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1.
Medicine (Baltimore) ; 100(9): e24975, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655966

RESUMO

RATIONALE: Jejunal varices are rare in portal hypertension and are often difficult to diagnose and treat. Herein, we present a case of gastrointestinal bleeding due to jejunal varices after hepatobiliary surgery. PATIENT CONCERNS: A 69-year-old man presented with recurrent massive gastrointestinal bleeding. He underwent partial right hepatectomy and cholangiojejunostomy 2 years prior to the first onset of bleeding. Two sessions of endoscopic vessel ligation for esophageal varices were performed afterwards, and hematemesis resolved completely, but massive melena still recurred during the following 5 years. DIAGNOSIS: The patient was diagnosed with jejunal varices caused by portal venous stenosis after hepatobiliary surgery. INTERVENTION: Portal venous angioplasty using balloon dilation and stent implantation was performed. OUTCOMES: After the intervention procedure, the patient did not experience any onset of gastrointestinal bleeding during follow-up. LESSONS: Hepatopancreatobiliary could lead to the formation of jejunal varices. The combined use of capsule endoscopy, contrast-enhanced computed tomography, and sometimes portal venography is a promising strategy to search for jejunal varices. Transcatheter angioplasty appears to be a safe and effective method for treatment of jejunal varices in certain appropriate cases.


Assuntos
Hemorragia Gastrointestinal/etiologia , Hepatectomia/efeitos adversos , Jejunostomia/efeitos adversos , Litíase/cirurgia , Hepatopatias/cirurgia , Hemorragia Pós-Operatória/etiologia , Idoso , Endoscopia por Cápsula , Colonoscopia/métodos , Diagnóstico Diferencial , Endoscopia do Sistema Digestório/métodos , Hemorragia Gastrointestinal/diagnóstico , Humanos , Masculino , Hemorragia Pós-Operatória/diagnóstico
2.
Medicine (Baltimore) ; 100(10): e24890, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725845

RESUMO

RATIONALE: Cystoisosporiasis is an intestinal infectious disease caused by a coccidian protozoa, Cystoisospora belli (C. belli). It can cause prolonged and refractory diarrhea most commonly in immunocompromised patients, while immunocompetent individuals usually exhibit no symptoms or self-limited diarrhea. PATIENT CONCERNS: We herein report a case of chronic cystoisosporiasis in an immunocompetent patient. A 62-year-old man, who had been first diagnosed with cystoisosporiasis 15 years ago and had been treated with oral administration of trimethoprim-sulfamethoxazole (TMP-SMX), complained of persistent watery diarrhea. He was negative for anti-human immunodeficiency virus antibody and anti-human T-cell leukemia virus type 1 (HTLV-1) antibody. DIAGNOSIS: Biopsy specimens from the duodenum revealed oocysts in the atrophic absorptive epithelium and protozoa were detected through stool examination, indicating the recurrence of cystoisosporiasis. Capsule endoscopy showed diffuse atrophic mucosa with white villi in the entire small intestine. We diagnosed him with chronic cystoisosporiasis that occurred in an immunocompetent adult. INTERVENTIONS: Since oral administration of TMP-SMX and ciprofloxacin were ineffective, the intravenous administration of TMP-SMX was initiated. OUTCOMES: Intravenous TMP-SMX exhibited a significant improvement. LESSONS: This case indicates that even immunocompetent individuals may develop recurrent and refractory cystoisosporiasis. Furthermore, intravenous treatment of antibiotic agents should be considered when the impaired absorptive ability from the small intestine is suspected.


Assuntos
Antiprotozoários/administração & dosagem , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/tratamento farmacológico , Isosporíase/diagnóstico , Isosporíase/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Administração Intravenosa , Administração Oral , Antiprotozoários/uso terapêutico , Endoscopia por Cápsula , Doença Crônica , Diarreia/parasitologia , Humanos , Imunocompetência , Masculino , Pessoa de Meia-Idade , Recidiva , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
5.
Vnitr Lek ; 66(7): 39-42, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33380133

