Therefore, close observation is required and alternative modalities should be considered in suspicious cases. PMID:23539070

Koh, Seong-Joon; Im, Jong Pil; Kim, Ji Won; Kim, Byeong Gwan; Lee, Kook Lae; Kim, Sang Gyun; Kim, Joo Sung; Jung, Hyun Chae

2013-01-01

42

NSAID-Induced Enteropathy in Rheumatoid Arthritis Patients with Chronic Occult Gastrointestinal Bleeding: A Prospective Capsule Endoscopy Study  

PubMed Central

Background. The purpose of study was to evaluate the diagnostic yield of capsule endoscopy for NSAID-induced enteropathy and clinical, laboratory, and endoscopic characteristics of disease in patients with rheumatoid arthritis. Methods. 37 rheumatoid arthritis patients (30 women; mean age 55) treated with NSAIDs (>1 month), presented with anaemia and/or positive faecal occult blood testing, entered the study and underwent capsule endoscopy (EndoCapsule; Olympus), laboratory tests, and filled in questionnaires. Results. The prevalence of NSAID-induced enteropathy diagnosed by capsule endoscopy was 68% (25/37), classified as mild (red spots or erosions) in 18 (49%), moderate (10–20 erosions) in 4 (11%), and severe enteropathy (>20 erosions or ulcers) in 3 (8%) patients. We did not find statistically significant relationship between the enteropathy and gender, age, haemoglobin, leukocytes, albumin and CRP, or dyspepsia. The difference between subgroups of NSAIDs according to the COX specificity was not statistically significant. Conclusions. Capsule endoscopy is a highly accurate noninvasive method for evaluation of NSAID-induced enteropathy. It was revealed in a substantial section of the patients with rheumatoid arthritis and occult gastrointestinal bleeding, mostly classified as mild damage. No simple clinical or laboratory markers of the presence or severity of NSAID-induced enteropathy were recognised. This trial is registered with DRKS00004940. PMID:24382953

Tachecí, Ilja; Bradna, Petr; Douda, Tomáš; Baštecká, Drahomíra; Kopá?ová, Marcela; Bureš, Jan

2013-01-01

43

Effects of nasal cleansing and topical decongestants on patient tolerance during upper gastrointestinal endoscopy: a prospective randomized study  

PubMed Central

Adequate patient tolerance is essential for successful completion of safe endoscopic examination. Although there are many reported methods to increase patient tolerance, none of these fully resolve this problem. The aim of this study was to investigate whether relaxing the nasal airways increase patient tolerance to upper gastrointestinal endoscopy (UGE). A total of 300 patients scheduled for diagnostic UGE were randomized into three separate groups. Prior to the UGE procedure the first group was administered intranasal cortisone spray following nasal cleansing (INC). Patients in the second group were administered intranasal saline after nasal cleansing (INSP). The patients in the third group were treated with the standard endoscopic procedure alone (SEP). After the UGE procedure, both endoscopists and patients were asked to evaluate the ease of performing the procedure. Furthermore, patients who had undergone endoscopy before were asked to compare their current experience to their most recent endoscopy. Results shown that INC and INSP groups had significantly better tolerance than the SEP group. When comparing their current experience with the previous one, INC and INSP groups reported that the current experience was better. Conclusions: Taking measures to relax the nasal airways makes breathing more comfortable and increase patient tolerance during UGE. PMID:24995106

Akbaba, Soner; Koseoglu, Huseyin; Bozk?rl?, Bahad?r Osman; Ak?n, Fatma Ebru; Gundogdu, R?za Haldun; Ersoy, Osman; Karakaya, Jale; Ersoy, Pamir Eren

2014-01-01

44

Milli Robotics for Endoscopy Je Wendlandt1  

E-print Network

and operate in the gastrointestinal tract. Current instruments lack #12;ne motion control and dexterity performs operations and inspections in the gastrointestinal tract. Endoscopy's primary bene#12;t Procedures 5 3.1 Upper Gastrointestinal (GI) Endoscopy : : : : : : : : : : : : : : : : : : : : : 8 3

Wendlandt, Jeff

45

Emergency Endoscopy after Gastrointestinal Haemorrhage in 50 Patients with Portal Hypertension  

Microsoft Academic Search

Endoscopy was carried out in 50 patients with oesophageal varices within 24 hours of a major haematemesis or melaena. Sources of bleeding were identified in 42 of the cases and in only 19 patients was bleeding due to oesophageal varices. Bleeding from gastric varices was present in 11 patients, and a variety of acute and chronic lesions made up the

R. Waldram; M. Davis; Heather Nunnerley; Roger Williams

1974-01-01

46

A Meta-Analysis of the Yield of Capsule Endoscopy Compared to Other Diagnostic Modalities in Patients with Obscure Gastrointestinal Bleeding  

Microsoft Academic Search

OBJECTIVES:Due to its superior ability to examine the entire small bowel mucosa, capsule endoscopy (CE) has broadened the diagnostic evaluation of patients with obscure gastrointestinal bleeding (OGIB). Published studies have revealed a numerically superior performance of CE in determining a source of OGIB compared with other modalities, but due to small sample sizes, the overall magnitude of benefit is unknown.

Stuart L. Triester; Jonathan A. Leighton; Grigoris I. Leontiadis; David E. Fleischer; Amy K. Hara; Russell I. Heigh; Arthur D. Shiff; Virender K. Sharma

2005-01-01

47

Volumetric photoacoustic endoscopy of upper gastrointestinal tract: ultrasonic transducer technology development  

NASA Astrophysics Data System (ADS)

We have successfully implemented a focused ultrasonic transducer for photoacoustic endoscopy. The photoacoustic endoscopic probe's ultrasound transducer determines the lateral resolution of the system. By using a focused ultrasonic transducer, we significantly improved the endoscope's spatial resolution and signal-to-noise ratio. This paper describes the technical details of the ultrasonic transducer incorporated into the photoacoustic endoscopic probe and the experimental results from which the transducer's resolution is quantified and the image improvement is validated.

Yang, Joon-Mo; Favazza, Christopher; Chen, Ruimin; Maslov, Konstantin; Cai, Xin; Zhou, Qifa; Shung, K. Kirk; Wang, Lihong V.

2011-03-01

48

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline.  

PubMed

This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR). It addresses the clinical indications for the use of computed tomographic colonography (CTC). A targeted literature search was performed to evaluate the evidence supporting the use of CTC. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations 1 ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia. ESGE/ESGAR do not recommend barium enema in this setting (strong recommendation, high quality evidence). 2 ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. Delay of CTC should be considered following endoscopic resection. In the case of obstructing colorectal cancer, preoperative contrast-enhanced CTC may also allow location or staging of malignant lesions (strong recommendation, moderate quality evidence). 3 When endoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of colorectal cancer (strong recommendation, high quality evidence). 4 ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp???6?mm in diameter detected at CTC. CTC surveillance may be clinically considered if patients do not undergo polypectomy (strong recommendation, moderate quality evidence). 5 ESGE/ESGAR do not recommend CTC as a primary test for population screening or in individuals with a positive first-degree family history of colorectal cancer (CRC). However, it may be proposed as a CRC screening test on an individual basis providing the screenee is adequately informed about test characteristics, benefits, and risks (weak recommendation, moderate quality evidence). PMID:25268304

Spada, Cristiano; Stoker, Jaap; Alarcon, Onofre; Barbaro, Federico; Bellini, Davide; Bretthauer, Michael; De Haan, Margriet C; Dumonceau, Jean-Marc; Ferlitsch, Monika; Halligan, Steve; Helbren, Emma; Hellstrom, Mikael; Kuipers, Ernst J; Lefere, Philippe; Mang, Thomas; Neri, Emanuele; Petruzziello, Lucio; Plumb, Andrew; Regge, Daniele; Taylor, Stuart A; Hassan, Cesare; Laghi, Andrea

2014-10-01

49

Capturing and stitching images with a large viewing angle and low distortion properties for upper gastrointestinal endoscopy  

NASA Astrophysics Data System (ADS)

Upper gastrointestinal endoscopies are primarily performed to observe the pathologies of the esophagus, stomach, and duodenum. However, when an endoscope is pushed into the esophagus or stomach by the physician, the organs behave similar to a balloon being gradually inflated. Consequently, their shapes and depth-of-field of images change continually, preventing thorough examination of the inflammation or anabrosis position, which delays the curing period. In this study, a 2.9-mm image-capturing module and a convoluted mechanism was incorporated into the tube like a standard 10- mm upper gastrointestinal endoscope. The scale-invariant feature transform (SIFT) algorithm was adopted to implement disease feature extraction on a koala doll. Following feature extraction, the smoothly varying affine stitching (SVAS) method was employed to resolve stitching distortion problems. Subsequently, the real-time splice software developed in this study was embedded in an upper gastrointestinal endoscope to obtain a panoramic view of stomach inflammation in the captured images. The results showed that the 2.9-mm image-capturing module can provide approximately 50 verified images in one spin cycle, a viewing angle of 120° can be attained, and less than 10% distortion can be achieved in each image. Therefore, these methods can solve the problems encountered when using a standard 10-mm upper gastrointestinal endoscope with a single camera, such as image distortion, and partial inflammation displays. The results also showed that the SIFT algorithm provides the highest correct matching rate, and the SVAS method can be employed to resolve the parallax problems caused by stitching together images of different flat surfaces.

Liu, Ya-Cheng; Chung, Chien-Kai; Lai, Jyun-Yi; Chang, Han-Chao; Hsu, Feng-Yi

2013-06-01

50

Provision of gastrointestinal endoscopy and related services for a district general hospital. Working Party of the Clinical Services Committee of the British Society of Gastroenterology.  

PubMed Central

(1) The number of endoscopic examinations performed is rising. Epidemiological data and the workload of well developed units show that annual requirements per head of population are approaching: Upper gastrointestinal 1 in 100 Flexible sigmoidoscopy 1 in 500 Colonoscopy 1 in 500 ERCP 1 in 2000 (2) Open access endoscopy to general practitioners is desirable and increasingly sought. For a district general hospital serving a population of 250,000, this workload entails about 3500 procedures annually, performed during 10 half day routine sessions plus emergency work. (3) High standards of training and experience are needed by all staff, who must work in purpose built accommodation designed to promote efficient and safe practice. (4) The endoscopy unit should be adjacent to day care facilities and near the x ray department. There should be easy access to wards. (5) An endoscopy unit needs at least two endoscopy rooms; a fully ventilated cleaning/disinfection area; rooms for patient reception, preparation, and recovery; and accommodation for administration, storage, and staff amenities. (6) The service should be consultant based. At least 10 clinical sessions are required, made up of six or more consultant sessions and two to four clinical assistant, hospital practitioner, or staff specialist sessions. Each consultant should be expected to commit at least two sessions weekly to endoscopy. Extra consultant sessions may be needed to provide an efficient service. (7) A specially trained nursing sister (grade G or H) and five other endoscopy nurses are needed to care for the patients; their work may be supplemented by care assistants. (8) A new post of endoscopy department assistant (analogous to an operating department assistant) is proposed to maintain and prepare instruments, and to give technical assistance during procedures. (9) A full time secretary should be employed. Records, appointments, and audit should be computer based. (10) ERCP needs the collaboration of an interventional radiologist working with high quality x ray equipment in a specially prepared radiology screening room. This facility may need to serve more than one hospital. (11) A gastrointestinal measurement laboratory can conveniently be combined with the endoscopy unit. In some hospitals one or more gastrointestinal measurement technicians may staff this laboratory. (12) An endoscopy unit is a service department analogous to a radiology department. It needs an annual budget. PMID:1991644

1991-01-01

51

Virtual gastrointestinal colonoscopy in combination with large bowel endoscopy: Clinical application  

PubMed Central

Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn’s disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. PMID:25320519

He, Qing; Rao, Ting; Guan, Yong-Song

2014-01-01

52

Computed tomography of iatrogenic complications of upper gastrointestinal endoscopy, stenting, and intubation.  

PubMed

Intraluminal procedures for the gastrointestinal tract range from simple intubation for feeding or bowel decompression to endoscopic procedures including stenting and pancreatobiliary ductal catheterization. Each of these procedures and interventions carries a risk of iatrogenic injury, including bleeding, perforation, infection, adhesions, and obstruction. An understanding of how anatomy and function may predispose to injury, and the distinct patterns of injury, can help the radiologist identify and characterize iatrogenic injury rapidly at computed tomography (CT) imaging. Furthermore, selective use of intravenous or oral CT contrast material can help reveal injury and triage clinical management. PMID:25173658

Valenzuela, David M; Behr, Spencer C; Coakley, Fergus V; Wang, Z Jane; Webb, Emily M; Yeh, Benjamin M

2014-09-01

53

Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy: A Randomized, Controlled Trial  

PubMed Central

Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult outpatients undergoing unsedated diagnostic UGE were randomized to receive either a bupivacaine lozenge (L-group, n = 51) or lidocaine spray (S-group, n = 42). Primary objective was assessment of patient discomfort including acceptance of the gag reflex during UGE. The L-group assessed the discomfort significantly lower on a visual analog scale compared with the S-group (P = 0.02). There was also a significant difference in the four-point scale assessment of the gag reflex (P = 0.03). It was evaluated as acceptable by 49% in the L-group compared with 31% in the S-group. A bupivacaine lozenge compared with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE. PMID:25374463

Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine; Rasmussen, Mette; Petersen, Janne; Andersen, Ove; Jacobsen, Jette

2014-01-01

54

The Cost-Effectiveness Analysis of Video Capsule Endoscopy Compared to Other Strategies to Manage Acute Upper Gastrointestinal Hemorrhage in the Emergency Department  

PubMed Central

Study objective Acute upper gastrointestinal (GI) hemorrhage is a common presentation in hospital-based emergency departments (EDs). A novel diagnostic approach is to use video capsule endoscopy to directly visualize the upper GI tract and identify bleeding. Our objective was to evaluate and compare the relative costs and benefits of video capsule endoscopy compared to other strategies in low to moderate risk ED patients with acute upper GI hemorrhage. Methods We constructed a model using standard decision analysis software to examine the cost-effectiveness of four available strategies for a base-case patient who presents to the ED with either mild or moderate risk scenarios (by Glasgow-Blatchford Score) for requiring invasive hemostatic intervention (i.e., endoscopic, surgical, etc.) The four available diagnostic strategies were (1) direct imaging with video capsule endoscopy performed in the ED, (2) risk stratification using the Glasgow-Blatchford score, (3) nasogastric tube placement and, finally, (4) an admit-all strategy. Results In the low-risk scenario, video capsule endoscopy was preferred strategy (cost $5,691, 14.69 QALYs) and more cost effective than the remaining strategies including nasogastric tube strategy (cost $8,159, 14.69 QALYs), risk stratification strategy (cost $10,695, 14.69 QALYs) and admit-all strategy (cost $22,766, 14.68 QALYs). In the moderate risk scenario, video capsule endoscopy continued to be preferred strategy (cost $9,190, 14.56 QALYs) compared to nasogastric tube (cost $9,487, 14.58 QALYs, ICER $15,891) and more cost effective than admit-all strategy (cost, $22,584, 14.54 QALYs.) Conclusion Video capsule endoscopy may be cost-effective for low and moderate risk patients presenting to the ED with acute upper GI hemorrhage. PMID:24961149

Meltzer, Andrew C.; Ward, Michael J.; Gralnek, Ian M.; Pines, Jesse M.

2014-01-01

55

Photometric stereo endoscopy  

E-print Network

While color video endoscopy has enabled wide-field examination of the gastrointestinal tract, it often misses or incorrectly classifies lesions. Many of these missed lesions exhibit characteristic three-dimensional surface ...

Parot, Vicente

56

Capsule endoscopy  

PubMed Central

Capsule endoscopy (CE) is a simple, safe, non-invasive, reliable technique, well accepted and tolerated by the patients, which allows complete exploration of the small intestine. The advent of CE in 2000 has dramatically changed the diagnosis and management of many diseases of the small intestine, such as obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, polyposis syndromes, etc. CE has become the gold standard for the diagnosis of most diseases of the small bowel. Lately this technique has also been used for esophageal and colonic diseases. PMID:19340899

Munoz-Navas, Miguel

2009-01-01

57

Current status of core and advanced adult gastrointestinal endoscopy training in Canada: Survey of existing accredited programs  

PubMed Central

OBJECTIVE: To determine the current status of core and advanced adult gastroenterology training in Canada. METHODS: A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed. RESULTS: All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery. CONCLUSION: Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula. PMID:23712301

Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

2013-01-01

58

Initial experience of wireless-capsule endoscopy for evaluating occult gastrointestinal bleeding and suspected small bowel pathology  

Microsoft Academic Search

OBJECTIVE:Small bowel pathology can be diagnosed using enteroscopy (which has limitations) and by x-ray (which is not sensitive for flat lesions). For the first time ever, we used a new technique, wireless-capsule video endoscopy, to diagnose small bowel pathology. Our aim was to prove the effectiveness and safety of this technology.METHODS:We used the Given (M2A) system in 35 patients, aged

Eitan Scapa; Harold Jacob; Shlomo Lewkowicz; Michal Migdal; Daniel Gat; Arkady Gluckhovski; Nurit Gutmann; Zvi Fireman

2002-01-01

59

Hospital-acquired Gastrointestinal Bleeding Outside The Critical Care Unit: Risk Factors, Role Of Acid Suppression, And Endoscopy Findings  

Microsoft Academic Search

Background: Although intensive care unit (ICU)-associated gastrointestinal (GI) bleeding has been extensively studied, limited data focus on medical patients outside the ICU. Routine prophylactic acid blockade is frequently employed in these patients despite an absence of evidence-based recommendations. We sought to identify risk factors for nosocomial gastrointestinal bleeding in non-ICU medical patients, to evaluate the utility of prophylactic gastric acid

Daniel J. Brotman; Mohammad A. Qadeer; Joel E. Richter

2005-01-01

60

Quality Metrics in Endoscopy  

PubMed Central

Endoscopy has evolved in the past 4 decades to become an important tool in the diagnosis and management of many digestive diseases. Greater focus on endoscopic quality has highlighted the need to ensure competency among endoscopists. A joint task force of the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy has proposed several quality metrics to establish competence and help define areas of continuous quality improvement. These metrics represent quality in endoscopy pertinent to pre-, intra-, and postprocedural periods. Quality in endoscopy is a dynamic and multidimensional process that requires continuous monitoring of several indicators and benchmarking with local and national standards. Institutions and practices should have a process in place for credentialing endoscopists and for the assessment of competence regarding individual endoscopic procedures. PMID:24711767

Gurudu, Suryakanth R.

2013-01-01

61

New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding  

PubMed Central

Objectives. Small bowel capsule endoscopy (SBCE) plays a decisive role in the obscure gastrointestinal bleeding (OGIB) diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE. Methods. Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential), P1 (uncertain bleeding potential: erosions), and P2 (high bleeding potential: angioectasias, ulcers, and tumors). We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE. Results. One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4%) were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11, P = 0.026). We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE. Conclusions. Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

Rosa, Bruno; Moreira, Maria João; Cotter, José

2014-01-01

62

Evidence-Based Recommendations on Upper Gastrointestinal Tract Stenting: A Report from the Stent Study Group of the Korean Society of Gastrointestinal Endoscopy  

PubMed Central

Endoscopic stents have evolved dramatically over the past 20 years. With the introduction of uncovered self-expanding metal stents in the early 1990s, they are primarily used to palliate symptoms of malignant obstruction in patients with inoperable gastrointestinal (GI) cancer. At present, stents have emerged as an effective, safe, and less invasive alternative for the treatment of malignant GI obstruction. Clinical decisions about stent placement should be made based on the exact understanding of the patient's condition. These recommendations based on a critical review of the available data and expert consensus are made for the purpose of providing endoscopists with information about stent placement. These can be helpful for management of patients with inoperable cancer or various nonmalignant conditions in the upper GI tract. PMID:23964331

Jee, Sam Ryong; Kim, Kyung Ho; Kim, Sang Gyun; Cho, Jun-Hyung

2013-01-01

63

Monitoring of stability of ASG-EUPOS network coordinates  

NASA Astrophysics Data System (ADS)

ASG-EUPOS (Active Geodetic Network - European Position Determination System) is the national system of precise satellite positioning in Poland, which increases a density of regional and global GNSS networks and is widely used by public administration, national institutions, entrepreneurs and citizens (especially surveyors). In near future ASG-EUPOS is to take role of main national network. Control of proper activity of stations and realization of ETRS'89 is a necessity. User of the system needs to be sure that observations quality and coordinates accuracy are high enough. Coordinates of IGS (International GNSS Service) and EPN (European Permanent Network) stations are precisely determined and any changes are monitored all the time. Observations are verified before they are archived in regional and global databases. The same applies to ASG-EUPOS. This paper concerns standardization of GNSS observations from different stations (uniform adjustment), examination of solutions correctness according to IGS and EPN standards and stability of solutions and sites activity

Figurski, M.; Szafranek, K.; Wrona, M.

2009-04-01

64

Clinical applications of small bowel capsule endoscopy  

PubMed Central

Video capsule endoscopy has revolutionized our ability to visualize the entire small bowel mucosa. This modality is established as a valuable tool for the diagnosis of obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, and other conditions involving the small bowel mucosa. This review includes an overview of the current and potential future clinical applications of small bowel video endoscopy. PMID:23983481

Kopylov, Uri; Seidman, Ernest G

2013-01-01

65

American Society for Gastrointestinal Endoscopy  

MedlinePLUS

... Screen4coloncancer.org Opportunities for Industry Advertising Donate Site maintenance alert! Some of our systems are currently unavailable. ... discounts end Oct. 27 GI Practice Management Essentials - Operations, Quality, Reimbursement December 11-14, 2014 Early reg. ...

66

ASG-EUPOS Monitoring with Reference to EPN  

Microsoft Academic Search

This paper concerns methods and results of processing of data collected by ASG-EUPOS (Active Geodetic Network - European Position Determination System) sites since the beginning of the system. The elaboration was made by Centre of Applied Geomatics from Military University of Technology and it was based on the experience gained during EPN (European Permanent Network) processing. Strategy was similar to

Mariusz Figurski; Pawel Kaminski; Krzysztof Kroszczynski; Karolina Szafranek

2009-01-01

67

Sketch of International Digestive Endoscopy Network 2012 Meeting: Overview  

PubMed Central

International Digestive Endoscopy Network (IDEN) is an international meeting covering scientific subjects of diverse topics about upper gastrointestinal (GI) endoscopy, colonoscopy, endoscopic ultrasonography, and PB endoscopy. IDEN is organized by Korean Society of Gastrointestinal Endoscopy and the Korean Gastrointestinal Endoscopy Research Foundation, and took its first step in 2011 in Seoul, Korea. IDEN inaugurated a new era of diagnostic and therapeutic GI endoscopy. IDEN 2012 was designed to offer participants from all over the world with opportunities to share up-to-date knowledge about basic and clinical aspects of GI endoscopy and to engage in in-depth discussion with worldwide well-known experts. During the 2 days of meeting, there were 62 invited lectures, 28 case-based discussions, 20 video lectures, and 6 breakfast with the experts. There were a total of 598 participants registered from 12 countries, including Asian countries, Europe, and USA as well as Korea. PMID:22977804

2012-01-01

68

Wireless endoscopy  

Microsoft Academic Search

Background: Miniaturization of electronic components may allow the construction of new types of endoscopes that no longer require external wires, cables, or optical fibers. Our aim was to assess the feasibility of wireless endoscopy and to construct experimental prototypes using miniature charge-coupled device cameras, light sources, microwave transmitters, and batteries. Methods: Feasibility, dimensions of miniature components, and power requirements were

Feng Gong; Paul Swain; Timothy Mills

2000-01-01

69

LC phase bias investigation of ASG-EUPOS stations  

NASA Astrophysics Data System (ADS)

Monitoring of permanent stations that make up the reference frame is an integral part of the geodesists work. Selection of reference stations is based on analysis of parameters characterizing them (hardware, coordinates' stability, mounting, location). In this paper, we took into account phase residual as an indicator of unmodelled signal. Phase residuals were computed based on ASG-EUPOS and EPN observation processing. The results show the connection between the method of mounting the antenna and the residuals. We have reviewed multipath effect at ASG-EUPOS stations, and chosen those which are characterized by the highest value of phase residual. The results show that LC phase residual is a good factor to characterize site's solutions' reliability. For majority of sites RMS values were less than 10 mm. Modulations associated with multipath effect were observed for few ASG-EUPOS sites only. Phase residuals are distributed specifically for sites, which antennas are mounted on pillars (more common for EPN sites). For majority of analysed sites phase residual distribution was similar for different days and did not depend directly on atmosphere condition. Monitorowanie permanentnych stacji GPS/GNSS, które tworz? uk?ad wspó?rz?dnych stanowi integraln? cz??? pracy geodetów. Wybór takich stacji bazuje na analizie parametrów, które charakteryzuj? jej jako?? (mi.in. sprz?t, stabilno?? wspó?rz?dnych, lokalizacja i monta? anteny). W przedstawionej pracy przeanalizowano jeden z nich - odchy?ki obserwacji fazowych. Warto?ci tych ró?nic obliczono dla stacji EPN oraz ASG-EUPOS z rozwi?za? dobowych. Dla wi?kszo?ci z analizowanych stacji ?rednia kwadratowa otrzymanych odchy?ek nie przekracza?a 10 mm. Warto?? ta oraz sam rozk?ad odchy?ek nie zmienia? si? znacz?co przy ró?nych warunkach atmosfery. Na podstawie otrzymanych odchy?ek fazowych przeanalizowano wp?yw wielotorowo?ci na tych stacjach. Modulacje warto?ci odchy?ek na niskich k?tach elewacji, których jednym ze ?róde? jest efekt wielotorowo?ci otr zymano zaledwie na kilku stacjach ASG-EUPOS. Taka sytuacja mia?a miejsce g?ównie dla stacji, których anteny zamontowane s? na s?upach. Wyniki pokaza?y, ?e podej?cie wykorzystuj?ce analiz? odchy?ek liniowej kombinacji obserwacji fazowych jest dobr? metod? do oceny pracy stacji.

Araszkiewicz, Andrzej; Szafranek, Karolina

2013-12-01

70

Asg1 is a stress-inducible gene which increases stomatal resistance in salt stressed potato  

PubMed Central

The identification of critical components in plant salt stress adaptation has greatly benefitted, in the last two decades, from fundamental discoveries in Arabidopsis and close model systems. Nevertheless, this approach has also highlighted a non-complete overlap between stress tolerance mechanisms in Arabidopsis and agricultural crops. Within a long-running research program aimed at identifying salt stress genetic determinants in potato by functional screening in Escherichia coli, we isolated Asg1, a stress-related gene with an unknown function. Asg1 is induced by salt stress in both potato and Arabidopsis and by abscisic acid in Arabidopsis. Asg1 is actively transcribed in all plant tissues. Furthermore, Asg1 promoter analysis confirmed its ubiquitous expression, which was remarkable in pollen, a plant tissue that undergoes drastic dehydration/hydration processes. Fusion of Asg1 with green fluorescent protein showed that the encoded protein is localized close to the plasma membrane with a non-continuous pattern of distribution. In addition, Arabidopsis knockout asg1 mutants were insensitive to both NaCl and sugar hyperosmotic environments during seed germination. Transgenic potato plants over-expressing the Asg1 gene revealed a stomatal hypersensitivity to NaCl stress which, however, did not result in a significantly improved tuber yield in stress conditions. Altogether, these data suggest that Asg1 might interfere with components of the stress signaling pathway by promoting stomatal closure and participating in stress adaptation. PMID:22854180

Batelli, Giorgia; Massarelli, Immacolata; Van Oosten, Michael; Nurcato, Roberta; Vannini, Candida; Raimondi, Giampaolo; Leone, Antonella; Zhu, Jian-Kang; Maggio, Albino; Grillo, Stefania

2013-01-01

71

Complex therapeutic-diagnostic endoscopy with laser irradiation and in-Situ spectrophotometry of erosive-ulcerative impairments of upper part of the gastrointestinal tract  

NASA Astrophysics Data System (ADS)

Today in the world there are a lot of effective methods to treat different disease with the use of low-level laser (LLL) radiation. And there are a number of well-known effective noninvasive optical diagnostic techniques, such as a laser fluorescence spectroscopy (LFS), elastic-scattering spectroscopy (ESS), absorption spectroscopy (ABSS), etc. In this paper the first experience of the complex laser-optical therapeutic-diagnostic treatment for the erosive-ulcerative impairments (EUI) of the upper part of the gastrointestinal tract (UPGT) are discussed. The EUI of the UPGT very often have a resistance to a medicamentous therapy and the treatment of that is very difficult in this case. The method of LLL irradiation through an endoscope has been used to increase the efficiency of LLL-therapy and to monitor a general process of recovery respectively. The standard biopsy was investigated to estimate the effect of care as well. As it is shown in this paper the in-situ ABSS allows to optimize the LLL treatment parameters for each patient and for each procedure if the laser has effect on a blood circulation in the irradiated zone. In this case the doctors can see the considerable effect and the reduction period of the cure for EUI. Otherwise, the ABSS indicates that there will be no any effect of LLL therapy for such patient and another methods of treatment are needed. The LFS in this case shows the absence of effect during the care course too. On the basis of analysis of the obtained results this paper presents our current understanding of mechanisms of the laser-induced fluorescence diagnostics and LLL therapy effect for EUI of the UPGT. Today this technique has the official approval of the Ministry of Health of Russian Federation.

Rogatkin, Dmitrii A.; Tereschenko, Sergey G.; Lapaeva, Ludmila G.; Gorenkov, Roman V.

2002-05-01

72

A cross-sectional study to assess the feasibility of a short message service to improve adherence of outpatients undergoing sedation gastrointestinal endoscopy in the People's Republic of China  

PubMed Central

Background Adherence to the prescribed preparation regimen for patients scheduled for sedation gastrointestinal endoscopy (SGIE) often fails to meet health care providers’ expectations. Therefore, the feasibility of using mobile phones to improve the adherence of outpatients was assessed among outpatients scheduled for SGIE. Methods The study was designed as a cross-sectional study using survey questionnaires. Outpatients who would be undergoing SGIE were enrolled. The main outcomes included proportions of outpatients who have access to mobile phones, and the use of text-messaging among outpatients. Willingness to receive text messages and personal opinions about short message service (SMS) were also investigated. Characteristics of outpatients, including socio-demographic factors, with a mobile phone (or those who could receive and read messages) compared with those without a mobile phone (or those who could not receive and read messages) were compared using the chi-square test. Logistic regression was used to analyze significant contributing factors associated with mobile phone ownership and the use of text messages. Results A large majority of outpatients owned personal mobile phones (94.9%) and could receive and read the messages (78.9%). Most of the outpatients were willing to receive a pre-procedure education via text message (81.9%). Outpatients aged 16–39 years old and those with a college education or higher were more likely to use mobile phones and read SMS than outpatients aged 60–80 years old and those with only a primary education level (P<0.0001). Outpatients who lived in an urban setting were more likely to own a mobile phone than outpatients who lived in a rural setting (P=0.002). Conclusion The accessibility of mobile phones and the frequent use of message functions on mobile phones provide support for the initiation of an SMS reminder system for outpatients who will undergo SGIE in the People’s Republic of China. In addition, the characteristics of the target study population should be considered when carrying out an SMS intervention. PMID:25278748

Deng, Xiaoqian; Ye, Ling; Wang, Yuting; Zhu, Tao

2014-01-01

73

New aspects of modern endoscopy.  

PubMed

The prognosis for patients with malignancies of the gastrointestinal-tract is strictly dependent on early detection of premalignant and malignant lesions. However, small, flat or depressed neoplastic lesions remain difficult to detect with these technologies thereby limiting their value for polyp and cancer screening. At the same time computer and chip technologies have undergone major technological changes which have greatly improved endoscopic diagnostic investigation. New imaging modalities and techniques are very notable aspects of modern endoscopy. Chromoendoscopy or filter-aided colonoscopy (virtual chromoendoscopy) with high definition endoscopes is able to enhance the detection and characterization of lesions. Finally, confocal laser endomicroscopy provides histological confirmation of the presence of neoplastic changes. The developing techniques around colonoscopy such as the retro-viewing colonoscope, the balloon-colonoscope or the 330-degrees-viewing colonoscope try to enhance the efficacy by reducing the adenoma miss rate in right-sided, non-polypoid lesions. Colon capsule endoscopy is limited to identifying cancer and not necessarily small adenomas. Preliminary attempts have been made to introduce this technique in clinical routine. PMID:25132916

Rey, Johannes Wilhelm; Kiesslich, Ralf; Hoffman, Arthur

2014-08-16

74

New aspects of modern endoscopy  

PubMed Central

The prognosis for patients with malignancies of the gastrointestinal-tract is strictly dependent on early detection of premalignant and malignant lesions. However, small, flat or depressed neoplastic lesions remain difficult to detect with these technologies thereby limiting their value for polyp and cancer screening. At the same time computer and chip technologies have undergone major technological changes which have greatly improved endoscopic diagnostic investigation. New imaging modalities and techniques are very notable aspects of modern endoscopy. Chromoendoscopy or filter-aided colonoscopy (virtual chromoendoscopy) with high definition endoscopes is able to enhance the detection and characterization of lesions. Finally, confocal laser endomicroscopy provides histological confirmation of the presence of neoplastic changes. The developing techniques around colonoscopy such as the retro-viewing colonoscope, the balloon-colonoscope or the 330-degrees-viewing colonoscope try to enhance the efficacy by reducing the adenoma miss rate in right-sided, non-polypoid lesions. Colon capsule endoscopy is limited to identifying cancer and not necessarily small adenomas. Preliminary attempts have been made to introduce this technique in clinical routine. PMID:25132916

Rey, Johannes Wilhelm; Kiesslich, Ralf; Hoffman, Arthur

2014-01-01

75

Endoscopy reporting standards  

PubMed Central

OBJECTIVES: The Canadian Association of Gastroenterology (CAG) recently published consensus recommendations for safety and quality indicators in digestive endoscopy. The present article focuses specifically on the identification of key elements that should be found in all electronic endoscopy reports detailing recommendations adopted by the CAG consensus group. METHODS: A committee of nine individuals steered the CAG Safety and Quality Indicators in Endoscopy Consensus Group, which had a total membership of 35 voting individuals with knowledge on the subject relating to endoscopic services. A comprehensive literature search was performed with regard to the key elements that should be found in an electronic endoscopy report. A task force reviewed all published, full-text, adult and human studies in French or English. RESULTS: Components to be entered into the standardized report include identification of procedure, timing, procedural personnel, patient demographics and history, indication(s) for procedure, comorbidities, type of bowel preparation, consent for the procedure, pre-endoscopic administration of medications, type and dose of sedation used, extent and completeness of examination, quality of bowel preparation, relevant findings and pertinent negatives, adverse events and resulting interventions, patient comfort, diagnoses, endoscopic interventions performed, details of pathology specimens, details of follow-up arrangements, appended pathology report(s) and, when available, management recommendations. Summary information should be provided to the patient or family. CONCLUSION: Continuous quality improvement should be the responsibility of every endoscopist and endoscopy facility to ensure improved patient care. Appropriate documentation of endoscopic procedures is a critical component of such activities. PMID:23712304

Beaulieu, Daphnee; Barkun, Alan N; Dube, Catherine; Tinmouth, Jill; Halle, Pierre; Martel, Myriam

2013-01-01

76

Towards CARS Endoscopy Franois Lgar*  

E-print Network

Towards CARS Endoscopy François Légaré* Center for Nanoscale Systems and Department of Chemistry provide a proof-of-principle demonstration of CARS endoscopy. The design utilizes a single mode optical characteristics at intensities needed for endoscopy. CARS endoscopic images are recorded by collecting the epi-CARS

Xie, Xiaoliang Sunney

77

Update in Biliary Endoscopy  

Microsoft Academic Search

Biliary endoscopy has seen the development of several new techniques in the last few years. Its current role includes direct diagnostic imaging, tissue sampling, early diagnosis and palliation of biliary tumors. Relatively new methods for biliary stones management are electrohydraulic lithotripsy combined with choledochoscope guidance and laser lithotripsy. Intraductal ultrasound, confocal laser endomicroscopy and optical coherence tomography are emerging, purely

Guido Costamagna; Ivo Boškoski; Pietro Familiari; Andrea Tringali; Paola Cesaro; Vincenzo Perri

2011-01-01

78

Interventional Radiology Endoscopy Service  

E-print Network

of indwelling ureteral catheter stents can significantly improve outcome after surgery and reduce the riskInterventional Radiology Endoscopy Service #12;Using advanced imaging equipment (digital. This allows certain conditions to be potentially managed without the need for open surgery, or with minimally

Maizels, Rick

79

Gastrointestinal involvement in POEMS syndrome: a novel clinical manifestation  

PubMed Central

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) is characterised by a rare multisystem disorder of unknown pathogenesis. Although its pathophysiology is not well understood, overexpression of proinflammatory cytokines has been implicated. Gastrointestinal system disorders have not been reported among the components of the syndrome. A case is reported of POEMS syndrome with gastrointestinal involvement shown by gastrointestinal endoscopy. PMID:16143676

Dogan, S; Beyazit, Y; Shorbagi, A; Koklu, S; Ustunel, S; Guler, N; Uner, A

2005-01-01

80

Endoscopy in screening for digestive cancer  

PubMed Central

The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett’s esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of superficial capillaries; then characterization of the morphology of the lesion according to the Paris classification and prediction of the risk of malignancy and depth of invasion, with the help of chromoscopy, magnification and image processing with neutrophil bactericidal index or FICE. Then treatment decision offers 3 options according to histologic prediction: abstention, endoscopic resection, surgery. The rigorous quality control of endoscopy will reduce the miss rate of lesions and the occurrence of interval cancer. PMID:23293721

Lambert, Rene

2012-01-01

81

Flexible and capsule endoscopy for screening, diagnosis and treatment.  

PubMed

Endoscopy dates back to the 1860s, but many of the most significant advancements have been made within the past decade. With the integration of robotics, the ability to precisely steer and advance traditional flexible endoscopes has been realized, reducing patient pain and improving clinician ergonomics. Additionally, wireless capsule endoscopy, a revolutionary alternative to traditional scopes, enables inspection of the digestive system with minimal discomfort for the patient or the need for sedation, mitigating some of the risks of flexible endoscopy. This review presents a research update on robotic endoscopic systems, including both flexible scope and capsule technologies, detailing actuation methods and therapeutic capabilities. A future perspective on endoscopic potential for screening, diagnostic and therapeutic gastrointestinal procedures is also presented. PMID:25148269

Sliker, Levin J; Ciuti, Gastone

2014-11-01

82

Innovative video capsule endoscopy for detection of ubiquitously elongated small intestinal villi in Cronkhite-Canada syndrome  

PubMed Central

Cronkhite-Canada syndrome (CCS) is a rare non-familial disorder with multiple gastrointestinal polyps and ectodermal changes. Adenomatous and carcinomatous changes have been reported. Video capsule endoscopy is a useful non-invasive tool to reveal polypoid lesions of the gastrointestinal tract suspicious for malignancy. We report a case of a patient with CCS with excessively elongated intestinal villi resembling dense sea grass under water as well as multiple polyps of the intestinal mucosa revealed by video capsule endoscopy. This report presents for the first time small bowel video sequences of CCS qualifying video capsule endoscopy for screening purposes and early detection of malignancy. PMID:24729822

Heinzow, Hauke Sebastian; Domschke, Wolfram

2013-01-01

83

Innovative video capsule endoscopy for detection of ubiquitously elongated small intestinal villi in Cronkhite-Canada syndrome.  

PubMed

Cronkhite-Canada syndrome (CCS) is a rare non-familial disorder with multiple gastrointestinal polyps and ectodermal changes. Adenomatous and carcinomatous changes have been reported. Video capsule endoscopy is a useful non-invasive tool to reveal polypoid lesions of the gastrointestinal tract suspicious for malignancy. We report a case of a patient with CCS with excessively elongated intestinal villi resembling dense sea grass under water as well as multiple polyps of the intestinal mucosa revealed by video capsule endoscopy. This report presents for the first time small bowel video sequences of CCS qualifying video capsule endoscopy for screening purposes and early detection of malignancy. PMID:24729822

Heinzow, Hauke Sebastian; Domschke, Wolfram; Meister, Tobias

2014-03-01

84

[Learning gastroenterologic endoscopy].  

PubMed

1. Knowledge of the gastroenterological endoscopy and biopsy is necessary at all levels of medical education. 2. Knowledge of students: possible methods, diagnostic effectiveness, stress of the patients. Knowledge of the candidates for specialisation: indications, contraindications, possibilities of the method also in reference to the individual case. Persons interested in the subspecialisation gastro-enterology: theory, possibilities and limits, technical performance. Experienced endoscopists: regular refreshment and supplementation of knowledge and skill in highly specialised endoscopic centres. 3. Tested teaching methods are lecture, report, study of atlants and text-books, demonstrations of diapositives in connection with schematic figures, seminars with diapositives, film demonstrations, work at the patient under supervision of the tutor and use of a demonstration device as well as endoscopic demonstration by means of colour television. The centre is, however, the individual examination of the patient. 4. Knowledge of the subspecialist: History of endoscopy, knowledge of instruments, optics and endoscopic perspective, physical fundaments about light and photography, human macro- and microscopic anatomy, care of instruments and desinfection. Indications, contraindications, possibilities and limits of the method, emergency and intensive medicine, writing of the findings. PMID:1020386

Koelsch, K A

1976-11-01

85

Evaluation and outcomes of patients with obscure gastrointestinal bleeding  

PubMed Central

Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent bleeding or presence of iron deficiency anaemia after evaluation with a negative bidirectional endoscopy. OGIB accounts for 5% of gastrointestinal bleeding and presents a diagnostic challenge. Current modalities available for the investigation of OGIB include capsule endoscopy, balloon assisted enteroscopy, spiral enteroscopy and computed tomography enterography. These modalities overcome the limitations of previous techniques. Following a negative bidirectional endoscopy, capsule endoscopy and double balloon enteroscopy remain the cornerstone of investigation in OGIB given their high diagnostic yield. Long-term outcome data in patients with OGIB is limited, but is most promising for capsule endoscopy. This article reviews the current literature and provides an overview of the clinical evaluation of patients with OGIB, available diagnostic and therapeutic modalities and long-term clinical outcomes. PMID:25400992

Santhakumar, Cositha; Liu, Ken

2014-01-01

86

Evaluation and outcomes of patients with obscure gastrointestinal bleeding.  

PubMed

Obscure gastrointestinal bleeding (OGIB) is defined as recurrent or persistent bleeding or presence of iron deficiency anaemia after evaluation with a negative bidirectional endoscopy. OGIB accounts for 5% of gastrointestinal bleeding and presents a diagnostic challenge. Current modalities available for the investigation of OGIB include capsule endoscopy, balloon assisted enteroscopy, spiral enteroscopy and computed tomography enterography. These modalities overcome the limitations of previous techniques. Following a negative bidirectional endoscopy, capsule endoscopy and double balloon enteroscopy remain the cornerstone of investigation in OGIB given their high diagnostic yield. Long-term outcome data in patients with OGIB is limited, but is most promising for capsule endoscopy. This article reviews the current literature and provides an overview of the clinical evaluation of patients with OGIB, available diagnostic and therapeutic modalities and long-term clinical outcomes. PMID:25400992

Santhakumar, Cositha; Liu, Ken

2014-11-15

87

Malpractice claims for endoscopy  

PubMed Central

AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure. METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time. RESULTS: There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequencies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374??794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70??730??101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation. CONCLUSION: There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation. PMID:23596540

Hernandez, Lyndon V; Klyve, Dominic; Regenbogen, Scott E

2013-01-01

88

Antenna calibration models in height determinations in ASG-EUPOS' POZGEO-D service - a case study  

NASA Astrophysics Data System (ADS)

GNSS observations in a network of permanent stations are a complex systems which offer both post-processing and corrections sent in real-time. In Poland such a system, known as the Polish Active Geodetic Network (ASG-EUPOS), has been in operation since June 2008. The GNSS development forces also continuous modernization of ASG-EUPOS (e.g.: GPS/GLONASS receivers mounting, ASG+ project) which aims to improve the accuracy of position determination. One of the factors limiting the accuracy (especially the vertical component) is antenna phase center variations (PCV) problem. PCV problem is resolved using the antenna calibration process. As a result, antenna phase center corrections models (PCC) are created. So far three methods have been developed to determine GNSS antenna PCV. For this reason and because of some problems in introducing of absolute models at present we can speak of three models of receiver antennas PCV (so called: relative, absolute converted and absolute). The aim of this paper was to study the height differences caused by using different calibration models in GNSS observation processing done in the ASG-EUPOS POZGEO-D service. The analysis was done using 3 days of GNSS data, collected with four different receivers and antennas, divided by one hour observation sessions. The results of the calculations show that switching between PCV models may have a visible effect on height determination, particularly in high accuracy applications.

Dawidowicz, Karol

2012-12-01

89

Aero-Sol-Gel (ASG) Reactor For Nano-Powder Synthesis G. Beaucage, J. Hyeon-Lee, D. J. Kohls  

E-print Network

Department of Materials Science and Engineering S. E. Pratsinis Department of Chemical Engineering University) allows for manipulation of the structure, chemical composition and surface area of silica powders through. The ASG reactor displays transport effects similar to those previously seen in laminar flame reactors

Beaucage, Gregory

90

Endoscopy in inflammatory bowel disease.  

PubMed

Small bowel imaging and endoscopy in inflammatory bowel disease (IBD) underwent a lot of change and advancement in the recent years. Modalities have shifted from gastroscopy, colonoscopy and small bowel follow through, to ileo-colonoscopy, computed tomography (CT) or magnetic resonance (MR), enteroscopy, wireless video capsule endoscopy and balloon assisted enteroscopy. Nowadays endoscopy has a major role in the diagnosis of IBD, assessing its extent, treating some of its complications (stricture, bleeding), assessing the success of various treatments (mucosal healing), and as a predictor of disease course. Wireless capsule endoscopy (WCE) is a relatively new "toy" allowing direct, patient friendly, visualization of the entire small bowel mucosa. It has gained a substantial role in the evaluation of patients with suspected Chron's Disease (CD) and indeterminate colitis. WCE has a high positive predictive value in patients with suspected CD, when one uses more than two of the International Conference on Capsule Endoscopy (ICCE) criteria, and not less important, a very high negative predictive value in patients with suspected CD. Its role in patients with known CD, assessing their disease activity and extent, its role in assessing postsurgical small bowel recurrence and its role in the evaluation of mucosal healing are still unclear. Balloon assisted enteroscopy has established its role as a complementary tool in cases where there is need of biopsies or treatment (dilatation of strictures). The present review will summarize the role of endoscopy in the diagnosis of IBD, in assessing its activity, its management, interventional endoscopy and cancer surveillance. PMID:23867947

Carter, D; Lang, A; Eliakim, R

2013-09-01

91

Intradural spinal endoscopy in children.  

