[Pan American Crohn's and Colitis Organization (PANCCO) and the Interamerican Society of Endoscopy (SIED) consensus on endoscopy in inflammatory bowel disease]. / Consenso de endoscopia en enfermedad inflamatoria intestinal de la Organización Panamericana de Crohn y Colitis (PANCCO) y la Sociedad Interamericana de endoscopia (SIED).

INTRODUCTION: Endoscopy plays a fundamental role in inflammatory bowel disease (IBD), and becomes essential in diagnosis, treatment monitoring, and detection and management of complications. MATERIALS AND METHODS: The Pan American Crohn's and Colitis Organization (PANCCO) and the Inter-American Society of Endoscopy (SIED) appointed 22 Latin American experts in IBD to develop a consensus study using the modified Delphi method, based on the best available evidence. A working group of 22 members from 9 countries identified 15 topics and formulated 98 statements, who participated in 2 rounds of voting. It was defined as agreement of ≥80% of experts for each statement. RESULTS: After the voting of all the statements, 8 statements were obtained that did not reach 80% consensus among the participants, so the questions were reconsidered in the Coordinating Committee of the consensus with the participation of the expert reviewers of these questions and 7 final statements were voted again by all the experts in a second round and 1 was eliminated with consensus. After two rounds of voting, the experts reached consensus with literature review with the best available evidence, the most important issues were developed with scientific evidence supporting each of the statements around the topic of endoscopy in IBD. CONCLUSIONS: Consensus statements were developed and based on the best available evidence about endoscopy in inflammatory bowel disease.

The economic burden of Chagas disease: A systematic review.

BACKGROUND: Chagas disease (CD) is a neglected disease affecting millions worldwide, yet little is known about its economic burden. This systematic review is part of RAISE project, a broader study that aims to estimate the global prevalence, mortality, and health and economic burden attributable to chronic CD and Chronic Chagas cardiomyopathy. The objective of this study was to assess the main costs associated with the treatment of CD in both endemic and non-endemic countries. METHODS: An electronic search of the Medline, Lilacs, and Embase databases was conducted until 31st, 2022, to identify and select economic studies that evaluated treatment costs of CD. No restrictions on place or language were made. Complete or partial economic analyses were included. RESULTS: Fifteen studies were included, with two-thirds referring to endemic countries. The most commonly investigated cost components were inpatient care, exams, surgeries, consultation, drugs, and pacemakers. However, significant heterogeneity in the estimation methods and presentation of data was observed, highlighting the absence of standardization in the measurement methods and cost components. The most common component analyzed using the same metric was hospitalization. The mean annual hospital cost per patient ranges from $25.47 purchasing power parity US dollars (PPP-USD) to $18,823.74 PPP-USD, and the median value was $324.44 PPP-USD. The lifetime hospital cost per patient varies from $209,44 PPP-USD for general care to $14,351.68 PPP-USD for patients with heart failure. DISCUSSION: Despite the limitations of the included studies, this study is the first systematic review of the costs of CD treatment. The findings underscore the importance of standardizing the measurement methods and cost components for estimating the economic burden of CD and improving the comparability of cost components magnitude and cost composition analysis. Finally, assessing the economic burden is essential for public policies designed to eliminate CD, given the continued neglect of this disease.

Influência de materiais restauradores na interpretação radiográfica / Restorative material influence on radiographic interpretation

O objetivo deste trabalho foi avaliar a influência de materiais restauradores na interpretação radiográfica de imagens compatíveis com cáries proximais recorrentes. Foram utilizados vinte dentes humanos posteriores que exibiam cárie proximal ou ocluso-proximal sem comprometimento pulpar, além de dez dentes hígidos, que foram selecionados por meio de exame clínico e radiográfico interproximal. Os dentes que possuíam cárie foram preparados, removendo-se o tecido cariado, e restaurados, de modo que cada dente possuísse apenas uma restauração, a qual poderia ser ocluso-mesial ou ocluso-distal. Das vinte restaurações, dez receberam a resina tipo flow (Natural Flow®, DFL) como base, e as demais, apenas a resina composta (TPH Spectrum®, Dentisply). Os dentes restaurados fora, radiografados pela técnica interproximal, e as imagens, avaliadas subjetivamente pos seis examinadores. Para avaliação da concordância interexaminadores, foi realizado o teste de Kappa, sendo utilizadp o teste qui-quadrado para verificar a influência dos materias na interpretação das radiografias. O valor de Kappa foi igual a 0,18, indicando uma concordância fraca entre os examinadores, e o valor de p foi igual a 0,3991, o que indicou não existir diferença significativa entre os grupos. Conclui-se que os materiais testados não interferiram na interpretação de imaens radiográficas de cáries secundárias em restaurações classe II.