Diagnosing chronic pancreatitis by endoscopic ultrasound assessing the association between ultrasound and pathological findings: A narrative review.

Endoscopic ultrasound (EUS) is widely recognized for its non-invasiveness and for its usefulness in chronic pancreatitis (CP) diagnosis, including early CP. Although it is desirable to obtain a definitive diagnosis of CP by tissue sampling with EUS-guided fine needle aspiration, histopathological changes in CP are heterogeneous in terms of the extent and the distribution of lesions. Therefore, histopathological diagnosis of appropriate tissue sampling by EUS-fine needle aspiration is expected to be difficult. Furthermore, it is virtually impossible to match EUS images with pathological sections, making direct contrast between EUS findings and pathology difficult. This narrative review presents a discussion of the diagnosis of CP/early CP by EUS, particularly assessing the association between ultrasound and pathological findings. Recently, the histological corroboration and correlation of EUS findings related to CP have been clarified by surgical specimens, including those obtained from animal studies. Furthermore, remarkable advances have occurred in the objective and quantitative diagnosis of pancreatic fibrosis by EUS-elastography. Future technological advances in EUS are expected to improve the accuracy of diagnosis of pancreatic fibrosis at earlier stages.

Effects of clear visual input and change in standing sequence on standing sway related to falls during night toilet use.

AIM: The aim of this study is to provide objective evidence that clear visual input and change in standing sequence can reduce fall risk related to night toilet use among hospitalized older patients. BACKGROUND: In hospitalized older patients, falls are likely to occur during night toileting needs. METHOD: Using a stabilometer, we measured and compared maximal standing sway for 10 seconds immediately after standing with three visual input modes in two standing patterns, comparing healthy younger adults (n=22) and older patients (n=19). The three modes are no visual input (mode 1), vague (mode 2), and clear visual input (mode 3). Standing sequences A and B are defined as supine-to-standing and supine-to-sitting-to-standing, respectively. RESULTS: For a given visual mode, maximal moved distance was significantly greater for older patients than for younger adults with both standing patterns (P<0.0001). Both standing pattern B and clear visual input decreased maximal moved distance in younger adults and older patients. A greater maximal moved distance score indicated a greater fall risk. RELEVANCE TO CLINICAL PRACTICE: It is important for nurses to train older patients to turn on the light and perform standing pattern B, when going to the bathroom at night. In addition, it is advisable to confirm the placement of distinct visual markers on the way to the bathroom.