PubMed

Intracranial endoscopy in the treatment of hydrocephalus, arachnoid cysts, or brain tumors has gained wide acceptance, but the use of endoscopy for intradural navigation in the pediatric spine has received much less attention. The aim of the authors' present study was to analyze their experience in using spinal endoscopy to treat various pathologies of the spinal canal. The authors performed a retrospective review of intradural spinal endoscopic cases at their institution. They describe 4 representative cases, including an arachnoid cyst, intrinsic spinal cord tumor, holocord syrinx, and split cord malformation. Intradural spinal endoscopy was useful in treating the aforementioned lesions. It resulted in a more limited laminectomy and myelotomy, and it assisted in identifying a residual spinal cord tumor. It was also useful in the fenestration of a multilevel arachnoid cyst and in confirming communication of fluid spaces in the setting of a complex holocord syrinx. Endoscopy aided in the visualization of the spinal cord to ensure the absence of tethering in the case of a long-length Type II split spinal cord malformation. Conclusions Based on their experience, the authors found intradural endoscopy to be a useful surgical adjunct and one that helped to decrease morbidity through reduced laminectomy and myelotomy. With advances in technology, the authors believe that intradural endoscopy will begin to be used by more neurosurgeons for treating diseases of this anatomical region. PMID:21721897

Chern, Joshua J; Gordon, Amber S; Naftel, Robert P; Tubbs, R Shane; Oakes, W Jerry; Wellons, John C

2011-07-01

92

Hyperemesis gravidarum: a case of starvation and altered sensorium gestosis (ASG).  

PubMed

Of the problems that complicate child-bearing, hyperemesis gravidarum (HG), or severe nausea and vomiting of pregnancy (NVP), is likely one of the most painful with unrelenting retching and vomiting that can lead to measurable injuries such as Mallory-Weiss Syndrome and esophageal rupture, and/or subtle maternal cognitive impairments related to starvation and dehydration. Recognized hallmarks of HG include dehydration, ketonuria, weight loss over 5%, and electrolyte abnormalities not attributable to other causes. Historically providers regarded the hyperemetic as a difficult to treat patient with potentially underlying psychological problems. Sick patients who experience pain and suffering present challenges to care, not excepting NVP. Ill patients can be demanding and agitated. Agitation can be one of the early signs of delirium or altered mental status (AMS). AMS can include previously diagnosed psychiatric conditions as well as new onset of Wernicke's encephalopathy, deliria, insomnia, hallucinations and autoscopy, resulting from various etiologies including and not limited to medications, pain including pain from hunger, vomiting and retching, constipation, dehydration, altered electrolytes, hypoglycemia, malnutrition and sleep deprivation. AMS may have a subtle waxing and waning trajectory, making the condition difficult to diagnosis in early stages. What have not been well elucidated in AMS are subjective images and/or experiences. Whether all AMS experiences are similar is unknown. We believe there may be a transient alteration of cognitive status or "altered sensorium gestosis" (ASG), attributed to the direct insults of hyperemesis gravidarum which will be discussed herein. How prevalent ASG might be is unknown and needs further investigation. PMID:24613734

Erick, Miriam

2014-05-01

93

The Real-Time Ionospheric Service for ASG-EUPOS Network  

NASA Astrophysics Data System (ADS)

ASG-EUPOS Network is the Polish part of the European Position Determination System consisting of more than 100 permanently working in Poland GNSS receivers. The main goal of the established ionospheric service is supporting positioning and navigation with high accuracy both in real-time and postprocessing. The primary products of the system are the daily variations of the TEC over stations and the daily maps of the TEC created using carrier phase leveled to code observations and spherical harmonic expansion as a mapping function. The maps are characterized by high temporal (0.5 hour) and spatial resolution (0.5 x 0.5 degree). In order to make possible taking into account observations with low elevation angles during the processing GNSS data, the final maps are extended using about 100 European GNSS stations belong to the IGS/EPN network. The final products are written in modified ionex file covering the area from -10 to 40 degree for longitude and from 35 to 60 degree for latitude. For the real-time application of the ionospheric TEC map in the GNSS positioning the predicted map using autocovariance and ARMA methods is created. The second part of the presented service is connected with monitoring of the different scale ionospheric irregularities. The detecting of the small-scale disturbances is done with two kind of high-rate GNSS receivers (50Hz): Septentrio POLARXS and JAVAD SIGMA. The scintillation indices for amplitude and phase are calculated in near real-time for each scintillation GNSS receiver. In order to monitor medium and large scale ionospheric irregularities the ROT (rate of TEC) time series for all ASG-EUPOS receivers are determined.

Sieradzki, Rafal; Zakharenkova, Irina; Sidorowicz, Tomasz; Krankowski, Andrzej

2013-04-01

94

On the quality of EPN and ASG-EUPOS time series  

NASA Astrophysics Data System (ADS)

The Centre of Applied Geomatics as the one of 18 EPN (EUREF Permanent Network) Local Analysis Centres processes data from the network consisting of 114 sites evenly distributed among the Europe. It provides coordinates with full matrices in SINEX files and troposphere parameters on weekly basis. They are being used to construct the reference frame. Helmert parameters indicate the coherence between reference solution and each of weekly solutions. Daily EPN solutions were determined in the frame of EPN Reprocessing project. Apart from that, data gathered by all ASG-EUPOS (Polish Active Geodetic Network consisting of more than 130 sites) is being processed using the same strategy, which is applied by the EPN community. As the result daily and weekly time series of coordinates are determined. Basing on the weekly solutions cumulative coordinates and velocities are calculated. Their characteristic is very important in the context of the reliability estimation since many potential ambiguities in GPS system exist. The basic parameters which were determined were skewness and kurtosis. Skewness is a measure of the lack of symmetry of probability distribution. Negative values for the skewness indicate data that are skewed left and positive values indicate data that are skewed right, the skewness for a normal distribution is zero. Kurtosis is a measure of whether the data are peaked or flat relative to the normal distribution. High kurtosis means that the peak near the mean is distinct, and probability distribution decline rather rapidly. Low kurtosis means that the peak near the mean is rather flat than sharp and the probability distribution tends to be more uniform than normal. The presentation will deal with the analysis on the topocentric coordinates (North-East and Up separately) of the chosen EPN and ASG-EUPOS sites aimed at quality and reliability investigation.

Bogusz, Janusz; Figurski, Mariusz; Klos, Anna; Kosek, Wieslaw; Szafranek, Karolina

2013-04-01

95

[Gastrointestinal bleeding in the elderly].  

PubMed

Peptic ulcer disease is a common cause of gastrointestinal bleeding, independent of the patient's age. With advancing age, an increase of lower gastrointestinal bleeding (diverticula, angiodysplasia) has been observed. The administration of non-steroidal anti-inflammatory drugs and aspirin is an important risk factor for upper and lower gastrointestinal bleeding, thus in patients aged 65 years and more a concomitant therapy with proton pump inhibitors is recommended in order to prevent ulcer bleeding. Even in very old individuals endoscopy should be used for the diagnosis of gastrointestinal bleeding, providing the opportunity for definite endoscopic bleeding therapy. In elderly patients with comorbidities and recurrent bleeding after endoscopic therapy or continuous blood loss, surgery or transarterial embolisation should be considered in good time. PMID:23460102

Glaser, J

2014-08-01

96

Patient satisfaction with the endoscopy experience and willingness to return in a central Canadian health region  

PubMed Central

OBJECTIVE: Patient experiences with endoscopy visits within a large central Canadian health region were evaluated to determine the relationship between the visit experience and the patients’ willingness to return for future endoscopy, and to identify the factors associated with patients’ willingness to return. METHODS: A self-report survey was distributed to 1200 consecutive individuals undergoing an upper and/or lower gastrointestinal endoscopy at any one of the six hospital-based endoscopy facilities in the region. The Spearman correlation coefficient was used to assess the association between the patients’ overall rating of the visits and willingness to return for repeat procedures under similar medical circumstances. Logistic regression analyses were performed to identify the factors associated with willingness to return for repeat endoscopy and overall satisfaction (rating) of the visit. RESULTS: A total of 529 (44%) individuals returned the questionnaire, with 45% rating the visit as excellent and 56% indicating they were extremely likely to return for repeat endoscopy. There was a low moderate correlation between overall rating of the visit and patients’ willingness to return for repeat endoscopy (r=0.30). The factors independently associated with patient willingness to return for repeat endoscopy included perceived technical skills of the endoscopists (OR 2.7 [95% CI 1.3 to 5.5]), absence of pain during the procedure (OR 2.2 [95% CI 1.3 to 3.6]) and history of previous endoscopy (OR 2.4 [95% CI 1.4 to 4.1]). In contrast, the independent factors associated with the overall rating of the visit included information provided pre- and postprocedure, wait time before and on the day of the visit, and the physical environment. CONCLUSIONS: To facilitate patient return for needed endoscopy, it is important to assess patients’ willingness to return because positive behavioural intent is not simply a function of satisfaction with the visit. PMID:23712300

Loftus, Russell; Nugent, Zoann; Graff, Lesley A; Schumacher, Frederick; Bernstein, Charles N; Singh, Harminder

2013-01-01

97

Self-Stabilizing Colonic Capsule Endoscopy: Pilot Study of Acute Canine Models  

Microsoft Academic Search

Video capsule endoscopy (VCE) is a noninvasive method for examining the gastrointestinal tract which has been successful in small intestine studies. Recently, VCE has been attempted in the colon. However, the capsule often tumbles in the wider colonic lumen, resulting in missed regions. Self-stabilizing VCE is a novel method to visualize the colon without tumbling. The aim of the present

Dobromir Filip; Orly Yadid-Pecht; Christopher N. Andrews; Martin P. Mintchev

2011-01-01

98

Acute Nonvariceal Upper Gastrointestinal Hemorrhage.  

PubMed

Upper endoscopy to assess the risk of rebleeding in patients with nonvariceal upper gastrointestinal bleeding may be used for triage, allowing outpatient care of selected patients and leading to significant cost savings. Over the last 10 years, hospitalization days required for upper gastrointestinal bleeding have decreased significantly and the majority of patients with upper gastrointestinal bleeding undergo endoscopy within 24 hours of admission. Twenty percent to 35% of these endoscopies include endoscopic hemostatic therapy. Endoscopic treatment is recommended for actively bleeding (ie, spurting or oozing) visible vessels and nonbleeding visible vessels that are raised and cannot be washed off. Endoscopic methods can be divided into thermal (multipolar coagulation, heater probe, argon plasma coagulator, Nd:YAG laser) and nonthermal (eg, injection therapy); both types are effective. A combination of injection and thermal therapy with initial injection to slow the bleeding or "clear the field" followed by coagulation of the identified vessel is popular. Bleeding recurs in 15% of patients. A recent randomized controlled trial of repeat endoscopic treatment versus surgery for patients with recurrent ulcer bleeding concluded that endoscopic retreatment is superior to surgery. Most peptic ulcer rebleeding occurs within the first 3 days of presentation. A comparison of omeprazole and placebo therapy in high-risk ulcer patients with bleeding stigmata at endoscopy who were not treated endoscopically found that high-dosage omeprazole (40 mg twice a day) significantly lowered the rates of further bleeding and surgical intervention. Although unlikely to replace endoscopic therapy, this study demonstrated the efficacy of potent acid suppression, perhaps due to stabilization of clotting activity. A recent placebo-controlled trial of high-dosage parenteral omeprazole after endoscopic treatment of bleeding peptic ulcers demonstrated a substantial reduction in the risk of rebleeding. PMID:11879595

Elta, Grace H.

2002-04-01

99

Capsule Endoscopy versus Standard Tests in Influencing Management of Obscure Digestive Bleeding: Results from a German Multicenter Trial  

Microsoft Academic Search

BACKGROUND:Capsule endoscopy (CE) is a new modality for obscure digestive bleeding (OBD), but little is known about its influence on management and outcome.PATIENTS AND METHODS:Fifty-six patients (male\\/female 26\\/30; mean age 63 yr) with ODB, and negative upper and lower gastrointestinal (GI) endoscopy were included in this multicenter study. The diagnostic yield of CE was compared to three other tests (OT:

Bruno Neu; Christian Ell; Andrea May; Elke Schmid; Jürgen-Ferdinand Riemann; Friedrich Hagenmüller; Martin Keuchel; Nib Soehendra; Uwe Seitz; Alexander Meining; Thomas Rösch

2005-01-01

100

Diagnosis of gastrointestinal bleeding: A practical guide for clinicians.  

PubMed

Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians. PMID:25400991

Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

2014-11-15

101

Diagnosis of gastrointestinal bleeding: A practical guide for clinicians  

PubMed Central

Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

2014-01-01

102

Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting  

PubMed Central

AIM: To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy. METHODS: Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) study. The two institutions are situated in geographically and socially disparate areas. Data collection was by self-completion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it’s clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed. RESULTS: Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e., after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement. CONCLUSION: The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy. PMID:23674853

Zschau, Nora B; Andrews, Jane M; Holloway, Richard H; Schoeman, Mark N; Lange, Kylie; Tam, William CE; Holtmann, Gerald J

2013-01-01

103

Comparative Analysis of Satellite Measurements Calculation Results Using the Postprocessing Services: Asg-Eupos (Poland), Apps (USA) and CSRS (Canada)  

NASA Astrophysics Data System (ADS)

The publication has a cognitive research character. It presents a comparative analysis of free Internet services in Poland and abroad, used to adjust the data obtained using satellite measurement techniques. The main aim of this work is to describe and compare free tools for satellite data processing and to examine them for possible use in the surveying works in Poland. Among the many European and global services three of them dedicated to satellite measurements were selected: ASG-EUPOS (Poland), APPS (USA) and CSRS (Canada). The publication contains the results of calculations using these systems. Calculations were based on RINEX files obtained via postprocessing service (ASG-EUPOS network) POZGEO D for 12 reference stations in the South Poland. In order to examine differences in results between the ASG-EUPOS, APPS and CSRS the transformation points coordinate to a single coordinate system ETRF 2000 (in force in Poland) was made. Studies have shown the possibility of the calculation in Poland (in postprocessing mode) using the analyzed applications with global coverage.

Mika, Monika; Kudach, Jakub

2014-06-01

104

Diagnostic yield and clinical management after capsule endoscopy in daily clinical practice: A single-center experience  

PubMed Central

Background: Capsule endoscopy is an effective method of examining the small bowel in patients with obscure gastrointestinal bleeding, suspected inflammatory mucosal diseases and neoplasms. We herein evaluate the diagnostic yield of capsule endoscopy and its effect on clinical management in daily clinical practice. Patients and Methods: One hundred and one capsule endoscopies performed at the Department of Endoscopy and Motility Unit of G. Gennimatas General Hospital of Thessaloniki from May 2007 to February 2009 were retrospectively reviewed. Clinical management following capsule endoscopy findings was evaluated. The most frequent indication was obscure gastrointestinal bleeding (n=56, overt=20). Results: The overall diagnostic yield was 47.5%. The diagnostic yield was 88.9% in patients with overt bleeding who underwent early capsule endoscopy (within 5 days), versus 36.4% in patients who underwent late capsule endoscopy (p=0.028). Moreover, it reached 81.8% in patients with abdominal pain, with/without diarrhea and abnormal biological markers, versus 8.3% in patients with normal biological markers (p<0.0001). Capsule endoscopy was diagnostic in all patients with symptomatic celiac disease. Adenomas were found in 9 of 14 familial adenomatous polyposis patients. Capsule retention (>72 hours) occurred in two patients. Forty-three of 48 (89.6%) patients with positive capsule endoscopy findings that received intervention or medical treatment had positive clinical outcomes. Conclusions: Capsule endoscopy has an important diagnostic role and contribution in the clinical management during routine clinical practice; however, it remains to be determined which patients are more likely to benefit from this expensive examination. PMID:21311636

Katsinelos, P; Fasoylas, K; Chatzimavroudis, Gr; Lazaraki, G; Zavos, C; Pilpilidis, I; Terzoudis, S; Kokonis, G; Patsis, I; Beltsis, A; Paroutoglou, G; Kountouras, J

2010-01-01

105

Endoscopy in the Diagnosis and Management of Motility Disorders  

Microsoft Academic Search

Background  Gastrointestinal illness may result from either an underlying structural abnormality (e.g. neoplastic obstruction), or a functional\\u000a disorder (e.g. motor diarrhea), or both (e.g. achalasia with squamous esophageal cancer).\\u000a \\u000a \\u000a \\u000a \\u000a Aims  The purpose of this study was to highlight the potential value and role of endoscopy in the recognition and management of\\u000a patients with functional and motility disorders.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We performed a literature review

Yael Kopelman; George Triadafilopoulos

2011-01-01

106

Acute endoscopic intervention in non-variceal upper gastrointestinal bleeding  

PubMed Central

Upper gastrointestinal bleeding is one of the commonest emergencies encountered by general physicians. Once haemodynamic stability has been achieved, therapeutic endoscopy is vital in control and arrest of bleeding. Various methods are available and the evidence is reviewed as to the most optimal approach. Clinical parameters including timing of endoscopy, risk stratification, and predictors of failure will also be discussed together with a summary of recommendations based on current available evidence. PMID:15701740

Arasaradnam, R; Donnelly, M

2005-01-01

107

Upper gastrointestinal bleeding.  

PubMed

Upper gastrointestinal bleeding is a life threatening condition in children. Common sources of upper gastrointestinal bleeding in children include variceal hemorrhage (most commonly extra-hepatic portal venous obstruction in our settings) and mucosal lesions (gastric erosions and ulcers secondary to drug intake). While most gastrointestinal bleeding may not be life threatening, it is necessary to determine the source, degree and possible cause of the bleeding. A complete and thorough history and physical examination is therefore vital. Esophagogastroduodenoscopy and colonoscopy are currently considered the first-line diagnostic procedures of choice for upper and lower GI bleeding, respectively. The goals of therapy in a child with GI bleeding should involve hemodynamic resuscitation, cessation of bleeding from source and prevention of future episodes of GI bleeding. Antacids supplemented by H2- receptor antagonists and proton pump inhibitors are the mainstay in the treatment of bleeding from mucosal lesion. For variceal bleeds, therapeutic emergency endoscopy is the treatment of choice after initial hemodynamic stabilization of the patient. Independent prognostic factors are presence of shock and co-morbidities. Underlying diagnosis, coagulation disorder, failure to identify the bleeding site, anemia and excessive blood loss are other factors associated with poor prognosis. PMID:21153570

Bhatia, Vidyut; Lodha, Rakesh

2011-02-01

108

Fluorescent Endoscopy of Tumors in Upper Part of Gastrointestinal Tract  

NASA Astrophysics Data System (ADS)

In the recent study delta-aminolevulinic acid/Protoporphyrin IX (5-ALA/PpIX) is used as fluorescent marker for dysplasia and tumor detection in esophagus and stomach. The 5-ALA is administered per os six hours before measurements at dose 20mg/kg weight. High-power light-emitting diode at 405 nm is used as an excitation source. Special opto-mechanical device is built for LED to use the light guide of standard video-endoscopic system (Olimpus Corp.). Through endoscopic instrumental channel a fiber is applied to return information about fluorescence to microspectrometer (USB4000, OceanOptics Inc.). Very good correlation between fluorescence signals and histology examination of the lesions investigated is achieved.

Borisova, E.; Vladimirov, B.; Angelov, I.; Avramov, L.

2007-04-01

109

Capsule endoscopy: Present status and future expectation.  

PubMed

Video capsule endoscopy (CE) since its introduction 13 years back, has revolutionized our approach to small intestinal diseases. Obscure gastrointestinal bleed (OGIB) continues to be the most important indication for CE with a high sensitivity, specificity as well as positive and negative predictive values. It is best performed during ongoing bleed or immediately thereafter. Overt OGIB has a higher diagnostic yield than occult OGIB. However, even in iron deficiency anemia, CE is emerging as important investigation after initial negative work up. In suspected Crohn's disease (CD), CE has been shown superior to traditional imaging and endoscopic technique and should be considered after a negative ileocolonoscopy. Although CE has also been used for evaluating established CD, a high capsule retention rate precludes its use ahead of cross-sectional imaging. Celiac disease, particularly where gastro-duodenoscopy cannot be performed or is normal, can also be investigated by CE. Small bowel tumor, hereditary polyposis syndrome, and non-steroidal anti-inflammatory drugs induced intestinal damage are other indications for CE. Capsule retention is the only significant adverse outcome of CE and occurs mostly in presence of intestinal obstruction. This can be prevented by use of Patency capsule prior to CE examination. Presence of cardiac pacemaker and intracardiac devices continue to be relative contraindications for CE, though data do not suggest interference of CE with these devices. Major limitations of CE today include failure to control its movement from outside, inability of CE to acquire tissue for diagnosis, and lack of therapeutic help. With ongoing interesting and exciting developments taking place in these areas, these issues would be solved in all probability in near future. CE has the potential to become one of the most important tools in diagnostic and possibly in the therapeutic field of gastrointestinal disorder. PMID:25110430

Goenka, Mahesh K; Majumder, Shounak; Goenka, Usha

2014-08-01

110

Blood detection in wireless capsule endoscopy using expectation maximization clustering  

NASA Astrophysics Data System (ADS)

Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

2006-03-01

111

[Update on non-variceal gastrointestinal bleeding].  

PubMed

This article summarizes the main studies in the field of non-variceal gastrointestinal bleeding reported in the last American Congress of Gastroenterology (Digestive Disease Week) in 2013. Some of these studies have provided new knowledge and expertise in areas of uncertainty. In this context and among other findings, it has been reported that the administration of a proton pump inhibitor (PPI) prior to endoscopy or the early performance of endoscopy-within 6 hours of admission in patients with upper gastrointestinal bleeding (UGIB) (or colonoscopy within 24 hours in patients with lower gastrointestinal bleeding)-does not improve the prognosis of the event. It has also been reported that oral administration of a PPI after endoscopic hemostasis may produce a similar outcome to that of intravenously administered PPI in patients with upper gastrointestinal bleeding (UGIB). In the field of endoscopic therapy, the use of radiofrequency ablation for antral vascular ectasia is of interest. Regarding UGIB and nonsteroidal antiinflammatory drugs (NSAIDs), new data confirm the risk of cardiovascular events by stopping treatment with acetylsalicylic acid (ASA) after an episode of UGIB, the increased risk of UGIB when associating gastrotoxic drugs, and the need to identify both the gastrointestinal and cardiovascular risks of each NSAID and coxib when prescribing these agents. Finally, there is evidence that both environmental and genetic factors are involved in individual susceptibility to gastrointestinal bleeding. PMID:24160953

Lanas, Ángel

2013-10-01

112

The role of the surgeon in the evolution of flexible endoscopy.  

PubMed

Several cultures, including the Egyptians, Greeks, Romans, and Arabs, made attempts to view accessible human body cavities using a variety of instruments such as spatulas and specula. The first endoscope was created in 1806 when Phillip Bozzini, a German-born urologist, constructed the lichtleiter, which used concave mirrors to reflect candlelight through an open tube into the esophagus, bladder, or rectum. Maximilian Carl-Friedrich Nitze, another German urologist, produced the first usable cystoscope in 1877 by using series of lenses to increase magnification. He was also the first to place light inside the organ of interest to aid visualization. In 1880 Mikulicz made the first gastroscope using a system similar to Nitze's cystoscope. Modern endoscopy was born with the introduction of the fiberoptic endoscope in the late 1950s. Over the ensuing 50 years endoscopy revolutionized many aspects of the surgeon's practice. Endoscopy can now be used to diagnose and often treat gastrointestinal cancer, hemorrhage, obstruction, and inflammatory conditions. This review was initiated by the SAGES Flexible Endoscopy Committee to chronicle the role of the surgeon in the development and introduction of flexible endoscopy into clinical practice, historically and in contemporary surgery. Flexible endoscopy evolved out of surgeons' need to overcome diagnostic and therapeutic challenges. There have been many recent technological advances that facilitate endoluminal therapies, and flexible endoscopy is now traversing new ground. Surgeons have been major contributors in the development of all aspects of endoscopy. There is a continually expanding list of therapeutic options available to patients. The difficult questions of which procedure, on which patient, and when can be answered best by the surgeon versed in endoscopic, laparoscopic, and open surgical techniques. PMID:17180263

Morgenthal, C B; Richards, W O; Dunkin, B J; Forde, K A; Vitale, G; Lin, E

2007-06-01

113

Infrared luminescence in Bi-doped Ge-S and As-Ge-S chalcogenide glasses and fibers  

E-print Network

Experimental and theoretical studies of spectral properties of chalcogenide Ge-S and As-Ge-S glasses and fibers are performed. A broad infrared (IR) luminescence band which covers the 1.2-2.3~$\\mu$m range with a lifetime about 6~$\\mu$s is discovered. Similar luminescence is also present in optical fibers drawn from these glasses. Arsenic addition to Ge-S glass significantly enhances both its resistance to crystallization and the intensity of the luminescence. Computer modeling of Bi-related centers shows that interstitial Bi$^+$ ions adjacent to negatively charged S vacancies are most likely responsible for the IR luminescence.

Plotnichenko, V G; Sokolov, V O; Sukhanov, M V; Velmuzhov, A P; Churbanov, M F; Dianov, E M

2014-01-01

114

An unusual cause of lower gastrointestinal haemorrhage.  

PubMed

A previously unreported cause of lower gastrointestinal haemorrhage in a 63-year-old female patient on clopidogrel for cardiac comorbidities is presented. Endoscopy suggested a small bowel or colonic aetiology but failed to accurately localise the source. The patient became haemodynamically unstable despite conservative management and temporary cessation of clopidogrel. CT angiography demonstrated a pseudoaneurysm arising from the superior rectal artery. Percutaneous embolisation using coils was performed to successfully occlude the pseudoaneurysm, prevent further haemorrhage and avoid emergency colonic resection. PMID:22669967

Janmohamed, Azara; Noronha, Lizanne; Saini, Ashish; Elton, Colin

2011-01-01

115

[Gastrointestinal bleeding, NSAIDs, aspirin and anticoagulants].  

PubMed

The studies presented at the recent American Congress of Gastroenterology in the field of non-variceal upper gastrointestinal bleeding (associated or not to NSAIDs or ASA use) have not been numerous but interesting. The key findings are: a) rabeprazole, the only PPI that had few studies in this field, is effective in the prevention of gastric ulcers; b) famotidine could also be effective in the prevention of complications by AAS; c) the new competitive inhibitors of the acid potassium pump are effective (as much as PPIs) on the recurrence of peptic ulcers by ASA; d) early endoscop (<8h) in non-variceal upper gastrointestinal bleeding seems to offer no better results than those made in the first 24h; e) endoscopic therapy in Forrest 1a ulcers does not obliterate the bleeding artery in 30% of cases and is the cause of bleeding recurrence; f) alternative therapies with glue or clotting products are being increasingly used in endoscopic therapy of gastrointestinal bleeding; g) liberal administration of blood in the GI bleeding is associated with poor prognosis; h) lesions of the small intestine are frequent cause of gastrointestinal bleeding when upper endoscopy shows no positive stigmata; and i) capsule endoscopy studies have high performance in gastrointestinal bleeding of obscure origin, if performed early in the first two days after the beginning of the bleeding episode. PMID:25294267

Lanas, Angel

2014-09-01

116

New EU regulations in endoscopy.  

PubMed

As a result of European unification, new regulations valid within the territory of the European Union (EU) have been negotiated and published. As in other medical fields, the Medical Device Directive (MDD) is the most important new regulation and also effects endoscopy. In a transition period until June 1998, the MDD will be transposed into national law by the member states of the EU. Compliance with the MDD and other European regulations is indicated by the CE mark affixed to the product. PMID:8565892

Wächter, M; Diekjobst, T

1995-09-01

117

Future and Advances in Endoscopy  

PubMed Central

The future of endoscopy will be dictated by rapid technological advances in the development of light sources, optical fibers, and miniature scanners that will allow for images to be collected in multiple spectral regimes, with greater tissue penetration, and in three dimensions. These engineering breakthroughs will be integrated with novel molecular probes that are highly specific for unique proteins to target diseased tissues. Applications include early cancer detection by imaging molecular changes that occur before gross morphological abnormalities, personalized medicine by visualizing molecular targets specific to individual patients, and image guided therapy by localizing tumor margins and monitoring for recurrence. PMID:21751414

Elahi, Sakib F.; Wang, Thomas D.

2012-01-01

118

Update of endoscopy in liver disease: more than just treating varices.  

PubMed

The management of complications in liver disease is often complex and challenging. Endoscopy has undergone a period of rapid expansion with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. In this review, relevant literature search and expert opinions have been used to provide a brief overview and update of the current endoscopic management of patients with liver disease and portal hypertension. The main areas covered are safety of endoscopy in patients with liver disease, the use of standard endoscopy for the treatment of varices and the role of new endoscopic modalities such as endoscopic ultrasound, esophageal capsule, argon plasma coagulation, spyglass and endomicroscopy in the investigation and treatment of liver-related gastrointestinal and biliary pathology. It is clear that the role of the endoscopy in liver disease is well beyond that of just treating varices. As the technology in endoscopy expands, so does the role of the endoscopist in liver disease. PMID:22346246

Krystallis, Christoforos; Masterton, Gail S; Hayes, Peter C; Plevris, John N

2012-02-01

119

Ingestible wireless capsules for enhanced diagnostic inspection of gastrointestinal tract  

NASA Astrophysics Data System (ADS)

Wireless capsule endoscopy has become a common procedure for diagnostic inspection of gastrointestinal tract. This method offers a less-invasive alternative to traditional endoscopy by eliminating uncomfortable procedures of the traditional endoscopy. Moreover, it provides the opportunity for exploring inaccessible areas of the small intestine. Current capsule endoscopes, however, move by peristalsis and are not capable of detailed and on-demand inspection of desired locations. Here, we propose and develop two wireless endoscopes with maneuverable vision systems to enhance diagnosis of gastrointestinal disorders. The vision systems in these capsules are equipped with mechanical actuators to adjust the position of the camera. This may help to cover larger areas of the digestive tract and investigate desired locations. The preliminary experimental results showed that the developed platform could successfully communicate with the external control unit via human body and adjust the position of camera to limited degrees.

Rasouli, Mahdi; Kencana, Andy Prima; Huynh, Van An; Ting, Eng Kiat; Lai, Joshua Chong Yue; Wong, Kai Juan; Tan, Su Lim; Phee, Soo Jay

2011-03-01

120

Subepithelial masses of the gastrointestinal tract evaluated by endoscopic ultrasonography  

Microsoft Academic Search

Objectives: To diagnose and characterize subepithelial lesions of the gastrointestinal (GI) tract using endoscopic ultrasonography (EUS) and search for markers of malignancy in stromal cell tumors. Methods: Fifty-four patients with suspected subepithelial lesions at endoscopy were examined using miniature ultrasound probes, integrated ultrasound endoscopes, or both. Surgical treatment was considered if a solid lesion had a maximum diameter of at

Lars B. Nesje; Ole D. Laerum; Knut Svanes; Svein Ødegaard

2002-01-01

121

Research on Key Technologies of Virtual Endoscopy  

Microsoft Academic Search

Key techniques on virtual endoscopy are researched in this paper. We use boundary model and local feature structure to realize tissue segmentation. A new efficient algorithm is presented to solve path planning based on distance transform. As for real-time processing, a frame in virtual endoscopy is divided into near viewpoint part and far viewpoint part based on volume data characteristics

Peng Yang-jun; Wang Yuan-hong; Shi Jiao-ying

2010-01-01

122

Research and Realization of Virtual Endoscopy  

Microsoft Academic Search

Research and realization technologies of virtual endoscopy are proposed in this paper. We use boundary model and local feature structure to realize tissue segmentation. A new efficient algorithm is presented to solve path planning based on distance transform. As for real-time processing, a frame in virtual endoscopy is divided into near viewpoint part and far viewpoint part based on volume

Peng Yang-jun; Zhao Wei-dong; Lu Xin-ming; Shi Jiao-ying

2010-01-01

123

Endoscopy of the lacrimal system  

PubMed Central

BACKGROUND/AIM—Until recently, diagnosis of disorders of the lacrimal system has depended on digital dacryocystography and on clinical examinations such as the fluorescein dye test, lacrimal probing, and irrigation. The lacrimal system and its mucous membranes can now be viewed directly with a lacrimal endoscope. While the first endoscopes were rigid and limited by poor picture quality in axial illuminations, the new generation of endoscopes are a great leap forward for new diagnostic and therapeutic approaches.?METHODS—132 patients ranging in age from 8 months to 73 years with nasolacrimal obstruction were referred to the lacrimal department. Diagnostic lacrimal imaging utilising various small calibre endoscopes less than 0.5 mm in external diameter was performed. The endoscopes are coupled to specially designed lacrimal probes as well as a CCD camera and a video recorder. The imaging was performed during standard lacrimal probing and irrigation in an outpatient clinic setting in 120 of 132 patients?RESULTS—All patients reported the pain of endoscopy as being similar to that of standard lacrimal probing and irrigation. No adverse effects such as bleeding or lacrimal perforation were noted. Endoscopic manipulation was not too difficult and the picture quality, depth of focus, and illumination were satisfactory in all cases. The most common site of stenosis was the nasolacrimal duct (59 patients), followed by the lacrimal sac (39 patients) and the canaliculi (34 patients). In 25 patients, partial obstruction, rather than complete stenosis, was visualised as a narrow lumen, which widened during irrigation. In 14 of 28 patients, obstruction was due to canalicular submucosal folds and was removed with laser. In addition, the colour and consistency of the lining mucosa correlated with type of obstruction. Normal mucosa is smooth and light pink in colour. Inflammatory changes manifest as thickened and reddish grey mucosa. More complete stenosis is shown as fibrotic plaques with grey white inelastic membranes.?CONCLUSION—Lacrimal endoscopy is a new, non-invasive method used to view directly and localise obstructions precisely. It allows differentiation between inflammatory, partial, and complete stenosis. Endoscopy enables one to choose the appropriate surgical therapy for patients. Patients tolerated the procedure well without any adverse reactions or effects. While it may not replace standard probing and irrigation, this technique is an extremely useful adjunct in determining the proper surgical modality, ease, and tolerance of the endoscopic manipulation by patients, and obtaining sharp and clear images of the nasolacrimal outflow system anatomy and pathology. Differentiation of various types of obstruction by precise location and severity can be achieved.?? PMID:10413700

Mullner, K.; Bodner, E.; Mannor, G.

1999-01-01

124

Recent advances in capsule endoscopy: development of maneuverable capsules.  

PubMed

One important disadvantage of modern capsule endoscopy is its lack of maneuverability. Thus, clinically available systems depend on transportation by spontaneous gastrointestinal motility. Even in subjects with normal motility, transit time for different intestinal segments may vary considerably, and relevant segments may be passed too quickly. This probably explains why approximately 10% of all pathologies are overlooked during small bowel investigations. Moreover, without maneuverable capsule endoscopes, the large inner surface of the stomach cannot be investigated properly. The most advanced approaches, which try to develop maneuverable systems for targeted inspection of the GI tract, use magnetic fields for steering of a videocapsule with magnetic inclusions. With such systems, preliminary clinical studies have already been performed. Other projects try to develop biologically inspired steering mechanisms such as capsules that can move on legs or they use electrical stimulation of the intestinal wall in order to induce contractions for propulsion of the videocapsule. PMID:23061707

Keller, Jutta; Fibbe, Christiane; Rosien, Ulrich; Layer, Peter

2012-09-01

125

Capsule Endoscopy in Patients with Implantable Electromedical Devices is Safe  

PubMed Central

Background and Study Aims. The presence of an implantable electromechanical cardiac device (IED) has long been considered a relative contraindication to the performance of video capsule endoscopy (CE). The primary aim of this study was to evaluate the safety of CE in patients with IEDs. A secondary purpose was to determine whether IEDs have any impact on images captured by CE. Patients and Methods. A retrospective chart review of all patients who had a capsule endoscopy at Mayo Clinic in Scottsdale, AZ, USA, or Rochester, MN, USA, (January 2002 to June 2010) was performed to identify CE studies done on patients with IEDs. One hundred and eighteen capsule studies performed in 108 patients with IEDs were identified and reviewed for demographic data, method of preparation, and study data. Results. The most common indications for CE were obscure gastrointestinal bleeding (77%), anemia (14%), abdominal pain (5%), celiac disease (2%), diarrhea (1%), and Crohn's disease (1%). Postprocedure assessments did not reveal any detectable alteration on the function of the IED. One patient with an ICD had a 25-minute loss of capsule imaging due to recorder defect. Two patients with LVADs had interference with capsule image acquisition. Conclusions. CE did not interfere with IED function, including PM, ICD, and/or LVAD and thus appears safe. Additionally, PM and ICD do not appear to interfere with image acquisition but LVAD may interfere with capsule images and require that capsule leads be positioned as far away as possible from the IED to assure reliable image acquisition. PMID:23710168

Harris, Lucinda A.; Hansel, Stephanie L.; Rajan, Elizabeth; Srivathsan, Komandoor; Rea, Robert; Crowell, Michael D.; Fleischer, David E.; Pasha, Shabana F.; Gurudu, Suryakanth R.; Heigh, Russell I.; Shiff, Arthur D.; Post, Janice K.; Leighton, Jonathan A.

2013-01-01

126

Unsedated transnasal endoscopy: A Canadian experience in daily practice  

PubMed Central

BACKGROUND: Esophagogastroduodenoscopy (EGD) is the most frequently performed diagnostic procedure for upper gastrointestinal disorders. The procedure is routinely performed under conscious sedation in North America. A significant proportion of morbidity and mortality associated with EGD is related to hypoxia due to conscious sedation. The use of sedation is also associated with an increase in cost, loss of work on the day of endoscopy and the need for the patient to be accompanied home after the procedure. Transnasal endoscopy has advantages such as no sedation and less patient monitoring, nursing time and expenses than conventional per oral EGD. OBJECTIVES: To assess the feasibility and acceptability of unsedated transnasal EGD in daily practice. METHODS: Patients due to undergo EGD were given a choice of either unsedated transnasal EGD or per oral EGD with sedation. Patients who chose unsedated transnasal EGD had the procedure performed in the office by a senior gastroenterologist with experience in transnasal EGD. All procedures were performed using a small-calibre esophagogastroduodenoscope. All patients were surveyed using a patient satisfaction questionnaire, and were asked to give specific scores in terms of choking sensation, sore throat, nasal discomfort and abdominal discomfort. All variables were assessed by scores between 0 and 10, with 10 indicating the most severe degree of each variable. Any complications were also recorded. RESULTS: Between March 2002 and August 2003, 231 patients underwent transnasal EGD. The median age of the patients was 57 years (range 15 to 87 years). Complete examinations were possible in 98% of patients. Patients reported a high degree of acceptability (mean score 6.6, range 1 to 10) and low degrees of choking sensation (mean 1.8, range 0 to 10), nasal discomfort (mean 1.7, range 0 to 10), sore throat (mean 0.8, range 0 to 9) and abdominal discomfort (mean 1.1, range 0 to 10). The only complications reported by the patients were epistaxis (n=2, 0.9%) and sinusitis (n=1, 0.4%). Some patients also reported transient light-headedness (n=12, 5%) and mucous discharge (n=2, 0.9%). When asked, 185 patients (88%) stated that they were willing to undergo the same procedure in the future if medically indicated. Of the 84 patients who had conventional EGD under conscious sedation in the past, 52 patients (62%) preferred transnasal EGD without sedation. CONCLUSIONS: Transnasal EGD is generally well tolerated, feasible and safe. It can be performed with topical anesthesia in an outpatient setting. The low complication rate, high patient satisfaction and potential cost savings make transnasal endoscopy an attractive alternative to conventional EGD to screen patients for upper gastrointestinal tract diseases. PMID:18354752

Cho, Sarah; Arya, Naveen; Swan, Katherine; Cirocco, Maria; Kandel, Gabor; Kortan, Paul; Marcon, Norman

2008-01-01

127

Upper Endoscopy for Gastroesophageal Reflux Disease  

MedlinePLUS

... upper endoscopy). Narrowing of the esophagus (strictures) and esophageal cancer are long-term complications of GERD. Approximately 10% ... called Barrett esophagus) and a higher risk for esophageal cancer. Before cancer develops, the cells lining the esophagus ...

128

Implementation of an endoscopy safety checklist  

PubMed Central

Patient safety and quality improvement are increasingly prioritised across all areas of healthcare. Errors in endoscopy are common but often inconsequential and therefore go uncorrected. A series of minor errors, however, may culminate in a significant adverse event. This is unsurprising given the rising volume and complexity of cases coupled with shift working patterns. There is a growing body of evidence to suggest that surgical safety checklists can prevent errors and thus positively impact on patient morbidity and mortality. Consequently, surgical checklists are mandatory for all procedures. Many UK hospitals are mandating the use of similar checklists for endoscopy. There is no guidance on how best to implement endoscopy checklists nor any measure of their usefulness in endoscopy. This article outlines lessons learnt from innovating service delivery in our unit.

Matharoo, M; Thomas-Gibson, S; Haycock, A; Sevdalis, N

2014-01-01

129

CAPSULE ENDOSCOPY 7th June 2013  

E-print Network

DUBLIN CAPSULE ENDOSCOPY COURSE 7th June 2013 EDUCATION CENTRE THE ADELAIDE & MEATH HOSPITAL, DUBLIN INCORPORATING THE NATIONAL CHILDRENS HOSPITAL RCPI Approved 6 CPD Points BOOKING FORM Places:______________________________ _____________________________________ _____________________________________ Email Address: __________________ Hospital: _______________________ Booking Fee: 250.00 Cheques made

O'Mahony, Donal E.

130

?enseignement de ?endoscopie digestive en Italie  

Microsoft Academic Search

Résumé  En Italie, nous disposons de deux écoles de postgraduat : Gastroentérologie et Endoscopie Digestive et ?autre part : Chirurgie\\u000a Digestive et Endoscopie Chirurgicale. Le premier cours dure quatre ans, le second cinq ans. Pour aucune des deux spécialisations,\\u000a il n’est prévue de formation préparatoire en connaissances générales (médecine interne, chirurgie générale). Jusqu’à ?année\\u000a académique passée, ?enseignement était purement théorique. ?annee

A. Russo

1991-01-01

131

Nodular lymphoid hyperplasia in common variable immunodeficiency syndrome mimicking familial adenomatous polyposis on endoscopy.  

PubMed

Common variable immunodeficiency syndrome (CVID) includes a heterogeneous disorder characterized by reduced levels of IgG, IgA or IgM, and recurrent bacterial infections with normal T-cell immunity in 60% of patients. It affects the gastrointestinal tract as the largest immune organ with a wide spectrum of symptoms and signs. We present a case of nodular lymphoid hyperplasia (NLH) of the small intestine in a 31-year-old man admitted for evaluation of chronic diarrhea. Upper and lower gastrointestinal endoscopy revealed multiple polyps in the stomach, duodenum, ileum, and large intestine mimicking familial adenomatous polyposis (FAP). Although he had no history of recurrent infection, immunological profiles were in favor of CVID. We emphasize the importance of considering CVID in any patient with gastrointestinal manifestations even in the absence of recurrent bacterial infections. Diagnostic delay results in more morbidity and complications in untreated patients. PMID:19805964

Molaei, Mahsa; Kaboli, Alireza; Fathi, Alireza Modares; Mashayekhi, Reza; Pejhan, Shervin; Zali, Mohammad Reza

2009-01-01

132

Wireless Capsule Endoscopy Detects Meckel's Diverticulum in a Child with Unexplained Intestinal Blood Loss.  

PubMed

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal (GI) tract, affecting about 2% of the population. Most cases of Meckel's diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with (99m)Tc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn's disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with (99m)Tc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding. PMID:23139657

Xinias, I; Mavroudi, A; Fotoulaki, M; Tsikopoulos, G; Kalampakas, A; Imvrios, G

2012-09-01

133

Preliminary results on performance of new ultra-fast static positioning module - POZGEO-2 in areas outside the ASG-EUPOS network  

NASA Astrophysics Data System (ADS)

The presented preliminary research concerns the accuracy and reliability of new ultra-fast static positioning module - POZGEO-2 - in case of processing GPS data collected outside the ASG-EUPOS network. Such a case requires extrapolation of the network-derived atmospheric corrections which limits correction accuracy and, therefore, has adverse effect on the carrier phase ambiguity resolution. The presented processing tests are based on processing 5-minute long observing sessions and show that precise positioning can be supported up to 35 km from the ASG-EUPOS borders. This means that precise positioning with POZGEO-2 module can be assured for the most of the border areas of Poland. W pracy prezentowane s? badania dotycz?ce dok?adno?ci i wiarygodno?ci pozycji wyznaczanej z wykorzystaniem nowego modu?u ultra-szybkiego pozycjonowania - POZGEO-2 opracowanego dla systemu ASG-EUPOS. Przedstawione testy obliczeniowe dotycz? szczególnego przypadku wyznaczania pozycji, gdy u?ytkownik znajduje si? poza granicami sieci stacji referencyjnych. W takich warunkach wymagana jest ekstrapolacja sieciowych poprawek atmosferycznych. Wp?ywa to negatywnie na dok?adno?? tych poprawek i mo?e doprowadzi? do sytuacji, w której wyznaczenie nieoznaczono?ci b?dzie niemo?liwe. Prezentowane badania oparte s? na pi?ciominutowych sesjach obserwacyjnych i pokazuj?, ?e poprawki mog? by? ekstrapolowane dla obszarów po?o?onych do oko?o 35 km od granic sieci ASG-EUPOS. Oznacza to, ?e w praktyce precyzyjne pozycjonowanie ultra-szybkie z u?yciem modu?u POZGEO-2 mo?e by? zapewnione dla niemal ca?ego obszaru Polski

Paziewski, Jacek; Krukowska, Marta; Wielgosz, Pawe?

2014-06-01

134

[Report on 16 cases of small intestine ascariasis diagnosed by capsule endoscopy].  

