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1.
Surg Clin North Am ; 101(2): 355-371, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33743974

RESUMO

Intragastric balloon therapy is an endoluminal treatment of obesity that is indicated for patients with moderate obesity (body mass index, 30-35 kg/m2) who have failed to lose weight with lifestyle and medical management. Treatment duration ranges from 4 to 12 months, and percent total body weight loss ranges from 6% to 15% at the time of balloon removal. Adverse events, such as bowel obstruction or gastric perforation, are rare, and early balloon removal because of intolerance is the most common complication. Long-term data are lacking, although weight regain after balloon removal seems to be common.


Assuntos
Índice de Massa Corporal , Endoscopia Gastrointestinal/métodos , Balão Gástrico , Obesidade Mórbida/terapia , Perda de Peso/fisiologia , Humanos , Obesidade Mórbida/fisiopatologia
2.
Surg Clin North Am ; 101(2): 373-379, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33743975

RESUMO

Although obesity rates are growing across the world, endoscopic modalities to treat obesity and its metabolic consequences are advancing rapidly. Multiple devices and techniques dedicated to weight management are being developed and have either been approved for use or are undergoing clinical trial. This article reviews many of these endoscopic interventions in bariatric surgery, including gastric aspiration devices, incisionless magnetic anastomotic systems, endoluminal bypass barrier sleeves, primary surgery obesity endoluminal, endoscopic sleeve gastroplasty, and duodenal mucosal resurfacing. These effective techniques may serve either as a primary therapy or as a bridge to bariatric surgery.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Endoscopia Gastrointestinal/estatística & dados numéricos , Obesidade/cirurgia , Cirurgia Bariátrica/métodos , Endoscopia Gastrointestinal/métodos , Humanos
3.
Medicine (Baltimore) ; 100(12): e25109, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761673

RESUMO

BACKGROUND: Endoscopic removal is the main method for the treatment of colorectal polyps in children. Due to the small age of children, poor coordination, postoperative sensitive postoperative response, it is not good for postoperative recovery. Systematic nursing has an advantage in promoting the postoperative recovery of children with colorectal polyps of endoscopic removal, but it is lack of evidence-based basis. The purpose of this study is to evaluate the effect of systematic nursing intervention on the rehabilitation of children after colorectal polyps of endoscopic removal. METHODS: China National Knowledge Infrastructure, Wanfang, China Science and Technology Journal Database and Chinese Biomedical Literature Database, PubMed, Embase, Web of Science, and the Cochrane Library databases will be searched by computer. A randomized controlled study is searched on the application of systematic nursing intervention of children with colorectal polyps of endoscopic removal from the establishment of the database in February 2021. The language is limited to English and Chinese. The quality of the included study is independently extracted and the literature quality is evaluated by 2 researchers. The RevMan5.3 software is used to conduct meta-analysis of the included literature. RESULTS: This study will evaluate the effect of systematic nursing intervention on the rehabilitation of children after colorectal polyps of endoscopic removal by the indexes of total effective rate, complication rate, and hospital stays. CONCLUSION: This study will provide reliable evidence-based basis for establishing a reasonable and effective nursing intervention for endoscopic removal of colorectal polyps in childhood. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/S57UX.


Assuntos
Pólipos do Colo/enfermagem , Pólipos do Colo/cirurgia , Endoscopia Gastrointestinal/enfermagem , Endoscopia Gastrointestinal/reabilitação , Enfermagem Perioperatória/métodos , Adolescente , Criança , Pré-Escolar , Pólipos do Colo/reabilitação , Feminino , Humanos , Lactente , Masculino , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
4.
Artigo em Alemão | MEDLINE | ID: mdl-33725740

RESUMO

The guideline "Sedation for gastrointestinal endoscopy" (AWMF-register-no. 021/014) was published initially in 2008. Because of new and developing evidence, the guideline was updated in 2015. The aim of the guideline is to define the necessary structural, equipment and personnel requirements that contribute to minimizing the risk of sedation for endoscopy. In view of the high and increasing significance of gastrointestinal endoscopy, the guideline will remain highly relevant in the future. Essential aspects are the selection of sedatives/hypnotics, structural requirements, personnel requirements with regard to number, availability and training, management of complications and quality assurance. In this article, the development and evaluation of the evidence and its influence on the practical implementation, in particular for anaesthesia, are highlighted.