RESUMO

Celiac disease is an immune mediated entheropathy triggered by gluten in genetically predisposed individuals. Patients with celiac disease are at a higher risk of gastrointestinal malignancies. Diagnosis at an advance stage is one of the factors of an unfavorable prognosis of these complications. Our patient is a woman who was diagnosed with celiac disease at 53 years of age. After two years on a gluten-free diet she developed sideropenic anemia. No source of bleeding was found on the esophagogastroduodenoscopy or colonoscopy. Video capsule endoscopy revealed exulcerated bleeding stenosis in the jejunum, in front of which the capsule lodged. There were no signs of infiltration on simultaneous CT enterography. The patient was operated on and the infiltration of the jejunum was resected. The specimen was evaluated by a histopathologist as a moderately differentiated adenocarcinoma. Due to the risk factors, the patient received adjuvant chemotherapy. The knowledge of the malignant complications of celiac disease, their risk factors and the possibilities of modern enteroscopic methods could help in the early diagnosis and improvement of the prognosis of these diseases. Due to a lack of data and an absence of guidelines, treatment of a small bowel adenocarcinoma is based on an expert agreement and guidelines for colon cancer. Surgical treatment is the only potentially curative option. For stage II with risk factors and stage III adjuvant chemotherapy should be considered.


Assuntos
Adenocarcinoma , Endoscopia por Cápsula , Doença Celíaca , Neoplasias Duodenais , Adenocarcinoma/diagnóstico por imagem , Doença Celíaca/complicações , Feminino , Humanos , Intestino Delgado/diagnóstico por imagem , Pessoa de Meia-Idade
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4345-4348, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018957

RESUMO

Wireless capsule endoscopy (WCE) has been an effective and safe way to diagnose gastrointestinal (GI) disorders, such as, colon cancers, polyps and bleeding. The detection of bleeding and other anomalies is currently determined through conventional visual inspection of the WCE images by the physicians. An on-chip bleeding sensor is thus required, that can perform an automatic prescreening of the bleeding areas in real-time using blood's optical properties to assist the diagnosis. In this study, a spectrophotometer was initially used to evaluate the chromatic properties of blood. It is found that the reflection ratio pairs of 700 nm to 630 nm and 480 nm to 530 nm provide important statistics to separate blood from non-blood samples. It has been implemented hardware using small LEDs and photodiodes to validate the results. Therefore, the proposed sensor system works as a good candidate to be integrated in a WCE device to detect GI bleeding quickly and in real-time.


Assuntos
Endoscopia por Cápsula , Cor , Hemorragia Gastrointestinal/diagnóstico , Humanos
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4766-4769, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019056

RESUMO

In recent years, the Simultaneous Magnetic Actuation and Localization (SMAL) technology has been developed to accelerate and locate the wireless capsule endoscopy (WCE) in the intestine. In this paper, we propose a novel approach to detect the state of the capsule for improving the localization results. By creating a function to fit the relationship between the theoretical values of the actuating magnetic field and the measurement results, we present an algorithm for automatic estimation of the capsule state according to the fitting parameters. Experiment results on phantoms demonstrate the feasibility of the proposed method for detecting different states of the capsule during magnetic actuation.


Assuntos
Endoscopia por Cápsula , Algoritmos , Campos Magnéticos , Magnetismo
9.
Medicine (Baltimore) ; 99(43): e22864, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120825

RESUMO

Video capsule endoscopy (VCE) can detect mucosal lesions in the intestine, especially in the small bowel.Our study aims to evaluate the applications of VCE for pediatric gastrointestinal diseases.In this retrospective study, we included all patients who underwent VCE between December 2012 and December 2018. Clinical information and VCE data were analyzed.Among 828 patients, the completion rate was 99.6% (n = 825), with an average age of 10.2 ±â€Š3.3 years old. A total of 459 VCE procedures showed abnormalities, and the overall diagnostic yield was 55.6%. The most common indications for VCE were abdominal pain among 505 (61.2%) patients and hematochezia (10.1%) among 83. Among the positive results of VCE, small bowel ulcers accounted for the highest percentage (57.7%), of which 164 cases were diagnosed as inflammatory bowel disease. For obscure gastrointestinal bleeding, 12 cases were diagnosed as Meckel's diverticulum. In terms of the small bowel transit time of VCE, compared with the negative group [288 (216.5, 390.3) min] and the enteritis group [277 (192.5, 374.8) min], a longer transit time was needed in the small bowel ulcer group [332.5 (240, 451.5) min, P < .01]. There were no correlations of positive VCE findings with anemia, the white blood cell count, the C-reactive protein level or the small bowel transit time according to Spearman rank analysis.VCE is relatively well tolerated and safe in children and has great value for the diagnosis and treatment of abdominal pain, especially inflammatory bowel disease and obscure gastrointestinal bleeding.