PubMed

The clinical data and capsule endoscopy image of 16 adult patients with small intestine ascariasis were reviewed and analyzed retrospectively from June 2006 to June 2012 in West China Hospital. Among the 16 patients, 15 cases manifested as gastrointestinal bleeding, 15 cases showed anemia (3 severe, 10 moderate, and 2 mild), 2 had hypoalbuminemia, 1 had peripheral blood eosinophilia. All the cases were found to be fecal occult blood positive, but no Ascaris eggs found in the feces. Capsule endoscopy showed they were infected with Ascaris worms. The worms were found in the proximal small intestine in 14 patients and 2 in the distal intestine. Mucosal erythema and erosions around the worm were observed in 3 cases, and 7 cases were found with active bleeding or old haemorrhage in small intestine. PMID:24812868

Wang, Pu; Li, Rong-Zhi; Huang, Zhi-Yin; Tang, Cheng-Wei

2013-06-01

135

System for clinical photometric stereo endoscopy  

NASA Astrophysics Data System (ADS)

Photometric stereo endoscopy is a technique that captures information about the high-spatial-frequency topography of the field of view simultaneously with a conventional color image. Here we describe a system that will enable photometric stereo endoscopy to be clinically evaluated in the large intestine of human patients. The clinical photometric stereo endoscopy system consists of a commercial gastroscope, a commercial video processor, an image capturing and processing unit, custom synchronization electronics, white light LEDs, a set of four fibers with diffusing tips, and an alignment cap. The custom pieces that come into contact with the patient are composed of biocompatible materials that can be sterilized before use. The components can then be assembled in the endoscopy suite before use. The resulting endoscope has the same outer diameter as a conventional colonoscope (14 mm), plugs into a commercial video processor, captures topography and color images at 15 Hz, and displays the conventional color image to the gastroenterologist in real-time. We show that this system can capture a color and topographical video in a tubular colon phantom, demonstrating robustness to complex geometries and motion. The reported system is suitable for in vivo evaluation of photometric stereo endoscopy in the human large intestine.

Durr, Nicholas J.; González, Germán.; Lim, Daryl; Traverso, Giovanni; Nishioka, Norman S.; Vakoc, Benjamin J.; Parot, Vicente

2014-02-01

136

Optical molecular imaging in the gastrointestinal tract.  

PubMed

Recent developments in optical molecular imaging allow for real-time identification of morphologic and biochemical changes in tissue associated with gastrointestinal neoplasia. This review summarizes widefield and high-resolution imaging modalities in preclinical and clinical evaluation for the detection of colorectal cancer and esophageal cancer. Widefield techniques discussed include high-definition white light endoscopy, narrow band imaging, autofluoresence imaging, and chromoendoscopy; high-resolution techniques discussed include probe-based confocal laser endomicroscopy, high-resolution microendoscopy, and optical coherence tomography. New approaches to enhance image contrast using vital dyes and molecular-specific targeted contrast agents are evaluated. PMID:23735112

Carns, Jennifer; Keahey, Pelham; Quang, Timothy; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

2013-07-01

137

Angiography in gastrointestinal bleeding in children  

SciTech Connect

Twenty-seven children aged 1 day to 16 years studied arteriographically for acute or chronic gastrointestinal bleeding were reviewed. Children with known esophageal varices and portal hypertension were excluded. Final diagnoses were made in 25 patients by means of surgery, endoscopy, biopsy, laboratory data, and clinical follow-up. Of these 25 cases, arteriography gave a correct diagnosis in 64% and was falsely negative in 36%. The common causes of bleeding in this study were gastric and duodenal ulcers, gastritis, vascular malformations, and typhlitis. Transcatheter therapy was attempted in six acute bleeders, with success in three (50%).

Meyerovitz, M.F.; Fellows, K.E.

1984-10-01

138

Optical Molecular Imaging in the Gastrointestinal Tract  

PubMed Central

Recent developments in optical molecular imaging allow for real-time identification of morphological and biochemical changes in tissue associated with gastrointestinal neoplasia. This review summarizes widefield and high resolution imaging modalities currently in pre-clinical and clinical evaluation for the detection of colorectal cancer and esophageal cancer. Widefield techniques discussed include high definition white light endoscopy, narrow band imaging, autofluoresence imaging, and chromoendoscopy; high resolution techniques discussed include probe-based confocal laser endomicroscopy, high-resolution microendoscopy, and optical coherence tomography. Finally, new approaches to enhance image contrast using vital dyes and molecular-specific targeted contrast agents are evaluated. PMID:23735112

Carns, Jennifer; Keahey, Pelham; Quang, Timothy; Anandasabapathy, Sharmila; Richards-Kortum, Rebecca

2013-01-01

139

Quality endoscopists and quality endoscopy units  

PubMed Central

Endoscopy plays an important role in the diagnosis and treatment of digestive diseases. The benefits are maximized when procedures are performed at an optimal level of quality. Technical failures and adverse events are more likely to occur when procedures are performed by inexperienced endoscopists. Professional organizations and manufacturing industry which support and represent endoscopy, and their leaders, have increasingly embraced the quality improvement paradigm that is advancing through medicine. We all need to agree on the metrics of endoscopic performance, to develop the infrastructure to collect and analyze the data, and to use the resulting knowledge to stimulate improvements in practice and benefit the patients. PMID:21776431

2011-01-01

140

Gastrointestinal Basidiobolomycosis  

PubMed Central

Gastrointestinal basidiobolomycosis (GIB) is a rare fungal infection with few reported cases worldwide. We report here the first case diagnosed in Oman in a previously healthy 5-year-old Omani female child who had been thought initially to have an abdominal malignancy. The case was referred to the Royal Hospital, Muscat, Oman, in July 2012. She was treated successfully with surgical resection and prolonged antifungal therapy (voriconazole). Physicians, including clinicians, radiologists and pathologists, should have a high index of suspicion for GIB when a patient presents with an abdominal mass and fever. PMID:24790749

Al-Maani, Amal S.; Paul, George; Jardani, Amina; Nayar, Madhavan; Al-Lawati, Fatma; Al-Baluishi, Sheikha; Hussain, Ibrahim B.

2014-01-01

141

Ruling in or out a source of gastrointestinal bleeding  

PubMed Central

Background and aims The search for a source of gastrointestinal bleeding is associated with two distinct approaches of trying to rule in a specific diagnosis or rule out any potential source of bleeding. The study aim was to understand the conceptual differences underlying the two searches. Methods The performance of endoscopy as diagnostic test is analyzed in terms of Bayes’ formula. Results The performance of gastrointestinal endoscopy to rule in a suspected lesion is mostly influenced by its underlying specificity. Because the specificity of endoscopy is less likely to be affected by procedural exigencies, the demands on pre-procedural prep and general quality can be more relaxed. In contradistinction, the performance of endoscopy to rule out a suspected bleeding site is mostly influenced by its sensitivity, which can easily be compromised by suboptimal procedural conditions. Conclusions Paradoxically, the more urgent, focused, and important search (to rule in a bleeding site), carries less stringent criteria for its execution than the more general and aimless search (to rule out a bleeding site) that frequently ends up just empty handed.

2014-01-01

142

Capsule endoscopy in clinical practice: concise up-to-date overview  

PubMed Central

Until recently, the small bowel was considered a ‘no man’s land’ as the imaging modalities available for its investigation were laborious, invasive, costly, or involve significant radiation exposure. Wireless capsule endoscopy (WCE) has changed the field dramatically, over the last eight years. The established indications for small bowel WCE are obscure gastrointestinal bleed/anemia, Crohn’s disease, hereditary polyposis syndromes, and to a lesser extent, evaluation of side effects of nonsteroidal anti-inflammatory medications and coeliac disease. We herein present an overview of the capsule examination, which seems to be a quickly improving area. PMID:21694834

Koulaouzidis, Anastasios; Douglas, Sarah

2009-01-01

143

Surveillance for gastrointestinal malignancies  

PubMed Central

Gastrointestinal (GI) malignancies are notorious for frequently progressing to advanced stages even in the absence of serious symptoms, thus leading to delayed diagnoses and dismal prognoses. Secondary prevention of GI malignancies through early detection and treatment of cancer-precursor/premalignant lesions, therefore, is recognized as an effective cancer prevention strategy. In order to efficiently detect these lesions, systemic application of screening tests (surveillance) is needed. However, most of the currently used non-invasive screening tests for GI malignancies (for example, serum markers such as alpha-fetoprotein for hepatocellular carcinoma, and fecal occult blood test, for colon cancer) are only modestly effective necessitating the use of highly invasive endoscopy-based procedures, such as esophagogastroduodenoscopy and colonoscopy for screening purposes. Even for hepatocellular carcinoma where non-invasive imaging (ultrasonography) has become a standard screening tool, the need for repeated liver biopsies of suspicious liver nodules for histopathological confirmation can’t be avoided. The invasive nature and high-cost associated with these screening tools hinders implementation of GI cancer screening programs. Moreover, only a small fraction of general population is truly predisposed to developing GI malignancies, and indeed needs surveillance. To spare the average-risk individuals from superfluous invasive procedures and achieve an economically viable model of cancer prevention, it’s important to identify cohorts in general population that are at substantially high risk of developing GI malignancies (risk-stratification), and select suitable screening tests for surveillance in these cohorts. We herein provide a brief overview of such high-risk cohorts for different GI malignancies, and the screening strategies that have commonly been employed for surveillance purpose in them. PMID:22969223

Tiwari, Ashish K; Laird-Fick, Heather S; Wali, Ramesh K; Roy, Hemant K

2012-01-01

144

Gastrointestinal complications of systemic sclerosis.  

PubMed

Systemic sclerosis is an autoimmune disease characterized by progressive skin thickening and tightness. Pulmonary interstitial fibrosis and kidney damage are the most important indicators for mortality; however, the gastrointestinal tract is the most commonly damaged system. Virtually all parts of the gastrointestinal (GI) tract can be involved, although the esophagus is the most frequently reported. The mechanisms that cause such extensive damage are generally unclear, but vascular changes, immunological abnormalities, excessive accumulation of collagen in the submucosa, smooth muscle atrophy and neuropathy may participate because these are the most common histological findings in biopsies and autopsies. Most patients with GI tract involvement complain about dyspepsia, nausea, vomiting, abdominal bloating/distension, and fecal incontinence. These symptoms are generally mild during the early stage of the disease and are likely ignored by physicians. As the disease becomes more advanced, however, patient quality of life is markedly influenced, whereby malnutrition and shortened survival are the usual consequences. The diagnosis for systemic sclerosis is based on manometry measurements and an endoscopy examination. Supportive and symptomatic treatment is the main therapeutic strategy; however, an early diagnosis is critical for successful management. PMID:24222949

Tian, Xin-Ping; Zhang, Xuan

2013-11-01

145

Therapeutic management options for patients with obscure gastrointestinal bleeding  

PubMed Central

Obscure gastrointestinal bleeding (OGIB) is one of the most challenging disorders faced by gastroenterologists because of its evasive nature and difficulty in identifying the exact source of bleeding. Recent technological advances such as video capsule endoscopy and small bowel deep enteroscopy have revolutionized the diagnosis and management of patients with OGIB. In this paper, we review the various diagnostic and therapeutic options available for the management of patients with OGIB. PMID:22282709

Kochhar, Gursimran S.; Sanaka, Madhusudhan R.

2012-01-01

146

Is peptic ulcer a common cause of upper gastrointestinal symptoms?  

Microsoft Academic Search

The aim of the study was to investigate retrospectively a cohort of children with peptic ulcer disease during a period that\\u000a covers the recent changes in diagnosis and management of the disease. Over a period of 9 years, 2550 children underwent upper\\u000a gastrointestinal endoscopy for various reasons. All children, in whom a diagnosis of primary peptic ulcer was established,\\u000a were

Eleftheria Roma; Yota Kafritsa; Joanna Panayiotou; Roula Liakou; Andreas Constantopoulos

2001-01-01

147

Value of Ear Endoscopy in Cholesteatoma Surgery  

Microsoft Academic Search

Objective: The purpose of this study was to assess the value of ear endoscopy in cholesteatoma surgery and to demonstrate its consequence in improving surgical outcome. Materials and Methods: A total of 92 ears with acquired cholesteatoma (primary or secondary) were operated on. In this prospective study, 82 cases were operated on by using canal wall up (CWU) technique, and

M. Badr-el-Dine

2002-01-01

148

Transnasal endoscopy: Technical considerations, advantages and limitations.  

PubMed

Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes. PMID:24567791

Atar, Mustafa; Kadayifci, Abdurrahman

2014-02-16

149

Diagnostic reasoning model validation in digestive endoscopy  

Microsoft Academic Search

The development of a computer-assisted diagnostic system in digestive endoscopy implies to understand the reasoning process of endoscopists. The aim of this study is to validate a reasoning model and a knowledge base previously defined. Eight endoscopists have participated to a diagnostic test including 5 video-sequences and using a \\

J. M. Cauvin; C. Le Guillou; B. Solaiman; M. Robaszkiewicz; H. Gouerou; C. Roux

2001-01-01

150

STABILITY AND ENDOSCOPY: INFORMAL MOTIVATION James Arthur  

E-print Network

STABILITY AND ENDOSCOPY: INFORMAL MOTIVATION James Arthur University of Toronto The purpose in response to some very natural problems in harmonic analysis. The article is intended for people who-valued functions f = f · ffin = v fv · v finite fv, in which the Archimedean component f lies in the usual space

Casselman, William

151

Gastrointestinal disorders - resources  

MedlinePLUS

Digestive disease - resources; Resources - gastrointestinal disorders ... www.acg.gi.org International Foundation for Functional Gastrointestinal ... Information Clearinghouse - http://digestive.niddk.nih.gov

152

Vascular malformations of the gastrointestinal tract.  

PubMed

The advent of fiberoptic endoscopy, which became widespread in the evaluation of gastrointestinal bleeding throughout the late 1970s and 1980s, has dramatically changed both our understanding of the extent to which vascular malformations account for gastrointestinal blood loss and our ability to treat these lesions at the time of diagnosis. Colonic vascular malformations appear to be the single most common cause of acute or recurrent gastrointestinal bleeding episodes in patients over 60 years of age, being responsible for the bleeding in as many as 35% of such patients. Although less common as a cause of upper gastrointestinal bleeding, these lesions still account for 2% to 5% of bleeding lesions in older patients. Diagnosis is accomplished by endoscopy, and the vascular malformations can then be coagulated via the endoscope using one of a number of thermal systems. The argon laser, the heater probe, and the BICAP system are all effective and safe throughout the gastrointestinal tract, especially in the cecum and right colon, where the majority of sporadic vascular malformations occur. Monopolar cautery and the Nd:YAG laser are equally efficacious, but their greater and less predictable depth of coagulation make them much less safe in the cecum and right colon. There are no apparent advantages in terms of efficacy and safety between laser treatment and the other thermal modalities. The laser has the advantage of being quicker, which is especially important when treating large or multiple lesions. The other modalities have the advantages of portability and low relative cost. Endoscopic therapy with lasers or other thermal devices is nonspecific. The effects are achieved by thermally coagulating the mucosal vascular lesions, allowing the coagulated tissue to slough, and leaving a mucosal ulceration that subsequently heals with re-epithelialization. Endoscopic coagulation has thus been reported effective in the treatment of gastrointestinal mucosal vascular lesions regardless of their etiology or characteristics. It has been effective for sporadic vascular malformations, hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease), radiation proctocolitis, the blue rubber-bleb nevus syndrome, and diffuse gastric antral vascular ectasia (the watermelon stomach). As we move through the 1990s and beyond, these endoscopic modalities offer an effective, relatively safe, and clearly less invasive treatment option for the many patients who experience acute, recurrent, or chronic gastrointestinal bleeding from any of these lesions. PMID:1589831

Buchi, K N

1992-06-01

153

Wide-field endoscopic fluorescence imaging for gastrointestinal tumor detection with glucose analogue  

NASA Astrophysics Data System (ADS)

The lack of functional information and targeted imaging in conventional white-light endoscopy leads to a high miss-rate of gastrointestinal tumor. The combination of near-infrared fluorescence imaging and endoscopy presents a promising approach. Here we introduce a new endoscopy method employing a home-made flexible wide-field epi-fluorescence endoscope, that can be inserted through the biopsy channel of a gastrointestinal endoscope, with the glucose analogue 2- DeoxyGlucosone as the near-infrared fluorescent probe. System characterization indicates a good sensitivity and linearity over a large field of view. Its capability of tumor identification and location is demonstrated with in-vivo imaging of xenografted tumor model.

He, Yun; Qu, Yawei; Bai, Jing; Liu, Haifeng

2014-05-01

154

Upper gastrointestinal bleeding among Saudis: Etiology and prevalence the Riyadh Central Hospital experience.  

PubMed

Fiberoptic esophagastroduodenoscopic examination of 747 Saudi patients who presented with acute upper gastrointestinal (UGI) bleeding between January 184G to December 1986G showed that ruptured esophageal varices, erosive gastritis, duodenitis and peptic ulcer disease were the most common findings. There were 515 males and 232 females (M:F 2.2:1). Multiple lesions were detected in 83% of patients, emphasizing the need to anticipate more than one lesion at endoscopy in a patient with UGI bleeding. Sixty-seven patients (8.9%) gave a history of drug ingestion prior to the episode of bleeding; gastric and duodenal erosions were the most common lesions in these patients. No source of bleeding was apparent in 26 (3.5%) patients at the time of endoscopy. Endoscopy rather than barium studies has become established as the standard investigation in our patients with upper gastrointestinal bleeding. PMID:17590791

Al-Mofarreh, M; Fakunle, Y M; Al-Moagel, M

1991-09-01

155

The incidence of upper extremity injuries in endoscopy nurses working in the United States.  

PubMed

Numerous studies have addressed musculoskeletal disorders in the international working population. The literature indicates that injuries exist at astounding rates with significant economic impact. Attempts have been made by government, private industry, and special interest groups to address the issues related to the occurrence and prevention of musculoskeletal injuries. Because of the limited research on the gastrointestinal (GI) endoscopy nursing sector, this descriptive, correlational study explored the incidence of upper extremity injuries in GI endoscopy nurses and technicians in the United States. A total of 215 subjects were included in the study. Findings show that upper extremity injuries exist among nurses working in GI endoscopy. Twenty-two percent of respondents missed work for upper extremity injuries. The findings also show that the severity of disability is related to the type of work done, type of assistive aids available at work, and whether or not ergonomic or physiotherapy assessments were provided at the place of employment. In reference to rate of injury and the availability of ergonomics and physiotherapy assessments, those who had ergonomic assessments available to them had scores on the Disabilities of the Arm, Shoulder, and Hand (DASH) inventory (indicating upper extremity disability) that were significantly lower (DASH score, 9.96) than those who did not have the assessments available (DASH score, 14.66). The results suggest that there are a significant number of subjects who are disabled to varying degrees and the majority of these are employed in full-time jobs. PMID:24084131

Drysdale, Susan A

2013-01-01

156

A robust real-time abnormal region detection framework from capsule endoscopy images  

NASA Astrophysics Data System (ADS)

In this paper we present a novel method to detect abnormal regions from capsule endoscopy images. Wireless Capsule Endoscopy (WCE) is a recent technology where a capsule with an embedded camera is swallowed by the patient to visualize the gastrointestinal tract. One challenge is one procedure of diagnosis will send out over 50,000 images, making physicians' reviewing process expensive. Physicians' reviewing process involves in identifying images containing abnormal regions (tumor, bleeding, etc) from this large number of image sequence. In this paper we construct a novel framework for robust and real-time abnormal region detection from large amount of capsule endoscopy images. The detected potential abnormal regions can be labeled out automatically to let physicians review further, therefore, reduce the overall reviewing process. In this paper we construct an abnormal region detection framework with the following advantages: 1) Trainable. Users can define and label any type of abnormal region they want to find; The abnormal regions, such as tumor, bleeding, etc., can be pre-defined and labeled using the graphical user interface tool we provided. 2) Efficient. Due to the large number of image data, the detection speed is very important. Our system can detect very efficiently at different scales due to the integral image features we used; 3) Robust. After feature selection we use a cascade of classifiers to further enforce the detection accuracy.

Cheng, Yanfen; Liu, Xu; Li, Huiping

2009-02-01

157

Locomotion of a legged capsule in the gastrointestinal tract: theoretical study and preliminary technological results  

Microsoft Academic Search

This work illustrates the analysis of locomotion in the gastrointestinal tract obtainable by a legged capsule for diagnostic and therapeutic purposes. A preliminary simulation of the legged locomotion onto slippery and deformable substrates has been performed and -simultaneously- mechanisms for on board actuation of the legs have been developed and tested. Moreover, an engineering translation of medical needs in endoscopy

A. Menciassi; C. Stefanini; S. Gorini; G. Pernorio; B. Kim; J. O. Park; P. Dario

2004-01-01

158

ASGE: Find a Doctor  

MedlinePLUS

... Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the SSI Spain Sri Lanka St Vincent and Grenadines Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland ...

159

Capsule Endoscopy: A Valuable Tool in the Follow-Up of People With Celiac Disease on a Gluten-Free Diet  

PubMed Central

OBJECTIVES: Traditional celiac disease guidelines recommend follow-up endoscopy and duodenal biopsies at 6–12 months after commencing a gluten-free diet (GFD). However, histology may remain abnormal even 1–2 years later. We evaluated the role of capsule endoscopy in patients with celiac disease after treatment with a GFD. METHODS: Twelve adult patients with newly diagnosed celiac disease were prospectively enrolled. All patients had baseline symptom assessment, celiac serology (tissue transglutaminase antibody, tTG), and capsule endoscopy. Twelve months after commencing a GFD, patients underwent repeat symptom assessment, celiac serology, upper gastrointestinal endoscopy, and capsule endoscopy. RESULTS: At baseline, capsule endoscopy detected endoscopic markers of villous atrophy in the duodenum and extending to a variable distance along the small intestine. On the basis of small bowel transit time, the mean±s.e.m. percentage of small intestine with villous atrophy was 18.2±3.7%. After 12 months on a GFD, repeat capsule endoscopy demonstrated mucosal healing from a distal to proximal direction, and the percentage of small intestine with villous atrophy was significantly reduced to 3.4±1.2% (P=0.0014) and this correlated with improvement in the symptom score (correlation 0.69, P=0.01). There was a significant improvement in symptom score (5.2±1.0 vs. 1.7±0.4, P=0.0012) and reduction in immunoglobulin A–tTG levels (81.5±10.6 vs. 17.5±8.2, P=0.0005). However, 42% of subjects demonstrated persistent villous abnormality as assessed by duodenal histology. CONCLUSIONS: After 12 months on a GFD, patients with celiac disease demonstrate an improvement in symptoms, celiac serology, and the extent of disease as measured by capsule endoscopy. Mucosal healing occurs in a distal to proximal direction. The extent of mucosal healing correlates with improvement in symptoms. Duodenal histology does not reflect the healing that has occurred more distally. PMID:23237971

Lidums, Ilmars; Teo, Edward; Field, John; Cummins, Adrian G

2011-01-01

160

Gastrointestinal system  

PubMed Central

The functions of the gastrointestinal (GI) tract include digestion, absorption, excretion, and protection. In this review, we focus on the electrical activity of the stomach and small intestine, which underlies the motility of these organs, and where the most detailed systems descriptions and computational models have been based to date. Much of this discussion is also applicable to the rest of the GI tract. This review covers four major spatial scales: cell, tissue, organ, and torso, and discusses the methods of investigation and the challenges associated with each. We begin by describing the origin of the electrical activity in the interstitial cells of Cajal, and its spread to smooth muscle cells. The spread of electrical activity through the stomach and small intestine is then described, followed by the resultant electrical and magnetic activity that may be recorded on the body surface. A number of common and highly symptomatic GI conditions involve abnormal electrical and/or motor activity, which are often termed functional disorders. In the last section of this review we address approaches being used to characterize and diagnose abnormalities in the electrical activity and how these might be applied in the clinical setting. The understanding of electrophysiology and motility of the GI system remains a challenging field, and the review discusses how biophysically based mathematical models can help to bridge gaps in our current knowledge, through integration of otherwise separate concepts. PMID:20836011

Cheng, Leo K.; O’Grady, Gregory; Du, Peng; Egbuji, John U.; Windsor, John A.; Pullan, Andrew J.

2014-01-01

161

Aspects of computer vision in surgical endoscopy  

NASA Astrophysics Data System (ADS)

This work is related to a project of medical robotics applied to surgical endoscopy, led in collaboration with Doctor Berreni from the Saint Roch nursing-home in Perpignan, France). After taking what Doctor Berreni advises, two aspects of endoscopic color image processing have been brought out: (1) The help to the diagnosis by the automatic detection of the sick areas after a learning phase. (2) The 3D reconstruction of the analyzed cavity by using a zoom.

Rodin, Vincent; Ayache, Alain; Berreni, N.

1993-09-01

162

Proposal of a Formal Gynecologic Endoscopy Curriculum  

Microsoft Academic Search

As minimally invasive surgery becomes the standard of care in the United States and around the world, the formal training of endoscopic surgeons is an issue of growing concern. With the implementation of the American Association of Gynecologic Laparoscopists\\/Society of Reproductive Surgeons (AAGL\\/SRS)–sponsored fellowship training in gynecologic endoscopy and a growing number of hands-on courses, we have the challenge of

Vadim Morozov; Ceana Nezhat

2009-01-01

163

Extra-articular hip endoscopy: A review of the literature.  

PubMed

The aim of this review is to evaluate the current available literature evidencing on peri-articular hip endoscopy (the third compartment). A comprehensive approach has been set on reports dealing with endoscopic surgery for recalcitrant trochanteric bursitis, snapping hip (or coxa-saltans; external and internal), gluteus medius and minimus tears and endoscopy (or arthroscopy) after total hip arthroplasty. This information can be used to trigger further research, innovation and education in extra-articular hip endoscopy. PMID:23610664

Verhelst, L; Guevara, V; De Schepper, J; Van Melkebeek, J; Pattyn, C; Audenaert, E A

2012-12-01

164

Use of endoscopy in peptic ulcer disease.  

PubMed

The diagnosis and treatment of acute bleeding caused by peptic ulcer disease has been greatly facilitated by fiberoptic endoscopy. The basic differentiation between malignant and benign gastric ulcer requires endoscopic confirmation with biopsy. The management of bleeding from peptic ulceration can be enhanced by endoscopic examination as can the prediction of risk for recurrent bleeding or need for surgical intervention. Various therapeutic maneuvers can be performed endoscopically, including monopolar and multipolar cautery, laser and heater probe therapy, and injection of vasoconstrictors to control bleeding. Endoscopic balloon dilation for the management of gastric outlet obstruction is often effective. PMID:2072790

Mamel, J J

1991-07-01

165

Zinc and gastrointestinal disease  

PubMed Central

This review is a current summary of the role that both zinc deficiency and zinc supplementation can play in the etiology and therapy of a wide range of gastrointestinal diseases. The recent literature describing zinc action on gastrointestinal epithelial tight junctions and epithelial barrier function is described. Zinc enhancement of gastrointestinal epithelial barrier function may figure prominently in its potential therapeutic action in several gastrointestinal diseases.

Skrovanek, Sonja; DiGuilio, Katherine; Bailey, Robert; Huntington, William; Urbas, Ryan; Mayilvaganan, Barani; Mercogliano, Giancarlo; Mullin, James M

2014-01-01

166

Zinc and gastrointestinal disease.  

PubMed

This review is a current summary of the role that both zinc deficiency and zinc supplementation can play in the etiology and therapy of a wide range of gastrointestinal diseases. The recent literature describing zinc action on gastrointestinal epithelial tight junctions and epithelial barrier function is described. Zinc enhancement of gastrointestinal epithelial barrier function may figure prominently in its potential therapeutic action in several gastrointestinal diseases. PMID:25400994

Skrovanek, Sonja; DiGuilio, Katherine; Bailey, Robert; Huntington, William; Urbas, Ryan; Mayilvaganan, Barani; Mercogliano, Giancarlo; Mullin, James M

2014-11-15

167

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy  

PubMed Central

AIM: To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy. METHODS: We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis. RESULTS: A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G. Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett’s esophagus, and 0.909 for esophageal varices. CONCLUSION: Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy. PMID:24748920

Aedo, María R; Zavala-González, Miguel Á; Meixueiro-Daza, Arturo; Remes-Troche, José María

2014-01-01

168

Method for continuous guidance of endoscopy  

NASA Astrophysics Data System (ADS)

Previous research has indicated that use of guidance systems during endoscopy can improve the performance and decrease the skill variation of physicians. Current guidance systems, however, rely on computationally intensive registration techniques or costly and error-prone electromagnetic (E/M) registration techniques, neither of which fit seamlessly into the clinical workflow. We have previously proposed a real-time image-based registration technique that addresses both of these problems. We now propose a system-level approach that incorporates this technique into a complete paradigm for real-time image-based guidance in order to provide a physician with continuously-updated navigational and guidance information. At the core of the system is a novel strategy for guidance of endoscopy. Additional elements such as global surface rendering, local cross-sectional views, and pertinent distances are also incorporated into the system to provide additional utility to the physician. Phantom results were generated using bronchoscopy performed on a rapid prototype model of a human tracheobronchial airway tree. The system has also been tested in ongoing live human tests. Thus far, ten such tests, focused on bronchoscopic intervention of pulmonary patients, have been run successfully.

Merritt, Scott A.; Rai, Lav; Gibbs, Jason D.; Yu, Kun-Chang; Higgins, William E.

2007-03-01

169

Evaluation of friction enhancement through soft polymer micro-patterns in active capsule endoscopy  

NASA Astrophysics Data System (ADS)

Capsule endoscopy is an emerging field in medical technology. Despite very promising innovations, some critical issues are yet to be addressed, such as the management and possible exploitation of the friction in the gastrointestinal environment in order to control capsule locomotion more actively. This paper presents the fabrication and testing of bio-inspired polymeric micro-patterns, which are arrays of cylindrical pillars fabricated via soft lithography. The aim of the work is to develop structures that enhance the grip between an artificial device and the intestinal tissue, without injuring the mucosa. In fact, the patterns are intended to be mounted on microfabricated legs of a capsule robot that is able to move actively in the gastrointestinal tract, thus improving the robot's traction ability. The effect of micro-patterned surfaces on the leg-slipping behaviour on colon walls was investigated by considering both different pillar dimensions and the influence of tissue morphology. Several in vitro tests on biological samples demonstrated that micro-patterns of pillars made from a soft polymer with an aspect ratio close to 1 enhanced friction by 41.7% with regard to flat surfaces. This work presents preliminary modelling of the friction and adhesion forces in the gastrointestinal environment and some design guidelines for endoscopic devices.

Buselli, Elisa; Pensabene, Virginia; Castrataro, Piero; Valdastri, Pietro; Menciassi, Arianna; Dario, Paolo

2010-10-01

170

Treatment of acute nonvariceal upper gastrointestinal hemorrhage.  

PubMed

Hospitalization for nonvariceal upper gastrointestinal hemorrhage (UGIH) is still common with an incidence of 100/100,000 adults/year. Mortality rates range between 8 and 14%. The most common etiologies of acute UGIH are gastric and duodenal ulcers which are associated with older age, Helicobacter pylori gastritis and nonsteroidal anti-inflammatory drugs. Approximately 70% of UGIH stop spontaneously, 10% bleed continuously and about 20% rebleed in the first 24-72 h. Mortality and the probability of rebleeding have been related to the ulcers' stigmata (Forrest) and to a variety of clinical findings (hematemesis, low initial hemoglobin, signs of shock, coagulopathy and liver disease). It is well established that only patients with continued bleeding or with a risk of rebleeding benefit from endoscopic or medical treatment. Endoscopic treatment (including heater probe, bipolar electrocoagulation, laser and injection therapy) control active bleeding in up to 90% and reduce significantly the rates of further bleeding, the need for blood transfusions, hospital costs and emergency surgery. Medical treatment is still controversial although positive results for somatostatin and octreotide have been found. A meta-analysis including 1,829 patients from 14 randomized trials showed the relative risk for continued bleeding or rebleeding of 0.53 (95% CI, 0.43-0.63) in favor of somatostatin and octreotide. Interventional endoscopy is the first line of treatment for UGIH. Somatostatin and its analogue octreotide may be a useful adjunct to endoscopic management or alternative when endoscopy is unsuccessful, contraindicated or unavailable. PMID:10207231

Meier, R; Wettstein, A R

1999-01-01

171

Autofluorescence endoscopy: Feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology  

Microsoft Academic Search

Background: Case studies are presented of fluorescence endoscopy in the upper and lower GI tract to illustrate the ability to detect early-stage lesions that were not observable with white light endoscopy or those in which the assessment of the stage or extension of the lesion were equivocal. Methods: A new fluorescence imaging system was used in which blue light excites

Jelle Haringsma; Guido N. J. Tytgat; Hiroyuki Yano; Hiroyasu Iishi; Masaharu Tatsuta; Tatsuo Ogihara; Haruo Watanabe; Nobuhiro Sato; Norman Marcon; Brian C. Wilson; Richard W. Cline

2001-01-01

172

Vascular lesions of the gastrointestinal tract.  

PubMed

Vascular lesions of the gastrointestinal (GI) tract include arterio-venous malformations as angiodysplasia and Dieulafoy's lesion, venous ectasias (multiple phlebectasias and haemorroids), teleangiectasias which can be associated with hereditary hemorrhagic teleangiectasia (HHT), Turner's syndrome and systemic sclerosis, haemangioma's, angiosarcoma's and disorders of connective tissue affecting blood vessels as pseudoxanthoma elasticum and Ehlers-Danlos's disease. As a group, they are relatively rare lesions that however may be a major source of upper and lower gastrointestinal bleeding. Clinical presentation is variable, ranging from asymptomatic cases over iron deficiency anaemia to acute or recurrent bleeding that may be life-threatening. Furthermore, patients may present with other symptoms, e.g. pain, dysphagia, odynophagia, the presence of a palpable mass, intussusception, obstruction, haemodynamic problems resulting from high cardiac output, lymphatic abnormalities with protein loosing enteropathy and ascites, or dermatological and somatic features in syndromal cases. Diagnosis can usually be made using endoscopy, sometimes with additional biopsy. Barium radiography, angiography, intraoperative enteroscopy, tagged red blood cell scan, CT-scan and MRI-scan may offer additional information. Treatment can be symptomatic, including iron supplements and transfusion therapy or causal, including therapeutic endoscopy (laser, electrocautery, heater probe or injection sclerotherapy), therapeutic angiography and surgery. The mode of treatment is of course depending on the mode of presentation and other factors such as associated disorders. If endoscopic or angiographic therapy is impossible and surgical intervention not indicated, pharmacological therapy may be warranted. Good results have been reported with different drugs, albeit most of them have not been tested in large trials. PMID:12619428

Dalle, I; Geboes, K

2002-01-01

173

Global-constrained hidden Markov model applied on wireless capsule endoscopy video segmentation  

NASA Astrophysics Data System (ADS)

Accurate analysis of wireless capsule endoscopy (WCE) videos is vital but tedious. Automatic image analysis can expedite this task. Video segmentation of WCE into the four parts of the gastrointestinal tract is one way to assist a physician. The segmentation approach described in this paper integrates pattern recognition with statiscal analysis. Iniatially, a support vector machine is applied to classify video frames into four classes using a combination of multiple color and texture features as the feature vector. A Poisson cumulative distribution, for which the parameter depends on the length of segments, models a prior knowledge. A priori knowledge together with inter-frame difference serves as the global constraints driven by the underlying observation of each WCE video, which is fitted by Gaussian distribution to constrain the transition probability of hidden Markov model.Experimental results demonstrated effectiveness of the approach.

Wan, Yiwen; Duraisamy, Prakash; Alam, Mohammad S.; Buckles, Bill

2012-06-01

174

[Design of extracorporeal apparatus of capsule endoscopy based on ARM+FPGA].  

PubMed

Considering that the patients would bear the annoyance of fixed posture for long time when they are examined with gastrointestinal wireless endoscopy, even though portable devices have been developed, the treatments still depend on PC so much, we proposed an embedded solution based on ARM + FPGA. It used embedded ARM9 S3C2440 as processor core, collected images from digestive tract through capsule endoscopy which can be swallowed down there, and wirelessly transferred these images to the receiving system, then used video decoder chip SAA7114H for analog of NTSC video image decode. And under FPGA's logic controlling, effective digital video signal was transferred to S3C2440 for further treatment. Finally within the embedded Linux environment, we programmed the visual user interfaces using the QT/Embedded, realizing the offline record of the real-time video images of digestive tract portable and preferences. It can make patients move more freely and even without PC when examining. In addition, the method greatly improves the efficiency of the doctor, and is more intelligent and with more humane nature. PMID:22097259

Wang, Shenghua; Zhang, Sijie; Wang, Yue; Wang, Zhenxing

2011-10-01

175

Targeted detection of murine colonic dysplasia in vivo with flexible multispectral scanning fiber endoscopy  

NASA Astrophysics Data System (ADS)

Gastrointestinal cancers are heterogeneous and can overexpress several protein targets that can be imaged simultaneously on endoscopy using multiple molecular probes. We aim to demonstrate a multispectral scanning fiber endoscope for wide-field fluorescence detection of colonic dysplasia. Excitation at 440, 532, and 635 nm is delivered into a single spiral scanning fiber, and fluorescence is collected by a ring of light-collecting optical fibers placed around the instrument periphery. Specific-binding peptides are selected with phage display technology using the CPC;Apc mouse model of spontaneous colonic dysplasia. Validation of peptide specificity is performed on flow cytometry and in vivo endoscopy. The peptides KCCFPAQ, AKPGYLS, and LTTHYKL are selected and labeled with 7-diethylaminocoumarin-3-carboxylic acid (DEAC), 5-carboxytetramethylrhodamine (TAMRA), and CF633, respectively. Separate droplets of KCCFPAQ-DEAC, AKPGYLS-TAMRA, and LTTHYKL-CF633 are distinguished at concentrations of 100 and 1 ?M. Separate application of the fluorescent-labeled peptides demonstrate specific binding to colonic adenomas. The average target/background ratios are 1.71+/-0.19 and 1.67+/-0.12 for KCCFPAQ-DEAC and AKPGYLS-TAMRA, respectively. Administration of these two peptides together results in distinct binding patterns in the blue and green channels. Specific binding of two or more peptides can be distinguished in vivo using a novel multispectral endoscope to localize colonic dysplasia on real-time wide-field imaging.

Miller, Sharon J.; Lee, Cameron M.; Joshi, Bishnu P.; Gaustad, Adam; Seibel, Eric J.; Wang, Thomas D.

2012-02-01

176

Application of Wireless Power Transmission Systems in Wireless Capsule Endoscopy: An Overview  

PubMed Central

Wireless capsule endoscopy (WCE) is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB). To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE) units may utilize advanced features such as active system control over capsule motion, drug delivery systems, semi-surgical tools and biopsy. However, the inclusion of the above advanced features demands additional power that make conventional power source methods impractical. In this regards, wireless power transmission (WPT) system has received attention among researchers to overcome this problem. Systematic reviews on techniques of using WPT for WCE are limited, especially when involving the recent technological advancements. This paper aims to fill that gap by providing a systematic review with emphasis on the aspects related to the amount of transmitted power, the power transmission efficiency, the system stability and patient safety. It is noted that, thus far the development of WPT system for this WCE application is still in initial stage and there is room for improvements, especially involving system efficiency, stability, and the patient safety aspects. PMID:24949645

Basar, Md Rubel; Ahmad, Mohd Yazed; Cho, Jongman; Ibrahim, Fatimah

2014-01-01

177

A case of primary jejunal cancer diagnosed by preoperative small intestinal endoscopy.  

PubMed

The patient was a 37-year-old female. She was brought to our hospital by ambulance with nausea and vomiting. Abdominal ultra sound and abdominal enhanced CT scan showed a tumor in left side of the abdominal aorta 6 cm in size, and it showed an expanded stomach and duodenum. Upper gastrointestinal series revealed an apple core sign in upper jejunum near the Treitz' ligament. Small intestinal endoscopy (XSIF-240 endoscope, Olympus Inc.) revealed stenosis related to an epithelially protruding lesion with an irregular surface in the jejunum on the anal side of the horizontal duodenal peduncle. Biopsy suggested a well-differentiated adenocarcinoma. Scintigraphy showed hot spot in left middle abdomen. Under a diagnosis of primary jejunum cancer, Partial resection of the jejunum and partial resection of the transverse colon was performed. Histopathologically, the tumor was well differentiated adenocarcinoma exposed serosal surface. Postoperatively, the stage was evaluated as III (T3, N1, M0). Preoperative diagnosis to use small intestinal endoscopy was effectiveness. We report a patient with primary jejunum cancer in whom a definitive diagnosis was made before surgery. PMID:21318964

Nabeshima, Kazuhito; Machimura, Takao; Wasada, Mitsuru; Takayasu, Hiroyuki; Ogoshi, Kyoji; Makuuchi, Hiroyasu

2008-04-01

178

Diagnostic efficiency of an ultrarapid endoscopy room test for Helicobacter pylori.  

PubMed Central

There are several reliable methods for detecting Helicobacter pylori but all have as a major disadvantage the time required to yield a definitive result. We have modified the standard urease test so that a positive result is available in one minute. We describe the use of this test in biopsy specimens from the gastric antrum from 220 consecutive patients referred for upper gastrointestinal endoscopy. The performance of the 'one minute test' was compared with a standard urease test, Gram stain, and microbiological culture. Using culture as the 'gold standard' 80 (36%) of the patients were H pylori positive. The one minute test produced no false positives and showed a sensitivity of 89% and specificity of 100%, while the predictive values of a positive and negative test were 100% and 94% respectively. The diagnostic efficiency of the test was 96% compared to 85% for both the Gram stain and direct urease test. All positive results using the one minute test were available within one minute. The test is easy to prepare and costs approximately pounds 0.04. This new modification of the urease test should be superior to the currently available urease tests because a reliable result will be available in almost 90% of infected individuals even before endoscopy is completed. PMID:2040465

Thillainayagam, A V; Arvind, A S; Cook, R S; Harrison, I G; Tabaqchali, S; Farthing, M J

1991-01-01

179

A discrete-time localization method for capsule endoscopy based on on-board magnetic sensing  

NASA Astrophysics Data System (ADS)

Recent achievements in active capsule endoscopy have allowed controlled inspection of the bowel by magnetic guidance. Capsule localization represents an important enabling technology for such kinds of platforms. In this paper, the authors present a localization method, applied as first step in time-discrete capsule position detection, that is useful for establishing a magnetic link at the beginning of an endoscopic procedure or for re-linking the capsule in the case of loss due to locomotion. The novelty of this approach consists in using magnetic sensors on board the capsule whose output is combined with pre-calculated magnetic field analytical model solutions. A magnetic field triangulation algorithm is used for obtaining the position of the capsule inside the gastrointestinal tract. Experimental validation has demonstrated that the proposed procedure is stable, accurate and has a wide localization range in a volume of about 18 × 103 cm3. Position errors of 14 mm along the X direction, 11 mm along the Y direction and 19 mm along the Z direction were obtained in less than 27 s of elaboration time. The proposed approach, being compatible with magnetic fields used for locomotion, can be easily extended to other platforms for active capsule endoscopy.

Salerno, Marco; Ciuti, Gastone; Lucarini, Gioia; Rizzo, Rocco; Valdastri, Pietro; Menciassi, Arianna; Landi, Alberto; Dario, Paolo

2012-01-01

180

A Review of Machine-Vision-Based Analysis of Wireless Capsule Endoscopy Video  

PubMed Central

Wireless capsule endoscopy (WCE) enables a physician to diagnose a patient's digestive system without surgical procedures. However, it takes 1-2 hours for a gastroenterologist to examine the video. To speed up the review process, a number of analysis techniques based on machine vision have been proposed by computer science researchers. In order to train a machine to understand the semantics of an image, the image contents need to be translated into numerical form first. The numerical form of the image is known as image abstraction. The process of selecting relevant image features is often determined by the modality of medical images and the nature of the diagnoses. For example, there are radiographic projection-based images (e.g., X-rays and PET scans), tomography-based images (e.g., MRT and CT scans), and photography-based images (e.g., endoscopy, dermatology, and microscopic histology). Each modality imposes unique image-dependent restrictions for automatic and medically meaningful image abstraction processes. In this paper, we review the current development of machine-vision-based analysis of WCE video, focusing on the research that identifies specific gastrointestinal (GI) pathology and methods of shot boundary detection. PMID:23197930

Chen, Yingju; Lee, Jeongkyu

2012-01-01

181

Multilevel wireless capsule endoscopy video segmentation  

NASA Astrophysics Data System (ADS)

Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. WCE transmits more than 50,000 video frames per examination and the visual inspection of the resulting video is a highly time-consuming task even for the experienced gastroenterologist. Typically, a medical clinician spends one or two hours to analyze a WCE video. To reduce the assessment time, it is critical to develop a technique to automatically discriminate digestive organs and shots each of which consists of the same or similar shots. In this paper a multi-level WCE video segmentation methodology is presented to reduce the examination time.

Hwang, Sae; Celebi, M. Emre

2010-03-01

182

Miniature Grating for Spectrally-Encoded Endoscopy  

PubMed Central

Spectrally-encoded endoscopy (SEE) is an ultraminiature endoscopy technology that acquires high-definition images of internal organs through a sub-mm endoscopic probe. In SEE, a grating at the tip of the imaging optics diffracts the broadband light into multiple beams, where each beam with a distinctive wavelength is illuminated on a unique transverse location of the tissue. By encoding one transverse coordinate with the wavelength, SEE can image a line of the tissue at a time without using any beam scanning devices. This feature of the SEE technology allows the SEE probe to be miniaturized to sub-mm dimensions. While previous studies have shown that SEE has the potential to be utilized for various clinical imaging applications, the translation of SEE for medicine has been hampered by challenges in fabricating the miniature grating inherent to SEE probes. This paper describes a new fabrication method for SEE probes. The new method uses a soft lithographic approach to pattern a high-aspect-ratio grating at the tip of the miniature imaging optics. Using this technique, we have constructed a 500-?m-diameter SEE probe. The miniature grating at the tip of the probe had a measured diffraction efficiency of 75%. The new SEE probe was used to image a human finger and formalin fixed mouse embryos, demonstrating the capability of this device to visualize key anatomic features of tissues with high image contrast. In addition to providing high quality imaging SEE optics, the soft lithography method allows cost-effective and reliable fabrication of these miniature endoscopes, which will facilitate the clinical translation of SEE technology. PMID:23503940

Kang, Dongkyun; Martinez, Ramses V.; Whitesides, George M.