Assuntos
Anestesia , Anestesiologia , Sedação Consciente , Endoscopia Gastrointestinal , Hipnóticos e Sedativos
5.
Medicine (Baltimore) ; 100(10): e25067, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725896

RESUMO

RATIONALE: Cronkhite-Canada syndrome (CCS) is a rare non-familial polyposis syndrome characterized by multiple gastrointestinal polyps with the ectodermal triad. To date, many complications of CCS have been reported in the literature, but perianal condyloma acuminatum with malignant transformation has not been included. PATIENT CONCERNS: This report presents the case of a 52-year-old Chinese man who presented with diarrhea, loss of appetite, and weight loss. He developed skin pigmentation and atrophy of the fingernails and toenails. Upper gastrointestinal endoscopy, colonoscopy, capsule endoscopy, and enteroscopy revealed diffuse polyps along the entire digestive tract. Histopathological examination revealed polyps of different pathological types dominated by hamartoma. Physical examination revealed a crissum cauliflower-like neoplasm (2.5 × 2.0 cm). After perianal tumor resection, pathology suggested that this was a perianal condylomatous lesion with malignant transformation, as well as well-differentiated squamous cell carcinoma. DIAGNOSES: These clinical features and endoscopic findings were consistent with CCS which associated with perianal condyloma acuminatum with malignant transformation. INTERVENTION: Clinical remission was achieved with glucocorticoid, azathioprine, and nutritional support. OUTCOME: At the 4-year follow-up, the patient had no diarrhea or loss of appetite, had gained 13 kg in weight, and the perianal tumor had not recurred. LESSONS: No previous report has described CCS in a patient with perianal condyloma acuminatum with malignant transformation. As both conditions are related to immune disorders, their occurrence may be correlated.


Assuntos
Neoplasias do Ânus/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Condiloma Acuminado/diagnóstico , Polipose Intestinal/diagnóstico , Canal Anal/patologia , Canal Anal/cirurgia , Neoplasias do Ânus/etiologia , Neoplasias do Ânus/patologia , Neoplasias do Ânus/terapia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Transformação Celular Neoplásica , Condiloma Acuminado/etiologia , Condiloma Acuminado/patologia , Condiloma Acuminado/terapia , Endoscopia Gastrointestinal , Glucocorticoides/administração & dosagem , Glutamina/administração & dosagem , Humanos , Polipose Intestinal/complicações , Polipose Intestinal/terapia , Masculino , Pessoa de Meia-Idade , Apoio Nutricional , Resultado do Tratamento
6.
World J Gastroenterol ; 27(11): 1022-1042, 2021 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-33776370

RESUMO

Managing inflammatory bowel disease (IBD) during the coronavirus disease 2019 (COVID-19) pandemic has been a challenge faced by clinicians and their patients, especially concerning whether to proceed with biologics and immunosuppressive agents in the background of a global outbreak of a highly contagious new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2). The knowledge about the impact of this virus on patients with IBD, although it is still scarce, is rapidly evolving. In particular, concerns surrounding medications' impact for IBD on the risk of acquiring SARS-CoV-2 infection or developing COVID-19, and potentially exacerbate viral replication and the COVID-19 course, are a current thinking of both practicing clinicians and providers caring for patients with IBD. Managing patients with IBD infected with SARS-CoV-2 depends on both the clinical activity of the IBD and the occasional development and severity of COVID-19. In this review, we summarize the current data regarding gastrointestinal involvement by SARS-CoV-2 and pharmacologic and surgical management for IBD concerning this infection, and the COVID-19 impact on both the patient's psychological functioning and endoscopy services, and we concisely summarize the telemedicine roles during the COVID-19 pandemic.