Assuntos
Endoscopia por Cápsula/métodos , Gastroenteropatias/patologia , Úlcera/diagnóstico por imagem , Dor Abdominal/diagnóstico , Adolescente , Estudos de Casos e Controles , Criança , China/epidemiologia , Feminino , Hemorragia Gastrointestinal/diagnóstico , Humanos , Doenças Inflamatórias Intestinais/diagnóstico , Masculino , Divertículo Ileal/diagnóstico , Estudos Retrospectivos
10.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(9): 1007-1010, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-32933635

RESUMO

OBJECTIVE: To evaluate the value of capsule endoscopy in children with small intestinal diseases with hematochezia as the chief complaint. METHODS: A retrospective analysis was performed on the clinical data and capsule endoscopy findings of 93 children with hematochezia who were admitted to Children's Hospital of Fudan University from May 2015 to January 2019 and underwent capsule endoscopy. According to the capsule endoscopy findings of the jejunum and the ileum, they were divided into a positive lesion group with 39 patients and a negative lesion group with 54 patients. Related clinical data and the features of lesion on capsule endoscopy were analyzed for the two groups. RESULTS: There were no significant differences in age, sex, duration of capsule endoscopy, gastric transit time, and small intestinal transit time between the positive lesion and negative lesion groups (P>0.05). The positive lesion group had a significantly lower level of hemoglobin than the negative lesion group (P<0.05). Hemoglobin level was negatively correlated with the rate of positive lesions on capsule endoscopy (r=-0.342, P=0.001). Among the 39 patients with positive lesions on capsule endoscopy, the detection of Meckel's diverticulum was the highest (41%), followed by inflammatory bowel disease (21%). CONCLUSIONS: Capsule endoscopy has a certain value in detecting small intestinal diseases, especially diseases in the jejunum and the ileum, in children with lower gastrointestinal hemorrhage.


Assuntos
Endoscopia por Cápsula , Enteropatias , Criança , Hemorragia Gastrointestinal , Humanos , Jejuno , Divertículo Ileal , Estudos Retrospectivos
11.
Am Heart J ; 228: 8-16, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32745734

RESUMO

BACKGROUND: Gastrointestinal injury is a common complication in patients treated with antiplatelet agents after percutaneous coronary intervention (PCI). However, the effects of different antiplatelet regimens on the incidence and severity of gastrointestinal injury have not been well studied, principally due to the lack of a low-risk sensitive and accurate detection system. TRIAL DESIGN: OPT-PEACE is a multicenter, randomized, double-blind, placebo-controlled trial. Gastrointestinal injury will be evaluated with the ANKON magnetically controlled capsule endoscopy system (AMCE), a minimally invasive approach for detecting mucosal lesions in the stomach, duodenum and small intestine. Patients without AMCE-detected gastrointestinal erosions, ulceration or bleeding after drug-eluting stent implantation are enrolled and treated with open-label aspirin (100 mg/d) plus clopidogrel (75 mg/d) for 6 months. Thereafter, 480 event-free patients will undergo repeat AMCE and are randomly assigned in a 1:1:1 ratio to receive aspirin plus clopidogrel, aspirin plus placebo or clopidogrel plus placebo for an additional 6 months. A final AMCE is performed at 12 months. The primary endpoint is the incidence of gastric or intestinal mucosal lesions (erosions, ulceration, or bleeding) within 12 months after enrollment. CONCLUSIONS: OPT-PEACE is the first study to investigate the incidence and severity of gastrointestinal injury in patients receiving different antiplatelet therapy regimens after stent implantation. This trial will inform clinical decision-making for personalized antiplatelet therapy post-PCI.


Assuntos
Aspirina , Endoscopia por Cápsula/métodos , Clopidogrel , Doença da Artéria Coronariana , Hemorragia Gastrointestinal , Intervenção Coronária Percutânea , Adulto , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Clopidogrel/administração & dosagem , Clopidogrel/efeitos adversos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/cirurgia , Método Duplo-Cego , Stents Farmacológicos , Terapia Antiplaquetária Dupla/métodos , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/prevenção & controle , Humanos , Masculino , Avaliação de Processos e Resultados em Cuidados de Saúde , Intervenção Coronária Percutânea/instrumentação , Inibidores da Agregação de Plaquetas/administração & dosagem , Inibidores da Agregação de Plaquetas/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco Ajustado/métodos
13.
Am J Gastroenterol ; 115(8): 1201-1209, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32558685