2013-01-01

183

Gastric cavernous hemangioma: A rare case with upper gastrointestinal bleeding  

PubMed Central

Upper gastrointestinal bleeding caused by a gastric hemangioma is a relatively rare occurrence. We report the case of a 65-year-old woman who suffered a sudden onset of hematemesis. Endoscopy revealed a 4×3 cm mass located in the gastric fundus. Abdominal contrast-enhanced CT revealed the shadow of enhancing linear blood vessels located in the gastric fundus. Based on her clinical appearance and the laboratory results, the patient was diagnosed with gastric hemangioma. In the laparotomy, a proximal gastrectomy was performed. The final diagnosis of cavernous hemangioma arising from the gastric fundus was confirmed by postoperative pathological examination. PMID:22848269

ZONG, LIANG; CHEN, PING; SHI, GUO HAO; WANG, LEI

2011-01-01

184

Gastrointestinal Morbidity in Obesity  

PubMed Central

Obesity is a complex disease that results from increased energy intake and decreased energy expenditure. The gastrointestinal system plays a key role in the pathogenesis of obesity and facilitates caloric imbalance. Changes in gastrointestinal hormones and the inhibition of mechanisms that curtail caloric intake result in weight gain. It is not clear if the gastrointestinal role in obesity is a cause or an effect of this disease. Obesity is often associated with type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). Obesity is also associated with gastrointestinal disorders, which are more frequent and present earlier than T2DM and CVD. Diseases such as gastro-esophageal reflux disease, cholelithiasis or non-alcoholic steatohepatitis are directly related to body weight and abdominal adiposity. Our objective is to assess the role of each gastrointestinal organ in obesity and the gastrointestinal morbidity resulting in those organs from effects of obesity. PMID:24602085

Acosta, Andres; Camilleri, Michael

2014-01-01

185

Murine endoscopy for in vivo multimodal imaging of carcinogenesis and assessment of intestinal wound healing and inflammation.  

PubMed

Mouse models are widely used to study pathogenesis of human diseases and to evaluate diagnostic procedures as well as therapeutic interventions preclinically. However, valid assessment of pathological alterations often requires histological analysis, and when performed ex vivo, necessitates death of the animal. Therefore in conventional experimental settings, intra-individual follow-up examinations are rarely possible. Thus, development of murine endoscopy in live mice enables investigators for the first time to both directly visualize the gastrointestinal mucosa and also repeat the procedure to monitor for alterations. Numerous applications for in vivo murine endoscopy exist, including studying intestinal inflammation or wound healing, obtaining mucosal biopsies repeatedly, and to locally administer diagnostic or therapeutic agents using miniature injection catheters. Most recently, molecular imaging has extended diagnostic imaging modalities allowing specific detection of distinct target molecules using specific photoprobes. In conclusion, murine endoscopy has emerged as a novel cutting-edge technology for diagnostic experimental in vivo imaging and may significantly impact on preclinical research in various fields. PMID:25226434

Brückner, Markus; Lenz, Philipp; Nowacki, Tobias M; Pott, Friederike; Foell, Dirk; Bettenworth, Dominik

2014-01-01

186

Upper Gastrointestinal Bleeding  

Microsoft Academic Search

Upper gastrointestinal bleeding is a life threatening condition in children. Common sources of upper gastrointestinal bleeding\\u000a in children include variceal hemorrhage (most commonly extra-hepatic portal venous obstruction in our settings) and mucosal\\u000a lesions (gastric erosions and ulcers secondary to drug intake). While most gastrointestinal bleeding may not be life threatening,\\u000a it is necessary to determine the source, degree and possible

Vidyut Bhatia; Rakesh Lodha

2011-01-01

187

Endoscopy equipment and instrumentation for use in exotic animal medicine.  

PubMed

The first descriptions of endoscopy date back to the times of Hippocrates (460-377 BC), who described the use of a rectal speculum in humans. Since that time, technologic advances have fueled the development of endoscopy equipment. The application of human pediatric instruments in exotic pet medicine has enabled these minimally invasive techniques to be applied to birds, reptiles, amphibians, fish, and small mammals. This article aims to summarize the development of endoscopy equipment and focuses on recent developments in miniature laparoscopy equipment that have found use in zoologic companion animal practice. PMID:20381771

Divers, Stephen J

2010-05-01

188

Advanced imaging and visualization in gastrointestinal disorders  

PubMed Central

Advanced medical imaging and visualization has a strong impact on research and clinical decision making in gastroenterology. The aim of this paper is to show how imaging and visualization can disclose structural and functional abnormalities of the gastrointestinal (GI) tract. Imaging methods such as ultrasonography, magnetic resonance imaging (MRI), endoscopy, endosonography, and elastography will be outlined and visualization with Virtual Reality and haptic methods. Ultrasonography is a versatile method that can be used to evaluate antral contractility, gastric emptying, transpyloric flow, gastric configuration, intragastric distribution of meals, gastric accommodation and strain measurement of the gastric wall. Advanced methods for endoscopic ultrasound, three-dimensional (3D) ultrasound, and tissue Doppler (Strain Rate Imaging) provide detailed information of the GI tract. Food hypersensitivity reactions including gastrointestinal reactions due to food allergy can be visualized by ultrasonography and MRI. Development of multi-parametric and multi-modal imaging may increase diagnostic benefits and facilitate fusion of diagnostic and therapeutic imaging in the future. PMID:17457973

Gilja, Odd Helge; Hatlebakk, Jan G; ?degaard, Svein; Berstad, Arnold; Viola, Ivan; Giertsen, Christopher; Hausken, Trygve; Gregersen, Hans

2007-01-01

189

Continuing challenges in the diagnosis and management of obscure gastrointestinal bleeding  

PubMed Central

The diagnosis and management of obscure gastrointestinal bleeding (OGIB) have changed dramatically since the introduction of video capsule endoscopy (VCE) followed by deep enteroscopy and other imaging technologies in the last decade. Significant advances have been made, yet there remains room for improvement in our diagnostic yield and treatment capabilities for recurrent OGIB. In this review, we will summarize the latest technologies for the diagnosis of OGIB, limitations of VCE, technological enhancement in VCE, and different management options for OGIB.

Baptista, Veronica; Marya, Neil; Singh, Anupam; Rupawala, Abbas; Gondal, Bilal; Cave, David

2014-01-01

190

Continuing challenges in the diagnosis and management of obscure gastrointestinal bleeding.  

PubMed

The diagnosis and management of obscure gastrointestinal bleeding (OGIB) have changed dramatically since the introduction of video capsule endoscopy (VCE) followed by deep enteroscopy and other imaging technologies in the last decade. Significant advances have been made, yet there remains room for improvement in our diagnostic yield and treatment capabilities for recurrent OGIB. In this review, we will summarize the latest technologies for the diagnosis of OGIB, limitations of VCE, technological enhancement in VCE, and different management options for OGIB. PMID:25400996

Baptista, Veronica; Marya, Neil; Singh, Anupam; Rupawala, Abbas; Gondal, Bilal; Cave, David

2014-11-15

191

Esophageal involvement of pemphigus vulgaris associated with upper gastrointestinal bleeding.  

PubMed

Esophageal involvement of pemphigus vulgaris is rare, and when present, the most common presenting symptoms reported in the medical literature are odynophagia and dysphagia. Here, we present two cases of pemphigus vulgaris presenting with upper gastrointestinal hemorrhage because of esophageal involvement of the disease. In case 1, a 41-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with hematemesis. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the oropharynx and esophagus. The patient recovered after the administration of high-dose corticosteroids and immunosuppressants. In case 2, a 30-year-old female patient with known pemphigus vulgaris also presented with hematemesis, showing similar endoscopic findings to the first case. She also responded to the same treatment. Esophageal involvement of pemphigus vulgaris responds to high-dose corticosteroids and immunosuppressants. Thus, in patients with pemphigus vulgaris with signs or symptoms of upper gastrointestinal bleeding, an early endoscopy for the evaluation of esophageal involvement is beneficial. PMID:25325007

Chang, Sooyun; Park, Soo Jung; Kim, Sun Wook; Jin, Moo-Nyun; Lee, Jung-Hee; Kim, Hyun Ju; Hong, Sung Pil; Kim, Tae Il

2014-09-01

192

A gastric fibrolipoma presenting as acute gastrointestinal hemorrhage.  

PubMed

A 56-year-old woman was admitted to our hospital with upper gastrointestinal hemorrhage from a gastric submucosal tumor that was treated by a laparoscopic technique. Endoscopy and endoscopic ultrasonography (EUS) revealed a 2-cm submucosal tumor located in the posterior wall of the upper gastric body, showing a heterogeneous hyperechoic tumor. A laparoscopic wedge resection of the stomach was performed. Pathological examinations revealed that the tumor was composed of spindle cells like fibroblasts and mature adipocytes. Immunohistochemical examinations revealed that the tumor was negative for desmin and alpha-smooth muscle actin. Based on these findings, a diagnosis of fibrolipoma was made. EUS is useful for differentiating a fibrolipoma from a gastrointestinal stromal tumor or lipoma by the findings of characteristic echogenesity and detection of the tumor origin. PMID:17274543

Kohashi, Toshihiko; Itamoto, Toshiyuki; Fukuda, Saburo; Yamasaki, Hiroyuki; Yokoya, Hitoshi; Yonehara, Shuji; Suzuki, Tsuyoshi; Asahara, Toshimasa

2006-12-01

193

Esophageal Involvement of Pemphigus Vulgaris Associated with Upper Gastrointestinal Bleeding  

PubMed Central

Esophageal involvement of pemphigus vulgaris is rare, and when present, the most common presenting symptoms reported in the medical literature are odynophagia and dysphagia. Here, we present two cases of pemphigus vulgaris presenting with upper gastrointestinal hemorrhage because of esophageal involvement of the disease. In case 1, a 41-year-old female patient with a prior diagnosis of pemphigus vulgaris presented with hematemesis. Esophagogastroduodenoscopy showed diffuse mucosal exfoliation and oozing bleeding of the oropharynx and esophagus. The patient recovered after the administration of high-dose corticosteroids and immunosuppressants. In case 2, a 30-year-old female patient with known pemphigus vulgaris also presented with hematemesis, showing similar endoscopic findings to the first case. She also responded to the same treatment. Esophageal involvement of pemphigus vulgaris responds to high-dose corticosteroids and immunosuppressants. Thus, in patients with pemphigus vulgaris with signs or symptoms of upper gastrointestinal bleeding, an early endoscopy for the evaluation of esophageal involvement is beneficial.

Chang, Sooyun; Kim, Sun Wook; Jin, Moo-Nyun; Lee, Jung-Hee; Kim, Hyun Ju; Hong, Sung Pil; Kim, Tae Il

2014-01-01

194

Giant bilateral submandibular sialoliths and the role of salivary endoscopy.  

PubMed

Sialolithiasis is the most common disease of the salivary glands. Sialoliths that exceed 15 mm in any dimension are considered as giant. We present the first case of simultaneous bilateral giant sialoliths reported in the literature and the role of salivary endoscopy in this scenario. Salivary endoscopy allows duct exploration and retrieval of smaller intra-ductal fragments during combined approaches (external and endoscopic). PMID:21225733

Rivera-Serrano, Carlos M; Schaitkin, Barry M

2010-01-01

195

Office endoscopy--when, why, what, and how.  

PubMed

Comprehensive diagnostic nasal endoscopy is a relatively recent advance in the office practice of rhinology. The examination is performed most commonly with 4.0-mm telescopes (0 and 30 degrees) and 2.7-mm telescopes (30 and 70 degrees). Nasal endoscopy provides the rhinologist with unparalleled visualization with brilliant illumination of the nasal cavity which permits more accurate diagnosis of nasal conditions. It also serves as an excellent teaching tool and source of photodocumentation. PMID:2771412

Gustafson, R O; Kern, E B

1989-08-01

196

Computer simulation training enhances patient comfort during endoscopy  

Microsoft Academic Search

Background & Aims: Computer-based endoscopy simulator (CBES) training’s impact on patient-based outcomes has never been examined. This study examines whether the endoscopy skills of trainees are improved and patient discomfort is reduced as a result of CBES training. Methods: From July 2001–June 2002, 38 residents received either 1 week of patient-based training (PBT) alone in flexible sigmoidoscopy (FS) or 3

Robert E. Sedlack; Joseph C. Kolars; Jeffrey A. Alexander

2004-01-01

197

Dopamine in gastrointestinal disease  

Microsoft Academic Search

Dopamine is an important enteric neuromodulator. Herein we review the data that support a role for dopaminergic involvement in experimental duodenal and gastric ulceration; gastric, pancreatic, and duodenal secretion; gastrointestinal motility; and gastric and intestinal submucosal blood flow regulation. There also is support for a role for dopamine and dopamimetic agents in the treatment of certain experimental gastrointestinal diseases because

Gary B. Glavin; Sandor Szabo

1990-01-01

198

Gastrointestinal Steering Committee  

Cancer.gov

The NCI Gastrointestinal Intergroup was the first disease-specific group to transition into a Disease-Specific Steering Committee (DSSC) as the Gastrointestinal Steering Committee (GISC). This transition occurred in January 2006. The GISC is currently composed of the Steering Committee and seven specific disease-site task forces.

199

Predicting Pathology in Medical Decision Support Systems in Endoscopy of the Gastrointestinal Tract  

E-print Network

the risk of can- cer in the GI tract are adenomas, Barrett's esophagus, Crohn's disease, celiac disease, GI tract, physicians are able to detect severe diseases already in early de- velopment stages and therefore the mortality rate for many diseases, especially different types of can- cers, has been lowered drastically

Uhl, Andreas

200

Interventional Endoscopy Database for Pancreatico-biliary, Gastrointestinal and Esophageal Disorders  

ClinicalTrials.gov

Ampullary Cancer; Duodenal Cancer; Bile Duct Cancer; Bile Duct Disorders; Gallstones; Obstructive Jaundice; Pancreatic Disorders (Noncancerous); Colorectal Cancer; Esophageal Cancer; Barrett's Esophagus; Gastric Malignancies; Pancreatic Cancer; Pediatric Gastroenterology; Cholangiocarcinoma; Pancreatic Pseudocysts; Acute and Chronic Pancreatitis; Recurrent Pancreatitis; Cholangitis; Bile Leak; Biliary Strictures; Pancreatic Divisum; Biliary and Pancreatic Stones; Choledocholithiasis

2014-06-11

201

Acupuncture as an alternative to diazepam sedation for diagnostic gastrointestinal endoscopy  

Microsoft Academic Search

SummaryA study was undertaken to compare the differences in ease of intubation, emotional distress and physical discomfort during oesophago-gastro-duodenoscopy in 3 groups of patients: sedated with intravenous diazepam, receiving acupuncture, or being part of a control group having neither treatment. Patients were given the option of sedation. Those that declined were randomly divided into two groups, either receiving acupuncture or

Anthony Stellon; Terence Palmer

1999-01-01

202

Upper gastrointestinal bleeding due to gastric stromal tumour: a case report  

PubMed Central

Introduction Gastro-intestinal stromal tumours are the most common mesenchymal tumours of the gastro-intestinal tract. This case report highlights the necessity of early surgical intervention in such cases to avoid mortality due to rebleeding and to raise the awareness of rare causes of upper gastrointestinal bleed and their management. Case presentation A 61-year-old male presented to the accident and emergency department with a one-day history of haemetemesis with coffee ground vomiting. After initial resuscitation, he underwent upper gastrointestinal endoscopy under sedation which demonstrated a large, bleeding, gastric mass with a central crater along the greater curvature of the stomach. A partial gastrectomy was performed taking a wedge of the stomach with clearance from the tumour, with no signs of extraperitoneal disease. Conclusion Early surgical intervention, either open or laparoscopic resection, is the treatment of choice to prevent rebleeds. In general, complete surgical resection is accomplished in 40-60% of all gastro-intestinal stromal tumours patients, and in >70% of those with primary non- metastatic gastro-intestinal stromal tumour. In our case we had completely excised the tumour. Following surgery, all patients must be referred to centres which have more experience in treating gastro-intestinal stromal tumours. Imatinib is proven to be the first effective systemic therapy in cases of unresectable or metastatic disease. All gastro-intestinal stromal tumours have the potential for aggressive behaviour with the risk being estimated from tumour size and mitotic count. PMID:20509859

2010-01-01

203

[Dieulafoy's lesion: rare cause of massive upper gastrointestinal bleeding].  

PubMed

Dieulafoy's lesion is an unusual and potentially life-threatening cause of massive, recurrent gastrointestinal bleeding. Its reported incidence as a source of upper gastrointestinal bleeding ranges from 0.3-6.7%. Dieulafoy's lesion is most commonly located in the proximal stomach (75% of cases). Lesion typically occur within 6 to 10 cm of the esophagogastric junction, generally along the lesser curvature of the stomach. Similar lesions have been identified in the esophagus, duodenal bulb, jejunum, ileum, colorectum, anal canal, even in bronchus. Detection and identification of the Dieulafoy's lesion as the source of bleeding can often be difficult, especially because most present with massive bleeding. Because of intermittent nature of bleeding, initial endoscopy is diagnostic in 60% of the cases, so repeated endoscopies are often necessary. If the lesion can be endoscopically documented, attempts should be made to achieve hemostasis using one or a combination of several endoscopic modalities. Success has been reported with multipolar electrocoagulation, heater probe, noncontact laser photocoagulation, injection sclerotherapy, endoscopic hemoclipping and band ligation. Surgery is reserved for lesions that cannot be controlled by endoscopic techniques. When localized, a wide wedge resection of entire area traversed by the large submucosal artery is recomended because rebleeding has been described after simple coagulation and ligation. PMID:17633872

Stojakov, D; Velickovi?, D; Sabljak, P; Bjelovi?, M; Ebrahimi, K; Spica, B; Sljuki?, V; Pesko, P

2007-01-01

204

Immunohistochemical identification and localization of pancreatic polypeptide cells in the pancreas and gastrointestinal tract of the human fetus and adult man  

Microsoft Academic Search

Pancreatic polypeptide (PP)-containing cells were detected by using anti-bovine PP (BPP) serum in the pancreas and gastrointestinal tract of human fetuses, premature infants and in the pancreas, antrum and jejunum of adult man obtained by biopsy from patients with normal gastroduodenal endoscopy. The localization was established by studying the distribution of PP cells in comparison to the distribution of glucagon-,

C. Paulin; P. M. Dubois

1978-01-01

205

Gastrointestinal Parasitic Infections  

PubMed Central

This article surveys the most important gastrointestinal parasites that affect humans. The modes of acquisition, pathology, epidemiology, diagnosis, and treatment are all briefly examined. Gastrointestinal parasites have become increasingly important in the differential diagnosis of gastrointestinal disease, as a result of a number of circumstances. These circumstances include: increasing travel to developing countries; increased numbers, for one reason or another, of immunocompromised individuals; increased consumption of raw or partially cooked ethnic delicacies; more crowding in day-care centres; increased immigration from developing countries; and an endemic pocket of individuals with certain unhygienic or unsanitary practices. PMID:21253148

Embil, Juan A.; Embil, John M.

1988-01-01

206

Gastrointestinal Drugs in Aircrew.  

National Technical Information Service (NTIS)

Gastrointestinal diseases (GID) are common disorders in the general population. More than 50% of patients presenting with GID complaints are in the decades of life typical of military personnel, and GID represent some of the commonest reasons for medicati...

D. Danese

2001-01-01

207

Creation of a therapeutic digestive endoscopy suite in Senegal: renovation, training and university certification. Results of a Belgian-Senegalese inter-university project.  

PubMed

Therapeutic digestive endoscopy did not exist in sub-Saharan Africa before 2005. However, the prevalence of digestive diseases that could potentially benefit from basic endoscopic treatment is very high in this region. Portal hypertension with variceal bleeding and severe dysphagia associated with benign or malignant upper gastrointestinal tract diseases are prominent in these countries. The aim of the Project described in this report was to create a digestive endoscopy facility in Dakar (Senegal, West Africa), that would also provide local training in therapeutic endoscopy to doctors and nurses and facilitate regional autonomy with the opening of a University Certification in Gastroenterology. It took about 10 years to achieve these targets - 5 years to prepare realistic aims that took into account local needs, available local resources, and funding, and 4 years for the Project itself (2005-2009). At the present time, Senegalese colleagues and nurses are autonomous for basic therapeutic procedures in the upper and lower gastrointestinal tract. Two years after the end of funding, the rate of therapeutic activity has increased from 0% in 2005 to 12 % of digestive endoscopic activity in 2011. Key points of success were preparation, confidence of medical personnel, university involvement, shared funding, local multidisciplinary training, and facilitation of autonomy. Belgian healthcare workers were present on-site in Dakar for a total of about 6 months over the 4-year Project period, with an annual budget of less than € 80000. The Project has enabled an efficient North-South collaboration with a minimal budget, which has changed the healthcare provision of digestive endoscopy in Senegal, and has also provided autonomy, and facilitated the development of South-South cooperation. PMID:22271028

Le Moine, O; Diouf, M L; Mbengue, M; Mbaye, P S; Diop, P M; Balme, F; Brihay, J; Le Moine-Pauwels, A; Le Moine, M; Moreira-Diop, T

2012-02-01

208

Review of Musculoskeletal Injuries and Prevention in the Endoscopy Practitioner  

PubMed Central

Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940

2014-01-01

209

Nutrition in Gastrointestinal Cancer  

Microsoft Academic Search

Gastrointestinal cancers can significantly impact nutrition status. Data indicate that the presence of malnutrition in cancer\\u000a patients negatively impacts response to treatment, quality of life and survival. The nutritional support of patients with\\u000a gastrointestinal cancer should be individualized and may be dependent upon anticancer treatment modality. Interventions with\\u000a parenteral nutrition, enteral nutrition and immunonutrition are indicated in certain situations. Nutritional

Maureen B. Huhmann; David A. August

210

Asbestos and Gastrointestinal Cancer  

PubMed Central

Exposure to asbestos is among several factors cited as possible causes of esophageal, gastric and colorectal cancer. More than 45 published studies have presented mortality data on asbestos-exposed workers. For each cohort, we listed the observed and expected rates of deaths from types of gastrointestinal cancer based on the latest published follow-up. Summary standardized mortality ratios (SMRs) were then derived. Finally, we calculated summary SMRs for total gastrointestinal tract cancer for three occupational groups: asbestos factory workers, insulators/shipyard workers and asbestos miners. Statistically significant elevations in summary SMRs were found for esophageal, stomach and total gastrointestinal tract cancer in all asbestos-exposed workers. Esophageal cancer summary SMRs remained significantly elevated when data were reanalyzed to include only those cohorts with death certificate diagnoses for cause of observed deaths. However, summary SMRs were not statistically significant for stomach and total gastrointestinal tract cancer after reanalysis. Summary SMRs by occupational group showed a significant elevation for total gastrointestinal cancer in insulators/shipyard workers. The elevation was not significant after reanalysis. Based on the results after reanalysis, the elevations in summary SMRs for stomach and total gastrointestinal tract cancer are of a magnitude that could result from diagnostic and investigator error. We conclude that more studies are required before stomach and colorectal cancers are documented as asbestos-related diseases. PMID:4036114

Morgan, Robert W.; Foliart, Donna E.; Wong, Otto

1985-01-01

211

Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience  

PubMed Central

Background Foreign bodies (FBs) in the upper gastrointestinal tract are produced chiefly by accidental swallowing but rarely produce symptoms. Removal of FBs is not an infrequent challenge for upper gastrointestinal endoscopy. The aim of this study is to elicit our experience in a 5-year period in dealing with FBs in the upper gastrointestinal tract using upper endoscopy. Methods This retrospective study was conducted at Zagazig University Hospitals, Egypt, over a 5-year period. We reviewed all patients’ files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. Results A total of 45 patients were identified. Their ages ranged from 6 months to 102 years. Slight male predominance was noticed (53.3%). The most frequent presentation was a history of FB ingestion without any associated manifestations (44.4%). Coins were the most commonly encountered FBs (14/45). Esophagus was the most common site of trapping (27/45). The overall success rate was 95.6% (43/45). Upper endoscopy successfully resolved the problem by either FB removal (41/43) or dislodgment of the impacted fleshy meat to the stomach (2/43). Two cases were referred for surgical removal. The rate of complications was 6.7%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. Conclusion Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units, and under conscious sedation in most cases, with high success rates and minor complications. PMID:25053889

Emara, Mohamed H; Darwiesh, Ehab M; Refaey, Mohamed M; Galal, Sherif M

2014-01-01

212

How Can We Maximize Skills for Non-Variceal Upper Gastrointestinal Bleeding: Injection, Clipping, Burning, or Others?  

PubMed Central

Endoscopy has its role in the primary diagnosis and management of acute non-variceal upper gastrointestinal bleeding. Main roles of endoscopy are identifying high risk stigmata lesion, and performing endoscopic hemostasis to lower the rebleeding and mortality risks. Early endoscopy within the first 24 hours enables risk classification according to clinical and endoscopic criteria, which guide safe and prompt discharge of low risk patients, and improve outcomes of high risk patients. Techniques including injection therapy, ablative therapy and mechanical therapy have been studied over the recent decades. Combined treatment is more effective than injection treatment, and single treatment with mechanical or thermal method is safe and effective in peptic ulcer bleeding. Specific treatment and correct decisions are needed in various situations depending on the site, location, specific characteristics of lesion and patient's clinical conditions. PMID:22977808

2012-01-01

213

Role of endoscopy, cross-sectional imaging and biomarkers in Crohn's disease monitoring.  

PubMed

Crohn's disease is characterised by recurrent and/or chronic inflammation of the gastrointestinal tract leading to cumulative intestinal tissue damage. Treatment tailoring to try to prevent this tissue damage as well as achieve optimal benefit/risk ratio over the whole disease course is becoming an important aspect of Crohn's disease management. For decades, clinical symptoms have been the main trigger for diagnostic procedures and treatment strategy adaptations. However, the correlation between symptoms and intestinal lesions is only weak. Furthermore, preliminary evidence suggests that a state of remission beyond the simple control of clinical symptoms, and including mucosal healing, may be associated with better disease outcome. Therefore monitoring the disease through the use of endoscopy and cross-sectional imaging is proposed. However, the degree of mucosal or bowel wall healing that needs to be reached to improve disease outcome has not been appropriately studied. Furthermore, owing to their invasive nature and cost, endoscopy and cross-sectional imaging are not optimal tools for the patients or the payers. The use of biomarkers as surrogate markers of intestinal and systemic inflammation might help. Two biomarkers have been most broadly assessed in Crohn's disease: C-reactive protein and faecal calprotectin. These markers correlate significantly with endoscopic lesions, with the risk of relapse and with response to therapy. They could be used to help make decisions about diagnostic procedures and treatment. In particular, with the use of appropriate threshold values, they could determine the need for endoscopic or medical imaging procedures to confirm the disease activity state. PMID:24203056

Benitez, Jose-Manuel; Meuwis, Marie-Alice; Reenaers, Catherine; Van Kemseke, Catherine; Meunier, Paul; Louis, Edouard

2013-12-01

214

On-the-fly detection of images with gastritis aspects in magnetically guided capsule endoscopy  

NASA Astrophysics Data System (ADS)

Capsule Endoscopy (CE) was introduced in 2000 and has since become an established diagnostic procedure for the small bowel, colon and esophagus. For the CE examination the patient swallows the capsule, which then travels through the gastrointestinal tract under the influence of the peristaltic movements. CE is not indicated for stomach examination, as the capsule movements can not be controlled from the outside and the entire surface of the stomach can not be reliably covered. Magnetically-guided capsule endoscopy (MGCE) was introduced in 2010. For the MGCE procedure the stomach is filled with water and the capsule is navigated from the outside using an external magnetic field. During the examination the operator can control the motion of the capsule in order to obtain a sufficient number of stomach-surface images with diagnostic value. The quality of the examination depends on the skill of the operator and his ability to detect aspects of interest in real time. We present a novel computer-assisted diagnostic-procedure (CADP) algorithm for indicating gastritis pathologies in the stomach during the examination. Our algorithm is based on pre-processing methods and feature vectors that are suitably chosen for the challenges of the MGCE imaging (suspended particles, bubbles, lighting). An image is classified using an ada-boost trained classifier. For the classifier training, a number of possible features were investigated. Statistical evaluation was conducted to identify relevant features with discriminative potential. The proposed algorithm was tested on 12 video sequences stemming from 6 volunteers. A mean detection rate of 91.17% was achieved during leave-one out cross-validation.

Mewes, P. W.; Neumann, D.; Juloski, A. L.; Angelopoulou, E.; Hornegger, J.

2011-03-01

215

Service user and carer participation in an endoscopy nursing programme.  

PubMed

This article reports an initiative to improve students' insight into service user and carer experience of endoscopy, particularly those with severe disability, such as spinal cord injury. This insight has the potential to improve the information provided and level of person-centred care in an endoscopy service. It was evident in the feedback from the classroom encounter that the teaching and learning strategy had a positive outcome, which will allow us to integrate the approach into future curriculum development and delivery, bringing the lived experience from the service user and carer perspective into the classroom. Students engaged in discussion and used their reflective skills to develop sensitivity to those with physical disability and complex needs requiring endoscopy procedures. PMID:24121848

Martin, Daphne; Hoy, Leontia; N Hoy, Karl

216

A typical presentation of a rare cause of obscure gastrointestinal bleeding  

PubMed Central

A 52-year-old white woman had suffered from intermittent gastrointestinal (GI) bleeding for one year. Upper GI endoscopy, colonoscopy and peroral double-balloon enteroscopy (DBE) did not detect any bleeding source, suggesting obscure GI bleeding. However, in videocapsule endoscopy a jejunal ulceration without bleeding signs was suspected and this was endoscopically confirmed by another peroral DBE. After transfusion of packed red blood cells, the patient was discharged from our hospital in good general condition. Two weeks later she was readmitted because of another episode of acute bleeding. Multi-detector row computed tomography with 3D reconstruction was performed revealing a jejunal tumor causing lower gastrointestinal bleeding. The patient underwent exploratory laparotomy with partial jejunal resection and end-to-end jejunostomy for reconstruction. Histological examination of the specimen confirmed the diagnosis of a low risk gastrointestinal stromal tumor (GIST). Nine days after surgery the patient was discharged in good health. No signs of gastrointestinal rebleeding occurred in a follow-up of eight months. We herein describe the complex presentation and course of this patient with GIST and also review the current approach to treatment. PMID:21403816

Reuter, Stefan; Bettenworth, Dominik; Mees, Soren Torge; Neumann, Jorg; Beyna, Torsten; Domschke, Wolfram; Wessling, Johannes; Ullerich, Hansjorg

2011-01-01

217

Burden of Gastrointestinal Disease in the United States: 2012 Update  

PubMed Central

Background & Aims Gastrointestinal (GI) diseases account for substantial morbidity, mortality and cost. Statistical analyses of the most recent data are necessary to guide GI research, education and clinical practice. We estimate the burden of GI disease in the US. Methods We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. These data were obtained from the National Ambulatory Medical Care Survey; National Health and Wellness Survey; Nationwide Inpatient Sample; Surveillance, Epidemiology, and End Results Program; National Vital Statistics System; Thompson Reuters MarketScan®; Medicare; Medicaid; and the Clinical Outcomes Research Initiative’s National Endoscopic Database. We estimated endoscopic use and costs and examined trends in endoscopic procedure. Results Abdominal pain was the most common gastrointestinal symptom that prompted a clinic visit (15.9 million visits). Gastroesophageal reflux was the most common GI diagnosis (8.9 million visits). Hospitalizations and mortality from Clostridium difficile infection have doubled in the last 10 years. Acute pancreatitis was the most common reason for hospitalization (274,119 discharges). Colorectal cancer accounted for more than half of all GI cancers and was the leading cause of GI-related mortality (52,394 deaths). There were 6.9 million upper, 11.5 million lower, and 228,000 biliary endoscopies performed in 2009. The total cost for outpatient gastrointestinal endoscopy examinations was $32.4 billion. Conclusions GI diseases are a source of substantial morbidity, mortality and cost in the US. PMID:22885331

Peery, Anne F.; Dellon, Evan S.; Lund, Jennifer; Crockett, Seth D.; McGowan, Christopher E.; Bulsiewicz, William J; Gangarosa, Lisa M.; Thiny, Michelle T.; Stizenberg, Karyn; Morgan, Douglas R.; Ringel, Yehuda; Kim, Hannah P; DiBonaventura, Marco daCosta; Carroll, Charlotte F.; Allen, Jeffery K.; Cook, Suzanne F.; Sandler, Robert S.; Kappelman, Michael D; Shaheen, Nicholas J.

2012-01-01

218

The role of endoscopy in the management of pancreatic necrosis.  

PubMed

The management of acute pancreatitis has seen many advances over the past three decades. Attempts to improve care have led to new definitions, classification systems, and treatment strategies. Despite those efforts, considerable morbidity and mortality result from complications of severe acute pancreatitis. Much attention has been given to new ways to treat these complications, including inflammatory pancreatic fluid collections and associated infections. Endoscopy has become one of the established modalities for the treatment of these complications in many expert centers. This chapter will specifically address the role of endoscopy in the management of pancreatic necrosis. PMID:25113041

Lewis, Aaron; Partridge, Brett; Haluszka, Oleh

2014-09-01

219

Commonly used gastrointestinal drugs.  

PubMed

This chapter reviews the spectrum and mechanisms of neurologic adverse effects of commonly used gastrointestinal drugs including antiemetics, promotility drugs, laxatives, antimotility drugs, and drugs for acid-related disorders. The commonly used gastrointestinal drugs as a group are considered safe and are widely used. A range of neurologic complications are reported following use of various gastrointestinal drugs. Acute neurotoxicities, including transient akathisias, oculogyric crisis, delirium, seizures, and strokes, can develop after use of certain gastrointestinal medications, while disabling and pervasive tardive syndromes are described following long-term and often unsupervised use of phenothiazines, metoclopramide, and other drugs. In rare instances, some of the antiemetics can precipitate life-threatening extrapyramidal reactions, neuroleptic malignant syndrome, or serotonin syndrome. In contrast, concerns about the cardiovascular toxicity of drugs such as cisapride and tegaserod have been grave enough to lead to their withdrawal from many world markets. Awareness and recognition of the neurotoxicity of gastrointestinal drugs is essential to help weigh the benefit of their use against possible adverse effects, even if uncommon. Furthermore, as far as possible, drugs such as metoclopramide and others that can lead to tardive dyskinesias should be used for as short time as possible, with close clinical monitoring and patient education. PMID:24365343

Aggarwal, Annu; Bhatt, Mohit

2014-01-01

220

Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies.  

PubMed

Gastrointestinal cancers represent a major cause of morbidity and mortality, with incomplete response to chemotherapy in the advanced stages and poor prognosis. Angiogenesis plays a crucial part in tumor growth and metastasis, with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network. Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents. Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination (immunoendoscopy), as a future challenge, will add functional analysis to the morphological aspect of the neoplastic process. This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization, resulting in a broad spectrum of potential clinical applications, and also preclinical research that could be translated to human studies. PMID:21218080

Gheonea, Dan Ionu?; Câr?ân?, Tatiana; Ciurea, Tudorel; Popescu, Carmen; B?d?r?u, Anca; S?ftoiu, Adrian

2011-01-01

221

Gastrointestinal Stent Update  

PubMed Central

The use of self-expanding metallic stents in the upper gastrointestinal tract, placed under radiologic imaging or endoscopic guidance, is the current treatment of choice for the palliation of malignant gastrointestinal outlet obstructions. Advances in metallic stent design and delivery systems have progressed to the stage where this treatment is now considered a minimally invasive therapy. Metallic stent placement will broaden further into the field of nonsurgical therapy for the gastrointestinal tract. To date, metallic stents placed in the esophagus, gastric outlet, colorectum, and bile ducts are not intended to be curative, but rather to provide a palliative treatment for obstructions. The evolution of metallic stent technology will render such procedures not only palliative but also therapeutic, by enabling local drug delivery, and the use of biodegradable materials will reduce procedure-related complications. PMID:21103290

2010-01-01

222

Endoscopic Gastrointestinal Laser Therapy  

PubMed Central

The development of flexible fibers for the delivery of laser energy led to the first endoscopic laser applications in humans in the early 1970s. Since that time, much has been learned about applications throughout the gastrointestinal tract. The risks appear to be minimal. The coagulative effect of laser energy is used to treat gastrointestinal hemorrhage and small, benign mucosal lesions. The ablative effect of the Nd:YAG laser on tissue is used for palliative therapy for malignant gastrointestinal disorders and incisional therapy for anatomic lesions such as strictures or cysts. New laser modalities that potentially can be tuned throughout large segments of the electromagnetic spectrum, new fiber-optic delivery systems with specialized tips and new methods of sensitizing tissue to laser energy all indicate that the endoscopic laser should continue to have many new and innovative applications. ImagesFigure 1.Figure 2.Figure 3. PMID:3911589

Buchi, Kenneth N.

1985-01-01

223

Regional differences in outcomes of nonvariceal upper gastrointestinal bleeding in Saskatchewan  

PubMed Central

BACKGROUND: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is associated with significant mortality. OBJECTIVE: To examine several factors that may impact the mortality and 30-day rebleed rates of patients presenting with NVUGIB. METHODS: A retrospective study of the charts of patients admitted to hospital in either the Saskatoon Health Region (SHR) or Regina Qu’Appelle Health Region (RQHR) (Saskatchewan) in 2008 and 2009 was performed. Mortality and 30-day rebleed end points were stratified according to age, sex, day of admission, patient status, health region, specialty of the endoscopist and time to endoscopy. Logistic regression modelling was performed, controlling for the Charlson comorbidity index, age and sex as covariates. RESULTS: The overall mortality rate observed was 12.2% (n=44), while the overall 30-day rebleed rate was 20.3% (n=80). Inpatient status at the time of the rebleeding event was associated with a significantly increased risk of both mortality and rebleed, while having endoscopy performed in the RQHR versus SHR was associated with a significantly decreased risk of rebleed. A larger proportion of endoscopies were performed both within 24 h and by a gastroenterologist in the RQHR. CONCLUSION: Saskatchewan has relatively high rates of mortality and 30-day rebleeding among patients with NVUGIB compared with published rates. The improved outcomes observed in the RQHR, when compared with the SHR, may be related to the employ of a formal call-back endoscopy team for the treatment of NVUGIB. PMID:24619634

O'Byrne, Michael; Smith-Windsor, Erin L; Kenyon, Chris R; Bhasin, Sanchit; Jones, Jennifer L

2014-01-01

224

Probiotics and Gastrointestinal Infections  

PubMed Central

Gastrointestinal infections are a major cause of morbidity and mortality worldwide, particularly in developing countries. The use of probiotics to prevent and treat a variety of diarrheal diseases has gained favor in recent years. Examples where probiotics have positively impacted gastroenteritis will be highlighted. However, the overall efficacy of these treatments and the mechanisms by which probiotics ameliorate gastrointestinal infections are mostly unknown. We will discuss possible mechanisms by which probiotics could have a beneficial impact by enhancing the prevention or treatment of diarrheal diseases. PMID:19277100

Britton, Robert A.; Versalovic, James

2008-01-01

225

DEPTH ENCODING WITH LENSLESS STRUCTURED ILLUMINATION FLUORESCENCE MICRO-ENDOSCOPY  

Microsoft Academic Search

While fluorescence sectioning microscopy techniques - such as confocal or structured illumination microscopy (SIM) - provide exquisite sub-cellular resolution, they remain limited essentially to surface imaging, and many efforts are developed toward implementing those techniques in an endoscopy configuration. Here, we present an endomicroscope system that utilizes structured illumination to produce high resolution (~6µm) optically sectioned fluorescence images over a

Cathie Ventalon; Jerome Mertz; Valentina Emilani

226

Diagnostic procedures for submucosal tumors in the gastrointestinal tract  

PubMed Central

This review is part one of three, which will present an update on diagnostic procedures for gastrointestinal (GI) submucosal tumors (SMTs). Part two identifies the classification and part three the therapeutic methods regarding GI SMTs. Submucosal tumors are typically asymptomatic and therefore encountered incidentally. Advances in diagnostic tools for gastrointestinal submucosal tumors have emerged over the past decade. The aim of this paper is to provide the readers with guidelines for the use of diagnostic procedures, when a submucosal tumor is suspected. Literature searches were performed to find information on diagnostics for gastrointestinal submucosal tumors. Based on the searches, the optimal diagnostic procedures and specific features of the submucosal tumors could be outlined. Standard endoscppy, capsule endoscopy and push-and-pull enteroscopy (PPE) together with barium contrast X-ray do not alone provide sufficient information, when examining submucosal tumors. Endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI) and fluorodeoxyglucose-labeled positron emission tomography (FDG-PET) are recommended as supplementary tools. PMID:17659668

Ponsaing, Laura Graves; Kiss, Katalin; Loft, Annika; Jensen, Lise Ingemann; Hansen, Mark Berner

2007-01-01

227

Bleeding detection in wireless capsule endoscopy using adaptive colour histogram model and support vector classification  

NASA Astrophysics Data System (ADS)

Wireless Capsule Endoscopy (WCE) is a colour imaging technology that enables detailed examination of the interior of the gastrointestinal tract. A typical WCE examination takes ~ 8 hours and captures ~ 40,000 useful images. After the examination, the images are viewed as a video sequence, which generally takes a clinician over an hour to analyse. The manufacturers of the WCE provide certain automatic image analysis functions e.g. Given Imaging offers in their Rapid Reader software: The Suspected Blood Indicator (SBI), which is designed to report the location in the video of areas of active bleeding. However, this tool has been reported to have insufficient specificity and sensitivity. Therefore it does not free the specialist from reviewing the entire footage and was suggested only to be used as a fast screening tool. In this paper we propose a method of bleeding detection that uses in its first stage Hue-Saturation-Intensity colour histograms to track a moving background and bleeding colour distributions over time. Such an approach addresses the problem caused by drastic changes in blood colour distribution that occur when it is altered by gastrointestinal fluids and allow detection of other red lesions, which although are usually "less red" than fresh bleeding, they can still be detected when the difference between their colour distributions and the background is large enough. In the second stage of our method, we analyse all candidate blood frames, by extracting colour (HSI) and texture (LBP) features from the suspicious image regions (obtained in the first stage) and their neighbourhoods and classifying them using Support Vector Classifier into Bleeding, Lesion and Normal classes. We show that our algorithm compares favourably with the SBI on the test set of 84 full length videos.

Mackiewicz, Michal W.; Fisher, Mark; Jamieson, Crawford

2008-03-01

228

Polyphenols and gastrointestinal diseases  

PubMed Central

Purpose of review This article will review the role of polyphenols in gastrointestinal diseases. Ingested polyphenols are concentrated in the gastrointestinal tract and are not well absorbed into the rest of the body. Thus, the high luminal concentrations achieved support a potential for therapeutic uses in the gastrointestinal tract. Additionally, there is great interest from the general public in complementary and alternative medicine. Recent findings Dietary polyphenols are a major source of antioxidants consumed by humans. Polyphenols possess not only antioxidant properties but also antiviral, antibacterial, antiinflammatory and anticarcinogenic effects, as well as the ability to modulate certain signaling pathways such as nuclear factor-?B activation. Green tea polyphenols have been shown to have efficacy in various models of inflammatory bowel disease. Silymarin, or milk thistle, is hepatoprotective against many forms of experimental liver injury and is widely used in human liver diseases, such as hepatitis C and alcoholic cirrhosis, with an excellent safety profile (but with unclear efficacy). Summary Substantial in-vitro and animal studies support the beneficial effects of polyphenols in many gastrointestinal diseases. Well designed multicenter trials in humans, such as those called for in the 2005 National Institutes of Health Requests for Applications for Silymarin Centers, will be critical for defining the safety, appropriate dosing and therapeutic efficacy of such agents. PMID:16462174

Dryden, Gerald W.; Song, Ming; McClain, Craig

2014-01-01

229

Apollo gastrointestinal analysis  

NASA Technical Reports Server (NTRS)

Fecal bile acid patterns for the Apollo 17 flight were studied to determine the cause of diarrhea on the mission. The fecal sterol analysis gave no indication of an infectious diarrhea, or specific, or nonspecific etiology occurring during the entire flight. It is assumed that the gastrointestinal problems encountered are the consequences of altered physiology, perhaps secondary to physical or emotional stress of flight.

Nichols, B. L.; Huang, C. T. L.

1975-01-01

230

Gastrointestinal Bleeding in Athletes.  

ERIC Educational Resources Information Center

Describes the scope and importance of gastrointestinal bleeding in runners and other athletes, discussing causes, sites, and implications of exercise-related bleeding. Practical tips to mitigate the problem, potentially more troublesome in women because of lower iron stores, are presented (e.g., gradual conditioning and avoidance of prerace…

Eichner, Edward R.

1989-01-01

231

Gastrointestinal Steering Committee Roster  

Cancer.gov

Gastrointestinal Steering Committee Roster Co-chairs Neal Meropol, M.D.Case Comprehensive Cancer CenterCleveland, OH Bruce Minsky, M.D.MD Anderson Cancer CenterHouston, TX Members Dan Haller, M.D. [Chair Emeritus]University of Pennsylvania Cancer CenterPhiladelphia,

232

Gastrointestinal bleeding in the elderly  

Microsoft Academic Search

Gastrointestinal bleeding affects a substantial number of elderly people and is a frequent indication for hospitalization. Bleeding can originate from either the upper or lower gastrointestinal tract, and patients with gastrointestinal bleeding present with a range of symptoms. In the elderly, the nature, severity, and outcome of bleeding are influenced by the presence of medical comorbidities and the use of

Patrick S Yachimski; Lawrence S Friedman

2008-01-01

233

GISentinel: a software platform for automatic ulcer detection on capsule endoscopy videos  

NASA Astrophysics Data System (ADS)

In this paper, we present a novel and clinically valuable software platform for automatic ulcer detection on gastrointestinal (GI) tract from Capsule Endoscopy (CE) videos. Typical CE videos take about 8 hours. They have to be reviewed manually by physicians to detect and locate diseases such as ulcers and bleedings. The process is time consuming. Moreover, because of the long-time manual review, it is easy to lead to miss-finding. Working with our collaborators, we were focusing on developing a software platform called GISentinel, which can fully automated GI tract ulcer detection and classification. This software includes 3 parts: the frequency based Log-Gabor filter regions of interest (ROI) extraction, the unique feature selection and validation method (e.g. illumination invariant feature, color independent features, and symmetrical texture features), and the cascade SVM classification for handling "ulcer vs. non-ulcer" cases. After the experiments, this SW gave descent results. In frame-wise, the ulcer detection rate is 69.65% (319/458). In instance-wise, the ulcer detection rate is 82.35%(28/34).The false alarm rate is 16.43% (34/207). This work is a part of our innovative 2D/3D based GI tract disease detection software platform. The final goal of this SW is to find and classification of major GI tract diseases intelligently, such as bleeding, ulcer, and polyp from the CE videos. This paper will mainly describe the automatic ulcer detection functional module.