Assuntos
Produtos Biológicos/uso terapêutico , Glucocorticoides/uso terapêutico , Imunossupressores/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Telemedicina , Assistência Ambulatorial , Portador Sadio , Desprescrições , Gerenciamento Clínico , Endoscopia Gastrointestinal , Hospitalização , Humanos , Fatores Imunológicos/uso terapêutico , Doenças Inflamatórias Intestinais/complicações , Guias de Prática Clínica como Assunto , Fatores de Risco , Índice de Gravidade de Doença
7.
World J Gastroenterol ; 27(6): 449-469, 2021 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-33642821

RESUMO

The novel coronavirus disease-2019 (COVID-19) is caused by a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family. In March 2019 the World Health Organization declared that COVID-19 was a pandemic. COVID-19 patients typically have a fever, dry cough, dyspnea, fatigue, and anosmia. Some patients also report gastrointestinal (GI) symptoms, including diarrhea, nausea, vomiting, and abdominal pain, as well as liver enzyme abnormalities. Surprisingly, many studies have found severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in rectal swabs and stool specimens of asymptomatic COVID-19 patients. In addition, viral receptor angiotensin-converting enzyme 2 and transmembrane protease serine-type 2, were also found to be highly expressed in gastrointestinal epithelial cells of the intestinal mucosa. Furthermore, SARS-CoV-2 can dynamically infect and replicate in both GI and liver cells. Taken together these results indicate that the GI tract is a potential target of SARS-CoV-2. Therefore, the present review summarizes the vital information available to date on COVID-19 and its impact on GI aspects.


Assuntos
/complicações , Gastroenteropatias/virologia , Hepatopatias/terapia , /fisiologia , /diagnóstico , Endoscopia Gastrointestinal , Gastroenteropatias/diagnóstico , Interações Hospedeiro-Patógeno , Humanos , Hepatopatias/complicações
8.
BMC Gastroenterol ; 21(1): 98, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33657994

RESUMO

BACKGROUND: Health care professionals in endoscopic labs have an elevated risk for COVID-19 infection, therefore, we aimed to determine the effect of current pandemic on the workflow and infection prevention and control strategies of endoscopy units in real-life setting. METHODS: All members of Hungarian Society of Gastroenterology were invited between 7 and 17 April 2020 to participate in this cross-section survey study and to complete an online, anonymous questionnaire. RESULTS: Total of 120 endoscopists from 83 institutes were enrolled of which 35.83% worked in regions with high cumulative incidence of COVID-19. Only 33.33% of them had undergone training about infection prevention in their workplace. 95.83% of endoscopists regularly used risk stratification of patients for infection prior endoscopy. While indications of examinations in low risk patients varied widely, in high-risk or positive patients endoscopy was limited to gastrointestinal bleeding (95.00%), removal of foreign body from esophagus (87.50%), management of obstructive jaundice (72.50%) and biliary pancreatitis (67.50%). Appropriate amount of personal protective equipment was available in 60.85% of endoscopy units. In high-risk or positive patients, surgical mask, filtering facepiece mask, protective eyewear and two pairs of gloves were applied in 30.83%, 76.67%, 90.00% and 87.50% of cases, respectively. Personal protective equipment fully complied with European guideline only in 67.50% of cases. CONCLUSIONS: Survey found large variability in indications of endoscopy and relative weak compliance to national and international practical recommendations in terms of protective equipment. This could be improved by adequate training about infection prevention.


Assuntos
/prevenção & controle , Endoscopia Gastrointestinal , Gastroenterologia/organização & administração , Unidades Hospitalares/organização & administração , Controle de Infecções/organização & administração , Fluxo de Trabalho , /epidemiologia , Estudos Transversais , Humanos , Hungria , Seleção de Pacientes , Equipamento de Proteção Individual
10.
Artigo em Inglês | MEDLINE | ID: mdl-33627313

