Frequency of Esophageal Eosinophilia in a Pediatric Population from Central Brazil.

Here we report a retrospective cross-sectional study on Esophageal eosinophilia (EsEo) frequency in Brazil, for 2, 425 pediatric patients with symptoms associated with gastroesophageal diseases in 2012. EsEo is defined by ≥15 eosinophils per high power field (400x) and confirmed through histological analyses of esophageal biopsies. Overall, 126 patients had EsEo equating to a frequency of 5.2%. There was a significant difference between the endoscopic features of patients with EsEo, where 10.7% had erosive esophagitis, 3.0% had non-erosive esophagitis and 1% showed normal esophageal mucosa. According to the interaction of the variables in the Classification and Regression Tree Analysis, most patients diagnosed with EsEo were older males with erosive esophagitis. On the other hand, the lowest frequency of EsEo was found among younger females with non-erosive esophagitis/normal mucosa. Environmental conditions, including climate variation and changes, were observed in association with EsEo, supporting a potential role for environmental factors in its pathogenesis. There was an inverse correlation between the number of EsEo, rainfall and humidity. EsEo is a relatively frequent finding in the pediatric population of Brazil with symptoms of gastroesophageal diseases. Both clinical and histological examinations of patients are important for a reliable diagnostic of EsEo cases and to patient care.

Qualidade em colonoscopia e taxa de detecção de adenoma no Centro-Oeste do Brasil / Adenoma detection rate evaluation and quality of colonoscopy in the center-west region of brazil

ABSTRACT BACKGROUND: Colorectal cancer is the third commonest cancer in men and the second in women worldwide. Peculiarities of its evolution allow secondary prevention measures through colonoscopy, with high diagnostic and therapeutic capacity. In this context, the quality indicators of the procedure become important, among them the adenoma detection rate (ADR). OBJECTIVE: To relate the ADR in a medium risk population subjected to colonoscopy with sociodemographic, technical and histopathological indicators. METHODS: This was a descriptive, observational and retrospective study whose data were collected from medical records of colonoscopy exams with the indication of colorectal cancer screening or prevention in the period from August to October 2016. RESULTS: A total of 436 exams were included for analysis. Female sex represented 66.3% with 289 patients versus 33.7% for men. Patients aged between 50 and 59 years were 223 (51.1%) and those between 60 and 75 years were 213 (48.9%). In 99 exams (22.7%) chromoscopy was used, and 420 patients (96.3%) were adequately prepared. There were 118 patients with adenomas, resulting in an overall ADR of 27.1%. The ADR for men was 30.6% and 25.3% for women. Patients between 60 and 75 years old had a significantly higher ADR (31.9%, compared to 22.4% of the younger ones). Examinations in which chromoscopy was used also presented higher ADR. CONCLUSION: The ADR values found for the population of the studied region were compatible with internationally established goals. Continuous evaluation of the ADR may yield interventions aimed at improving quality standards for colonoscopy and promote better prevention of colorectal cancer.

RESUMO CONTEXTO: O câncer colorretal é o terceiro câncer mais incidente em homens e o segundo em mulheres em todo o mundo. Peculiaridades de sua evolução permitem medidas de prevenção secundária através da colonoscopia, com alta capacidade diagnóstica e terapêutica. Nesse contexto os indicadores de qualidade se tornam importantes, dentre eles a taxa de detecção de adenomas (TDA). OBJETIVO: Avaliar a taxa de detecção de adenomas em uma população de médio risco submetida a colonoscopia, relacionando-a a indicadores sociodemográficos, técnicos e histopatológicos. MÉTODOS: Trata-se de estudo descritivo, observacional e retrospectivo cujos dados foram coletados de registros e prontuários médicos de exames de colonoscopia com indicação de rastreamento ou prevenção do câncer colorretal no período de agosto a outubro de 2016. RESULTADOS: Foram incluídos 436 laudos de exames para análise de dados. O sexo feminino representou 66,3% com 289 pacientes contra 33,7% de homens. Os pacientes entre 50 e 59 anos de idade foram 223 (51,1%) e 213 entre 60 a 75 anos (48,9%). Em 99 exames (22,7%) foi feito uso de cromoscopia e 420 exames (96,3%) tiveram preparo adequado. Cento e dezoito pacientes tiveram adenomas, resultando em uma TDA geral no serviço de 27,1%. A TDA para homens foi de 30,6% e 25,3% para mulheres. Os pacientes entre 60 e 75 anos tiveram uma TDA significativamente maior (31,9%, contra 22,4% dos mais jovens). Exames em que foi feito uso cromoscopia também apresentaram maior TDA. CONCLUSÃO: Os valores de TDA encontrados podem validar o uso de metas estabelecidas mundialmente para a população da região estudada e sua progressão temporal pode propor medidas para o aumento dessa taxa.

ADENOMA DETECTION RATE EVALUATION AND QUALITY OF COLONOSCOPY IN THE CENTER-WEST REGION OF BRAZIL.

BACKGROUND: Colorectal cancer is the third commonest cancer in men and the second in women worldwide. Peculiarities of its evolution allow secondary prevention measures through colonoscopy, with high diagnostic and therapeutic capacity. In this context, the quality indicators of the procedure become important, among them the adenoma detection rate (ADR). OBJECTIVE: To relate the ADR in a medium risk population subjected to colonoscopy with sociodemographic, technical and histopathological indicators. METHODS: This was a descriptive, observational and retrospective study whose data were collected from medical records of colonoscopy exams with the indication of colorectal cancer screening or prevention in the period from August to October 2016. RESULTS: A total of 436 exams were included for analysis. Female sex represented 66.3% with 289 patients versus 33.7% for men. Patients aged between 50 and 59 years were 223 (51.1%) and those between 60 and 75 years were 213 (48.9%). In 99 exams (22.7%) chromoscopy was used, and 420 patients (96.3%) were adequately prepared. There were 118 patients with adenomas, resulting in an overall ADR of 27.1%. The ADR for men was 30.6% and 25.3% for women. Patients between 60 and 75 years old had a significantly higher ADR (31.9%, compared to 22.4% of the younger ones). Examinations in which chromoscopy was used also presented higher ADR. CONCLUSION: The ADR values found for the population of the studied region were compatible with internationally established goals. Continuous evaluation of the ADR may yield interventions aimed at improving quality standards for colonoscopy and promote better prevention of colorectal cancer.