Yi, Steven; Jiao, Heng; Meng, Fan; Leighton, Jonathon A.; Shabana, Pasha; Rentz, Lauri

2014-03-01

234

Effects of the Oral Administration of Mosapride Citrate on Capsule Endoscopy Completion Rate  

PubMed Central

Background/Aims In capsule endoscopy (CE), the capsule does not always reach the cecum within its battery life, which may reduce its diagnostic yield. We evaluated the effect of mosapride citrate, a 5-hydroxytryptamine-4 agonist that increases gastrointestinal motility, on CE completion. Methods In a retrospective study, we performed univariate and multivariate analyses for 232 CE procedures performed at our hospital. To identify factors that affect CE completion, the following data were systematically collected: gender, age, gastric transit time (GTT), nonsteroidal anti-inflammatory drug administration, previous abdominal surgery, hospitalization, use of a polyethylene glycol solution, use of mosapride citrate (10 mg), body mass index (BMI), and total recording time. Results The univariate analysis showed that oral mosapride citrate, GTT, and BMI were associated with improved CE completion. Multivariate analyses showed that oral mosapride citrate (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.01 to 3.91) and GTT (OR, 2.34; 95% CI, 1.13 to 4.87) were significant factors for improving the CE completion. Oral mosapride citrate significantly shortened the GTT and small bowel transit time (SBTT). Conclusions Oral mosapride citrate reduced the GTT and SBTT during CE and improved the CE completion rate. PMID:22844562

Ida, Yosuke; Hosoe, Naoki; Imaeda, Hiroyuki; Bessho, Rieko; Ichikawa, Riko; Naganuma, Makoto; Kanai, Takanori; Hibi, Toshifumi

2012-01-01

235

Abnormal pattern detection in Wireless Capsule Endoscopy images using nonlinear analysis in RGB color space.  

PubMed

In recent years, an innovative method has been developed for the non-invasive observation of the gastrointestinal tract (GT), namely Wireless Capsule Endoscopy (WCE). WCE especially enables a detailed inspection of the entire small bowel and identification of its clinical lesions. However, the foremost disadvantage of this technological breakthrough is the time consuming task of reviewing the vast amount of images produced. To address this, a novel technique for distinguishing pathogenic endoscopic images related to ulcer, the most common disease of GT, is presented here. Towards this direction, the Bidimensional Ensemble Empirical Mode Decomposition was applied to RGB color images of the small bowel acquired by a WCE system in order to extract their Intrinsic Mode Functions (IMFs). The IMFs reveal differences in structure from their finest to their coarsest scale, providing a new analysis domain. Additionally, lacunarity analysis was employed as a method to quantify and extract the texture patterns of the ulcer regions and the normal mucosa, respectively, in order to discriminate the abnormal from the normal images. Experimental results demonstrated promising classification accuracy (>95%), exhibiting a high potential towards WCE-based analysis. PMID:21097046

Charisis, Vasileios; Hadjileontiadis, Leontios J; Liatsos, Christos N; Mavrogiannis, Christos C; Sergiadis, George D

2010-01-01

236

A clinically viable capsule endoscopy video analysis platform for automatic bleeding detection  

NASA Astrophysics Data System (ADS)

In this paper, we present a novel and clinically valuable software platform for automatic bleeding detection on gastrointestinal (GI) tract from Capsule Endoscopy (CE) videos. Typical CE videos for GI tract run about 8 hours and are manually reviewed by physicians to locate diseases such as bleedings and polyps. As a result, the process is time consuming and is prone to disease miss-finding. While researchers have made efforts to automate this process, however, no clinically acceptable software is available on the marketplace today. Working with our collaborators, we have developed a clinically viable software platform called GISentinel for fully automated GI tract bleeding detection and classification. Major functional modules of the SW include: the innovative graph based NCut segmentation algorithm, the unique feature selection and validation method (e.g. illumination invariant features, color independent features, and symmetrical texture features), and the cascade SVM classification for handling various GI tract scenes (e.g. normal tissue, food particles, bubbles, fluid, and specular reflection). Initial evaluation results on the SW have shown zero bleeding instance miss-finding rate and 4.03% false alarm rate. This work is part of our innovative 2D/3D based GI tract disease detection software platform. While the overall SW framework is designed for intelligent finding and classification of major GI tract diseases such as bleeding, ulcer, and polyp from the CE videos, this paper will focus on the automatic bleeding detection functional module.

Yi, Steven; Jiao, Heng; Xie, Jean; Mui, Peter; Leighton, Jonathan A.; Pasha, Shabana; Rentz, Lauri; Abedi, Mahmood

2013-02-01

237

A video wireless capsule endoscopy system powered wirelessly: design, analysis and experiment  

NASA Astrophysics Data System (ADS)

Wireless capsule endoscopy (WCE), as a relatively new technology, has brought about a revolution in the diagnosis of gastrointestinal (GI) tract diseases. However, the existing WCE systems are not widely applied in clinic because of the low frame rate and low image resolution. A video WCE system based on a wireless power supply is developed in this paper. This WCE system consists of a video capsule endoscope (CE), a wireless power transmission device, a receiving box and an image processing station. Powered wirelessly, the video CE has the abilities of imaging the GI tract and transmitting the images wirelessly at a frame rate of 30 frames per second (f/s). A mathematical prototype was built to analyze the power transmission system, and some experiments were performed to test the capability of energy transferring. The results showed that the wireless electric power supply system had the ability to transfer more than 136 mW power, which was enough for the working of a video CE. In in vitro experiments, the video CE produced clear images of the small intestine of a pig with the resolution of 320 × 240, and transmitted NTSC format video outside the body. Because of the wireless power supply, the video WCE system with high frame rate and high resolution becomes feasible, and provides a novel solution for the diagnosis of the GI tract in clinic.

Pan, Guobing; Xin, Wenhui; Yan, Guozheng; Chen, Jiaoliao

2011-06-01

238

Stomach, intestine, and colon tissue discriminators for wireless capsule endoscopy images  

NASA Astrophysics Data System (ADS)

Wireless Capsule Endoscopy (WCE) is a new colour imaging technology that enables close examination of the interior of the entire small intestine. Typically, the WCE operates for ~8 hours and captures ~40,000 useful images. The images are viewed as a video sequence, which generally takes a doctor over an hour to analyse. In order to activate certain key features of the software provided with the capsule, it is necessary to locate and annotate the boundaries between certain gastrointestinal (GI) tract regions (stomach, intestine and colon) in the footage. In this paper we propose a method of automatically discriminating stomach, intestine and colon tissue in order to significantly reduce the video assessment time. We use hue saturation chromaticity histograms which are compressed using a hybrid transform, incorporating the Discrete Cosine Transform (DCT) and Principal Component Analysis (PCA). The performance of two classifiers is compared: k-nearest neighbour (kNN) and Support Vector Classifier (SVC). After training the classifier, we applied a narrowing step algorithm to converge to the points in the video where the capsule firstly passes through the pylorus (the valve between the stomach and the intestine) and later the ileocaecal valve (IV, the valve between the intestine and colon). We present experimental results that demonstrate the effectiveness of this method.

Berens, Jeff; Mackiewicz, Michal; Bell, Duncan

2005-04-01

239

Semantic and topological classification of images in magnetically guided capsule endoscopy  

NASA Astrophysics Data System (ADS)

Magnetically-guided capsule endoscopy (MGCE) is a nascent technology with the goal to allow the steering of a capsule endoscope inside a water filled stomach through an external magnetic field. We developed a classification cascade for MGCE images with groups images in semantic and topological categories. Results can be used in a post-procedure review or as a starting point for algorithms classifying pathologies. The first semantic classification step discards over-/under-exposed images as well as images with a large amount of debris. The second topological classification step groups images with respect to their position in the upper gastrointestinal tract (mouth, esophagus, stomach, duodenum). In the third stage two parallel classifications steps distinguish topologically different regions inside the stomach (cardia, fundus, pylorus, antrum, peristaltic view). For image classification, global image features and local texture features were applied and their performance was evaluated. We show that the third classification step can be improved by a bubble and debris segmentation because it limits feature extraction to discriminative areas only. We also investigated the impact of segmenting intestinal folds on the identification of different semantic camera positions. The results of classifications with a support-vector-machine show the significance of color histogram features for the classification of corrupted images (97%). Features extracted from intestinal fold segmentation lead only to a minor improvement (3%) in discriminating different camera positions.

Mewes, P. W.; Rennert, P.; Juloski, A. L.; Lalande, A.; Angelopoulou, E.; Kuth, R.; Hornegger, J.

2012-03-01

240

Survey of symptoms, respiratory function, and immunology and their relation to glutaraldehyde and other occupational exposures among endoscopy nursing staff  

Microsoft Academic Search

OBJECTIVESTo find the nature and incidence of symptoms experienced by a large sample of hospital endoscopy nurses. To find whether nurses in endoscopy units develop asthma under current working conditions in endoscopy units. To obtain analytically reliable data on exposure concentrations of glutaraldehyde (GA) vapour in endoscopy units, and to relate them to individual hygiene and work practices. To characterise

A Vyas; C A C Pickering; L A Oldham; H C Francis; A M Fletcher; T Merrett; R McL Niven

2000-01-01

241

Management of variceal and nonvariceal upper gastrointestinal bleeding in patients with cirrhosis  

PubMed Central

Acute upper gastrointestinal haemorrhage remains the most common medical emergency managed by gastroenterologists. Causes of upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis can be grouped into two categories: the first includes lesions that arise by virtue of portal hypertension, namely gastroesophageal varices and portal hypertensive gastropathy; and the second includes lesions seen in the general population (peptic ulcer, erosive gastritis, reflux esophagitis, Mallory–Weiss syndrome, tumors, etc.). Emergency upper gastrointestinal endoscopy is the standard procedure recommended for both diagnosis and treatment of UGIB. The endoscopic treatment of choice for esophageal variceal bleeding is band ligation of varices. Bleeding from gastric varices is treated by injection with cyanoacrylate. Treatment with vasoactive drugs as well as antibiotic treatment is started before or at the same time as endoscopy. Bleeding from portal hypertensive gastropathy is less frequent, usually chronic and treatment options include ?-blocker therapy, injection therapy and interventional radiology. The standard of care of UGIB in patients with cirrhosis includes careful resuscitation, preferably in an intensive care setting, medical and endoscopic therapy, early consideration for placement of transjugular intrahepatic portosystemic shunt and, sometimes, surgical therapy or hepatic transplant. PMID:25177367

Ribeiro, Suzane

2014-01-01

242

A rare cause of upper gastrointestinal haemorrhage: Ruptured cystic artery pseudoaneurysm with concurrent cholecystojejunal fistula???  

PubMed Central

INTRODUCTION Cystic artery pseudoaneurysms and cholecystoenteric fistulae represent two rare complications of gallstone disease. PRESENTATION OF CASE An 86 year old male presented to the emergency department with obstructive jaundice, RUQ pain and subsequent upper gastrointestinal bleeding. Upper GI endoscopy revealed bleeding from the medial wall of the second part of the duodenum and a contrast-enhanced computed tomography scan revealed a cystic artery pseudoaneurysm, concurrent cholecystojejunal fistula and gallstone ileus. This patient was successfully managed surgically with open subtotal cholecystectomy, pseudoaneurysm resection and fistula repair. DISCUSSION To date there are very few cases describing haemobilia resulting from a bleeding cystic artery pseudoaneurysm. This report is the first to describe upper gastrointestinal bleeding as a consequence of two synchronous rare pathologies: a ruptured cystic artery pseudoaneurysm causing haemobilia and bleeding through a concurrent cholecystojejunal fistula. CONCLUSION Through this case, we stress the importance of accurate and early diagnosis through ultra- sonography, endoscopy, and contrast-enhanced CT imaging and emphasise that haemobilia should be included in the differential diagnosis of anyone presenting with upper gastrointestinal bleeding. We have demonstrated the success of surgical management alone in the treatment of such a case, but accept that consideration of combined therapeutic approach with angiography be given in the first instance, when available and clinically indicated. PMID:24394852

Glaysher, Michael A.; Cruttenden-Wood, David; Szentpali, Karoly

2013-01-01

243

Capsule endoscopy in Crohn's disease: Are we seeing any better?  

PubMed Central

Crohn’s disease (CD) is a complex, immune-mediated disorder that often requires a multi-modality approach for optimal diagnosis and management. While traditional methods include ileocolonoscopy and radiologic modalities, increasingly, capsule endoscopy (CE) has been incorporated into the algorithm for both the diagnosis and monitoring of CD. Multiple studies have examined the utility of this emerging technology in the management of CD, and have compared it to other available modalities. CE offers a noninvasive approach to evaluate areas of the small bowel that are difficult to reach with traditional endoscopy. Furthermore, CE maybe favored in specific sub segments of patients with inflammatory bowel disease (IBD), such as those with IBD unclassified (IBD-U), pediatric patients and patients with CD who have previously undergone surgery.

Hudesman, David; Mazurek, Jonathan; Swaminath, Arun

2014-01-01

244

Lower gastrointestinal functions.  

PubMed

The human colon serves to absorb water and electrolytes, store intraluminal contents until elimination is socially convenient, and salvage nutrients by bacterial metabolism of carbohydrates that have not been absorbed in the small intestine. The anorectum is responsible for fecal continence and defecation. This article is a broad perspective of the current status and a personal perspective of future challenges in understanding lower gastrointestinal functions in health and disease in humans. PMID:18402647

Bharucha, A E

2008-05-01

245

Pediatric gastrointestinal imaging  

SciTech Connect

This book is on imaging of the gastrointestinal tract in children. Discussions of each condition include all imaging modalities plain film, computed tomography, sonography, magnetic resonance imaging and interventional radiology. It highlights key points, outstanding information on the techniques of examination of the child and infant, material on embryogenesis, and an in-depth bibliography. It also covers how and why to perform such interventional techniques as foreign body removal, drainage of abscesses or fluid collections, intestinal tube placement, and much more.

Stringer, D.D. (Univ. of Toronto, Sections of Ultrasound and Gastrointestinal Radiology, Hospital for Sick Children, Toronto, Ontario (CA))

1989-01-01

246

Gastrointestinal Mucus Gel Barrier  

Microsoft Academic Search

A family of glycoproteins, known as gel-forming mucins, endow gastrointestinal mucus with its characteristic viscoelastic\\u000a and biological properties. In the mucus, these large oligomeric glycoproteins are organized into entangled networks that occasionally\\u000a can be stabilized by non-covalent interactions as in the stomach lumen. This network is a formidable chemical and physical\\u000a barrier that not only protects the underlying epithelia but

Juan Perez-Vilar

247

Laparoscopic cholecystectomy and interventional endoscopy for gallstone complications during pregnancy  

Microsoft Academic Search

Background: Symptomatic or complicated gallstone disease is the most common reason for nongynecological operations during pregnancy.\\u000a Gallstones are present in 12% of all pregnancies, and more than one-third of patients fail medical treatment and therefore\\u000a require surgical endoscopy or laparoscopy. Gallstone pancreatitis and jaundice during pregnancy is associated with a high\\u000a recurrence rate, exposing both fetus and mother to an

P. Sungler; P. M. Heinerman; H. Steiner; H. W. Waclawiczek; J. Holzinger; F. Mayer; A. Heuberger; O. Boeckl

2000-01-01

248

Dual modality optoacoustic and laser ultrasound endoscopy system  

NASA Astrophysics Data System (ADS)

Ultrasound endoscopy has been proven effective in identifying and staging relatively advanced tumors in esophageal or colon wall lining. When combined with optoacoustic imaging modality, the endoscopy examination may prove beneficial in detecting also early stage tumors as well as more accurate staging of advanced tumors based on functional - anatomical maps. Here we present a prototype of a dual-modality optoacoustic - laser ultrasound (OA-LUS) endoscopy system with enhanced imaging capabilities. The system consists of a rotating 90° off-axis parabolic reflector which is acoustically coupled to a flat 8-element transducer array. A parabolic mirror serves dual purpose of directing light towards a sample and reflecting incoming optically generated ultrasound signals towards a detector. LUS modality is enabled by placing an optically absorbing and acoustically transparent polymeric membrane in the path of laser light to generate broadband and non-reverberating transient ultrasound waves propagating towards the sample. Focused system detects ultrasound signals and reconstructs the image similar to optoacoustic mode. Presence of a delay between optically generated and reflected acoustic signals allows concurrent image acquisition in OA and LUS modalities.

Tsyboulski, Dmitri; Conjusteau, André; Oraevsky, Alexander

2014-03-01

249

Assessment of Antigenemia Assay for the Diagnosis of Cytomegalovirus Gastrointestinal Diseases in HIV-Infected Patients  

PubMed Central

Abstract We conducted a single-center prospective study to evaluate the utility of cytomegalovirus (CMV) antigenemia assay for the diagnosis of CMV-gastrointestinal disease (GID). The study subjects were HIV-infected patients with CD4 count ?200??L/cells who had undergone endoscopy. A definite diagnosis of CMV-GID was made by histological examination of endoscopic biopsied specimen. CMV antigenemia assay (C10/C11 monoclonal antibodies), CD4 count, HIV viral load, history of HAART, and gastrointestinal symptoms as measured by 7-point Likert scale, were assessed on the same day of endoscopy. One hundred cases were selected for analysis, which were derived from 110 cases assessed as at high-risk for CMV-GID after endoscopy screening of 423 patients. Twelve patients were diagnosed with CMV-GID. Among the gastrointestinal symptoms, mean bloody stool score was significantly higher in patients with CMV-GID than in those without (2.5 vs. 1.7, p=0.02). The area under the receiver-operating characteristic curve of antigenemia was 0.80 (95%CI 0.64–0.96). The sensitivity, specificity, positive likelihood ratio (LR), and negative LR of antigenemia were 75.0%, 79.5%, 3.7, and 0.31, respectively, when the cutoff value for antigenemia was ?1 positive cell per 300,000 granulocytes, and 50%, 92.0%, 5.5, and 0.55, respectively, for ?5 positive cells per 300,000 granulocytes. In conclusion, CMV antigenemia seems a useful diagnostic test for CMV-GID in patients with HIV infection. The use of ?5 positive cells per 300,000 granulocytes as a cutoff value was associated with high specificity and high positive LR. Thus, a positive antigenemia assay with positive endoscopic findings should allow the diagnosis of CMV-GID without biopsy. PMID:23799239

Hamada, Yohei; Shimbo, Takuro; Igari, Toru; Nakashima, Ryo; Asayama, Naoki; Nishimura, So; Yazaki, Hirohisa; Teruya, Katsuji; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Akiyama, Junichi; Ohmagari, Norio; Uemura, Naomi; Oka, Shinichi

2013-01-01

250

A Large-Sized Phytobezoar Located on the Rare Site of the Gastrointestinal Tract  

PubMed Central

Bezoars are concretions of undigested material and are most often observed in the stomach. They can occur at any site in the gastrointestinal tract; however, duodenal localization is very rare. We report the case of a 71-year-old male who had undergone subtotal gastrectomy with gastroduodenostomy and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. An approximately 7×8 cm-sized mass was found on an abdominal computed tomography scan. On following endoscopy, a large bezoar was revealed in the duodenum and was removed using an endoscopic removal technique, assisted by a large amount of Coca-Cola infusion. PMID:23964339

Yang, Jee Eun; Kim, Gi Ae; Kim, Ga Hee; Yoon, Da Lim; Jeon, Sung Jin; Jung, Hwoon-Yong; Kim, Jin-Ho

2013-01-01

251

Analysis of cardiopulmonary stress during endoscopy: Is unsedated transnasal esophagogastroduodenoscopy appropriate for elderly patients?  

PubMed Central

BACKGROUND: Transnasal esophagogastroduodenoscopy (EGD) without sedation has been reported to be safe and tolerable. It has recently been used widely in Japan for the detection of upper gastrointestinal disease. Alternatively, transoral examination using a thin endoscope has also been reported to be highly tolerable. OBJECTIVE: To examine the cardiocirculatory effects of transoral versus transnasal EGD in an attempt to determine the most suitable endoscopic methods for patients ?75 years of age. METHODS: Subjects who underwent monitoring of respiratory and circulatory dynamics without sedation during endoscopic screening examinations were enrolled at the New Ooe Hospital (Kyoto, Japan) between April 2008 and March 2009. A total of 165 patients (age ?75 years) provided written informed consent and were investigated in the present study. Patients were randomly divided into three subgroups: UO group – thin endoscope; SO group – standard endoscope; and UT group – transnasal EGD. Percutaneous arterial blood oxygen saturation, heart rate and blood pressure were evaluated just before EGD and at five time points during EGD. After transnasal EGD, patients who had previously been examined using transoral EGD with a standard endoscope were asked about preferences for their next examination. RESULTS: There were no statistical differences in the characteristics among the groups. Percutaneous oxygen saturation in the UT group showed a transient drop compared with the SO and UO groups at the beginning of the endoscopic procedure. Heart rate showed no significant differences among the SO, UO and UT groups; Systolic blood pressure in the UO group was lower immediately after insertion compared with the SO and UT groups. The rate pressure product in the UO group was comparable with that in the UT group during endoscopy, and the SO group showed a continuously higher level than the UO and UT groups. More than one-half (54.4%) of patients were ‘willing to choose transnasal EGD for next examination’. CONCLUSIONS: For elderly patients, unsedated transnasal EGD failed to show an advantage over unsedated standard endoscopy. Transoral thin EGD was estimated to be safe and tolerable. PMID:24288691

Uchiyama, Kazuhiko; Ishikawa, Takeshi; Sakamoto, Naoyuki; Kajikawa, Hirokazu; Takagi, Tomohisa; Handa, Osamu; Tatsumi, Yoshihide; Yagi, Nobuaki; Naito, Yuji; Itoh, Yoshito; Takemura, Shuhei

2014-01-01

252

[Gastrointestinal stroma tumor].  

PubMed

Gastrointestinal stromal tumor (GIST) represents less than 3% of gastrointestinal malignancies. However, it is the most common mesenchymal tumor of the digestive tract. GIST is characterized by the expression tyrosine kinase CD117, which differentiates it from other mesenchymal tumors such as leiomyomas, leio-miosarcomas, leiomyoblastoma and neurogenic tumors that do not express this protein. 70-80% of the GIST are benign and located mostly in the stomach and small intestine (> 90%).They can also arise from any portion of the digestive tract, mesentery, omentum and retroperitoneum. Malignant GISTs are usually large (> 5 cm), with a high mitotic index, and it can metastasize to the liver and peritoneum. The treatment is surgical resection.Good results have been reported with tyrosine kinase inhibitor STI571. The treatment is the surgical resection; in cases of surgical resection tumors cannot do it, radiotherapy and chemotherapy is carried out. A 43 year-old patient is presented, admitted to present pain in the epigastrium, melena in an occasion. The ecography, CT scan, and laparoscopic view, showed a tumor in the second portion of the duodenum, approximately 10 cm size. Whipple´s operation was carried out (cephalic pancreatoduodenectomy) with conservation of the pylorus (Traverso-Longmire), resecting the entirely tumor. Final results of pathological anatomy informed: fusocelular tumor of the gastrointestinal estroma (GIST of duodenal wall), with high potential of malignancy. Size of the tumor 9,5 cm, mitotic index of 9 for 50 HPF with high positive for CD117, CD34. Two years later of theintervention he presents a good evolution. PMID:25293993

Ramos Socarrás, Aníval Ernesto; Vallés Gamboa, Moraima Emilia; Rodríguez Núñez, José Rolando; Neyra Rodríguez, Carlos Manuel; Vargas La O, Francisco Antonio

2014-01-01

253

Nutrition and gastrointestinal disease.  

PubMed

Nutrition and intestinal function are intimately interrelated. The chief purpose of the gut is to digest and absorb nutrients in order to maintain life. Consequently, chronic gastrointestinal (GI) disease commonly results in malnutrition and increased morbidity and mortality. For example, studies have shown that 50-70% of adult patients with Crohn's disease were weight-depleted and 75% of adolescents growth-retarded. On the other hand, chronic malnutrition impairs digestive and absorptive function because food and nutrients are not only the major trophic factors to the gut but also provide the building blocks for digestive enzymes and absorptive cells. For example, recent studies of ours have shown that a weight loss of greater than 30% accompanying a variety of diseases was associated with a reduction in pancreatic enzyme secretion of over 80%, villus atrophy and impaired carbohydrate and fat absorption. Finally, specific nutrients can induce disease, for example, gluten-sensitive enteropathy, whilst dietary factors such as fibre, resistant starch, short-chain fatty acids, glutamine and fish-oils may prevent gastrointestinal diseases such as diverticulitis, diversion colitis, ulcerative colitis, colonic adenomatosis and colonic carcinoma. The role of dietary antigens in the aetiology of Crohn's disease is controversial, but controlled studies have suggested that elemental diets may be as effective as corticosteroids in inducing a remission in patients with acute Crohn's disease. In conclusion, nutrition has both a supportive and therapeutic role in the management of chronic gastrointestinal diseases. With the development of modern techniques of nutritional support, the morbidity and mortality associated with chronic GI disease can be reduced. On the other hand, dietary manipulation may be used to treat to prevent specific GI disorders such as coeliac disease, functional bowel disease, Crohn's disease and colonic neoplasia. The future development of nutria-pharmaceuticals is particularly attractive in view of their low cost and wide safety margins. PMID:8898436

O'Keefe, S J

1996-01-01

254

Gastrointestinal Motility Disorders and Acupuncture  

PubMed Central

During the last decades, numerous studies have been performed to investigate the effects and mechanisms of acupuncture or electroacupuncture (EA) on gastrointestinal motility and patients with functional gastrointestinal diseases. A PubMed search was performed on this topic and all available studies published in English have been reviewed and evaluated. This review is organized based on the gastrointestinal organ (from the esophagus to the colon), components of gastrointestinal motility and the functional diseases related to specific motility disorders. It was found that the effects of acupuncture or EA on gastrointestinal motility were fairly consistent and the major acupuncture points used in these studies were ST36 and PC6. Gastric motility has been mostly studied, whereas much less information is available on the effect of EA on small and large intestinal motility or related disorders. A number of clinical studies have been published, investigating the therapeutic effects of EA on a number of functional gastrointestinal diseases, such as gastroesophageal reflux, functional dyspepsia and irritable bowel syndrome. However, the findings of these clinical studies were inconclusive. In summary, acupuncture or EA is able to alter gastrointestinal motility functions and improve gastrointestinal motility disorders. However, more studies are needed to establish the therapeutic roles of EA in treating functional gastrointestinal diseases. PMID:20363196

Yin, Jieyun; Chen, Jiande D Z

2010-01-01

255

Acute Lower Gastrointestinal Bleeding  

PubMed Central

The annual incidence of lower gastrointestinal bleeding (LGIB) is ?20.5 in 100,000 in the general Western population and results in 1 to 2% of hospital emergencies. When medical management and endoscopic therapy are inadequate in cases of acute LGIB, endovascular intervention can be lifesaving. In these emergent situations it is important for the interventional radiologist to be well versed in the multidisciplinary preangiographic work-up, the angiographic presentations of LGIB, and the endovascular therapeutic options. We describe a case of LGIB managed with endovascular embolization and detail the angiographic techniques used, followed by a detailed discussion of the various treatment approaches to LGIB. PMID:23997409

Navuluri, Rakesh; Kang, Lisa; Patel, Jay; Van Ha, Thuong

2012-01-01

256

Lower gastrointestinal bleeding.  

PubMed

The differential diagnosis of lower gastrointestinal bleeding in children can be reduced markedly simply by taking into account the age of the child. The clinical condition of the patient can further help narrow the diagnostic possibilities. Newborns and infants who are clinically unstable are more likely to have diseases such as necrotizing enterocolitis, volvulus, Hirschprung disease, intussusception, or Meckel diverticulum. A baby who appears healthy should be examined for swallowed blood, allergic colitis, anal fissures, or lymphonodular hyperplasia. An older child of healthy appearance with bleeding is likely to have a juvenile polyp or infectious colitis, but a child who appears sick may have hemolytic uremic syndrome, Henoch-Schoenlein purpura, or inflammatory bowel disease. This information, along with that gleaned from the physical examination, can lead the pediatrician to determine the need for specific tests, such as abdominal radiographs, stool cultures, and an endoscopic evaluation. We have come a long way in our ability to diagnose the causes of lower gastrointestinal bleeding. With the availability of newer radiographic and nuclear medicine modalities and the ability to visualize the colon endoscopically, the need for exploratory laparotomy for diagnosis is rarer. While surgery may still be the therapy of choice, new diagnostic modalities give the surgeon much more preoperative information. PMID:2235771

Silber, G

1990-09-01

257

Gastrointestinal complications of diabetes.  

PubMed

Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullness, or upper abdominal pain. The diagnosis of diabetic gastroparesis is made when other causes are excluded and postprandial gastric stasis is confirmed by gastric emptying scintigraphy. Whenever possible, patients should discontinue medications that exacerbate gastric dysmotility; control blood glucose levels; increase the liquid content of their diet; eat smaller meals more often; discontinue the use of tobacco products; and reduce the intake of insoluble dietary fiber, foods high in fat, and alcohol. Prokinetic agents (e.g., metoclopramide, erythromycin) may be helpful in controlling symptoms of gastroparesis. Treatment of diabetes-related constipation and diarrhea is aimed at supportive measures and symptom control. Nonalcoholic fatty liver disease is common in persons who are obese and who have diabetes. In persons with diabetes who have elevated hepatic transaminase levels, it is important to search for other causes of liver disease, including hepatitis and hemochromatosis. Gradual weight loss, control of blood glucose levels, and use of medications (e.g., pioglitazone, metformin) may normalize hepatic transaminase levels, but the clinical benefit of aggressively treating nonalcoholic fatty liver disease is unknown. Controlling blood glucose levels is important for managing most gastrointestinal complications. PMID:18619079

Shakil, Amer; Church, Robert J; Rao, Shobha S

2008-06-15

258

Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea  

PubMed Central

Pediatric obstructive sleep apnea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of pediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic, and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. Sleep endoscopy is a technique that can enable the surgeon to determine the level of obstruction in a sleeping child with OSA. With this knowledge, site-specific surgical therapy for persistent and complex pediatric OSA may be possible. PMID:22518178

Lin, Aaron C.; Koltai, Peter J.

2012-01-01

259

Gastrointestinal Motility Disorders: An Update  

Microsoft Academic Search

Gastrointestinal motility disorders encompass a wide array of signs and symptoms that can occur anywhere throughout the luminal gastrointestinal tract. Motility disorders are often chronic in nature and dramatically affect patients’ quality of life. These prevalent disorders cause a tremendous impact both to the individual patient and to society as a whole. Significant progress has been made over the last

Brian E. Lacy; Kirsten Weiser

2006-01-01

260

Small bowel mucosal damage in familial Mediterranean fever: results of capsule endoscopy screening.  

PubMed

Abstract Objective. Familial Mediterranean fever (FMF) is the most common form of autoinflammatory diseases. We aimed to evaluate the small bowel mucosa by capsule endoscopy (CE) in FMF patients for investigation of other possible causes of abdominal pain. Material and methods. The study group consisted of 41 patients with FMF. A standard questionnaire was used to record the gastrointestinal symptoms, other clinical findings, Mediterranean fever gene (MEFV) mutations, and history of medications including non-steroidal anti-inflammatory drugs (NSAIDs). Gastroscopy, colonoscopy and small bowel CE were performed in all patients, and biopsies were taken from terminal ileum and duodenum. Results. The mean age of the patients was 34 ± 11 years, 63% of them were female, and 76.5% of them were carrying MEFV exon 10 mutations. Only one patient used NSAIDs in addition to colchicine. In endoscopic investigations, gastric erosion was detected in only one patient, and no significant findings were detected in colonoscopy. CE showed small bowel mucosal defects in 44% (erosions in 26.8%, ulcer in 17.1%) and edema in 29.3% of the patients. Most (64%) of the ulcer and erosions were localized to jejunum, and only 24% were in ileum. Mitotic changes as an indirect finding of colchicine toxicity were not different from the changes observed in samples of independent group of patients with irritable bowel syndrome. Conclusion. Mucosal defect was observed in half of the FMF patients, which may be associated with underlying inflammation or chronic colchicine exposure. Detection of nonspecific chronic inflammation without mitotic changes supports that mucosal defects may be associated with the autoinflammatory process. PMID:25369738

Demir, Abdurrahman; Akyüz, Filiz; Göktürk, Suut; Evirgen, Sami; Akyüz, Umit; Ormeci, Asl?; Soyer, Ozlem; Karaca, Cetin; Demir, Kadir; Gundogdu, Gökcen; Güllüo?lu, Mine; Erer, Burak; Kamal?, Sevil; Kaymakoglu, Sabahattin; Besisik, Fatih; Gül, Ahmet

2014-12-01

261

Capsule endoscopy compared with conventional colonoscopy for detection of colorectal neoplasms.  

PubMed

Colon capsule endoscopy (CCE) may be a means to overcome the low adherence to colorectal cancer screening. The device is an ingestible capsule with a video camera at both ends that can take photographs as it progresses through the gastrointestinal tract. PillCam colon (PCC1) may be used for structural evaluation of the large bowel following an adequate cleaning procedure. PCC1 measures 11 mm × 31 mm and has dual cameras that enable the device to acquire video images from both ends with a wide coverage area, automatic light control and a frame rate of four frames per second. The system includes a sensor array and data recorder connected to the patient during the procedure. The recorded data are downloaded to the Given Imaging Rapid workstation for review of the colon video. The second generation of PillCam Colon (PCC2) is similar to PCC1 and incorporates new developments. The angle of view has been increased to 172 degrees. It has an adaptive frame rate, alternating from 35 frames per second while in motion to 4 images when virtually stationary. The new RAPID(®) software now includes a simple graphic interface tool for polyp size estimation. The procedure of bowel cleansing until capsule ingestion is similar to that used for traditional colonoscopy. However it is more rigorous as the bowel cleanliness for capsule colonoscopy has to be excellent or at least good to result in an adequate sensitivity of the method. Briefly, it consists of 3.5-4 L of split dose polyethylene glycol. Oral NaP boosters are administered after 1-2 h if the capsule has entered the small bowel. Sodium phosphate (NaP) seems to be a necessary adjunct to the regimen because the total transit time is doubled without NaP. The cleansing level was considered to be good to excellent in 72%-88% in studies with PCC1. The sensitivity for significant polyps (> 6 mm or more than 3 polyps >3 mm) ranged from 63%-88% with specificities between 64%-94%. PCC2 showed an improved sensitivity of 89% and a specificity of 76%. CCE seems to be a safe and effective method of visualizing the colonic mucosa through colon fluids without the need for sedation or insufflation of air. The sensitivity of CCE to detect polyps, advanced adenomas and cancer is lower compared to optical colonoscopy but improvements will be made in the near future. With an increased recording duration, even a panenteric examination of the whole gastrointestinal tract may be possible. PMID:21772938

Sieg, Andreas

2011-05-16

262

Lactoferrin in gastrointestinal disease.  

PubMed

Lactoferrin, a major whey protein, is a red iron-binding protein present mainly in external secretions such as breast milk and in polymorphonuclear neutrophils. The presence of lactoferrin in body fluids is proportional to the flux of neutrophils and its assessment can provide a reliable biomarker for inflammation. In gastrointestinal diseases increased fecal lactoferrin is a sensitive and specific surrogate marker for inflammatory bowel diseases in patients with chronic diarrhea and pain, and ascites lactoferrin can also provide a promising and reliable biomarker for bacterial peritonitis. Lactoferrin in pancreatic juice and stone could provide pathophysiological information of protein plug and stone formation in the pancreatic duct. Serum anti-lactoferrin autoantibody might contribute to the clarification of the pathogenetic mechanisms of autoimmune pancreatitis and liver diseases, although its diagnostic and prognostic value appears to be limited. Further studies will be necessary to elucidate the exact details. PMID:19652425

Hayakawa, Tetsuo; Jin, Chun Xiang; Ko, Shigeru B H; Kitagawa, Motoji; Ishiguro, Hiroshi

2009-01-01

263

Evaluation of technetium-99m DTPA for localization of site of acute upper gastrointestinal bleeding  

SciTech Connect

Intravenous Tc-99m DTPA was evaluated in 34 patients with active upper gastrointestinal bleeding. Active bleeding was detected in 25 patients: nine in the stomach, 12 in the duodenum, and four from esophageal varices. No active bleeding was seen in nine patients (two gastric ulcers and seven duodenal ulcers). Results were correlated with endoscopic and/or surgical findings. All completely correlated except: 1) one case of esophageal varices in which there was disagreement on the site, 2) three cases of duodenal ulcers that were not bleeding on endoscopy but showed mild oozing on delayed images and 3) one case of gastric ulcer, in which no bleeding was detected in the Tc-99m DTPA study, but was found to be bleeding at surgery 24 hours later. The Tc-99m DTPA study is a reliable method for localization of upper gastrointestinal bleeding with an agreement ratio of 85%. This method also can be used safely for follow-up of patients with intermittent bleeding. It is less invasive than endoscopy, is easily repeatable, and has the same accuracy.

Abdel-Dayem, H.M.; Mahajan, K.K.; Ericsson, S.; Nawaz, K.; Owunwanne, A.; Kouris, K.; Higazy, E.; Awdeh, M.

1986-11-01

264

Fulminant gastrointestinal bleeding caused by EBV-triggered hemophagocytic lymphohistiocytosis: report of a case.  

PubMed

Hemophagocytic lymphohistiocytosis (HLH) is a rare and often fatal hyperinflammatory syndrome characterized by fever, cytopenia, dramatically increased ferritin and hepatosplenomegaly. Here, we describe a previously healthy 39 year old pregnant woman in 30th week of her pregnancy with diarrhoea, intermittent gastrointestinal bleeding and fever of unknown focus. After cesarean section of twins in the 31st week she deteriorated with fulminant upper and lower gastrointestinal bleeding and disseminated intravascular coagulation. Gastro-, ileocolonoscopy and capsule endoscopy identified multiple bleeding punched ulcerations in the stomach, the entire small bowel and in parts of the colon. Emergency surgery with intraoperative endoscopy for uncontrolled hemorrhagic shock resulted in the resection of actively bleeding ulcers in the jejunum which temporally stabilized the critically ill patient. Jejunal histology and in situ hybridisation showed extensive ulcerations, focal lymphohistiocytic infiltration and EBV-positive immunoblasts. The diagnosis fulminant EBV-related HLH was confirmed based on the HLH-2004 diagnostic criteria and through detection of a reactivated EBV infection (up to 3?×?10(7) DNA copies/mL serum). Despite immunosuppressive therapy with steroids, cyclosporine A and etoposide in combination with Rituximab, the patient died from this sepsis-like, hyper-inflammatory syndrome in multiorgan failure with uncontrolled bleeding. PMID:24718941

Klein, S; Schmidt, C; La Rosée, P; Pletz, M; Harz, S; Dirsch, O; Fritzenwanger, M; Stallmach, A

2014-04-01

265

Immunoscopy—a technique combining endoscopy and immunofluorescence for diagnosis of colorectal carcinoma  

Microsoft Academic Search

Background: Colorectal carcinoma is a common malignant disease with a high mortality rate. It arises most frequently in adenomas of the colorectum with different grades of dysplasia. Endoscopy and biopsy are among the most reliable diagnostic tools currently available. Diagnosis of malignancy at an early stage is sometimes difficult. This study reports on a new method, “immunoscopy”, that combines endoscopy

Ralf Keller; Günther Winde; Christian Eisenhawer; Ralf Herwig; Hans-Joachim Terpe; Wolfram Domschke; Ernst C. Foerster

1998-01-01

266

Mast Cells in Gastrointestinal Disease  

PubMed Central

The function of mast cells in allergic inflammatory reactions is well documented in the literature. Mast cells also play an important role in the regulation of gastrointestinal visceral sensitivity and vascular permeability. Several studies have noted an increased number of mast cells in the mucosa of patients with gastrointestinal diseases such as irritable bowel syndrome, mastocytic enterocolitis, and systemic mastocytosis. The role of mast cells in the symptomatology of these and other diseases has only recently been fully appreciated and could provide avenues for new therapeutic opportunities. This paper examines studies that have evaluated the role of mast cells in various gastrointestinal diseases. PMID:21301631

Ramsay, David B.; Stephen, Sindu; Borum, Marie; Voltaggio, Lysandra

2010-01-01

267

Gastrointestinal complications of oncologic therapy.  

PubMed

Gastrointestinal complications are common in patients undergoing various forms of cancer treatment, including chemotherapy, radiation therapy, and molecular-targeted therapies. Many of these complications are life-threatening and require prompt diagnosis and treatment. Complications of oncologic therapy can occur in the esophagus (esophagitis, strictures, bacterial, viral and fungal infections), upper gastrointestinal tract (mucositis, bleeding, nausea and vomiting), colon (diarrhea, graft-versus-host disease, colitis and constipation), liver (drug hepatotoxicity and graft-versus-host disease), and pancreas (pancreatitis). Treatment of the different gastrointestinal complications should be tailored to the individual patient and based on the underlying pathophysiology of the complication. PMID:18941434

Davila, Marta; Bresalier, Robert S

2008-12-01

268

Gastrointestinal complications of immunodeficiency syndromes.  

PubMed

Patients with B cell deficiency have a high incidence of prolonged Giardia lamblia infection of the gastrointestinal tract that causes symptoms of malabsorption with villus flattening. The changes are reversible with therapy directed against Giardia. There is a high incidence of pernicious anaemia in patients with agammaglobulinaemia. Those with abnormal B lymphocytes tend to develop lymphoid nodular hyperplasia. Gastrointestinal disease is rare in boys with X-linked agammaglobulinaemia when compared with adults with the 'acquired' or common variable form of the disease. T cell deficiency results in intractable diarrhoea and monilial infection of the gastrointestinal tract. PMID:346324

Katz, A J; Rosen, F S

269

Zn concentration in plasma and gastric fluid in patients with upper gastrointestinal disease  

SciTech Connect

Very few data are available about Zn in gastrointestinal fluids in humans. To obtain data in one such fluid Zn was measured in plasma and gastric fluid, obtained by direct visual aspiration through an endoscope placed into the gastric fundus, in 36 subjects with normal gastrointestinal mucosa (N) and in 36 patients with the following upper gastrointestinal pathology confirmed by endoscopy: 13 with esophagitis (E), 9 with gastritis (G) and 14 with duodenal ulcer disease (DU). Plasma and gastric fluid Zn were estimated by flame atomic absorption spectrophotometry. Mean plasma Zn was significantly lower than normal in patients with E (N, 87 +/- 2 ..mu..g/dl, M +/- SEM; E, 75 +/- 4, p < 0.01) but plasma values were similar to normal in the other patient groups (G, 89 +/- 4; DU, 87 +/- 2). Mean gastric fluid zinc in G was significantly higher than in normal subjects (G, 664 +/- 159 ..mu..g/L; N, 360 +/- 43, p < 0.02) but not significantly different from normal in patients with DU or E (DU, 402 +/- 76; E, 307 +/- 55). Mean gastric fluid Zn in women with DU was approximately 45% higher than in men with DU, although it was 17% lower in normal women than in normal men. Compared to other normal tissues gastric fluid Zn is about 1/3 that in serum and about 3 times that in saliva. These results indicate that Zn in plasma and gastric fluid is altered in some upper gastrointestinal diseases.

Kadakia, S.C.; Wong, R.H.K.; Maydonovitch, C.; Johnson, L.F.; Nelson, N.; Henkin, R.I.

1986-03-05

270

Radiological Atlas of Gastrointestinal Disease  

SciTech Connect

This book is a reference to gastrointestinal disease and radiographic methods. It provides complete information for diagnosis and management and includes coverage of plain radiography, barium studies, water-soluble contrast studies, and more.

Nolan, D.J.

1983-01-01

271

DRUG DISCOVERY Modulation of gastrointestinal  

E-print Network

loss, increased HDL cholesterol and improved insulin sensitivity in response to these ligands [4MECHANISMS DRUG DISCOVERY TODAY DISEASE Modulation of gastrointestinal inflammation and colorectal their pharmacological effects. Interestingly, these drugs were developed without a priori knowledge of the actual

Omiecinski, Curtis

272

Gastrointestinal Motility Disorders in Children  

PubMed Central

The most common and challenging gastrointestinal motility disorders in children include gastroesophageal reflux disease (GERD), esophageal achalasia, gastroparesis, chronic intestinal pseudo-obstruction, and constipation. GERD is the most common gastrointestinal motility disorder affecting children and is diagnosed clinically and treated primarily with acid secretion blockade. Esophageal achalasia, a less common disorder in the pediatric patient population, is characterized by dysphagia and treated with pneumatic balloon dilation and/or esophagomyotomy. Gastroparesis and chronic intestinal pseudo-obstruction are poorly characterized in children and are associated with significant morbidity. Constipation is among the most common complaints in children and is associated with significant morbidity as well as poor quality of life. Data on epidemiology and outcomes, clinical trials, and evaluation of new diagnostic techniques are needed to better diagnose and treat gastrointestinal motility disorders in children. We present a review of the conditions and challenges related to these common gastrointestinal motility disorders in children. PMID:24799835

Ambartsumyan, Lusine

2014-01-01

273

Adenosine and Gastrointestinal Inflammation  

PubMed Central

Nucelosides such as adenosine (Ado) influence nearly every aspect of physiology and pathophysiology. Extracellular nucleotides liberated at local sites of inflammation are metabolized through regulated phosphohydrolysis by a series of ecto-nucleotidases including ectonucleoside triphosphate diphosphohydrolase-1 (CD39) and ecto-5?-nucleotidase (CD73), found on the surface of a variety of cell types. Once generated, Ado is made available to bind and activate one of four G-protein-coupled Ado receptors. Recent in vitro and in vivo studies implicate Ado in a broad array of tissue protective mechanisms that provide new insight into adenosine actions. Studies in cultured cells and murine tissues have indicated that Ado receptors couple to novel post-translational protein modifications, including Cullin deneddylation, as a new anti-inflammatory mechanism. Studies in Ado receptor-null mice have been revealing and indicate a particularly important role for the Ado A2B receptor in animal models of intestinal inflammation. Here, we review contributions of Ado to cell and tissue stress responses, with a particular emphasis on the gastrointestinal mucosa. PMID:23296303

Colgan, Sean P.; Fennimore, Blair; Ehrentraut, Stefan F.

2013-01-01

274

Gastrointestinal perforation: ultrasonographic diagnosis.  