RESUMO

BACKGROUND: Although evidence suggests frequent gastrointestinal (GI) involvement during coronavirus disease 2019 (COVID-19), endoscopic findings are scarcely reported. AIMS: We aimed at registering endoscopic abnormalities and potentially associated risk factors among patients with COVID-19. METHODS: All consecutive patients with COVID-19 undergoing endoscopy in 16 institutions from high-prevalence regions were enrolled. Mann-Whitney U, χ2 or Fisher's exact test were used to compare patients with major abnormalities to those with negative procedures, and multivariate logistic regression to identify independent predictors. RESULTS: Between February and May 2020, during the first pandemic outbreak with severely restricted endoscopy activity, 114 endoscopies on 106 patients with COVID-19 were performed in 16 institutions (men=70.8%, median age=68 (58-74); 33% admitted in intensive care unit; 44.4% reporting GI symptoms). 66.7% endoscopies were urgent, mainly for overt GI bleeding. 52 (45.6%) patients had major abnormalities, whereas 13 bled from previous conditions. The most prevalent upper GI abnormalities were ulcers (25.3%), erosive/ulcerative gastro-duodenopathy (16.1%) and petechial/haemorrhagic gastropathy (9.2%). Among lower GI endoscopies, 33.3% showed an ischaemic-like colitis.Receiver operating curve analysis identified D-dimers >1850 ng/mL as predicting major abnormalities. Only D-dimers >1850 ng/mL (OR=12.12 (1.69-86.87)) and presence of GI symptoms (OR=6.17 (1.13-33.67)) were independently associated with major abnormalities at multivariate analysis. CONCLUSION: In this highly selected cohort of hospitalised patients with COVID-19 requiring endoscopy, almost half showed acute mucosal injuries and more than one-third of lower GI endoscopies had features of ischaemic colitis. Among the hospitalisation-related and patient-related variables evaluated in this study, D-dimers above 1850 ng/mL was the most useful at predicting major mucosal abnormalities at endoscopy. TRIAL REGISTRATION NUMBER: ClinicalTrial.gov (ID: NCT04318366).


Assuntos
/patologia , Endoscopia Gastrointestinal , Mucosa Gástrica/patologia , Idoso , Colite Isquêmica/etiologia , Colite Isquêmica/patologia , Estudos Transversais , Duodeno/patologia , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Fatores de Risco , Úlcera Gástrica/etiologia , Úlcera Gástrica/patologia
12.
Acta Gastroenterol Belg ; 84(1): 73-77, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639696

RESUMO

Background and study aims: Data on procedural outcome and quality of endoscopic retrograde cholangiopancreatography (ERCP) in Belgian practice are scarce. The aim of this study is to assess current status of ERCP-performance in Belgium. Methods: National multi-institutional survey (online questionnaire) among members of the Belgian Society of Gastrointestinal Endoscopy (BSGIE), conducted in the period June-August 2018. The RIZIV/INAMI provided real-life data on the total number of ERCPs performed in Belgium. Results: Forty-five responders completed the survey (for 43 centers performing ERCP), providing information for 8368 ERCPs performed in 45% (43/95) of institutions performing ERCP in Belgium. Fifty-eight percent of centers performed > 100 ERCPs/year and 7% of centers (n=3) performed < 50 ERCPs/year. According to the RIZIV/INAMI data, low case-volume centers are underrepresented in this survey. The most common ERCPindication was stone extraction (52%). 74% of endoscopists had more than 10 years of experience in performing ERCP. The majority of centers had their own written protocol (84%) for microbiological duodenoscope surveillance. Monitoring of cannulation rate and post-ERCP pancreatitis (PEP) was only performed in a minority of centers (30%). The majority of centers (76%) provided verbal informed consent relating to the ERCP-procedure ; a minority also requested a written informed consent (23%). 65% of centers systematically use NSAIDs for PEP prophylaxis. Conclusion: This is the first survey of ERCP performance in Belgium. There were wide variations in practice. Adherence to key performance measures and measurement and evaluation of ERCP performance in daily practice at center and endoscopist level are not uniformly widespread.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Pancreatite , Bélgica/epidemiologia , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Endoscopia Gastrointestinal , Humanos , Inquéritos e Questionários
14.
Gastrointest. endosc ; 93(2): 309-322, Feb. 1, 2021. ilus
Artigo em Inglês | BIGG - guias GRADE | ID: biblio-1146652

RESUMO

This American Society for Gastrointestinal Endoscopy guideline provides evidence-based recommendations for the endoscopic management of gastric outlet obstruction (GOO). We applied the Grading of Recommendations, Assessment, Development and Evaluation methodology to address key clinical questions. These include the comparison of (1) surgical gastrojejunostomy to the placement of self-expandable metallic stents (SEMS) for malignant GOO, (2) covered versus uncovered SEMS for malignant GOO, and (3) endoscopic and surgical interventions for the management of benign GOO. Recommendations provided in this document were founded on the certainty of the evidence, balance of benefits and harms, considerations of patient and caregiver preferences, resource utilization, and cost-effectiveness.