PubMed

Gastrointestinal tract perforations can occur for various causes such as peptic ulcer, inflammatory disease, blunt or penetrating trauma, iatrogenic factors, foreign body or a neoplasm that require an early recognition and, often, a surgical treatment.Ultrasonography could be useful as an initial diagnostic test to determine, in various cases the presence and, sometimes, the cause of the pneumoperitoneum.The main sonographic sign of perforation is free intraperitoneal air, resulting in an increased echogenicity of a peritoneal stripe associated with multiple reflection artifacts and characteristic comet-tail appearance.It is best detected using linear probes in the right upper quadrant between the anterior abdominal wall, in the prehepatic space.Direct sign of perforation may be detectable, particularly if they are associated with other sonographic abnormalities, called indirect signs, like thickened bowel loop and air bubbles in ascitic fluid or in a localized fluid collection, bowel or gallbladder thickened wall associated with decreased bowel motility or ileus.Neverthless, this exam has its own pitfalls. It is strongly operator-dependant; some machines have low-quality images that may not able to detect intraperitoneal free air; furthermore, some patients may be less cooperative to allow for scanning of different regions; sonography is also difficult in obese patients and with those having subcutaneous emphysema. Although CT has more accuracy in the detection of the site of perforation, ultrasound may be particularly useful also in patient groups where radiation burden should be limited notably children and pregnant women. PMID:23902744

Coppolino, Ff; Gatta, G; Di Grezia, G; Reginelli, A; Iacobellis, F; Vallone, G; Giganti, M; Genovese, Ea

2013-07-15

275

Role of small bowel capsule endoscopy in the diagnosis and management of iron deficiency anemia in elderly: a comprehensive review of the current literature.  

PubMed

Iron deficiency anemia (IDA) is common and often under recognized problem in the elderly. It may be the result of multiple factors including a bleeding lesion in the gastrointestinal tract. Twenty percent of elderly patients with IDA have a negative upper and lower endoscopy and two-thirds of these have a lesion in the small bowel (SB). Capsule endoscopy (CE) provides direct visualization of entire SB mucosa, which was not possible before. It is superior to push enteroscopy, enteroclysis and barium radiography for diagnosing clinically significant SB pathology resulting in IDA. Angioectasia is one of the commonest lesions seen on the CE in elderly with IDA. The diagnostic yield of CE for IDA progressively increases with advancing age, and is highest among patients over 85 years of age. Balloon assisted enteroscopy is used to treat the lesions seen on CE. CE has some limitations mainly lack of therapeutic capability, inability to provide precise location of the lesion and false positive results. Overall CE is a very safe and effective procedure for the evaluation of IDA in elderly. PMID:25024599

Muhammad, Adnan; Vidyarthi, Gitanjali; Brady, Patrick

2014-07-14

276

Gastrointestinal complications of oncologic therapy  

Microsoft Academic Search

Gastrointestinal complications are common in patients undergoing various forms of cancer treatment, including chemotherapy, radiation therapy, and molecular-targeted therapies. Many of these complications are life-threatening and require prompt diagnosis and treatment. Complications of oncologic therapy can occur in the esophagus (esophagitis, strictures, bacterial, viral and fungal infections), upper gastrointestinal tract (mucositis, bleeding, nausea and vomiting), colon (diarrhea, graft–versus–host disease, colitis

Marta Davila; Robert S Bresalier

2008-01-01

277

Electromechanical performance of piezoelectric scanning mirrors for medical endoscopy  

PubMed Central

The electromechanical performance of piezoelectric scanning mirrors for endoscopy imaging is presented. The devices are supported by a single actuating cantilever to achieve a high fill factor, the ratio of mirror area to the combined mirror and actuator area. The largest fill factor devices (74%) achieved 10° mechanical scan range at +/?10V with a 300 ?m long cantilever. The largest angular displacement of 30° mechanical scan range was obtained with a 500 ?m long cantilever device with a 63% fill factor driven at 40 Vpp. A systematic investigation of device performance (displacement and speed) as a function of fabrication and operational parameters including the stress balance in the cantilever revealed unexpectedly large displacements with lack of inversion at the coercive field. An interpretation of the results is presented based on piezoelectric film domain orientation and clamping with supporting piezoelectric film characterization measurements. PMID:22773894

Gilchrist, Kristin H.; Dausch, David E.; Grego, Sonia

2012-01-01

278

Development of positron sensor for multi-modal endoscopy  

NASA Astrophysics Data System (ADS)

Endoscopy is an important inspection device to detect cancers in the human body, but there exists the case of cancer that is hard to detect with only an optical device. Double inspection with optical and radio images is preferable for high accuracy diagnosis, and real time radio imaging is also promising for real time surgery with an endoscope. We have simulated, designed and fabricated a Si-based positron imaging probe for more accurate cancer detection in multi-modality endoscope systems. The fabricated Si-based detector with 2 mm diameter and 1 mm thickness was tested with gamma and positron sources, and also tested to detect cancers in a tumor bearing mouse. The direct positron imaging could have an advantage over gamma imaging in its high sensitivity and resolution.

Shimazoe, Kenji; Takahashi, Hiroyuki; Fujita, Kaoru; Mori, Hiroshi; Momose, Toshimitsu

2011-08-01

279

State of the art in advanced endoscopic imaging for the detection and evaluation of dysplasia and early cancer of the gastrointestinal tract  

PubMed Central

Ideally, endoscopists should be able to detect, characterize, and confirm the nature of a lesion at the bedside, minimizing uncertainties and targeting biopsies and resections only where necessary. However, under conventional white-light inspection – at present, the sole established technique available to most of humanity – premalignant conditions and early cancers can frequently escape detection. In recent years, a range of innovative techniques have entered the endoscopic arena due to their ability to enhance the contrast of diseased tissue regions beyond what is inherently possible with standard white-light endoscopy equipment. The aim of this review is to provide an overview of the state-of-the-art advanced endoscopic imaging techniques available for clinical use that are impacting the way precancerous and neoplastic lesions of the gastrointestinal tract are currently detected and characterized at endoscopy. The basic instrumentation and the physics behind each method, followed by the most influential clinical experience, are described. High-definition endoscopy, with or without optical magnification, has contributed to higher detection rates compared with white-light endoscopy alone and has now replaced ordinary equipment in daily practice. Contrast-enhancement techniques, whether dye-based or computed, have been combined with white-light endoscopy to further improve its accuracy, but histology is still required to clarify the diagnosis. Optical microscopy techniques such as confocal laser endomicroscopy and endocytoscopy enable in vivo histology during endoscopy; however, although of invaluable assistance for tissue characterization, they have not yet made transition between research and clinical use. It is still unknown which approach or combination of techniques offers the best potential. The optimal method will entail the ability to survey wide areas of tissue in concert with the ability to obtain the degree of detailed information provided by microscopic techniques. In this respect, the challenging combination of autofluorescence imaging and confocal endomicroscopy seems promising, and further research is awaited. PMID:24868168

Coda, Sergio; Thillainayagam, Andrew V

2014-01-01

280

The effect of marriage on utilization of colorectal endoscopy exam in the United States  

PubMed Central

Purpose This study examines the association between marriage and colorectal endoscopy exam, and whether this association varies by gender and financial benefits of marriage including improved access to health insurance and pooled family income. Methods Representative survey data of the non-institutionalized United States population were used from the 2000, 2005, and 2008 National Health Interview Survey. Analyses targeted persons 50–85 years of age without a personal history of cancer and with complete information on all study variables (n = 21,760). Multivariate logistic regression was used to model marital status differences in the probability of undergoing a colorectal endoscopy exam with interaction effects used to model variation over time by gender, health insurance, and poverty level. Results Married persons were more likely than unmarried persons to report ever having undergone a colorectal endoscopy exam (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.29), and the difference between married and unmarried persons in the probability of undergoing a colorectal endoscopy exam remained stable over time. Married persons were more likely than unmarried persons to report having undergone a colorectal endoscopy exam within the past 10 years (OR, 1.49; 95% CI, 1.15–1.95). For each survey year, married men were significantly more likely than women and unmarried men to report having undergone a colorectal endoscopy exam. For example, in 2008, 56% of married men reported having undergone a colorectal endoscopy exam, compared to 49% of unmarried men, 52% of married women, and 50% of unmarried women. Among persons with health insurance, married persons were significantly more likely than unmarried persons to have undergone a colorectal endoscopy exam. Among persons who were poor, there was no difference by marital status in the likelihood of having undergone a colorectal endoscopy exam. However, among persons who were not poor, married persons were more likely than unmarried persons to have undergone a colorectal endoscopy exam. Conclusion Given that colorectal endoscopy exams are a potentially life-saving procedure, persistently higher uptake of colorectal endoscopy for married persons over time may be an important health promoting benefit of marriage. Therefore, clinicians and policy makers should focus on improving the use of cancer prevention services among unmarried persons. PMID:22633538

Wilson, Fernando A.; Watanabe-Galloway, Shinobu; Peek, M. Kristen

2012-01-01

281

Should computerised tomography replace endoscopy in the evaluation of symptomatic ingestion of corrosive substances?  

PubMed

Abstract Introduction. Corrosive ingestions are common, although most ingestions do not result in clinically significant effects. Limited guidance is available on the role of endoscopy and/or computerised tomography (CT) in the investigation of individuals with corrosive ingestion, and the present data regarding predictors of poor outcome are confusing. Furthermore, whilst there are many case series describing the use of endoscopy in corrosive ingestions, no clear ideal time frame has been established as to when it should be undertaken. More recently, CT has been used to grade injuries, but there are few studies on its role in managing corrosive injuries, and those studies that have been reported are conflicting in their results. Methods. A Medline search was performed with the terms 'Caustic ingestion' and 'Corrosive ingestion' and a second search by adding the words 'Endoscopy', 'CT', and 'Computerised tomography' as a subject term or keyword. These searches revealed a total of 277 reviews and papers, of which 33 original papers were relevant for analysis. Three further papers were identified during the analysis of these papers and a PubMed search of the same terms added one further paper, bringing the total to 37. There have been no prospective, randomised controlled trials directly comparing endoscopy and CT. Only two retrospective studies compared the use of CT and that of endoscopy. Thirty-five studies examined whether an endoscopy is always needed, and if so, within what time frame this should be done: CT or endoscopy? A review of these studies suggests that the data regarding the use of CT in these circumstances are not yet of sufficient weight to replace endoscopy as the first-line investigation in corrosive ingestion-related injury. Who needs investigation after corrosive ingestion? We believe that signs and symptoms indicate the likelihood of clinically significant injury in adults. Specifically, any evidence of oropharyngeal burns, drooling, vomiting, pain or dysphagia clearly indicates the need for an endoscopy. In children, it appears that an even greater degree of caution is needed. How soon after ingestion should investigation be performed? For whom an endoscopy is required, it is prudent to enable surgery and other specifics regarding management of corrosives to be decided quickly (< 12 h). There are many incidences where endoscopy has been done safely beyond 48 h although this is not needed frequently. Management recommendations Asymptomatic patients, particularly adults with a normal clinical examination and who can eat and drink normally, can be discharged safely without endoscopy. Endoscopy is preferred over CT in the assessment of risk in symptomatic patients with corrosive ingestion. If patients have any oropharyngeal injury and in particular symptoms of drooling, vomiting, dysphagia or pain (retrosternal or otherwise), the risk of having a high-grade injury is higher, and urgent endoscopy should be performed to grade the injury and determine whether surgical intervention is required. Patients who have non-specific symptoms, such as cough, should also undergo endoscopy, but this is less urgent. Conclusions Despite the lack of high-quality clinical trial data, the available evidence and clinical experience support the use of early endoscopy (< 12 h) in patients who are symptomatic after ingestion of a corrosive substance. We propose a clinical guideline that can be used to help plan management of corrosives. PMID:25224219

Bonnici, K S; Wood, D M; Dargan, P I

2014-11-01

282

Non-Helicobacter pylori, non-NSAIDs peptic ulcers: a descriptive study on patients referred to Taleghani hospital with upper gastrointestinal bleeding  

PubMed Central

Aim The purpose of the present study was to evaluate the number and proportion of various causes of upper gastrointestinal bleeding and actual numbers of non-NSAID, non-Helicobacter pylori (H.pylori) peptic ulcers seen in endoscopy of these patients. Background The number and the proportion of patients with non- H.pylori, non-NSAIDs peptic ulcer disease leading to upper gastrointestinal bleeding is believed to be increasing after eradication therapy for H.pylori. Patients and methods Medical records of patients referred to the emergency room of Taleghani hospital from 2010 with a clinical diagnosis of upper gastrointestinal bleeding (hematemesis, coffee ground vomiting and melena) were included in this study. Patients with hematochezia with evidence of a source of bleeding from upper gastrointestinal tract in endoscopy were also included in this study. Results In this study, peptic ulcer disease (all kinds of ulcers) was seen in 61 patients which were about 44.85% of abnormalities seen on endoscopy of patients. Among these 61 ulcers, 44 were duodenal ulcer, 22 gastric ulcer (5 patients had the both duodenal and gastric ulcers). Multiple biopsies were taken and be sent to laboratory for Rapid Urease Test and pathological examination. About 65.53% of patients had ulcers associated with H.pylori, 9.83% had peptic ulcer disease associated with NSAIDs and 11.47% of patients had ulcers associated with both H.pylori and consumption of NSAIDs. 13.11% of patients had non-NSAIDs non- H.pylori peptic ulcer disease. Conclusion The results of this study supports the results of other studies that suggest the incidence of H.pylori infection related with duodenal ulcer is common, and that non-H pylori and non-NSAIDs duodenal ulcer is also common. PMID:24834225

Rajabalinia, Hasan; Ghobakhlou, Mehdi; Nikpour, Shahriar; Dabiri, Reza; Bahriny, Rasoul; Sherafat, Somayeh Jahani; Moghaddam, Pardis Ketabi

2012-01-01

283

Therapeutic Vaccines for Gastrointestinal Cancers  

PubMed Central

Despite progress in the management of gastrointestinal malignancies, these diseases remain devastating maladies. Conventional treatment with chemotherapy and radiation is still only partially effective and highly toxic. In the era of increasing knowledge of the molecular biology of tumors and the interaction between the tumor and immune system, the development of targeted agents, including cancer vaccines, has emerged as a promising modality. In this paper, we discuss the principals of vaccine development, and we review most of the published trials on gastrointestinal cancer vaccines that have been conducted over the last decade. Many antigens and various treatment approaches have already been tested in colon, pancreatic, and other cancers. Some of these approaches have already shown some clinical benefit. In this paper, we discuss these different strategies and some of the future directions for targeting gastrointestinal malignancies with vaccines. PMID:22298988

Rahma, Osama E.

2011-01-01

284

Gastrointestinal complications after cardiac surgery.  

PubMed Central

Gastrointestinal complications after cardiac surgery are uncommon, but are associated with a high morbidity and mortality. Over 11 years 8559 procedures requiring cardiopulmonary bypass were performed in this unit and 35 patients were identified who developed gastrointestinal complications after surgery, an incidence of 0.41%. There were nine deaths in this group, a mortality of 25.7% compared with an overall mortality after cardiac surgery in Ireland ranging from 3.24% to 4.81%. These complications required surgery in 21 patients. The most common indication for surgical intervention was upper gastrointestinal bleeding in 10 patients, three patients had acute pancreatitis, two patients had perforated peptic ulcer; two patients had intestinal ischaemia, with five cases of colon pathology. The difficulties of making an early diagnosis are outlined and a low threshold to exploratory laparotomy is recommended. PMID:8422146

Egleston, C. V.; Wood, A. E.; Gorey, T. F.; McGovern, E. M.

1993-01-01

285

A Case of an Upper Gastrointestinal Bleeding Due to a Ruptured Dissection of a Right Aortic Arch  

SciTech Connect

We report a case of severe upper gastrointestinal hemorrhage with a rare underlying cause. The patient was unconscious when he was admitted to the hospital. No chest radiogram was performed. Routine diagnostic measures, including endoscopy, failed to reveal the origin of the bleeding, which was believed to originate from the esophagus secondary to a peptic ulcer or varices. Exploratory laparotomy added no further information, but contrast-enhanced multislice computed tomography (MSCT) of the chest showed dextroposition of the widened aortic arch with a ruptured type-B dissection and a consecutive aorto-esophageal fistula (AEF). The patient died on the day of admission. Noninvasive MSCT angiography gives rapid diagnostic information on patients with occult upper gastrointestinal bleeding and should be considered before more invasive conventional angiography or surgery.

Born, Christine; Forster, Andreas; Rock, Clemens; Pfeifer, Klaus-Juergen; Rieger, Johannes; Reiser, Maximilian [Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, D-80336 Munich, Institute for Clinical Radiology (Germany)

2003-09-15

286

Ankaferd Blood Stopper for controlling gastrointestinal bleeding due to distinct benign lesions refractory to conventional antihemorrhagic measures  

PubMed Central

OBJECTIVE: To assess the hemostatic efficacy of the Ankaferd Blood Stopper (ABS, Ankaferd Health Products Ltd, Turkey) hemostatic agent for controlling gastrointestinal bleeding associated with various benign lesions refractory to conventional antihemorrhagic measures. METHODS: The records of all patients who underwent upper and lower endoscopy procedures at the Turkiye Yuksek Ihtisas Teaching and Research Hospital (Ankara, Turkey) between April 2008 and June 2009 were reviewed. Patients in whom ABS was used as a primary or adjuvant hemostatic agent were included in the study. Rates of bleeding control and postprocedural complications were documented. RESULTS: Hemostasis with no immediate complications was achieved in all patients within seconds of endoscopic application of ABS. CONCLUSIONS: ABS may have a role as a primary treatment or as an adjuvant to conventional modalities used to control gastrointestinal bleeding. Prospective controlled studies are needed to help establish its efficacy and, perhaps, offer a comparison with conventional hemostatic interventions. PMID:20559581

Kurt, Mevlut; Onal, Ibrahim Koral; Akdogan, Meral; Kekilli, Murat; Arhan, Mehmet; Sayilir, Abdurrahim; Oztas, Erkin; Haznedaroglu, Ibrahim Celalettin

2010-01-01

287

Clinical Outcomes Associated with Attempts to Educate Patients about Lower Endoscopy: A Narrative Review  

Microsoft Academic Search

Patient knowledge about lower endoscopy might have beneficial effects on satisfaction outcomes, pre-procedure anxiety, and\\u000a adherence, although this is poorly understood. Methods Searching the national and international literature, we reviewed 20 years of observational studies and randomized trials\\u000a that examine possible relationships between educating patients about lower endoscopy and clinical outcomes. Twenty-three publications\\u000a were included but their heterogeneity precluded meta-analyses. Standard

John M. Coombes; John F. Steiner; David B. Bekelman; Allan V. Prochazka; Thomas D. Denberg

2008-01-01

288

Motion management in gastrointestinal cancers  

PubMed Central

The presence of tumor and organ motions complicates the planning and delivery of radiotherapy for gastrointestinal cancers. Without proper accounting of the movements, target volume could be under-dosed and the nearby normal critical organs could be over-dosed. This situation is further exacerbated by the close proximity of abdominal tumors to many normal organs at risk (OARs). A number of strategies have been developed to deal with tumor and organ motions in radiotherapy. This article presents a review of the techniques used in the evaluation, quantification, and management of tumor and organ motions for radiotherapy of gastrointestinal cancers. PMID:24982771

Abbas, Hassan; Chang, Bryan

2014-01-01

289

Gastrointestinal function development and microbiota  

PubMed Central

The intestinal microbiota plays an important role in the development of post-natal gastrointestinal functions of the host. Recent advances in our capability to identify microbes and their function offer exciting opportunities to evaluate the complex cross talk between microbiota, intestinal barrier, immune system and the gut-brain axis. This review summarizes these interactions in the early colonization of gastrointestinal tract with a major focus on the role of intestinal microbiota in the pathogenesis of feeding intolerance in preterm newborn. The potential benefit of early probiotic supplementation opens new perspectives in case of altered intestinal colonization at birth as preventive and therapeutic agents. PMID:23433508

2013-01-01

290

Is the Environment of the Endoscopy Unit a Reservoir of Pathogens?  

PubMed Central

Background/Aims Given the characteristic procedures involved in the endoscopy unit, the spread of pathogens is much more frequent in this unit than in other environments. However, there is a lack of data elucidating the existence of pathogens in the endoscopy unit. The aim of this study was to detect the presence of possible pathogens in the endoscopy unit. Methods We performed environmental culture using samples from the endoscopy rooms of 2 tertiary hospitals. We used sterile cotton-tipped swabs moistened with sterile saline to swab the surfaces of 197 samples. Then, we cultured the swab in blood agar plate. Samples from the colonoscopy room were placed in thioglycollate broth to detect the presence of anaerobes. After 2 weeks of culture period, we counted the colony numbers. Results The most commonly contaminated spots were the doctor's keyboard, nurse's cart, and nurse's mouse. The common organisms found were non-pathogenic bacterial microorganisms Staphylococcus, Micrococcus, and Streptococcus spp.. No definite anaerobe organism was detected in the colonoscopy room. Conclusions Although the organisms detected in the endoscopy unit were mainly non-pathogenic organisms, they might cause opportunistic infections in immunocompromised patients. Therefore, the environment of the endoscopy room should be managed appropriately; moreover, individual hand hygiene is important for preventing possible hospital-acquired infections. PMID:25374497

Choi, Eun Sung; Choi, Jae Hyuk; Lee, Jung Min; Lee, Sang Min; Lee, Yoo Jin; Kang, Yu Jin; Cho, Kwang Bum; Park, Kyung Sik; Jang, Byoung Kuk; Hwang, Jae Seok; Chung, Woo Jin; Ryoo, Nam Hee; Jeon, Seong Woo; Jung, Min Kyu

2014-01-01

291

Classification of colon polyps in NBI endoscopy using vascularization features  

NASA Astrophysics Data System (ADS)

The evolution of colon cancer starts with colon polyps. There are two different types of colon polyps, namely hyperplasias and adenomas. Hyperplasias are benign polyps which are known not to evolve into cancer and, therefore, do not need to be removed. By contrast, adenomas have a strong tendency to become malignant. Therefore, they have to be removed immediately via polypectomy. For this reason, a method to differentiate reliably adenomas from hyperplasias during a preventive medical endoscopy of the colon (colonoscopy) is highly desirable. A recent study has shown that it is possible to distinguish both types of polyps visually by means of their vascularization. Adenomas exhibit a large amount of blood vessel capillaries on their surface whereas hyperplasias show only few of them. In this paper, we show the feasibility of computer-based classification of colon polyps using vascularization features. The proposed classification algorithm consists of several steps: For the critical part of vessel segmentation, we implemented and compared two segmentation algorithms. After a skeletonization of the detected blood vessel candidates, we used the results as seed points for the Fast Marching algorithm which is used to segment the whole vessel lumen. Subsequently, features are computed from this segmentation which are then used to classify the polyps. In leave-one-out tests on our polyp database (56 polyps), we achieve a correct classification rate of approximately 90%.

Stehle, Thomas; Auer, Roland; Gross, Sebastian; Behrens, Alexander; Wulff, Jonas; Aach, Til; Winograd, Ron; Trautwein, Christian; Tischendorf, Jens

2009-02-01

292

Gastric Lipoma Presenting with Massive Upper Gastrointestinal Bleeding  

PubMed Central

A case of massive upper gastrointestinal bleeding in a 37-year-old female is presented showing a submucosal mass in the gastric body. At laparotomy a pedunculated submucosal mass was found located on the posterior wall at the junction of the body and antrum of the stomach, 8?cm from the pylorus. Pathology confirmed that it was a 4?cm benign gastric lipoma with a bleeding central ulcer. Gastric lipomas are rare, benign, typically submucosal tumors occurring in the gastric antrum. They are usually asymptomatic but can become symptomatic depending on size, location, and if there is ulceration of the lesion. These lesions may be mistaken as malignant tumors or present with upper GI bleeding or intussusception. The diagnosis can be made using a combination of upper endoscopy, endoscopic ultrasound, CT, and MRI with surgical excision being the definitive treatment of choice. We hope that this case highlights the fact that these lesions can present with massive upper GI haemorrhage and should be included in the diagnosis when appropriate. PMID:24363942

Ramdass, Michael J.; Barrow, Shaheeba

2013-01-01

293

Computed tomography of the gastrointestinal tract  

SciTech Connect

This volume presents computed tomography of the major disease states involving the gastrointestinal tract, mesentery, and peritoneal cavity. Computed Tomography of the Gastrointestinal Tract combined experience of l5 authorities includes illustrations (most of these radiographs).

Meyers, M.A.

1986-01-01

294

Nutritional management of gastrointestinal disease  

Microsoft Academic Search

The gastrointestinal (GI) tract is primarily responsible for acquiring and digesting food, absorbing nutrients and water, and expelling wastes from the body as feces. A proper diet and normally functioning GI tract are integral for the delivery of nutrients, prevention of nutrient deficiencies and malnutrition, repair of damaged intestinal epithelium, restoration of normal luminal bacterial populations, promotion of normal GI

Deb Zoran

2003-01-01

295

[Motility and functional gastrointestinal disorders].  

PubMed

This article discusses the studies on functional and motor gastrointestinal disorders presented at the 2014 Digestive Diseases Week conference that are of greatest interest to us. New data have been provided on the clinical importance of functional gastrointestinal disorders, with recent prevalence data for irritable bowel syndrome and fecal incontinence. We know more about the pathophysiological mechanisms of the various functional disorders, especially irritable bowel syndrome, which has had the largest number of studies. Thus, we have gained new data on microinflammation, genetics, microbiota, psychological aspects, etc. Symptoms such as abdominal distension have gained interest in the scientific community, both in terms of patients with irritable bowel syndrome and those with constipation. From the diagnostic point of view, the search continues for a biomarker for functional gastrointestinal disorders, especially for irritable bowel syndrome. In the therapeutic area, the importance of diet for these patients (FODMAP, fructans, etc.) is once again confirmed, and data is provided that backs the efficacy of already marketed drugs such as linaclotide, which rule out the use of other drugs such as mesalazine for patients with irritable bowel syndrome. This year, new forms of drug administration have been presented, including metoclopramide nasal sprays and granisetron transdermal patches for patients with gastroparesis. Lastly, a curiosity that caught our attention was the use of a vibrating capsule to stimulate gastrointestinal transit in patients with constipation. PMID:25294261

Mearin, Fermín; Rey, Enrique; Balboa, Agustín

2014-09-01

296

Intestinal Permeation and Gastrointestinal Disease  

Microsoft Academic Search

The gastrointestinal tract constitutes one of the largest sites of exposure to the outside environment. The function of the gastro- intestinal tract in monitoring and sealing the host interior from intruders is called the gut barrier. A variety of specific and non- specific mechanisms are in operation to establish the host barrier; these include luminal mechanisms and digestive enzymes, the

Mark T. DeMeo; Ece A. Mutlu; Ali Keshavarzian; Mary C. Tobin

2002-01-01

297

Proteases in gastrointestinal neoplastic diseases  

Microsoft Academic Search

Cysteine and serine proteases are involved in cancer invasion and metastasis. In the past few years we investigated the tissue levels of these proteases in gastric cancer (GC), gastric precancerous changes (CAG), colorectal cancer (CRC) and the plasma and serum levels of proteases in several gastrointestinal tumours, using ELISA methods. Significantly higher antigen levels were found not only in GC

László Herszényi; Mario Plebani; Paolo Carraro; Massimo De Paoli; Giovanni Roveroni; Romilda Cardin; Francesca Foschia; Zsolt Tulassay; Remo Naccarato; Fabio Farinati

2000-01-01

298

Eicosanoids and the gastrointestinal tract  

Microsoft Academic Search

Determining the role of eicosanoids in gastrointestinal physiology and pathophysiology has been an active area of investigation over the past 20 years. The landmark discovery of prostaglandin endoperoxide synthase and other enzymes involved in the production of arachidonic acid products (lipoxygenases and epoxygenases) ushered in a new era of research. The goal of this review is to distill a large

Charles E. Eberhart; Raymond N. Dubois

1995-01-01

299

Gastrointestinal complications in renal transplantation  

Microsoft Academic Search

One wonders whether the use of cyclosporin, histamine receptor antagonists, low doses of steroids, and early diagnosis and treatment actually modify the incidence, morbidity, and mortality of gastrointestinal (GI) and pancreatic complications in renal transplantation. To find out, we reviewed 614 kidney transplant recipients between January 1984 and December 1988. One hundred patients (16.2%) were found to have GI and\\/or

G. Benoit; M. Moukarzel; G. Verdelli; C. Hiesse; C. Buffet; H. Bensadoun; B. Charpentier; A. Jardin; D. Fries

1993-01-01

300

[Autonomic neuropathy of the gastrointestinal tract].  

PubMed

The paper focuses on the issues of diabetic autonomic neuropathy in the gastrointestinal tract. It describes the aethiopathogenesis of diabetic polyneuropathy. More detailed discussion is then provided with respect to gastrointestinal tract. The clinical picture and options available for the diagnosis and treatment when various parts of the gastrointestinal tract are involvement are examined. PMID:21612065

Olsovský, J

2011-04-01

301

Pediatric and Adolescent Gastrointestinal Motility & Pain Program  

E-print Network

?" There are only two causes for gas distending the gastrointestinal tract: 1) excessive air swallowing, and 2) gasPediatric and Adolescent Gastrointestinal Motility & Pain Program Department of Pediatrics diagnosed the functional gastrointestinal disorder aerophagia, and do not think of it as a possibility when

302

Therapeutic Decision-Making in Endoscopically Unmanageable Nonvariceal Upper Gastrointestinal Hemorrhage  

SciTech Connect

The purpose of this study was to identify endoscopic and clinical parameters influencing the decision-making in salvage of endoscopically unmanageable, nonvariceal upper gastrointestinal hemorrhage (UGIH) and to report the outcome of selected therapy. We retrospectively retrieved all cases of surgery and arteriography for arrest of endoscopically unmanageable UGIH. Only patients with overt bleeding on endoscopy within the previous 24 h were included. Patients with preceding nonendoscopic hemostatic interventions, portal hypertension, malignancy, and transpapillar bleeding were excluded. Potential clinical and endoscopic predictors of allocation to either surgery or arteriography were tested using statistical models. Outcome and survival were regressed on the choice of rescue and clinical variables. Forty-six arteriographed and 51 operated patients met the inclusion criteria. Univariate analysis revealed a higher number of patients with a coagulation disorder in the catheterization group (41.4%, versus 20.4% in the laparotomy group; p = 0.044). With multivariate analysis, the identification of a bleeding peptic ulcer at endoscopy significantly steered decision-making toward surgical rescue (OR = 5.2; p = 0.021). Taking into account reinterventions, hemostasis was achieved in nearly 90% of cases in both groups. Overall therapy failure (no survivors), rebleeding within 3 days (OR = 3.7; p = 0.042), and corticosteroid use (OR = 5.2; p = 0.017) had a significant negative impact on survival. The odds of dying were not different for embolotherapy or surgery. In conclusion, decision-making was endoscopy-based, with bleeding peptic ulcer significantly directing the choice of rescue toward surgery. Unsuccessful hemostasis and corticosteroid use, but not the choice of rescue, negatively affected outcome.

Defreyne, Luc, E-mail: Luc.Defreyne@UGent.b [Ghent University Hospital, Department of Interventional Radiology (Belgium); Schrijver, Ignace De [Clinique de Flandre, Flandre Imagerie (France); Decruyenaere, Johan [Ghent University Hospital, Department of Intensive Care (Belgium); Maele, Georges Van [Ghent University Hospital, Department of Medical Informatics and Statistics (Belgium); Ceelen, Wim [Ghent University Hospital, Department of Digestive Surgery (Belgium); Looze, Danny De [Ghent University Hospital, Department of Gastroenterology (Belgium); Vanlangenhove, Peter [Ghent University Hospital, Department of Interventional Radiology (Belgium)

2008-09-15

303

Gastrointestinal bleeding as presentation of small bowel metastases of malignant melanoma: Is surgery a good choice?  

PubMed Central

INTRODUCTION Melanoma shows a particular predilection in involving small intestine both in a single site and in multiple localization and acute or chronic gastrointestinal bleedings are often the first sign of tumour. PRESENTATION OF CASE We report two cases of GI metastases of malignant melanoma, one presented with only a big mass that cause intestinal obstruction and the other with a tumour spread throughout the small intestine that produce enterorrhagia. DISCUSSION Diagnosis and follow-up are very difficult: CT scan, PET-CT scan and capsule endoscopy should be complementary for the assessment of patients with GI symptoms and melanoma history. CONCLUSION What is the role of surgery? Several studies suggest metastasectomy to achieve both R0 results and palliative resolutions of acute symptoms, such as obstruction, pain, and bleeding. PMID:25262323

Conversano, Angelica; Macina, Simona; Indellicato, Rocco; Lacavalla, Domenico; D'Abbicco, Dario

2014-01-01

304

Quality control in gastrointestinal surgery.  

PubMed

We analyzed the Mexican legal framework, identifying the vectors that characterize quality and control in gastrointestinal surgery. Quality is contemplated in the health protection rights determined according to the Mexican Constitution, established in the general health law and included as a specific goal in the actual National Development Plan and Health Sector Plan. Quality control implies planning, verification and application of corrective measures. Mexico has implemented several quality strategies such as certification of hospitals and regulatory agreements by the General Salubrity Council, creation of the National Health Quality Committee, generation of Clinical Practice Guidelines and the Certification of Medical Specialties, among others. Quality control in gastrointestinal surgery must begin at the time of medical education and continue during professional activities of surgeons, encouraging multidisciplinary teamwork, knowledge, abilities, attitudes, values and skills that promote homogeneous, safe and quality health services for the Mexican population. PMID:22169378

Ramírez-Barba, Ector Jaime; Arenas-Moya, Diego; Vázquez-Guerrero, Arturo

2011-01-01

305

Gastrointestinal Manifestations of Systemic Sclerosis  

Microsoft Academic Search

Systemic sclerosis is a chronic disorder of connective tissue that affects the gastrointestinal tract in more than 80% of\\u000a patients. Changes in neuromuscular function with progressive fibrosis of smooth muscle within the muscularis propria impair\\u000a normal motor function, which may secondarily alter transit and nutrient absorption. Esophageal manifestations with gastroesophageal\\u000a reflux and dysphagia are the most common visceral manifestation of

Robyn Domsic; Kenneth Fasanella; Klaus Bielefeldt

2008-01-01

306

MRI of the gastrointestinal tract  

Microsoft Academic Search

.   This article reviews the application of magnetic resonance imaging (MRI) to study the gastrointestinal (GI) tract. A summary\\u000a of the current MRI techniques is included, emphasizing the choice of pulsing sequences, imaging plane, surface coils and intravenous\\u000a and oral contrast agents for each of the different segments of the GI tract. The multiple available oral contrast agents are\\u000a reviewed,

M. R. Paley; P. R. Ros

1997-01-01

307

Gastrointestinal infections caused by cytomegalovirus  

Microsoft Academic Search

Cytomegalovirus (CMV) is an important human pathogen, causing a variety of syndromes ranging from asymptomatic infections\\u000a to life-threatening end-organ disease. Infections of the gastrointestinal tract are an especially common form of disease caused\\u000a by CMV and are usually manifest as luminal infections, such as esophagitis or colitis. Solid organ disease caused by CMV is\\u000a also known to occur, with hepatitis

David A. Bobak

2003-01-01

308

Lymphomas of the gastrointestinal tract  

Microsoft Academic Search

The gastrointestinal tract is the most frequently involved extranodal localization, representing 30–40% of extranodal lymphomas\\u000a and from 4% to 20% of all non-Hodgkin’s lymphoma (NHL) cases1, 2. In Western countries the most common location is the stomach (approximately 50–60%), followed by the small intestines (30%)\\u000a and the large intestine (around 10%)3. Involvement of the oesophagus is very rare. These proportions

E. Zucca

309

Endoprobe: a system for radionuclide-guided endoscopy.  

PubMed

Methods to guide the surgical treatment of cancer utilizing handheld beta-sensitive probes in conjunction with tumor-avid radiopharmaceuticals [such as 18F-fluorodeoxyglucose (FDG)] have previously been developed. These technologies could also potentially be used to assist in minimally invasive techniques for the diagnosis of cancer. The goal of this project is to develop and test a system for performing radionuclide-guided endoscopies. This system (called Endoprobe) has four major subsystems: beta detector, position tracker, endoscope, and user interface. The beta detection unit utilizes two miniaturized solid state detectors to preferentially detect beta particles. The position tracking system allows real-time monitoring of the unit's location. The beta detector and position tracking system's receiver are mounted on the tip of an endoscope. Information from the beta detector and tracking system, in addition to the video signal from the endoscope, are combined and presented to the user via a computer interface. The system was tested in a simulated search for radiotracer-avid areas of esophageal cancer. The search for esophageal cancer was chosen because this type of cancer is often diagnosed with endoscopic procedures and has been reported to have good affinity for FDG. Accumulations of FDG in the normal organs of the abdomen were simulated by an anthropomorphic torso phantom filled with the appropriate amounts of radioactivity. A 1.5- mm-thick gelatin film containing FDG was used to simulate radiotracer uptake in the lining of normal esophagus. Esophageal lesions (both benign and malignant) were simulated by thin disks of gelatin (diameters=3.5-12 mm) containing appropriate concentrations of FDG embedded in the gelatin film simulating normal esophagus. Endoprobe facilitated visual identification and examination of the simulated lesions. The position tracking system permitted the location of the Endoprobe tip to be monitored and plotted in real time on a previously acquired positron emission tomography-computed tomography (PET-CT) image of the phantom. The detection system successfully acquired estimates of the beta flux emitted from areas chosen by the user. Indeed, Endoprobe was able to assist in distinguishing simulated FDG-avid areas as small as 3.5 mm in diameter from normal esophagus (p value <0.025). In addition to FDG, Endoprobe can be used with other positron or electron-emitting radionuclides such as IC or 131I. The next phase of this project will focus on modification of the prototype to make it more suitable for clinical use. PMID:15651613

Raylman, Raymond R; Srinivasan, Amarnath

2004-12-01

310

Maintenance time of sedative effects after an intravenous infusion of diazepam: A guide for endoscopy using diazepam  

PubMed Central

AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP) 2C19 genotypes after an infusion regimen of diazepam commonly used for gastrointestinal endoscopy in Japan. METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical flicker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS) symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg). RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively) and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively), which changed significantly compared with the baseline level before infusion (P < 0.05). On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests. CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved. PMID:18777597

Sugimoto, Mitsushige; Furuta, Takahisa; Nakamura, Akiko; Shirai, Naohito; Ikuma, Mutsuhiro; Misaka, Shingen; Uchida, Shinya; Watanabe, Hiroshi; Ohashi, Kyoichi; Ishizaki, Takashi; Hishida, Akira

2008-01-01

311

Interference between pacemakers/implantable cardioverter defibrillators and video capsule endoscopy  

PubMed Central

Our Letter to the Editor, related to the article “Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry” by Cuschieri et al, comments on some small errors, that slipped into the authors discussions. The given informations concerning the pacemaker- and implantable cardioverter defibrillators modes were inaccurate and differ between the text and the table. Moreover, as 8 of 20 patient’s pacemakers were programmed to VOO or DOO (“interference mode”) and one patient was not monitored by telemetry during capsule endoscopy, 9 of 20 patients (45%) lack the informations of possible interference between capsule endoscopy their implanted device. Another objection refers to the interpretation of an electrocardiogram (figure 1, trace B) presented: in contrast to the author’s opinion the marked spike should be interpreted as an artefact and not as ”undersensing of a fibrillatory wave”. Finally, three comments to cited reviews were not complete respectively not quoted correctly. PMID:23596547

Bandorski, Dirk; Gehron, Johannes; Holtgen, Reinhard

2013-01-01

312

Is there a role for colon capsule endoscopy beyond colorectal cancer screening? A literature review  

PubMed Central

Colon capsule endoscopy is recommended in Europe alternatively to colonoscopy for colorectal cancer screening in average risk individuals. The procedure has also been proposed to complete colon examination in cases of incomplete colonoscopy or when colonoscopy is contraindicated or refused by the patient. As tissue samples cannot be obtained with the current capsule device, colon capsule endoscopy has no place in diagnosing ulcerative colitis or in dysplasia surveillance. Nevertheless, data are accumulating regarding its feasibility to examine ulcerative colitis disease extent and to monitor disease activity and mucosal healing, even though reported results on the capsule’s performance in this field vary greatly. In this review we present the currently available evidence for the use of colon capsule endoscopy to complement colonoscopy failure to reach the cecum and its use to evaluate ulcerative colitis disease activity and extent. Moreover, we provide an outlook on issues requiring further investigation before the capsule becomes a mainstream alternative to colonoscopy in such cases.

Triantafyllou, Konstantinos; Beintaris, Iosif; Dimitriadis, George D

2014-01-01

313

Developing a clinical research network: the Northern Region Endoscopy Group experience.  

PubMed

Research is central to the National Health Service. Clinical trial recruitment has been aided by the National Institute for Health Research's Comprehensive Research Network but these networks do not support development of research. The Northern Region Endoscopy Group (NREG) was founded in 2007, encompasses 17 endoscopy units and has become a highly successful collaborative research network. The network is now a major contributor to UK trials, has published over 20 papers (>60 abstracts) and holds grants totalling more than £1.5 million. The NREG provides an exemplar model of how collaborative working can contribute significantly to biomedical research. PMID:24715118

Rajasekhar, Praveen; Rees, Colin; Rutter, Matthew; Hungin, Pali

2014-04-01

314

[Emergency endoscopy in the diagnosis of hemorrhage from the upper part of the digestive tract].  

PubMed

Within a two-year period urgent endoscopy due to bleeding from the upper digestive tract was performed in 209 patients, that is, 4,6% of all endoscopies. The cause of bleeding was detected in 84% of the examined patients. The most common cause of bleeding was: gastroduodenal ulcer, erosive esophagogastroduodenitis, malignant gastric neoplasm, and, in a smaller percentage, peptic postresection ulcer and esophageal varices. Analysing causes of a relatively high percentage of nonidentified bleedings the authors insist on detection of small lesions as well as indirect signs of mucosal alterations as possible causes of bleeding. PMID:6985110

Lukacevi?, S; Elakovi?, M; Bjeli?, J; Petrovi?, M; Sosi?, M; Petrovi?, Z

1981-01-01

315

Acute rectocolitis following endoscopy in health check-up patients—glutaraldehyde colitis or ischemic colitis?  

Microsoft Academic Search

Purpose  Acute rectocolitis is a rare complication that follows endoscopy. It could be caused by glutaraldehyde or ischemic injury.\\u000a The clinical, endoscopic, radiological, and pathological features of glutaraldehyde-induced colitis may mimic those of ischemic\\u000a colitis. We reported our experiences regarding this problem.\\u000a \\u000a \\u000a \\u000a Methods  The medical records of patients with acute rectocolitis following endoscopy treated at Kaohsiung Veterans General Hospital\\u000a since 2001 were

Chao-Wen Hsu; Chieh-Hsin Lin; Jui-Ho Wang; Hsin-Tai Wang; Wen-Chieh Ou; Tai-Ming King

2009-01-01

316

Eosinophilic gastrointestinal diseases: review and update.  

PubMed

Eosinophilic gastrointestinal disorders (EGIDs) are a progressively more frequent diverse group of intestinal diseases. The intention of this paper is to present the newest developments in the care of patients with EGIDs and to sum up a rising literature defining the clinical features and mechanistic elements of eosinophils and their intricate associations with the gastrointestinal tract. Clinicians ought to stay sensitive to EGIDs as a diagnostic likelihood for patients with general gastrointestinal symptoms. Further research is warranted to establish various methods leading to dysfunction coupled with eosinophilic gastrointestinal inflammation. PMID:22792476

Jawairia, Mahreema; Shahzad, Ghulamullah; Mustacchia, Paul

2012-01-01

317

Hepatobiliary imaging after gastrointestinal surgery  

Microsoft Academic Search

\\u000a Hepatobiliary imaging with 99mTc labelled imidodiacetic acid derivatives such as 99mTc-HIDA, 99mTc-PIPIDA, 99mTc-MIBIDA, 99mTc-DISIDA has become a convenient, noninvasive and efficacious tool for the evaluation of the functional status of the hepatocytes,\\u000a biliary tree, and the gallbladder. It also provides unique and important information on the biliary drainage system after\\u000a varied upper gastrointestinal or biliary surgery. It plays an important

Hee-Myung Park; Henry N. Wellman; James A. Madura

318

Gastrointestinal obstruction in penguin chicks.  

PubMed

A 7-day-old gentoo penguin (Pygoscelis papua) was found dead and postmortem examination revealed impaction of the ventriculus with feathers. A review of mortality in gentoo penguin chicks from 1997 to 2007 at that institution revealed another case of feather impaction of the ventriculus in a 4-week-old chick, a sibling of the previous chick. A third case of gastrointestinal impaction occurred in a 24-day-old king penguin (Aptenodytes patagonicus) with omphallitis and enteritis. In this chick, a fibrin mat produced a complete obstruction of the intestine at the level of Meckel's diverticulum. PMID:20235460

Perpiñán, David; Curro, Thomas G

2009-12-01

319

Ethics and gastrointestinal artificial feeding.  

PubMed

Medical ethics is the study of human values as they relate to the practice of medicine. Ethics intersects with gastroenterology primarily involving issues of gastric and intestinal artificial feeding at the end of life. Language imparts meaning. Gastric artificial feeding is not the same as eating. Recent data suggest that gastric artificial feeding does not prolong life in patients with dementia and dysphagia. Given the lack of documented benefit of gastrointestinal feeding in these patients, the literature has focused on selection of appropriate patients for this medical intervention. Ethical care involves compassion, communication, consultation, and collaboration in dealing with emotionally difficult circumstances. PMID:15245701

Lipman, Timothy O

2004-08-01

320

Imaging of primary gastrointestinal lymphoma.  

PubMed

Primary gastrointestinal (GI) lymphoma most often arises from stomach, small bowel, or colon. The 2 most common subtypes of primary GI lymphoma include low-grade mucosa-associated lymphoid tissue lymphoma, strongly associated with Helicobacter pylori infection, and high-grade diffuse, large B-cell lymphoma. Primary GI lymphoma demonstrates a myriad of imaging manifestations that can commonly mimic other pathologies. Timely and accurate diagnosis remains important because treatment and prognosis of primary GI lymphoma differ significantly from other GI malignancies and even lymphoma of other primary sites. PMID:24332207

Chang, Stephanie T; Menias, Christine O

2013-12-01

321

Hypnotherapy for functional gastrointestinal disorders.  