Assuntos
Humanos , Stents , Endoscopia Gastrointestinal/métodos , Obstrução da Saída Gástrica/cirurgia , Obstrução da Saída Gástrica/etiologia , Resultado do Tratamento , Medicina Baseada em Evidências
15.
Artigo em Inglês | MEDLINE | ID: mdl-33436482

RESUMO

BACKGROUND AND AIMS: Digestive endoscopy is considered a high-risk procedure for COVID-19. Recommendations have been made for its practice during the pandemic. This study was conducted to determine adherence to recommendations for endoscopy practice during the COVID-19 pandemic in Latin America (LA). METHODS: A survey was conducted of endoscopists from LA consisting of 43 questions for the evaluation of four items: general and sociodemographic features, and preprocedure, intraprocedure and postprocedure aspects. RESULTS: A response was obtained from 338 endoscopists (response rate 34.5%) across 15 countries in LA. In preprocedure aspects (hand washing, use of face masks for patients, respiratory triage area, training for the placement/removal of personal protective equipment (PPE) and availability of specific area for the placement/removal of PPE), there was adherence in <75%. Regarding postprocedure aspects, 77% (261/338) had reused PPE, mainly the N95 respirator or higher, and this was with a standardised decontamination procedure only in 32% (108/338) of the time. Postprocedure room decontamination was carried out by 47% on >75% of occasions. In relationship to intraprocedure aspects (knowledge of risk and type of endoscopic procedures, use of PPE, airway management in patients and infrastructure), there was adherence in >75% for all the parameters and 78% of endoscopists only performed emergencies or time-sensitive procedures. CONCLUSIONS: Adherence to the recommendations for endoscopy practice during the COVID-19 pandemic is adequate in the intraprocedure aspect. However, it is deficient in the preprocedure and postprocedure aspects.


Assuntos
Endoscopia Gastrointestinal , Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Adulto , /prevenção & controle , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Equipamento de Proteção Individual , Estudos Prospectivos , Fatores de Risco
16.
BMC Surg ; 21(1): 5, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397326

RESUMO

BACKGROUND: Phlegmonous gastritis (PG) is a rare, suppurative bacterial infection of the gastric wall, which may rapidly evolve into fatal septicemia. The etiology and pathogenesis are poorly understood; however, multiple risk factors have been cited in current literature. Most cases have been diagnosed at autopsy, and occasionally at laparotomy, as the clinical presentation is often variable. CASE PRESENTATION: We report a case of a 67-year-old male presenting with intractable nausea, vomiting, and epigastric pain following an uneventful upper gastrointestinal (GI) endoscopy. Diagnostic workup including contrast tomography (CT) and endoscopic assessment was in keeping with PG. This was subsequently followed by development of abdominal compartment syndrome (ACS) and clinical deterioration necessitating surgical resection of the stomach. CONCLUSION: This case emphasizes the importance of early diagnosis of this potentially fatal infection that can follow endoscopic procedures and illustrates ACS and septic shock as serious complications. There is currently no consensus on the proper management of PG; however, in this case, a combination of surgery and antibiotics provided a favourable outcome. Limited number of cases of PG have been reported in literature, and to our knowledge, this is the first reported case of PG with subsequent ACS as an acute complication.


Assuntos
Endoscopia Gastrointestinal/efeitos adversos , Gastrite/complicações , Hipertensão Intra-Abdominal/etiologia , Idoso , Antibacterianos/uso terapêutico , Diabetes Mellitus Tipo 2 , Gastrite/diagnóstico , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Humanos , Hipertensão Intra-Abdominal/diagnóstico , Masculino , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus/isolamento & purificação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
17.
Rev Esp Enferm Dig ; 113(2): 149, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33406846

RESUMO

We read with interest the study by Hernández-Camba et al. about the low value of antibody testing for COVID-19 before endoscopic procedures and we would like to make some comments. Nine months after the first state of alarm was declared in Spain due to the SARS-CoV-2 pandemic, we knew that infections in endoscopy staff were scarce if adequate protection was worn and non-urgent procedures were postponed in patients with an active infection. Therefore, the conclusions of the study currently appear to be self-evident. However, things were different at the time it was performed.


Assuntos
Pandemias , Endoscopia Gastrointestinal , Humanos , Espanha/epidemiologia
18.
Dig Liver Dis ; 53(3): 283-288, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33388247

RESUMO

BACKGROUND: IBD management has been significantly affected during the COVID-19 lockdown with potential clinical issues. AIMS: The aim of this study was to analyse the impact of COVID-19 pandemic on the Italian paediatric IBD cohort. METHODS: This was a multicentre, retrospective, cohort investigation including 21 different Italian IBD referral centres. An electronic data collection was performed among the participating centres including: clinical characteristics of IBD patients, number of COVID-19 cases and clinical outcomes, disease management during the lockdown and the previous 9 weeks. RESULTS: 2291 children affected by IBD were enrolled. We experienced a significant reduction of the hospital admissions [604/2291 (26.3%) vs 1281/2291 (55.9%); p < 0.001]. More specifically, we observed a reduction of hospitalizations for new diagnosis (from n = 44 to n = 27) and endoscopic re-evaluations (from n = 46 to n = 8). Hospitalization for relapses and surgical procedures remained substantially unchanged. Biologic infusions did not significantly vary [393/2291 (17.1%) vs 368/2291 (16%); p = 0.3]. Telemedicine services for children with IBD were activated in 52.3% of the centres. In 42/2291(1.8%) children immunosuppressive therapies were adapted due to the concurrent COVID-19 pandemic. CONCLUSION: Due to the several limitations of the lockdown, cares for children with IBD have been kept to minimal standards, giving priorities to the urgencies and to biologics' infusions and implementing telemedicine services.


Assuntos
Produtos Biológicos/uso terapêutico , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológico , Endoscopia Gastrointestinal/tendências , Fármacos Gastrointestinais/uso terapêutico , Hospitalização/tendências , Telemedicina/tendências , Adolescente , Criança , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/epidemiologia , Doença de Crohn/diagnóstico , Doença de Crohn/epidemiologia , Gerenciamento Clínico , Feminino , Humanos , Imunossupressores/uso terapêutico , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Doenças Inflamatórias Intestinais/epidemiologia , Itália/epidemiologia , Masculino , Recidiva
19.
Curr Opin Gastroenterol ; 37(1): 23-29, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33074995

RESUMO

PURPOSE OF REVIEW: The COVID-19 pandemic has impacted the practicing gastroenterologist in several ways. Although majority of COVID-19 patients present with respiratory symptoms, gastrointestinal symptoms are also seen. COVID-19 has also disrupted gastrointestinal endoscopy services in numerous ways. There are also concerns regarding the impact of these changes on gastrointestinal cancer screening and management of chronic gastrointestinal diseases. The purpose of this review is to provide an overview of the implications of COVID-19 for the practicing gastroenterologist. RECENT FINDINGS: COVID-19 patients can have gastrointestinal symptoms including diarrhea, nausea and vomiting, abdominal pain and anorexia. Separate from the management of COVID-19 patients, there has been a reduction in endoscopy volume worldwide. This has also resulted in reduction/cessation of in-person clinic visits and an increasing use of telemedicine services. In addition, patients with certain chronic diseases like chronic liver disease or inflammatory bowel disease may have worse outcomes during the COVID-19 pandemic. SUMMARY: Gastroenterologists need to rapidly adapt to the challenges being faced and need to make both systems and practice-based changes to the endoscopy unit and outpatient clinic practices. Gastroenterologists should stay up-to-date with the rapidly evolving literature regarding gastrointestinal symptoms in COVID-19 patients as well as its impact on chronic gastrointestinal illnesses.


Assuntos
Gastroenterologia/métodos , Gastroenteropatias , /complicações , /terapia , Doença Crônica , Endoscopia Gastrointestinal/métodos , Gastroenterologia/organização & administração , Gastroenteropatias/diagnóstico , Gastroenteropatias/terapia , Gastroenteropatias/virologia , Saúde Global , Alocação de Recursos para a Atenção à Saúde/métodos , Acesso aos Serviços de Saúde , Humanos , Controle de Infecções/métodos , Padrões de Prática Médica , Telemedicina/métodos
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