PubMed

About 20% of people in the UK have functional gastrointestinal disorders such as irritable bowel syndrome and functional dyspepsia. These conditions account for about 4% of GP consultations and 50% of gastroenterologists' workload. Forsome, the symptoms affect quality of life and ability to work. Drug treatment aimed at relieving symptoms is often ineffective. Other options include psychological treatments such as cognitive behavioural therapy, brief psychotherapy and gut-directed hypnotherapy. Here we discuss whether hypnotherapy has a role in the treatment of patients with irritable bowel syndrome or functional dyspepsia. PMID:15966557

2005-06-01

322

Regorafenib in gastrointestinal stromal tumors.  

PubMed

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the GI tract and constitute less than 1% of all digestive tract tumors--the stomach is the most common site. Regorafenib is a multi-tyrosine kinase inhibitor with regulatory approvals granted for colorectal cancers and GIST. The US FDA granted approval for the use of regorafenib in February 2013 in patients with advanced GIST for those who had failed on imatinib and sunitinib. This was based on a pivotal Phase III double-blind placebo controlled randomized trial that showed that there was a significant improvement in progression-free survival for patients on regorafenib. PMID:25145429

Sirohi, Bhawna; Philip, Deepa Susan; Shrikhande, Shailesh V

2014-01-01

323

Endoscopic features of gastro-intestinal lymphomas: From diagnosis to follow-up  

PubMed Central

Many progresses have been done in the management of gastrointestinal (GI) lymphomas during last decades, especially after the discovery of Helicobacter pylori-dependent lymphoma development. The stepwise implementation of new endoscopic techniques, by means of echoendoscopy or double-balloon enteroscopy, enabled us to more precisely describe the endoscopic features of GI lymphomas with substantial contribution in patient management and in tailoring the treatment strategy with organ preserving approaches. In this review, we describe the recent progresses in GI lymphoma management from disease diagnosis to follow-up with a specific focus on the endoscopic presentation according to the involved site and the lymphoma subtype. Additionally, new or emerging endoscopic technologies that have an impact on the management of gastrointestinal lymphomas are reported. We here discuss the two most common subtypes of GI lymphomas: the mucosa-associated lymphoid tissue and the diffuse large B cell lymphoma. A general outline on the state-of-the-art of the disease and on the role of endoscopy in both diagnosis and follow-up will be performed. PMID:25278693

Vetro, Calogero; Romano, Alessandra; Amico, Irene; Conticello, Concetta; Motta, Giovanna; Figuera, Amalia; Chiarenza, Annalisa; Di Raimondo, Cosimo; Giulietti, Giorgio; Bonanno, Giacomo; Palumbo, Giuseppe Alberto; Di Raimondo, Francesco

2014-01-01

324

Nodular lymphoid hyperplasia in the gastrointestinal tract in adult patients: A review  

PubMed Central

Nodular lymphoid hyperplasia of the gastrointestinal tract is characterized by the presence of multiple small nodules, normally between between 2 and 10 mm in diameter, distributed along the small intestine (more often), stomach, large intestine, or rectum. The pathogenesis is largely unknown. It can occur in all age groups, but primarily in children and can affect adults with or without immunodeficiency. Some patients have an associated disease, namely, common variable immunodeficiency, selective IgA deficiency, Giardia infection, or, more rarely, human immunodeficiency virus infection, celiac disease, or Helicobacter pylori infection. Nodular lymphoid hyperplasia generally presents as an asymptomatic disease, but it may cause gastrointestinal symptoms like abdominal pain, chronic diarrhea, bleeding or intestinal obstruction. A diagnosis is made at endoscopy or contrast barium studies and should be confirmed by histology. Its histological characteristics include markedly hyperplasic, mitotically active germinal centers and well-defined lymphocyte mantles found in the lamina propria and/or in the superficial submucosa, distributed in a diffuse or focal form. Treatment is directed towards associated conditions because the disorder itself generally requires no intervention. Nodular lymphoid hyperplasia is a risk factor for both intestinal and, very rarely, extraintestinal lymphoma. Some authors recommend surveillance, however, the duration and intervals are undefined.

Albuquerque, Andreia

2014-01-01

325

Nodular lymphoid hyperplasia in the gastrointestinal tract in adult patients: A review.  

PubMed

Nodular lymphoid hyperplasia of the gastrointestinal tract is characterized by the presence of multiple small nodules, normally between between 2 and 10 mm in diameter, distributed along the small intestine (more often), stomach, large intestine, or rectum. The pathogenesis is largely unknown. It can occur in all age groups, but primarily in children and can affect adults with or without immunodeficiency. Some patients have an associated disease, namely, common variable immunodeficiency, selective IgA deficiency, Giardia infection, or, more rarely, human immunodeficiency virus infection, celiac disease, or Helicobacter pylori infection. Nodular lymphoid hyperplasia generally presents as an asymptomatic disease, but it may cause gastrointestinal symptoms like abdominal pain, chronic diarrhea, bleeding or intestinal obstruction. A diagnosis is made at endoscopy or contrast barium studies and should be confirmed by histology. Its histological characteristics include markedly hyperplasic, mitotically active germinal centers and well-defined lymphocyte mantles found in the lamina propria and/or in the superficial submucosa, distributed in a diffuse or focal form. Treatment is directed towards associated conditions because the disorder itself generally requires no intervention. Nodular lymphoid hyperplasia is a risk factor for both intestinal and, very rarely, extraintestinal lymphoma. Some authors recommend surveillance, however, the duration and intervals are undefined. PMID:25400867

Albuquerque, Andreia

2014-11-16

326

Use of Provocative Angiography to Localize Site in Recurrent Gastrointestinal Bleeding  

SciTech Connect

Background. While the source of most cases of lower gastrointestinal bleeding may be diagnosed with modern radiological and endoscopic techniques, approximately 5% of patients remain who have negative endoscopic and radiological investigations.Clinical Problem. These patients require repeated hospital admissions and blood transfusions, and may proceed to exploratory laparotomy and intraoperative endoscopy. The personal and financial costs are significant. Method of Diagnosis and Decision Making. The technique of adding pharmacologic agents (anticoagulants, vasodilators, fibrinolytics) during standard angiographic protocols to induce a prohemorrhagic state is termed provocative angiography. It is best employed when significant bleeding would otherwise necessitate emergency surgery. Treatment. This practice frequently identifies a bleeding source (reported success rates range from 29 to 80%), which may then be treated at the same session. We report the case of a patient with chronic lower gastrointestinal hemorrhage with consistently negative endoscopic and radiological workup, who had an occult source of bleeding identified only after a provocative angiographic protocol was instituted, and who underwent succeeding therapeutic coil embolization of the bleeding vessel.

Johnston, Ciaran, E-mail: ciaranjohnston@yahoo.co.uk; Tuite, David [St. James' Hospital, Department of Radiology (Ireland); Pritchard, Ruth; Reynolds, John [St. James' Hospital, Department of Surgery (Ireland); McEniff, Niall; Ryan, J. Mark [St. James' Hospital, Department of Radiology (Ireland)

2007-09-15

327

Gastrointestinal citrate absorption in nephrolithiasis  

NASA Technical Reports Server (NTRS)

Gastrointestinal absorption of citrate was measured in stone patients with idiopathic hypocitraturia to determine if citrate malabsorption could account for low urinary citrate. Citrate absorption was measured directly from recovery of orally administered potassium citrate (40 mEq.) in the intestinal lavage fluid, using an intestinal washout technique. In 7 stone patients citrate absorption, serum citrate levels, peak citrate concentration in serum and area under the curve were not significantly different from those of 7 normal subjects. Citrate absorption was rapid and efficient in both groups, with 96 to 98% absorbed within 3 hours. The absorption of citrate was less efficient from a tablet preparation of potassium citrate than from a liquid preparation, probably due to a delayed release of citrate from wax matrix. However, citrate absorption from solid potassium citrate was still high at 91%, compared to 98% for a liquid preparation. Thus, hypocitraturia is unlikely to be due to an impaired gastrointestinal absorption of citrate in stone patients without overt bowel disease.

Fegan, J.; Khan, R.; Poindexter, J.; Pak, C. Y.

1992-01-01

328

Histopathology of gastrointestinal neuroendocrine neoplasms.  

PubMed

Gastrointestinal neuroendocrine neoplasms (GI-NENs) arise from neuroendocrine cells distributed mainly in the mucosa and submucosa of the gastrointestinal tract. In 2010, the World Health Organization (WHO) classification of NENs of the digestive system was changed, categorizing these tumors as grade 1 neuroendocrine tumor (NET), grade-2NET, neuroendocrine carcinoma (large- or small-cell type), or mixed adenoneuroendocrine carcinoma (MANEC). Such a classification is based on the Ki-67 index and mitotic count in histological material. For the accurate pathological diagnosis and grading of NENs, it is important to clearly recognize the characteristic histological features of GI-NENs and to understand the correct method of counting Ki-67 and mitoses. In this review, we focus on the histopathological features of GI-NENs, particularly regarding biopsy and cytological diagnoses, neuroendocrine markers, genetic and molecular features, and the evaluation of the Ki-67 index and mitotic count. In addition, we will address the histological features of GI-NEN in specific organs. PMID:23346552

Hirabayashi, Kenichi; Zamboni, Giuseppe; Nishi, Takayuki; Tanaka, Akira; Kajiwara, Hiroshi; Nakamura, Naoya

2013-01-01

329

Volume xx (200y), Number z, pp. 127 Virtual Endoscopy in Research and Clinical Practice  

E-print Network

Virtual endoscopy is among the most active topics in virtual medicine and medical imaging. It focuses research systems in virtually every commercial medical imaging software, but with a varying quality are navigation through the respective body organ and the orientation aids for the users. Furthermore, I

Bartz, Dirk

330

Volume 24 (2005), Number 1 pp. 117 Virtual Endoscopy in Research and Clinical Practice  

E-print Network

Virtual endoscopy is among the most active topics in virtual medicine and medical imaging. It focuses research systems in virtually every commercial medical imaging software, but with varying quality are navigation through the respective body organ and the orientation aids for the users. Furthermore, I

Bartz, Dirk

331

EUROGRAPHICS 2003 STAR State of The Art Report Virtual Endoscopy in Research and Clinical Practice  

E-print Network

@gris.uni-tuebingen.de Abstract Virtual endoscopy is among the most active topics in virtual medicine and medical imaging transferred from research systems in virtually every commercial medical imaging software, but with a varying systems. Among these issues are navigation through the respective body organ and the orientation aids

Bartz, Dirk

332

Can nasal endoscopy be used to predict residual symptoms after adenoidectomy for nasal obstruction?  

Microsoft Academic Search

Background: the efficacy of adenoidectomy in relieving nasal symptoms has been questioned. Although enlarged adenoids are often blamed for nasal obstruction, other causes can be missed if examination is not thorough. We suggest that endoscopy at the time of adenoidectomy may be useful to confirm large adenoids and exclude other causes, and the findings may help predict residual symptoms 2

Haytham Kubba; Brian J. G Bingham

2001-01-01

333

Morphometry of the canine intestine with reference to the use of double balloon endoscopy  

Microsoft Academic Search

Double balloon endoscopy (DBE) enables the diagnosis and treatment of small intestinal disease. The dog is a potential animal model for DBE training and also a candidate for the clinical application of this technique. However, the anatomy of the canine small intestine may limit the use of DBE by restricting the push-and-pull manoeuvres required for DBE. To establish what these

O. López Albors; D. Rojo; R. Sarriá; F. Soria; E. Pérez Cuadrado; R. Latorre

2011-01-01

334

Automated Image Rectification in Video-Endoscopy , Yuan-Fang Wang  

E-print Network

an endoscopy surgery, with large panning and rotation of the scope, deduce the amount of the about has increased the difficulty of performing the procedures for the surgeon. E.g. in open surgery is established through the understanding of the anatomy. A large, about-the-axis rotation of the scope

Wang, Yuan-Fang

335

Do Clinical Characteristics Predict the Presence of Small Bowel Angioectasias on Capsule Endoscopy?  

Microsoft Academic Search

Background and Aims  Angioectasias (AVMs) are the most common vascular anomaly of the gastrointestinal (GI) tract, and these lesions are often\\u000a associated with obscure gastrointestinal bleeding (OGIB). It is unknown if the presence of upper and\\/or lower gastrointestinal\\u000a AVMs are predictive of small bowel AVMs. The aims of this study are to define the small bowel segmental distribution of AVMs\\u000a and

Anthony T. DeBenedet; Sameer D. Saini; Mimi Takami; Laurel R. Fisher

2011-01-01

336

What's New in Gastrointestinal Stromal Tumor Research and Treatment?  

MedlinePLUS

... Topic Additional resources for gastrointestinal stromal tumor What’s new in gastrointestinal stromal tumor research and treatment? There ... GIST) Talking With Your Doctor After Treatment What`s New in Gastrointestinal Stromal Tumor (GIST) Research? Other Resources ...

337

Bench to Bedside Primer: The Gastrointestinal System and Gastrointestinal Disease  

NSDL National Science Digital Library

This bench-to-bedside is a four-page ÃÂprimerÃÂ (a booklet of basic principles) that highlights gastrointestinal (GI) physiology. This primer should be readable by your students or the general public to help inform them about the organ system, diseases that affect it, and basic and clinical research being done on it. It could also be used as a teaching model your students could follow in creating their own bench-to-beside primer.This teaching resource was developed by a K-12 science teacher in the American Physiological SocietyÃÂs 2011 Frontiers Online in Physiology Program. For more information on this program, please visit www.frontiersinphys.org.

Katie Anderson (Dakota Middle School)

2011-10-07

338

Gastrointestinal hemangioma in childhood: a rare cause of gastrointestinal bleeding.  

PubMed

Gastrointestinal (GI) hemangiomas are relatively rare benign vascular tumors. The choice of an appropriate diagnostic method depends on patient age, anatomic location, and presenting symptoms. However, GI hemangiomas are not a common suspected cause of GI bleeding in children because of their rarity. Based on medical history, laboratory results, and imaging study findings, the patient could be treated with either medication or surgery. Herein, we report 3 cases of GI hemangioma found in the small bowel, rectum, and GI tract (multiple hemangiomas). Better knowledge and understanding of GI hemangioma could help reduce the delayed diagnosis rate and prevent inappropriate management. Although rare, GI hemangiomas should be considered in the differential diagnosis of GI bleeding. PMID:25045368

Han, Eon Chul; Kim, Soo-Hong; Kim, Hyun-Young; Jung, Sung-Eun; Park, Kwi-Won

2014-05-01

339

Gastrointestinal hemangioma in childhood: a rare cause of gastrointestinal bleeding  

PubMed Central

Gastrointestinal (GI) hemangiomas are relatively rare benign vascular tumors. The choice of an appropriate diagnostic method depends on patient age, anatomic location, and presenting symptoms. However, GI hemangiomas are not a common suspected cause of GI bleeding in children because of their rarity. Based on medical history, laboratory results, and imaging study findings, the patient could be treated with either medication or surgery. Herein, we report 3 cases of GI hemangioma found in the small bowel, rectum, and GI tract (multiple hemangiomas). Better knowledge and understanding of GI hemangioma could help reduce the delayed diagnosis rate and prevent inappropriate management. Although rare, GI hemangiomas should be considered in the differential diagnosis of GI bleeding. PMID:25045368

Han, Eon Chul; Kim, Soo-Hong; Jung, Sung-Eun; Park, Kwi-Won

2014-01-01

340

Assessment and management of gastrointestinal (GI) haemorrhage  

Microsoft Academic Search

Acute gastrointestinal (GI) bleeding is both a common reason for hospital attendance and a common occurrence in hospitalized patients. Acute upper gastrointestinal haemorrhage (AUGH) is much more likely to be responsible for profuse or life-threatening bleeding than is lower GI haemorrhage. Despite advances in endoscopic and pharmacological treatments, AUGH still carries an overall mortality of around 10%. Prompt assessment and

Andrew R. Moore; Anthony I. Morris

2008-01-01

341

Less frequent causes of upper gastrointestinal bleeding.  

PubMed

Although they account for a minority of episodes of upper gastrointestinal bleeding, the awareness of less frequent causes of upper gastrointestinal bleeding can be crucial to the endoscopist in the evaluation of the patient with bleeding. This review discusses the Dieulafoy lesion, hemobilia, gastric antral vascular ectasia, Mallory-Weiss tear, and gastroduodenal arteriovenous malformation. PMID:8307643

Katz, P O; Salas, L

1993-12-01

342

Pediatric and Adolescent Gastrointestinal Motility & Pain Program  

E-print Network

Pediatric and Adolescent Gastrointestinal Motility & Pain Program Department of Pediatrics% of visits to the pediatric gastroenterologist. Constipation is a problem for about 1 in 6 children at some pediatric functional gastrointestinal disorders that prompt parents to bring their child to the doctor

343

Upper gastrointestinal disease in rheumatoid arthritis  

Microsoft Academic Search

Upper gastrointestinal series were done in 140 consecutive patients with rheumatoid arthritis, irrespective of the presence or absence of symptoms suggesting upper gastrointestinal disease. In addition, intraluminal pH and manometric studies of the esophagus and esophagoscopy were done in 66 of these 140 patients. Gastric ulcers were found in 12 patients, and duodenal ulcers in 27, an incidence of peptic

David C. H. Sun; Sanford H. Roth; Charles S. Mitchell; DeWitt W. Englund

1974-01-01

344

Nitric oxide in gastrointestinal health and disease  

Microsoft Academic Search

Nitric oxide is an intracellular and intercellular messenger with important functions in a number of physiologic and pathobiologic processes within gastroenterology and hepatology, including gastrointestinal tract motility, mucosal function, inflammatory responses, gastrointestinal malignancy, and blood flow regulation. Since the broad review of this topic in Gastroenterology more than 10 years ago, a number of advances have been made in the

Vijay Shah; Greg Lyford; Greg Gores; Gianrico Farrugia

2004-01-01

345

Original Article Gastrointestinal Stem Cells and Cancer--  

E-print Network

of advances in the Introduction The cells that line the gastrointestinal tract are among the most rapidlyOriginal Article Gastrointestinal Stem Cells and Cancer-- Bridging the Molecular Gap S.J. Leedham Cancer is believed to be a disease involving stem cells. The digestive tract has a very high cancer

Dove, William

346

Moderate Alcohol Consumption and the Gastrointestinal Tract  

Microsoft Academic Search

Background: A high alcohol intake is significantly associated with diseases of the gastrointestinal tract, but less is known about the effects of moderate consumption, specifically moderate average volume of alcohol consumption. Methods: A systematic computer-assisted literature review was completed in order to review current scientific knowledge surrounding this topic. Results: Moderate alcohol consumption is associated with a number of gastrointestinal

Benjamin Taylor; Jürgen Rehm; Gerhard Gmel

2005-01-01

347

Assessment of Gastrointestinal Sensation – A Review  

Microsoft Academic Search

Understanding the mechanisms of symptoms in patients with gastrointestinal disorders remains a great challenge. One of the major problems facing clinicians in this area is the limited information gained from subjective outcome measures commonly used to assess these conditions. To address this, various stimulation and recording techniques, commonly used by neurologists, have been adapted to study gastrointestinal sensory processing. This

Anthony R. Hobson; Qasim Aziz

2006-01-01

348

Jejunal diverticulosis - rare cause of gastrointestinal bleed.  

PubMed

Jejunal diverticulosis was first described by Somerling in 1794 and by Sir Astley Cooper in 1807. Jejunal diverticula are rare. Hemorrhage from jejunal diverticula usually presents as gastrointestinal bleeding. Here, we present a case of severe gastrointestinal bleeding presenting as malena due to jejunal diverticulosis. PMID:24799777

Shetty, Shiran; Balasundaram, Priyanka; Muthuraman, M; Leelakrishnan, Venkatakrishnan

2014-02-01

349

INTRODUCTION Morphology and physiology of the gastrointestinal tract show several  

E-print Network

3981 INTRODUCTION Morphology and physiology of the gastrointestinal tract show several adaptations digestive capacity could allow some energy and nutrients to escape the gastrointestinal tract unutilized

Mladenoff, David

350

Epigenetic Events in Gastrointestinal Cancer  

PubMed Central

Epigenetics refers to heritable changes in gene expression that are, unlike mutations, not attributable to alterations in DNA sequence. Two predominant epigenetic mechanisms are DNA methylation and histone modification. Epigenetic regulation of gene expression has emerged as a fundamental pathway in the pathogenesis of numerous malignancies, including cancers of the digestive system—in fact, many exciting discoveries in epigenetics have come out of the study of cancers of the gastrointestinal tract and hepatobiliary tree. Epigenetic modifications of DNA in cancer and precancerous lesions offer the promise of novel biomarkers for early cancer detection, prediction, prognosis, and response to treatment. Furthermore, reversal of epigenetic changes represents a potential target of novel therapeutic strategies and medication design. In the future, innovative diagnostic tests and treatment regimens will likely be based on epigenetic mechanisms and be incorporated into the gastroenterologist’s practice. PMID:19661933

Selaru, Florin M.; David, Stefan; Meltzer, Stephen J.; Hamilton, James P.

2010-01-01

351

Epigenetic events in gastrointestinal cancer.  

PubMed

Epigenetics refers to heritable changes in gene expression that are, unlike mutations, not attributable to alterations in DNA sequence. Two predominant epigenetic mechanisms are DNA methylation and histone modification. Epigenetic regulation of gene expression has emerged as a fundamental pathway in the pathogenesis of numerous malignancies, including cancers of the digestive system-in fact, many exciting discoveries in epigenetics have come out of the study of cancers of the gastrointestinal tract and hepatobiliary tree. Epigenetic modifications of DNA in cancer and precancerous lesions offer the promise of novel biomarkers for early cancer detection, prediction, prognosis, and response to treatment. Furthermore, reversal of epigenetic changes represents a potential target of novel therapeutic strategies and medication design. In the future, innovative diagnostic tests and treatment regimens will likely be based on epigenetic mechanisms and be incorporated into the gastroenterologist's practice. PMID:19661933

Selaru, Florin M; David, Stefan; Meltzer, Stephen J; Hamilton, James P

2009-08-01

352

Pathology of Gastrointestinal Stromal Tumors  

PubMed Central

Gastrointestinal stromal tumor (GIST) is a well recognized and relatively well understood soft tissue tumor. Early events in GIST development are activating mutations in KIT or PDGFRA, which occur in most GISTs and encode for mutated tyrosine receptor kinases that are therapeutic targets for tyrosine kinase inhibitors, including imatinib and sunitinib. A small minority of GISTs possessing neither KIT nor PDGFRA mutations may have germline mutations in SDH, suggesting a potential role of SDH in the pathogenesis. Immunohistochemical detection of KIT, and more recently DOG1, has proven to be reliable and useful in the diagnosis of GISTs. Because current and future therapies depend on pathologists, it is important that they recognize KIT-negative GISTs, GISTs in specific clinical contexts, GISTs with unusual morphology, and GISTs after treatment. This review focuses on recent developments in the understanding of the biology, immunohistochemical diagnosis, the role of molecular analysis, and risk assessment of GISTs. PMID:22855636

Foo, Wai Chin; Liegl-Atzwanger, Bernadette; Lazar, Alexander J.

2012-01-01

353

Neuropathophysiology of functional gastrointestinal disorders  

PubMed Central

The investigative evidence and emerging concepts in neurogastroenterology implicate dysfunctions at the levels of the enteric and central nervous systems as underlying causes of the prominent symptoms of many of the functional gastrointestinal disorders. Neurogastroenterological research aims for improved understanding of the physiology and pathophysiology of the digestive subsystems from which the arrays of functional symptoms emerge. The key subsystems for defecation-related symptoms and visceral hyper-sensitivity are the intestinal secretory glands, the musculature and the nervous system that controls and integrates their activity. Abdominal pain and discomfort arising from these systems adds the dimension of sensory neurophysiology. This review details current concepts for the underlying pathophysiology in terms of the physiology of intestinal secretion, motility, nervous control, sensing function, immuno-neural communication and the brain-gut axis. PMID:17457962

Wood, Jackie D

2007-01-01

354

Early detection of acute graft-versus-host disease by wireless capsule endoscopy and probe-based confocal laser endomicroscopy: results of a pilot study  

PubMed Central

Objective Acute gastrointestinal graft-versus-host disease (GI-GVHD) is usually diagnosed using endoscopic examinations and biopsies for conventional histology. The aim of this pilot study was to determine whether mini-invasive techniques such as probe-based confocal laser endomicroscopy (pCLE) combined with wireless capsule endoscopy (WCE) could detect early lesions of GI-GVHD prior to symptoms. Design Fifteen patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) were prospectively examined with a small bowel WCE, duodenal and colorectal pCLE, and standard biopsies. Per study protocol, all these examinations were scheduled between day 21 and day 28 after allo-HSCT, independently of the presence or absence of digestive symptoms. Results During follow up, eight patients developed acute GI-GVHD. Sensitivity of WCE, pCLE, and histology were 50, 87.5, and 50%, respectively. Specificity of WCE, pCLE, and histology were 80, 71.5, and 80%, respectively. We showed a positive correlation between the Glücksberg scoring system and WCE (rho?=?0.543, p?=?0.036) and pCLE (rho?=?0.727, p?=?0.002) but not with standard histology (rho?=?0.481, p?=?0.069). Conclusions The results from this pilot study suggest that novel methods such as pCLE and WCE could be part of a mini-invasive algorithm for early detection of GI-GVHD.

Laurent, Valerie; Malard, Florent; Le Rhun, Marc; Chevallier, Patrice; Guillaume, Thierry; Mosnier, Jean-Francois; Galmiche, Jean-Paul; Mohty, Mohamad

2014-01-01

355

Gastrointestinal miniprobe sonography: the current status  

Microsoft Academic Search

Endoscopic ultrasonography (EUS) represents a major advance in endoscopic imaging. The usefulness and effectiveness of EUS have been established during the past few years. However, endosonography using dedicated echoendoscopes (7.5\\/12 MHz) has some serious drawbacks, as follows: 1) Combining endoscopy and ultrasonography in one instrument increases the diameter of such echoendoscopes (12–13 mm); 2) Because of the large diameter, complete

Josef Menzel; Wolfram Domschke

2000-01-01

356

Clinical and psychosocial variables associated with behavioral intentions to undergo surveillance endoscopy  

PubMed Central

Background Many patients with Barrett’s esophagus do not adhere to guideline-recommended endoscopic surveillance. Among patient factors related to cancer prevention behaviors, patients’ stated behavioral intention is a strong predictor of behavior performance. Little is known about the patient factors associated with having a strong behavioral intention to pursue surveillance endoscopy. This study explores the association of clinical and psychosocial variables and behavioral intention to pursue surveillance endoscopy among patients with Barrett’s Esophagus and no or low-grade dysplasia. Methods Potential subjects were screened using electronic medical records of a regional Veterans Affairs Medical Center and a pathologically confirmed Barrett’s esophagus registry. Eligible participants were recruited by a mailer or phone call and completed a questionnaire to measure six distinct psychosocial factors, their behavioral intention to undergo surveillance endoscopy, and various demographic and clinical variables. Univariate and multivariate linear regression identified the relation of behavioral intention with each of six psychosocial variables. Results One-hundred and one subjects consented and returned surveys. The analytical sample for this study consists of the 94% of surveys with complete responses to the behavior intention items. Three of the six psychosocial domains were statistically significant predictors of intention in both univariate and adjusted univariate analysis (salience/coherence ??=?0.59, 95% CI?=?0.45-0.76, P <0.01; self-efficacy ??=?0.30, 95% CI?=?0.10-0.51, P <0.01; and social influence ??=?0.20, 95% CI?=?0.08-0.33, P <0.01). In a multivariate analysis only salience/coherence (??=?0.65, 95% CI?=?0.42-0.88, P <0.01) remained statistically significant predictor of intention. Conclusion This study established the validity of a scale to measure psychosocial variables associated with behavioral intentions to undergo surveillance endoscopy. Results demonstrate the importance of assessing self-efficacy, social influences, and bottom-line belief in the value of surveillance endoscopy when evaluating a patient’s likelihood of completing surveillance endoscopy. PMID:24916457

2014-01-01

357

Laparoscopic management of gastric gastrointestinal stromal tumors.  

PubMed

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-07-16

358

Laparoscopic management of gastric gastrointestinal stromal tumors  

PubMed Central

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-01-01

359

Current therapy for nonvariceal upper gastrointestinal bleeding.  

PubMed

Upper gastrointestinal bleeding continues to plague physicians despite the discovery of Helicobacter pylori and advances in medical therapy for peptic ulcer disease. Medical therapy with new nonsteroidal anti-inflammatory medications and somatostatin/octreotide and intravenous proton pump inhibitors provides hope for reducing the incidence of and treating bleeding peptic ulcer disease. Endoscopic therapy remains the mainstay for diagnosis and treatment of upper gastrointestinal bleeding. Many methods of endoscopic hemostasis have proven useful in upper gastrointestinal hemorrhage. Currently, combination therapy with epinephrine injection and bicap or heater probe therapy is most commonly employed in the United States. Angiography and embolization play a role primarily when endoscopic therapy is unsuccessful. PMID:14625723

Blocksom, J M; Tokioka, S; Sugawa, C

2004-02-01

360

Carbonic anhydrases in normal gastrointestinal tract and gastrointestinal tumours  

PubMed Central

Carbonic anhydrases (CAs) catalyse the hydration of CO2 to bicarbonate at physiological pH. This chemical interconversion is crucial since HCO3- is the substrate for several biosynthetic reactions. This review is focused on the distribution and role of CA isoenzymes in both normal and pathological gastrointestinal (GI) tract tissues. It has been known for many years that CAs are widely present in the GI tract and play important roles in several physiological functions such as production of saliva, gastric acid, bile, and pancreatic juice as well as in absorption of salt and water in intestine. New information suggests that these enzymes participate in several processes that were not envisioned earlier. Especially, the recent reports on plasma membrane-bound isoenzymes IX and XII have raised considerable interest since they were reported to participate in cancer invasion and spread. They are induced by tumour hypoxia and may also play a role in von Hippel-Lindau (VHL)-mediated carcinogenesis. PMID:15633208

Kivela, Antti J.; Kivela, Jyrki; Saarnio, Juha; Parkkila, Seppo

2005-01-01

361

A benign gastric ulcer eroding into a splenic artery pseudoaneurysm presenting as a massive upper gastrointestinal bleed  

PubMed Central

Upper gastrointestinal (UGI) bleeding secondary to a ruptured splenic artery (SA) pseudoaneurysm into the stomach is a rare but a life-threatening condition. Owing to the low prevalence, it remains a diagnostic and therapeutic challenge. A frail 77-year-old Caucasian female presented with epigastric pain and hematemesis. Endoscopy was non-diagnostic for an etiology. She then underwent diagnostic angiography that revealed an SA pseudoaneurysm with active contrast extravasation into the stomach. Subsequent transcatheter arterial coil embolization was conducted of the SA. The patient was subsequently taken for a partial gastrectomy, distal pancreatectomy and splenectomy. She had an uncomplicated postoperative course. Diagnosis of an UGI bleeding secondary to a ruptured SA pseudoaneurysm into the stomach remains difficult. However, we report that in a hemodynamically stable patient, a multidisciplinary approach can be taken, with interval optimization of the patient prior to definitive surgery for a satisfactory outcome.

Syed, Shareef M.; Moradian, Simon; Ahmed, Mohammed; Ahmed, Umair; Shaheen, Samuel; Stalin, Vasanth

2014-01-01

362

Comparison of virtual and conventional endoscopy of nose and paranasal sinuses.  

PubMed

We compared computed tomographic virtual rhinosinus endoscopy (VRS) and conventional fiberoptic endoscopy (FE) for the detection of inflammatory-obstructive rhinosinusal disease. We recruited 158 patients; 100 (group A) had inflammatory-obstructive rhinosinus disease, and 58 (group B) had a history of rhinosinus surgery. All patients underwent VRS within 2 to 6 hours of FE, and VRS was able to demonstrate the anatomic details of the nasal fossa and rhinopharynx with a high correspondence to FE. A satisfying representation of anatomic detail was found in both groups A and B. The VRS was able to visualize invasiveness of the endosinusal cavities, which was not accessible to FE. The VRS is a fast, relatively easy, and noninvasive technique that could be integrated into FE or used as an alternative when FE is unfeasible. Because of the ability to explore the sinus cavity, we suggest that virtual rhinosinusoscopy should be considered as the appropriate term, instead of virtual rhinoscopy. PMID:12597286

Di Rienzo, Lino; Coen Tirelli, Guido; Turchio, Piergiorgio; Garaci, Francesco; Guazzaroni, Marco

2003-02-01

363

Streaming video-based 3D reconstruction method compatible with existing monoscopic and stereoscopic endoscopy systems  

NASA Astrophysics Data System (ADS)

Compared to open surgery, minimal invasive surgery offers reduced trauma and faster recovery. However, lack of direct view limits space perception. Stereo-endoscopy improves depth perception, but is still restricted to the direct endoscopic field-of-view. We describe a novel technology that reconstructs 3D-panoramas from endoscopic video streams providing a much wider cumulative overview. The method is compatible with any endoscope. We demonstrate that it is possible to generate photorealistic 3D-environments from mono- and stereoscopic endoscopy. The resulting 3D-reconstructions can be directly applied in simulators and e-learning. Extended to real-time processing, the method looks promising for telesurgery or other remote vision-guided tasks.

Bouma, Henri; van der Mark, Wannes; Eendebak, Pieter T.; Landsmeer, Sander H.; van Eekeren, Adam W. M.; ter Haar, Frank B.; Wieringa, F. Pieter; van Basten, Jean-Paul

2012-06-01

364

Prediction scores or gastroenterologists' Gut Feeling for triaging patients that present with acute upper gastrointestinal bleeding  

PubMed Central

Introduction Several prediction scores for triaging patients with upper gastrointestinal (GI) bleeding have been developed, yet these scores have never been compared to the current gold standard, which is the clinical evaluation by a gastroenterologist. The aim of this study was to assess the added value of prediction scores to gastroenterologists’ Gut Feeling in patients with a suspected upper GI bleeding. Methods We prospectively evaluated Gut Feeling of senior gastroenterologists and asked them to estimate: (1) the risk that a clinical intervention is needed; (2) the risk of rebleeding; and (3) the risk of mortality in patients presenting with suspected upper GI bleeding, subdivided into low, medium, or high risk. The predictive value of the gastroenterologists’ Gut Feeling was compared to the Blatchford and Rockall scores for various outcomes. Results We included 974 patients, of which 667 patients (68.8%) underwent a clinical intervention. During the 30-day follow up, 140 patients (14.4%) developed recurrent bleeding and 44 patients (4.5%) died. Gut Feeling was independently associated with all studied outcomes, except for the predicted mortality after endoscopy. Predictive power, based on the AUC of the Blatchford and Rockall prediction scores, was higher than the Gut Feeling of the gastroenterologists. However, combining both the Blatchford and Rockall scores and the Gut Feeling yielded the highest predictive power for the need of an intervention (AUC 0.88), rebleeding (AUC 0.73), and mortality (AUC 0.71 predicted before and 0.77 predicted after endoscopy, respectively). Conclusions Gut Feeling is an independent predictor for the need of a clinical intervention, rebleeding, and mortality in patients presenting with upper GI bleeding; however, the Blatchford and Rockall scores are stronger predictors for these outcomes. Combining Gut Feeling with the Blatchford and Rockall scores resulted in the most optimal prediction.

van Oijen, MGH; Kessels, K; Hemmink, M; Weusten, BLAM; Timmer, R; Hazen, WL; van Lelyveld, N; Vermeijden, JR; Curvers, WL; Baak, LC; Verburg, R; Bosman, JH; de Wijkerslooth, LRH; de Rooij, J; Venneman, NG; Pennings, M; van Hee, K; Scheffer, RCH; van Eijk, RL; Meiland, R; Siersema, PD; Bredenoord, AJ

2014-01-01

365

Unexpected FDG-PET uptake in the gastrointestinal tract: Endoscopic and histopathological correlations  

PubMed Central

AIM: To investigate the nature and significance of unexpected positron emission tomography with fluorodeoxyglucose (FDG-PET) uptake within the gastrointestinal tract (GIT). METHODS: Patients with unexpected FDG-PET findings in the GIT were evaluated. All patients had a previous confirmed malignancy, either solid or lymphoproliferative. The radiologic reports were performed by experienced radiologists with an exclusive PET expertise. Endoscopy, i.e., esophagogastroduodenoscopy (EGD) and colonoscopy, and histopathological evaluation of all findings was performed in all patients in accordance to the FDG-PET results. The findings from each of these modalities were compared to each other. Both clinically significant and insignificant findings were assessed. RESULTS: Seventy-two patients were endoscopically evaluated. Twenty-seven patients (37.5%) had primarily a lymphoproliferative tumor and 45 (62.5%) had solid tumors. In 50 patients (69.4%) the endoscopic examination revealed lesions in the same anatomical areas as the FDG-PET findings. Among these 50 patients, malignant and premalignant lesions i.e., adenomatous polyps were found in 16 (32%) and 9 (18%) patients, respectively. Inflammation was noted in an additional 20 patients (40%). Compared to primary solid tumors, a background of primary lymphoproliferative malignancy was more likely to reveal an additional primary malignancy (15.6% vs 33.3%, respectively, P < 0.01). EGD compared to colonoscopy, revealed altogether 11 (25.6%) new malignancies compared to 5 (17.2%), respectively, P = 0.12. No GIT clinically significant findings were overseen by the FDG-PET. CONCLUSION: Unexpected FDG uptake in the GIT is commonly encountered and may contain significant findings. Endoscopy evaluation is justified in order to detect these additional findings. PMID:24764676

Goldin, Eran; Mahamid, Mahmud; Koslowsky, Benjamin; Shteingart, Shimon; Dubner, Yael; Lalazar, Gadi; Wengrower, Dov

2014-01-01

366

Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions  

PubMed Central

Objective Highly sensitive guaiac-based faecal occult blood (Hemoccult SENSA) and Helicobacter pylori stool antigen testing might help detect upper gastrointestinal lesions when appended to a colorectal cancer screening programme with faecal immunochemical testing. We evaluated the diagnostic accuracies of two stool tests in detecting upper gastrointestinal lesions. Design Cross-sectional design. Setting Hospital-based and community-based screening settings. Participants A hospital-based deviation cohort of 3172 participants to evaluate test performance and a community-based validation cohort of 3621 to verify the findings. Interventions Three types of stool tests with bidirectional endoscopy as the reference standard. Outcomes Sensitivity, specificity and positive and negative likelihood ratios. Results For detecting upper gastrointestinal lesions in cases with negative immunochemical tests, the sensitivity, specificity, and positive and negative likelihood ratios of the guaiac-based and H pylori antigen tests were 16.3% (95% CI 13.3% to 19.8%), 90.1% (88.9% to 91.2%), 1.64 (1.31 to 2.07), and 0.93 (0.89 to 0.97), respectively, and 52.5% (48.1% to 56.9%), 80.6% (79.0% to 82.1%), 2.71 (2.41 to 3.04) and 0.59 (0.54 to 0.65), respectively. For detecting upper gastrointestinal lesions in cases with normal colonoscopy, the results of the guaiac-based and H pylori antigen tests were 17.9% (14.8% to 21.5%), 90.1% (88.9% to 91.2%), 1.81 (1.45 to 2.26) and 0.91 (0.87 to 0.95), respectively, and 53.1% (48.6% to 57.4%), 80.7% (79.1% to 82.2%), 2.75 (2.45 to 3.08) and 0.58 (0.53 to 0.64), respectively. Within the community, positive predictive values of the immunochemical and H pylori antigen tests were 36.0% (26.0% to 46.0%) and 31.9% (28.3% to 35.5%), respectively, for detecting lower and upper gastrointestinal lesions, which were similar to expected values. Conclusions The H pylori stool antigen test is more accurate than the guaiac-based test in the screening of upper gastrointestinal lesions in a population with high prevalence of H pylori infection and upper gastrointestinal lesions. It is applicable to add the H pylori antigen test to the immunochemical test for pan detection. Trial registration NCT01341197 (ClinicalTrial.gov). PMID:24176798

Lee, Yi-Chia; Chiu, Han-Mo; Chiang, Tsung-Hsien; Yen, Amy Ming-Fang; Chiu, Sherry Yueh-Hsia; Chen, Sam Li-Sheng; Fann, Jean Ching-Yuan; Yeh, Yen-Po; Liao, Chao-Sheng; Hu, Tsung-Hui; Tu, Chia-Hung; Tseng, Ping-Huei; Chen, Chien-Chuan; Chen, Mei-Jyh; Liou, Jyh-Ming; Liao, Wei-Chih; Lai, Yo-Ping; Wang, Chen-Ping; Ko, Jenq-Yuh; Wang, Hsiu-Po; Chiang, Hung; Lin, Jaw-Town; Chen, Hsiu-Hsi; Wu, Ming-Shiang

2013-01-01

367

Three-dimensional echocardiographic virtual endoscopy for the diagnosis of congenital heart disease in children  

Microsoft Academic Search

Virtual endoscopy (VE) is a new post-processing method that uses volumetric data sets to simulate the tracks of a “conventional”\\u000a flexible endoscope. However, almost all studies of this method have involved virtual visualizations of the cardiovascular\\u000a structures applied to computed tomography (CT) and magnetic resonance (MR) datasets. This paper introduces a novel visualization\\u000a method called the “three-dimensional echocardiographic intracardiac endoscopic

Haihong XueKun; Kun Sun; Jianguo Yu; Binjin Chen; Guozhen Chen; Wenjing Hong; Liping Yao; Lanping Wu

2010-01-01

368

New applications for endoscopy: the emerging field of endoluminal and transgastric bariatric surgery  

Microsoft Academic Search

Endoluminal and transgastric procedures are evolving concepts that combine the skills and techniques of flexible endoscopy\\u000a with minimally invasive surgery. Precisely how this technology and skill set will be applied in the field of general surgery\\u000a is not yet known, but the treatment of obesity with an endoluminal or transgastric procedure holds great promise. As the demand\\u000a for bariatric surgery

P. Schauer; B. Chand; S. Brethauer

2007-01-01

369

Effectiveness and safety of endoscopy for treatment of surgical site infection: A randomized control trial  

PubMed Central

The aim of this randomized control study was to evaluate the effectiveness and safety of endoscopy for the treatment of surgical site infection (SSI), compared with conventional therapy. One hundred and six patients who were diagnosed with severe SSI were included in the study, performed from May 2005 to July 2012 at Tianjin Binhai New Area Dagang Hospital, China. Patients were randomly divided into two groups: 57 patients in group A treated by endoscopy and 49 patients in group B treated by conventional therapy for SSI. The primary outcome was the healing period of the wound; the secondary outcomes were the blood loss following surgery, visual analog scale (VAS) measurement, volume of irrigation saline during surgery, rate of skin transplantation, length of hospital stay and other complications. The mean wound healing time was significantly less in group A (10.0±2.5 days) than in group B (19.4±5.2 days). The mean VAS score 7 days after surgery in group A was significantly less compared with group B. The intra-operative blood loss, intra-operative volume of irrigation saline and length of the hospital stay were significantly reduced in group A compared with group B. No significant differences between the groups were revealed in terms of the duration of surgery and the clinical complications. This study demonstrated that the endoscopy procedure for the treatment of SSI reduces the wound healing time compared with that of traditional surgery, without increasing any risk of clinical events. The present study showed that endoscopy was not only effective but also safe in the therapy of serious SSI. However, a further randomized control trial is necessary to testify our conclusions. PMID:25371723

WANG, HAILONG; DOU, XINLI; HU, XIANGPING; YU, JINSHENG; WANG, SHAOSHAN

2014-01-01

370

Capsule Endoscopy in a Patient with an Implanted CCM System and an Implantable Defibrillator  

PubMed Central

Wireless video capsule endoscopy (CE) is a modern diagnostic tool. Because of its use of digital radiofrequency, it is still relatively contraindicated in patients with implanted cardiac devices. We report the case of a patient with an Optimizer III system delivering cardiac contractility modulating signals (CCM) for heart failure therapy and an implantable cardioverter defibrillator (ICD) who underwent CE. No interferences between the devices were found. PMID:24940511

Streitner, Florian; Schoene, Nina; Borggrefe, Martin; Kuschyk, Jurgen

2011-01-01

371

A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease  

Microsoft Academic Search

Background & Aims: This study was undertaken to prospectively compare the clinical outcomes of small bowel radiographs with the wireless capsule endoscopy. Methods: Twenty-two patients were selected consecutively because of suspected small bowel disease. Two patients were excluded owing to ileal stenosis. Thus, the results of barium follow-through and the Given M2A wireless video capsule (Given Imaging Ltd., Yoqneam, Israel)

Guido Costamagna; Saumil K. Shah; Maria Elena Riccioni; Francesca Foschia; Massimiliano Mutignani; Vincenzo Perri; Amorino Vecchioli; Maria Gabriella Brizi; Aurelio Picciocchi; Pasquale Marano

2002-01-01

372

Occult and obscure gastrointestinal bleeding: causes and clinical management  

Microsoft Academic Search

Occult gastrointestinal bleeding, defined as bleeding that is unknown to the patient, is the most common form of gastrointestinal bleeding and can be caused by virtually any lesion in the gastrointestinal tract. Patients with occult gastrointestinal bleeding include those with fecal occult blood and iron-deficiency anemia (IDA). In men and postmenopausal women, IDA should be considered to be the result

Don C. Rockey

2010-01-01

373

Evaluation of the gastrointestinal tract in dogs using computed tomography.  

PubMed

Abdominal computed tomography (CT) studies of 19 dogs with no history or clinical signs of gastrointestinal disease, and two dogs with a histological diagnosis of gastrointestinal neoplasia were examined retrospectively. Gastrointestinal segments were evaluated subjectively for conspicuity, contrast enhancement, and wall layering after contrast medium administration. In dogs without gastrointestinal disease, there were 62.8% of gastrointestinal segments (serosa to serosa) and 77.7% of gastrointestinal walls (serosa to mucosa) visualized. Wall layering on postcontrast images was seen in 21.8% of gastrointestinal segments. There was significant association between gastrointestinal diameter and wall thickness. There was significant association between weight and gastrointestinal wall thickness in the following regions: gastric fundus, gastric body, gastric pylorus, gastric pyloric antrum, duodenal cranial flexure, jejunum and ascending colon, and between patient weight and gastrointestinal diameter in cranial duodenal flexure, descending duodenum, transverse duodenum, ascending duodenum, and jejunum. Measurements acquired from CT studies correlated well with previously published normal reference ranges for radiographic and ultrasonographic studies. Gastrointestinal neoplasia, diagnosed in two dogs, had a gastrointestinal wall thickness greater than the range of the dogs without gastrointestinal disease. Computed tomography offers identification of the gastrointestinal tract segments in dogs, allows for evaluation of gastrointestinal diameter and aids in investigation of gastrointestinal wall thickness. PMID:22985215

Hoey, Seamus; Drees, Randi; Hetzel, Scott

2013-01-01

374

2011 Update in Gastrointestinal Cancer Therapeutics  

PubMed Central

ABSTRACT This discussion highlights key investigational findings of existing cytotoxic and novel biological therapeutics, combination regimens, and predictive and prognostic biomarkers in the field of gastrointestinal oncology during the past year. PMID:23077682

Sahai, Vaibhav; Nimeiri, Halla

2012-01-01

375

Equine gastrointestinal motility -- ileus and pharmacological modification  

PubMed Central

Abstract Colic is a common problem encountered in equine practice. Alteration of gastrointestinal motility is often the underlying cause for abdominal pain. Gastrointestinal motility can be measured as myoelectric activity, mechanical activity, and transit of intraluminal contents. Regulation of motility is based on a complex interaction between central innervation, autonomic innervation, and the enteric nervous system. Various humoral and neurochemical substances are required to interact flawlessly to allow propulsive motility. Ileus is defined as the absence of propulsive aboral movement of gastrointestinal contents, irrespective of its pathophysiology. Potential etiologies for ileus are described in this review. The prokinetic drugs available for clinical use are discussed. Choosing the appropriate prokinetic drug requires knowledge about the complex nature of gastrointestinal motility and its abnormalities. PMID:16808227

Cote, Nathalie

2006-01-01

376

Other Gastrointestinal Cancers - Featured Clinical Trials  

Cancer.gov

Other Gastrointestinal Cancers - Featured Clinical Trials The following list shows Featured Clinical Trials for a specific type of cancer. You may also want to view: Multiple Cancer Types - Featured Clinical Trials Supportive Care - Featured Clinical

377

Drugs Approved for Gastrointestinal Stromal Tumors  

Cancer.gov

This page lists cancer drugs approved by the Food and Drug Administration (FDA) for gastrointestinal stromal tumors (GIST). The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

378

Rate and yield of repeat upper endoscopy in patients with dyspepsia  

PubMed Central

AIM: To determine the rate and yield of repeat esophagogastroduodenoscopy (EGD) for dyspepsia in clinical practice, whether second opinions drive its use, and whether it is performed at the expense of colorectal cancer screening. METHODS: We performed a retrospective cohort study of all patients who underwent repeat EGD for dyspepsia from 1996 to 2006 at the University of California, San Francisco endoscopy service. RESULTS: Of 24 780 EGDs, 5460 (22%) were performed for dyspepsia in 4873 patients. Of these, 451 patients (9.3%) underwent repeat EGD for dyspepsia at a median 1.7 (interquartile range, 0.8-3.1) years after initial EGD. Significant findings possibly related to dyspepsia were more likely at initial (29%) vs repeat EGD (18%) [odds ratio (OR), 1.45; 95% confidence interval (CI): 1.20-1.75, P < 0.0001], and at repeat EGD if the initial EGD had reported such findings (26%) than if it had not (14%) (OR, 1.32; 95% CI: 1.08-1.62, P = 0.0015). The same endoscopist performed the repeat and initial EGD in 77% of cases. Of patients aged 50 years or older, 286/311 (92%) underwent lower endoscopy. CONCLUSION: Repeat EGD for dyspepsia occurred at a low but substantial rate, with lower yield than initial EGD. Optimizing endoscopy use remains a public health priority. PMID:20503451

Ladabaum, Uri; Dinh, Viam

2010-01-01

379

Impact of endoscopy-based research on quality of life in healthy volunteers  

PubMed Central

AIM: To study the impact of an endoscopy-based long-term study on the quality of life in healthy volunteers (HV). METHODS: Ten HV were included into a long-term prospective endoscopy-based placebo-controlled trial with 15 endoscopic examinations per person in 5 different drug phases. Participants completed short form-36 (SF-36) and visual analog scale-based questionnaires (VAS) for different abdominal symptoms at days 0, 7 and 14 of each drug phase. Analyses were performed according to short- and long-term changes and compared to the control group. RESULTS: All HV completed the study with duration of more than 6 mo. Initial quality of life score was comparable to a general population. Analyses of the SF-36 questionnaires showed no significant changes in physical, mental and total scores, either in a short-term perspective due to different medications, or to potentially endoscopic procedure-associated long-term cumulative changes. Analogous to SF-36, VAS revealed no significant changes in total scores for pathological abdominal symptoms and remained unchanged over the time course and when compared to the control population. CONCLUSION: This study demonstrates that quality of life in HV is not significantly affected by a long-term endoscopy-based study with multiple endoscopic procedures. PMID:20101773

Link, Alexander; Treiber, Gerhard; Peters, Brigitte; Wex, Thomas; Malfertheiner, Peter

2010-01-01

380

Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora  

PubMed Central

BACKGROUND—Congenital nasolacrimal obstruction is usually the result of failure of canalisation of the distal end of the nasolacrimal duct. The most common outcome is spontaneous resolution, but some children do require surgical treatment by probing. Probing is a blind procedure with a recognised failure rate.?METHODS—In 52 lacrimal systems of 40 children nasal endoscopy was combined with a "stepwise" systematic probing in an attempt to improve the outcome and reduce the number of repeat procedures.?RESULTS—Combined nasal endoscopy and probing improved the understanding of outflow obstruction in young children. The success of the procedure depended upon the level of the obstruction within the outflow system. Formation of a false passage was seen in six cases (15%). The probe was rerouted under direct visualisation in these cases to form a functioning passage. Reasons for failure were identified in those who did not have a successful outcome and only one repeat procedure was required.?CONCLUSION—Using nasal endoscopy the area of lacrimal outflow obstruction at the lower end of the nasolacrimal duct can be observed directly and it is possible to guide the progress of probing under direct vision. This gives better information about the nature of the obstruction, minimises the formation of false passages, and allows a wider range of treatment options under a single anaesthetic.?? PMID:11222337

MacEwen, C; Young, J; Barras, C; Ram, B; White, P

2001-01-01

381

Gastrointestinal dysfunction in liver cirrhosis  

PubMed Central

Patients with liver cirrhosis exhibit several features of gut dysfunction which may contribute to the development of cirrhosis complications as well as have an impact on nutritional status and health-related quality of life. Gastrointestinal symptoms are common in cirrhosis and their pathophysiology probably involves factors related to liver disease severity, psychological distress, and gut dysfunction (e.g., increased gastric sensitivity to distension and delayed gut transit). They may lead to reduced food intake and, thus, may contribute to the nutritional status deterioration in cirrhotic patients. Although tense ascites appears to have a negative impact on meal-induced accommodation of the stomach, published data on gastric accommodation in cirrhotics without significant ascites are not unanimous. Gastric emptying and small bowel transit have generally been shown to be prolonged. This may be related to disturbances in postprandial glucose, insulin, and ghrelin levels, which, in turn, appear to be associated to insulin resistance, a common finding in cirrhosis. Furthermore, small bowel manometry disturbances and delayed gut transit may be associated with the development of small bowel bacterial overgrowth. Finally, several studies have reported intestinal barrier dysfunction in patients with cirrhosis (especially those with portal hypertension), which is related to bacterial translocation and permeation of intestinal bacterial products, e.g., endotoxin and bacterial DNA, thus potentially being involved in the pathogenesis of complications of liver cirrhosis. PMID:25356031

Kalaitzakis, Evangelos

2014-01-01

382

[Functional and motility gastrointestinal disorders].  

PubMed

We summarize and discuss the studies presented at the congress of the American Association of Gastroenterology (Digestive Disease Week) that, in our opinion, are of greatest interest. Both clinically and physiopathologically, functional gastrointestinal (GI) disorders are highly complex. A single cause is unlikely to explain symptoms as heterogeneous as those of functional dyspepsia and irritable bowel syndrome (IBS). Therefore, it is easier (and more useful) to try to understand functional GI disorders using a bio-psycho-social model. Moreover, data supporting the combined importance of genetic, organic and psychological factors in the onset and persistence of functional GI disorders are increasingly convincing. This year, new data have been provided on pharmacogenetics in gastroparesis, on microinflammation or alterations in the modulation of somatic and visceral sensitivity in functional dyspepsia, and on the impact of psychological factors in IBS. From the therapeutic point of view, further information has been provided on the role of probiotics, the antinociceptive effect of linaclotide (demonstrated in several studies presented this year), and on the high efficacy of hypnotherapy in patients with IBS. Finally, data on the clinical management of patients with constipation due to pelvic floor dyssynergia and on the safety and efficacy of prucalopride in patients with severe constipation were also of interest. PMID:23018003

Mearin, Fermín; Rey, Enrique; Balboa, Agustín

2012-09-01

383

Gastrointestinal complications of diabetes mellitus  

PubMed Central

Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

2013-01-01

384

Gastrointestinal decontamination of the poisoned patient.  

PubMed

Gastrointestinal decontamination has been a historically accepted modality in the emergency management of oral intoxicants. Theoretically, gastric and whole-bowel emptying procedures hinder absorption, remove toxic substances, prevent clinical deterioration, and hasten recovery. This article presents a current overview of gastrointestinal decontamination. It challenges the accepted precepts of gut decontamination and assesses the utility of syrup of ipecac-induced emesis, orogastric lavage, single-dose-activated charcoal, cathartics, and whole-bowel irrigation. PMID:18347499

Greene, Spencer; Harris, Cindy; Singer, Jonathan

2008-03-01

385

Gastrointestinal stromal tumors, version 2.2014.  

PubMed

Gastrointestinal stromal tumors (GIST) are the most common soft tissue sarcoma of the gastrointestinal tract, resulting most commonly from KIT or platelet-derived growth factor receptor ? (PDGFR?)-activating mutations. These NCCN Guideline Insights highlight the important updates to the NCCN Guidelines for Soft Tissue Sarcoma specific to the management of patients with GIST experiencing disease progression while on imatinib and/or sunitinib. PMID:24925196

von Mehren, Margaret; Randall, R Lor; Benjamin, Robert S; Boles, Sarah; Bui, Marilyn M; Casper, Ephraim S; Conrad, Ernest U; DeLaney, Thomas F; Ganjoo, Kristen N; George, Suzanne; Gonzalez, Ricardo J; Heslin, Martin J; Kane, John M; Mayerson, Joel; McGarry, Sean V; Meyer, Christian; O'Donnell, Richard J; Pappo, Alberto S; Paz, I Benjamin; Pfeifer, John D; Riedel, Richard F; Schuetze, Scott; Schupak, Karen D; Schwartz, Herbert S; Van Tine, Brian A; Wayne, Jeffrey D; Bergman, Mary Anne; Sundar, Hema

2014-06-01

386

Gastrointestinal cancer after treatment of Hodgkin's disease  

Microsoft Academic Search

Purpose: This study aimed to quantify the risk of gastrointestinal cancer following Hodgkin's disease treatment according to age at treatment, type of treatment, and anatomic sites.Methods and Materials: Cases were identified from the records of 2,441 patients treated for Hodgkin's disease between 1961 and 1994. Follow-up averaged 10.9 years, representing 26,590 person-years of observation. Relative risks (RR) for gastrointestinal cancer

Sandra H. Birdwell; Steven L. Hancock; Anna Varghese; Richard S. Cox; Richard T. Hoppe

1997-01-01

387

Colonic Gastrointestinal Stromal Tumour Presenting as Intussusception  

PubMed Central

Gastrointestinal stromal tumours (GIST) are rare in paediatric patients and have a discrete clinicopathological and molecular divergence from that observed in adults. In the present report we present a case of a 2-month-old female in whom colonic gastrointestinal stromal tumour acted as a lead point of colocolic intussusception. Laparoscopically assisted reduction of the intussusception and resection of tumour was done. PMID:24040597

Goel, Garima; Sobti, Parul; Khurana, Nita; Mathur, Mohit; Sinha, Shandip K; Aggarwal, Satish K

2013-01-01

388

Gastrointestinal radiation injury: Prevention and treatment  

PubMed Central

With the recent advances in detection and treatment of cancer, there is an increasing emphasis on the efficacy and safety aspects of cancer therapy. Radiation therapy is a common treatment for a wide variety of cancers, either alone or in combination with other treatments. Ionising radiation injury to the gastrointestinal tract is a frequent side effect of radiation therapy and a considerable proportion of patients suffer acute or chronic gastrointestinal symptoms as a result. These side effects often cause morbidity and may in some cases lower the efficacy of radiotherapy treatment. Radiation injury to the gastrointestinal tract can be minimised by either of two strategies: technical strategies which aim to physically shift radiation dose away from the normal intestinal tissues, and biological strategies which aim to modulate the normal tissue response to ionising radiation or to increase its resistance to it. Although considerable improvement in the safety of radiotherapy treatment has been achieved through the use of modern optimised planning and delivery techniques, biological techniques may offer additional further promise. Different agents have been used to prevent or minimize the severity of gastrointestinal injury induced by ionising radiation exposure, including biological, chemical and pharmacological agents. In this review we aim to discuss various technical strategies to prevent gastrointestinal injury during cancer radiotherapy, examine the different therapeutic options for acute and chronic gastrointestinal radiation injury and outline some examples of research directions and considerations for prevention at a pre-clinical level. PMID:23345942

Shadad, Abobakr K; Sullivan, Frank J; Martin, Joseph D; Egan, Laurence J

2013-01-01

389

Ghrelin Cells in the Gastrointestinal Tract  

PubMed Central

Ghrelin is 28-amino-acid peptide that was discovered from the rat and human stomach in 1999. Since the discovery of ghrelin, various functions of ghrelin, including growth hormone release, feeding behavior, glucose metabolism, memory, and also antidepressant effects, have been studied. It has also been reported that ghrelin in the gastrointestinal tract has an important physiological effect on gastric acid secretion and gastrointestinal motility. Ghrelin has a unique structure that is modified by O-acylation with n-octanoic acid at third serine residues, and this modification enzyme has recently been identified and named ghrelin O-acyl transferase (GOAT). Ghrelin is considered to be a gut-brain peptide and is abundantly produced from endocrine cells in the gastrointestinal mucosa. In the gastrointestinal tract, ghrelin cells are most abundant in the stomach and are localized in gastric mucosal layers. Ghrelin cells are also widely distributed throughout the gastrointestinal tract. In addition, abundance of ghrelin cells in the gastric mucosa is evolutionally conserved from mammals to lower vertebrates, indicating that gastric ghrelin plays important roles for fundamental physiological functions. Ghrelin cells in the gastrointestinal tract are a major source of circulating plasma ghrelin, and thus understanding the physiology of these cells would reveal the biological significance of ghrelin. PMID:20798855

Sakata, Ichiro; Sakai, Takafumi

2010-01-01

390

[Functional and motor gastrointestinal disorders].  

PubMed

Functional gastrointestinal (GI) and motility disorders generate a large volume of consultations in gastroenterology and primary care offices. The present article summarizes the most interesting studies presented in the annual meeting of the American Gastroenterological Association 2008. For all functional GI disorders, studies were presented that evaluated the applicability of diagnostic criteria in clinical practice and new data were presented on physiopathology (for example, mediation by neuromodulators such as serotonin, microinflammation, alterations in intestinal microbiota, and psychological factors). More specifically, the therapeutic results of new prokinetic agents in functional dyspepsia, such as acotiamide, were presented. This agent has been demonstrated to have good efficacy in symptom control, especially in patients with postprandial distress syndrome. In irritable bowel syndrome, data were presented on several drugs that act through diverse mechanisms of action and have been shown to be more effective than placebo in symptom control. These drugs include antiinflammatory agents such as mesalazine, antibiotics such as rifaximin, probiotics with distinct bacterial strains, and prokinetic agents such as lubiprostone. Highly promising results have been obtained in the treatment of constipation with prokinetics such as prucalopride and with novel laxatives such as linaclotide, as well as with techniques that continue to be shown to be effective such as anorectal biofeedback, which is also highly useful in patients with fecal incontinence. Another disorder that is less frequent but highly difficult to treat is gastroparesis. For several years, treatment in the most severe cases has consisted of implantation of a gastric pacemaker. Although the results are far from perfect, new data were presented that allow better patient selection to achieve greater symptom control. The list of new advances, both in knowledge of the physiopathology of these disorders and on their treatments, is extensive. Consequently, 2008 has been a good year in terms of the useful information gathered for physicians interested in functional GI and motor disorders. PMID:19434861

Mearin, Fermín; Perelló, Antonia; Balboa, Agustín

2008-10-01

391

[Functional and motility gastrointestinal disorders].  

PubMed

As in previous years, a huge number of studies were presented at the Congress of the American Gastroenterology Association (Digestive Diseases Week [DDW]), some of which were better than others. The present article attempts to extract and summarize the most interesting findings reported. In general terms, certain technological advances have been consolidated, with full incorporation into clinical practice, such as impedancemetry and high-resolution manometry. New physiopathological data are coming to light that increasingly indicate the inextricable link between organic and psychological factors (the biopsychosocial model) in functional gastrointestinal disorders (FGID). Despite the high hopes that the Rome III criteria would improve the diagnosis of FGID and especially that of functional dyspepsia, their practical application has been fairly discouraging. Moreover, at least two studies have demonstrated that these criteria cannot be used to differentiate subtypes of functional dyspepsia and that there is wide overlap with gastroesophageal reflux disease. New data were presented on the role of genetic, microinflammatory and psychological factors in the etiopathogenesis of the two main FGID: functional dyspepsia and irritable bowel syndrome (IBS). The results on the safety and efficacy of acotiamide in functional dyspepsia and of linaclotide and prucalopride in idiopathic and IBS-associated constipation were also presented. Several studies, and even meta-analyses, have demonstrated the utility of biofeedback in the treatment of constipation. Even so, the efficacy of this therapy has been questioned due to certain methodological deficiencies in some studies. In DDW 2011, studies confirming the utility of biofeedback, whether hospital- or home-based were presented, in dyssynergy constipation. The present article also mentions certain features of special interest in the diagnosis and treatment of rumination syndrome, thoracic pain of possible esophageal origin and cannabinoid-induced hyperemesis syndrome. PMID:22330152

Mearin, Fermín; Rey, Enrique; Balboa, Agustín

2011-10-01

392

Abstract--Wireless Capsule Endoscopy (WCE) is a non-invasive colour imaging technique that has been introduced for  

E-print Network

been introduced for the screening of the gastrointestinal tract and especially the small intestine. WCE the expert to view both ends of a patient's gastrointestinal tract including the foodpipe, stomach, duodenum of gastrointestinal disorders, including ulcer, unexplained bleeding, and polyps. Although WCE exhibits significant

Athens, University of

393

Endoscopic holmium:YAG laser ablation of early gastrointestinal intramucosal cancer.  

PubMed

Various endoscopic techniques are being increasingly used in early gastrointestinal (GI) cancer. The holmium: yttrium-aluminum-garnet (Ho:YAG) laser has precise tissue cutting ability and good hemostatic properties and has been widely applicated to soft tissue, but the use of endoscopic Ho:YAG laser ablation for early gastrointestinal cancer has not been reported. Twenty patients with biopsy-proven early GI cancer who had a high surgical risk or refused surgery were treated by endoscopic Ho:YAG laser ablation. The tumors of all patients were confined to the mucosal layer without ulceration and without lymph node metastasis. The tumor diameter was not more than 2.5 cm. Endoscopy, endoscopic ultrasound, and computed tomography scan were performed 1-3 months after the treatment, and a biopsy was performed to evaluate the effects of the therapy. Long-term endoscopic follow-up was maintained. Complete eradication was achieved in all the 20 patients, including four patients with high-grade dysplasia associated with focal canceration, seven patients with well-differentiated squamous cell cancer, and nine patients with well-differentiated adenocarcinoma, resulting in a complete response rate of 100% at 1-3 months after treatment. No recurrence was found during 36-73 months of follow-up in all 20 patients. No operative or delayed complications were observed in any of the 20 patients. Preliminary study shows that endoscopic Ho:YAG laser ablation may be an effective, safe, and minimally invasive method for selected patients with early GI intramucosal cancer. Further research is required to confirm the safety and efficacy of this technique compared to its alternative techniques in a multicenter randomized controlled trial. PMID:23329369

Mao, Yongping; Qiu, Haixia; Liu, Qingsen; Lu, Zhongsheng; Fan, Kaichun; Huang, Yingcai; Yang, Yunsheng

2013-11-01

394

Selective Serotonin Reuptake Inhibitors and Gastrointestinal Bleeding: A Case-Control Study  

PubMed Central

Background Selective serotonin reuptake inhibitors (SSRIs) have been associated with upper gastrointestinal (GI) bleeding. Given their worldwide use, even small risks account for a large number of cases. This study has been conducted with carefully collected information to further investigate the relationship between SSRIs and upper GI bleeding. Methods We conducted a case-control study in hospitals in Spain and in Italy. Cases were patients aged ?18 years with a primary diagnosis of acute upper GI bleeding diagnosed by endoscopy; three controls were matched by sex, age, date of admission (within 3 months) and hospital among patients who were admitted for elective surgery for non-painful disorders. Exposures to SSRIs, other antidepressants and other drugs were defined as any use of these drugs in the 7 days before the day on which upper gastrointestinal bleeding started (index day). Results 581 cases of upper GI bleeding and 1358 controls were considered eligible for the study; no differences in age or sex distribution were observed between cases and controls after matching. Overall, 4.0% of the cases and 3.3% of controls used an SSRI antidepressant in the week before the index day. No significant risk of upper GI bleeding was encountered for SSRI antidepressants (adjusted odds ratio, 1.06, 95% CI, 0.57–1.96) or for whichever other grouping of antidepressants. Conclusions The results of this case-control study showed no significant increase in upper GI bleeding with SSRIs and provide good evidence that the magnitude of any increase in risk is not greater than 2. PMID:21625637

Carvajal, Alfonso; Ortega, Sara; Del Olmo, Lourdes; Vidal, Xavier; Aguirre, Carmelo; Ruiz, Borja; Conforti, Anita; Leone, Roberto; Lopez-Vazquez, Paula; Figueiras, Adolfo; Ibanez, Luisa

2011-01-01

395

The Chronic Gastrointestinal Manifestations of Chagas Disease  

PubMed Central

Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer. PMID:20037711

Matsuda, Nilce Mitiko; Miller, Steven M.; Evora, Paulo R. Barbosa

2009-01-01

396

A classification of the verbal methods currently used to teach endoscopy  

PubMed Central

Background As endoscopy does not lend itself well to assisting or exposure by the teacher, most of the teaching is, by necessity, done verbally. Methods The verbal teaching occurring during 19 colonoscopies and 14 gastroscopies was recorded by dictaphone and later transcribed. The resultant 53-page transcript was then analyzed using the Grounded Theory method. Teaching was compared between learners with less than one month versus more than one month of training and between teaching of colonoscopy versus gastroscopy. Results The process of iterative review and repeated testing yielded 6 types of verbal teaching: demonstration by the teacher, motor instructions, broad tips/tricks/pointers, verbal feedback, questioning, and non-procedural information. Inter-rater agreement was excellent (Fleiss’s kappa?=?0.76) between resident (DM), the non-medical educator (MP), and the medical teacher (MM). Overall, there was less non-procedural teaching (6.7% vs 23.7%, p?=?0.01) and a trend towards more teaching moments per case (13.2 vs 7.9, p?=?0.07) in the first month of the rotation compared to the later months. A greater proportion of the teaching for colonoscopy involved demonstration (13.7% vs. 2.7%, p?=?0.040) and tips/tricks/pointers (26.6% vs. 12.4%, p?=?0.012) compared to gastroscopy. Conclusions We describe a means of categorizing verbal teaching in endoscopy that is simple and shows strong inter-rater agreement that will serve as a starting point for further studies aiming to improve how endoscopy is taught. PMID:25106078

2014-01-01

397

Gastrointestinal manifestations in myotonic muscular dystrophy.  

PubMed

Myotonic dystrophy (MD) is characterized by myotonic phenomena and progressive muscular weakness. Involvement of the gastrointestinal tract is frequent and may occur at any level. The clinical manifestations have previously been attributed to motility disorders caused by smooth muscle damage, but histologic evidence of alterations has been scarce and conflicting. A neural factor has also been hypothesized. In the upper digestive tract, dysphagia, heartburn, regurgitation and dyspepsia are the most common complaints, while in the lower tract, abdominal pain, bloating and changes in bowel habits are often reported. Digestive symptoms may be the first sign of dystrophic disease and may precede the musculo-skeletal features. The impairment of gastrointestinal function may be sometimes so gradual that the patients adapt to it with little awareness of symptoms. In such cases routine endoscopic and ultrasonographic evaluations are not sufficient and targeted techniques (electrogastrography, manometry, electromyography, functional ultrasonography, scintigraphy, etc.) are needed. There is a low correlation between the degree of skeletal muscle involvement and the presence and severity of gastrointestinal disturbances whereas a positive correlation with the duration of the skeletal muscle disease has been reported. The drugs recommended for treating the gastrointestinal complaints such as prokinetic, anti-dyspeptic drugs and laxatives, are mainly aimed at correcting the motility disorders. Gastrointestinal involvement in MD remains a complex and intriguing condition since many important problems are still unsolved. Further studies concentrating on genetic aspects, early diagnostic techniques and the development of new therapeutic strategies are needed to improve our management of the gastrointestinal manifestations of MD. PMID:16609987

Bellini, Massimo; Biagi, Sonia; Stasi, Cristina; Costa, Francesco; Mumolo, Maria Gloria; Ricchiuti, Angelo; Marchi, Santino

2006-03-28

398

Evaluative survey-questionnaire exploring the perceptions and experiences of endoscopy and sterile service staff.  

PubMed

There is considerable research surrounding professionalization and the barriers that emerging allied health professions may face. In order to develop any emerging profession, the move to voluntary registration and academic qualification will substantially pave the way towards raising the profile and professional recognition with a regulatory governing body. The aim of this evaluative survey-questionnaire was to explore the attitudes and experiences of endoscopy and sterile service staff in their current job roles and to identify any perceived barriers during the proposed transition to professionalization. This article concludes by highlighting the positive and negative aspects of current job roles in relation to job satisfaction, staff retention and career progression opportunities. PMID:24404705

Cobbold, A

2013-12-01

399

The Safety of Same-Day Endoscopy and Percutaneous Liver Biopsy  

Microsoft Academic Search

Background and Aims  The aim of this study was to review our experience with same-day endoscopy (SDE) plus percutaneous liver biopsy (PLB) and\\u000a to evaluate its safety compared to PLB alone.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We retrospectively examined records of all patients who underwent PLB between January 2003 and September 2009 and identified\\u000a those who underwent SDE and matched these patients to those undergoing PLB

Jonathan G. Stine; Gordon Liss; James H. Lewis

2011-01-01

400

Upper Gastrointestinal Cancer and Reflux Disease  

PubMed Central

There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature. PMID:23844321

2013-01-01

401

Gastrointestinal complications of leukemia and its treatment  

SciTech Connect

Leukemia represents 4% of all cancer deaths and is the leading cause of death from malignancy for all patients under 30 years of age. Various rare, usually preterminal gastrointestinal complications of leukemia have been reported. These complications are becoming more common and no longer should be considered unusual. Their increasing incidence is the result of new, more aggressive treatment methods and increased patient lifespan. The authors describe the relative incidence and common radiographic presentations of leukemia-related gastrointestinal disease and emphasize that its prognosis is favorable with prompt diagnosis and treatment.

Hunter, T.B.; Bjelland, J.C.

1984-03-01

402

Michael Liedlgruber, Andreas Uhl, Computer-aided Decision Support Sys-tems for Endoscopy in the Gastrointestinal Tract: A Review, IEEE Reviews in  

E-print Network

-malignant or to increase the risk of cancer in the GI tract are adenomas, Barrett's esophagus, Crohn's disease, celiac of the GI tract, physicians are able to detect severe diseases already in early development stages and therefore the mortality rate for many diseases, especially different types of cancers, has been lowered

Uhl, Andreas

403

An educational intervention to improve the endoscopist's ability to correctly diagnose small gastric lesions using magnifying endoscopy with narrow-band imaging  

PubMed Central

Background Magnifying endoscopy with narrow-band imaging (ME-NBI) and a simple and systematic classification system based on microvascular and microsurface patterns, the “VS” classification system (VSCS), have been shown to be useful for the diagnosis of early gastric cancer. The aim of this study was to clarify whether an educational lecture about the VSCS improves performance with ME-NBI. Methods Sixty-four gastrointestinal endoscopists took the 1st exam before receiving the lecture about the VSCS, the 2nd exam immediately after the lecture, and the 3rd exam 2 months after the lecture. We compared the VSCS-based diagnostic accuracy among the participants before and after the lecture. Results The proportion of correct diagnoses was significantly higher, at 70.8% in the 2nd exam than in the 1st exam, at 53.1% (P<0.001). The correct diagnosis rate in the 3rd exam was significantly lower than that in the 2nd exam (60.9% vs. 70.8%; P<0.001) but was still higher than that in the 1st exam (60.9% vs. 53.1%; P<0.001). The difference in proportion of correct diagnosis between the 2nd and the 3rd exams was smaller among routine ME-NBI practitioners (n=6; 79.2% and 76.1%, respectively), compared to that among non-routine practitioners (n=34; 71.6% and 59.8%, respectively) or non-practitioners (n=24; 67.5% and 58.8%, respectively). Conclusion This study revealed that an educational intervention increased correct diagnosis rate of small gastric lesions using the VSCS, diagnosis criteria based on ME-NBI and also showed that the routine use of the modality and the diagnosis criteria was necessary to maintain diagnostic skills. PMID:24733047

Mabe, Katsuhiro; Yao, Kenshi; Nojima, Masanori; Tanuma, Tokuma; Kato, Mototsugu

2014-01-01

404

Solitary extramedullary plasmacytoma in the gastrointestinal tract: report of two cases and review of literature.  

PubMed

Solitary extramedullary plasmacytoma (EMP) is a plasma cell neoplasm without bone marrow involvement. EMPs are rare in the gastrointestinal (GI) tract. We report two cases of primary EMP, one in the transverse colon and the other in the stomach. In the first case, a mass on the transverse colon was found on colonoscopy. The patient underwent left hemicolectomy and has been followed-up for 3 years without recurrence postoperatively. The latter case had several masses in the stomach. The patient underwent bypass surgery and has received supportive care for 1 month. Histopathologic specimens of both the cases showed a monoclonal lambda chain EMP. Subsequent investigations included a bone marrow biopsy, serum IgA, IgG, IgM and serum protein electrophoresis, and the results were negative for multiple myeloma in both the cases. Solitary EMP in the GI tract can be mistaken for colon cancer or stomach cancer on endoscopy; therefore, a sufficient number of biopsy specimens can help diagnose solitary EMPs. Surgical resection alone or with radiation therapy in cases with positive surgical margin is currently the only treatment for solitary EMP in the GI tract. Further study is necessary to determine disease prognosis and to investigate other treatment methods. PMID:24870305

Han, You Jin; Park, Seun Ja; Park, Moo In; Moon, Won; Kim, Sung Eun; Ku, Ki Hwan; Ock, So Young

2014-05-01

405

Validation of binding of SE-75 labeled sucralfate to sites of gastrointestinal ulceration  

SciTech Connect

This study was performed to determine if and for how long sucralfate (SU) binds selectively to sites of gastro-intestinal (GI) ulceration. Se-Su was prepared by sulfating sucrose with tracer Se-75 and precipitating it as the basic Al salt. All patients (pts) had endoscopy to confirm the presence of either: esophagitis (n=5), gastritis (GA) (n=5), gastric ulcers (GU) (n=5), duodenal ulcers (DU) (n=5), or no ulceration (NU) (n=5). Following an overnight fast the pts swallowed 1 gm with 100 ..mu..Ci of Se-SU and were imaged continuously over 24 hours or until no activity remained in the upper GI tract. Pts with GU visually demonstrated focal SU binding at the ulcers for an average of 3.9 +- 1.1 hrs. with a mean GET of 68 +- 25 min. Mean GET for pts with DU was prolonged, 171 +- 63 min, however focal binding at duodenal ulcers was not seen. All pts with GA had diffuse retention of SU in the stomach with a mean GET of 118 +- 34 min. Focal binding of SU at all sites of esophagitis was seen with a T-1/2 of 65 +- 32 min at the ulcerations. In conclusion these data support the theory that the mechanism of ulcer healing with SU is related to its ability to adhere to the ulcer site forming a protective barrier. In addition Se-SU is a potential ulcer imaging agent which can be used to noninvasively assess healing.

Maurer, A.H.; Knight, L.C.; Kollman, M.; Krevsky, B.; Pleet, D.; D'Ercole, F.; Siegel, J.A.; Fisher, R.S.; Malmud, L.S.

1985-05-01

406

Epistaxis in end stage liver disease masquerading as severe upper gastrointestinal hemorrhage  

PubMed Central

AIM: To describe the prevalence, diagnosis, treatment, and outcomes of end stage liver disease (ESLD) patients with severe epistaxis thought to be severe upper gastrointestinal hemorrhage (UGIH). METHODS: This observational single center study included all consecutive patients with ESLD and epistaxis identified from consecutive subjects hospitalized with suspected UGIH and prospectively enrolled in our databases of severe UGIH between 1998 and 2011. RESULTS: A total of 1249 patients were registered for severe UGIH in the data basis, 461 (36.9%) were cirrhotics. Epistaxis rather than UGIH was the bleeding source in 20 patients. All patients had severe coagulopathy. Epistaxis was initially controlled in all cases. Fifteen (75%) subjects required posterior nasal packing and 2 (10%) embolization in addition to correction of coagulopathy. Five (25%) patients died in the hospital, 12 (60%) received orthotopic liver transplantation (OLT), and 3 (15%) were discharged without OLT. The mortality rate was 63% in patients without OLT. CONCLUSION: Severe epistaxis in patients with ESLD is (1) a diagnosis of exclusion that requires upper endoscopy to exclude severe UGIH; and (2) associated with a high mortality rate in patients not receiving OLT.

Camus, Marine; Jensen, Dennis M; Matthews, Jason D; Ohning, Gordon V; Kovacs, Thomas O; Jutabha, Rome; Ghassemi, Kevin A; Machicado, Gustavo A; Dulai, Gareth S

2014-01-01

407

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses  

PubMed Central

The gastrointestinal (GI) tract is a major site of disease in HIV infection: almost half of HIV-infected patients present with GI symptoms, and almost all patients develop GI complications. GI symptoms such as anorexia, weight loss, dysphagia, odynophagia, abdominal pain, and diarrhea are frequent and usually nonspecific among these patients. Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. In the past three decades, studies have elucidated a variety of HIV-associated inflammatory, infectious, and neoplastic GI diseases, often with specific predilection for various sites. HIV-associated esophageal disease, for example, commonly includes candidiasis, cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, Kaposi's sarcoma (KS), and idiopathic ulceration. Gastric disease, though less common than esophageal disease, frequently involves CMV, Mycobacterium avium-intracellulare (MAI), and neoplasia (KS, lymphoma). Small bowel biopsies and intestinal aspirates from HIV-infected patients often show HIV enteropathy, MAI, protozoa (Giardia, Isospora, Cryptosporidia, amebae, Microsporidia), and helminths (Strongyloides stercoralis). Colorectal biopsies demonstrate viral (CMV, HSV), bacterial (Clostridia, Salmonella, Shigella, Campylobacter), fungal (cryptococcosis, histoplasmosis), and neoplastic (KS, lymphoma) processes. Herein, we review HIV-associated GI pathology, with emphasis on common endoscopic biopsy diagnoses. PMID:21559197

Bhaijee, Feriyl; Subramony, Charu; Tang, Shou-Jiang; Pepper, Dominique J.

2011-01-01

408

Duodenal histoplasmosis presenting with upper gastrointestinal bleeding in an AIDS patient.  

PubMed

Gastrointestinal histoplasmosis (GIH) is common in patients with disseminated disease but only rarely comes to clinical attention due to the lack of specific signs and symptoms. We report the unusual case of a 33-year-old Caucasian male with advanced AIDS who presented with upper GI bleeding from diffuse erosions throughout the duodenum. Biopsy of the lesions revealed small bowel mucosa with granulomatous inflammation and macrophages with small intracellular yeasts consistent with disseminated histoplasmosis. The patient demonstrated significant clinical improvement following a two-week course of liposomal amphotericin B. To our knowledge, this is the first case report of duodenal histoplasmosis leading to clinically significant bleeding, manifesting with worsening anemia and melanotic stools. Given our findings, we maintain that GIH should be considered on the differential diagnosis for GI bleeding in AIDS patients at risk, specifically those with advanced immunosuppression (i.e., CD4(+) cell counts <100?cells/mm(3)) who reside in endemic areas (Ohio or Mississippi river valleys) and/or have a prior history of histoplasmosis. For diagnostic evaluation, we recommend checking a urine Histoplasma quantitative antigen EIA as well as upper and/or lower endoscopy with biopsy. We recommend treatment with a two-week course of liposomal amphotericin B followed by indefinite itraconazole. PMID:23091745

Spinner, Michael A; Paulin, Heather N; Wester, C William

2012-01-01

409

What's New in Gastrointestinal Carcinoid Tumors Research and Treatment?  

MedlinePLUS

... Topic Additional resources for gastrointestinal carcinoid tumors What’s new in gastrointestinal carcinoid tumor research and treatment? There ... for the causes of , ways to prevent , and new approaches to diagnose and treat GI carcinoid tumors. ...

410

75 FR 59732 - Gastrointestinal Drugs Advisory Committee; Notice of Meeting  

Federal Register 2010, 2011, 2012, 2013

...FDA-2010-N-0001] Gastrointestinal Drugs Advisory Committee...public. Name of Committee: Gastrointestinal Drugs Advisory Committee...in gastroespohageal reflux disease (GERD) in patients less...The pathophysiology (disease process) of GERD, its...

2010-09-28

411

A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma  

Microsoft Academic Search

Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare. We present a 25-year-old female who was admitted to the emergency room with

Mircelal Kazimi; Murat Ulas; Cem Ibis; Mutlu Unver; Nazan Ozsan; Funda Yilmaz; Galip Ersoz; Murat Zeytunlu; Murat Kilic; Ahmet Coker

2009-01-01

412

Contact endoscopy of the larynx as an auxiliary method to the surgical margins in frontolateral laryngectomy  

PubMed Central

Summary Contact laryngomicroscopy is in vivo laryngeal mucosa microscopic examination and rigid telescopy is a non-invasive technique that enables the systematic observation of many details in the large area of vocal fold mucosa. These are performed during laryngomicroscopy. This study was performed in order to evaluate the use of rigid and contact endoscopy effectiveness in establishing the margins in patients undergoing frontolateral laryngectomy. Ten patients with glottic squamous cell carcinoma underwent frontolateral laryngectomy from 2000 to 2003. Eight were staged as T1bN0M0, whereas two were staged as T2N0M0. During the frontolateral approach, the lesion and its limits were carefully defined, the surgical margins were established under the rigid telescope and the patients’ margins were studied under contact endoscopy after methylene blue staining. Frozen section examination of the margins was performed and the histopathological analysis was compared to the surgical and endocopic findings. The infraglottic region and the surgical margins were free of disease in all cases and there was a 100% correlation with the histopathological examination. All patients are alive with no evidence of disease after a minimum of 5 years’ follow-up. In conclusion, rigid and contact laryngoscopy is effective in establishing the disease-free surgical margins in patients submitted to frontolateral laryngectomy. PMID:19609377

Dedivitis, RA; Pfuetzenreiter Jr., EG; Guimaraes, AV

2009-01-01

413

Flexible and transparent gastric battery: energy harvesting from gastric acid for endoscopy application.  

PubMed

In this paper, we present the potential to harvest energy directly from the digestive system for powering a future wireless endoscopy capsule. A microfabricated electrochemical cell on flexible parylene film is proposed as a gastric battery. This electrochemical cell uses gastric juice as a source of unlimited electrolyte. Planar fabricated zinc [Zn] and palladium [Pd] electrodes serve as anode and cathode respectively. Due to planar geometry, no separator is needed. Moreover the annular structure of the electrodes provides lower distance between cathode and anode reducing the internal resistance. Both electrodes are biocompatible and parylene provides flexibility to the system. For a surface area of 15 mm(2), 1.25 mW is generated which is sufficient for most implantable endoscopy applications. Open circuit output voltage of this battery is 0.75 V. Since this gastric battery does not require any external electrolyte, it has low intrinsic weight, and since it is flexible and is made of biocompatible materials, it offers a promising solution for power in implantable applications. PMID:24287419

Mostafalu, Pooria; Sonkusale, Sameer

2014-04-15

414

Gender identification in great sturgeon (Huso huso) using morphology, sex steroids, histology and endoscopy.  

PubMed

Gender identification of great sturgeon during different life stages was conducted using morphology, sex steroid concentrations, histological and endoscopic techniques. One hundred and forty great sturgeons from two sturgeon farms at ages between 3-16 years were selected for examination. Most of the morphological indices showed no significant sex-related differences except for the ratio of fork length to distance of snout to anterior of dorsal fin (PD). The urogenital opening had no difference in shapes for both sexes. Mean sex steroid concentrations showed no significant difference in levels of testosterone, estradiol and progesterone between males and females in the stage II of maturity. 95.8% of fish were correctly sexed using endoscopy at this stage. Histological investigation indicated the ovaries of 3- to 9-year-old females were at the different stages of pre-vitellogenic, and most males were at the early spermatogenesis for age 3. The result of this study suggests that endoscopy is a reliable tool for sex and stage determination after the age of 3 years. This method is useful in providing a quick discernment of sexes and stages compared with utilizing morphometric and blood indices. Direct observation of gonads can give us important information about the gonadal and maturity stages in sturgeon aquaculture and wild population management, with minimal damage or stress to this endangered species. PMID:23565575

Falahatkar, B; Poursaeid, S

2014-04-01

415

In vivo early diagnosis of gastric dysplasia using narrow-band image-guided Raman endoscopy  

NASA Astrophysics Data System (ADS)

We first report on the implementation of a novel narrow-band image-guided Raman endoscopy technique for in vivo diagnosis of gastric dysplasia. High-quality in vivo Raman spectra can be acquired from normal and dysplastic gastric mucosal tissue within 0.5 sec under narrow-band image (NBI) guidance at gastroscopy. Significant differences are observed in in vivo Raman spectra between normal (n=54) and dysplastic (n=18) gastric tissue from 30 gastric patients, particularly in the spectral ranges of 825 to 950, 1000 to 1100, 1250 to 1500, and 1600 to 1800 cm-1, which primarily contain signals related to proteins, nucleic acids, and lipids. The multivariate analysis [i.e., principal components analysis (PCA) and linear discriminant analysis (LDA)], together with the leave-one tissue site-out, cross validation on in vivo gastric Raman spectra yields a diagnostic sensitivity of 94.4% (17/18) and specificity of 96.3% (52/54) for distinction of gastric dysplastic tissue. This study suggests that narrowband image-guided Raman endoscopy associated with PCA-LDA diagnostic algorithms has potential for the noninvasive, in vivo early diagnosis and detection of gastric precancer during clinical gastroscopic examination.

Huang, Zhiwei; Bergholt, Mads Sylvest; Zheng, Wei; Lin, Kan; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan

2010-05-01

416

High-intensity focused ultrasound for the treatment of allergic rhinitis using nasal endoscopy  

PubMed Central

The present study aimed to observe the therapeutic effect of high-intensity focused ultrasound for the treatment of allergic rhinitis (AR) using nasal endoscopy. A total of 72 patients with perennial AR received treatment using the CZB ultrasonic therapeutic instrument with nasal endoscopy. A scoring method was adopted for evaluation of effectiveness according to the AR therapeutic principles and recommendations described in Allergic Rhinitis and its Impact on Asthma (ARIA) in 2001. The patients were followed up between 2 and 6 months after treatment. The excellence rate was 34.7% (25/72), the effective rate was 62.5% (45/72) and the ineffective rate was 2.8% (2/72). The total effective rate reached 97.2% high (70/72). Endoscopic high-intensity focused ultrasound for the treatment of AR is a non-invasive method and has the advantages of simple manipulation, a short course, high safety and a clear short-term effect. PMID:23251291

CHENG, LIANG-JUN; LIU, BING; NING, BO; MING, HAO; WANG, CHI; WAN, LI-XIA

2013-01-01

417

Assessing upper gastrointestinal bleeding in adults.  

PubMed

Acute upper gastrointestinal (GI) bleeding is a potentially life-threatening condition requiring accurate, prompt, and appropriate patient evaluation and management. Clinicians of all specialties must know the best practices for preventing and managing upper GI bleeding. This article focuses on assessing and managing adults with acute nonvariceal upper GI bleeding. PMID:25102077

Pezzulo, Gabrielle; Kruger, Danielle

2014-09-01

418

Nutritional Influences in Selected Gastrointestinal Diseases  

Microsoft Academic Search

Nutritional factors, as sources of luminal antigens, have been thought to be important factors in the immunopathogenesis of numerous gastrointestinal diseases. In some diseases, the role of the nutritional component is causal in the susceptible host. Such diseases include celiac disease, a common heritable chronic inflammatory condition of the small intestine induced by dietary wheat, rye and barley, in susceptible

Peter Laszlo Lakatos; Lajos S. Kiss; Pal Miheller

2011-01-01

419

[Gastrointestinal abnormalities in children with autism].  

PubMed

The autistic spectrum disorder (ASD) is a neurodevelopmental disorder characterized by socially aloof behavior and impairment of language and social interaction. This paper is a review of literature on gastrointestinal problems in children with ASD. Gastrointestinal symptoms are described in 9-54% of autistic children, among which most common are: constipation, diarrhea and abdominal distension. The gastro-intestinal abnormalities reported in autism include: inflammation (esophagitis, gastritis, duodenitis, enterocolitis) with or without autoimmunity, lymphoid nodular hyperplasia, increased intestinal permeability, low activities of disaccharidase enzymes, impairment of detoxification (e.g. defective sulfation of ingested phenolic amines), dysbiosis with bacterial overgrowth, food intolerance or exorphin intoxication (by opioid derived from casein and gluten). A beneficial effect of dietary intervention on behavior and cognition of some autistic children indicates a functional relationship between the alimentary tract and the central nervous system. There are no epidemiologic data concerning the incidence or prevalence of gastrointestinal problems within the population of children with ASD in comparison to the population of non-ASD children. PMID:19650428

Wasilewska, Jolanta; Jarocka-Cyrta, Elzbieta; Kaczmarski, Maciej

2009-07-01