RESUMO

INTRODUCTION: Nonendoscopic Barrett's esophagus (BE) screening may help improve esophageal adenocarcinoma outcomes. We previously demonstrated promising accuracy of methylated DNA markers (MDMs) for the nonendoscopic diagnosis of BE using samples obtained from a capsule sponge-on-string (SOS) device. We aimed to assess the accuracy of these MDMs in an independent cohort using a commercial grade assay. METHODS: BE cases had ≥ 1 cm of circumferential BE with intestinal metaplasia; controls had no endoscopic evidence of BE. The SOS device was withdrawn 8 minutes after swallowing, followed by endoscopy (the criterion standard). Highest performing MDMs from a previous study were blindly assessed on extracted bisulfite-converted DNA by target enrichment long-probe quantitative amplified signal (TELQAS) assays. Optimal MDM combinations were selected and analyzed using random forest modeling with in silico cross-validation. RESULTS: Of 295 patients consented, 268 (91%) swallowed the SOS device; 112 cases and 89 controls met the pre-established inclusion criteria. The median BE length was 6 cm (interquartile range 4-9), and 50% had no dysplasia. The cross-validated sensitivity and specificity of a 5 MDM random forest model were 92% (95% confidence interval 85%-96%) and 94% (95% confidence interval 87%-98%), respectively. Model performance was not affected by age, gender, or smoking history but was influenced by the BE segment length. SOS administration was well tolerated (median [interquartile range] tolerability 2 [0, 4] on 10 scale grading), and 95% preferred SOS over endoscopy. DISCUSSION: Using a minimally invasive molecular approach, MDMs assayed from SOS samples show promise as a safe and accurate nonendoscopic test for BE prediction.


Assuntos
Adenocarcinoma/diagnóstico , Esôfago de Barrett/diagnóstico , Neoplasias Esofágicas/diagnóstico , Marcadores Genéticos , Adenocarcinoma/genética , Adenocarcinoma/patologia , Idoso , Área Sob a Curva , Esôfago de Barrett/genética , Esôfago de Barrett/patologia , Biópsia , Endoscopia por Cápsula , Estudos de Casos e Controles , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/patologia , Esofagoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Estados Unidos
14.
Clin Med (Lond) ; 20(4): 352-358, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32518104

RESUMO

Many non-emergency clinical services were suspended during COVID-19 pandemic peak. It is essential to develop a plan for restarting services following the peak. It is equally important to protect patients and staff and to use resources and personal protective equipment (PPE) efficiently. The British Society of Gastroenterology Endoscopy Committee and Quality Improvement Programme has produced guidance on how a restart can be safely delivered. Key recommendations include the following: all patients should have need for endoscopy assessed by senior clinicians and prioritised according to criteria we have outlined; once the need for endoscopy is confirmed, patients should undergo telephone screening for symptoms using systematic questionnaires; all outpatients should undergo RT-PCR testing for COVID-19 virus 1-3 days prior to endoscopy; and PPE should be determined by patient risk stratification, the nature of the procedure and the results of testing. While this guidance is tailored to endoscopy services, it could be adapted for any interventional medical discipline.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Endoscopia Gastrointestinal/normas , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Endoscopia por Cápsula/normas , Colangiopancreatografia Retrógrada Endoscópica/normas , Colonoscopia/normas , Endossonografia/normas , Humanos , Saúde do Trabalhador , Segurança do Paciente , Equipamento de Proteção Individual
15.
Rev. argent. cir ; 112(2): 141-156, tab
Artigo em Inglês, Espanhol | LILACS | ID: biblio-1125795

RESUMO

Antecedentes: la cirugía robótica es una alternativa a la cirugía abierta, microcirugía láser CO2, o quimiorradioterapia en vía aerodigestiva superior. El robot permite trasladar la técnica quirúrgica abierta a un abordaje mínimamente invasivo, con acceso por boca, para patología benigna y maligna. Actualmente se emplean diferentes terapéuticas con similares resultados oncológicos. Objetivo: introducir una herramienta quirúrgica para abordaje bucal. Comunicar la experiencia inicial con el uso del robot. Evaluar la preservación de respiración y deglución. Analizar variables que determinaron una disminución en la hospitalización. Material y métodos: 13 mujeres y 11 hombres. Edad entre 16 y 82 años, media de 55,08. Total 24 pacientes con enfermedad inflamatoria crónica (8), tumores benignos (4) y malignos (12). Variables consideradas en cirugía robótica: tiempo y lugar de internación, complicaciones, estado respiratorio y deglutorio, uso de técnicas reconstructivas. Se realizó videoendoscopia de deglución para objetivar la seguridad del método. Resultados: tiempo medio de internación: 1,92 días. El 83,3% internado 1 día. El 79,9% en internación general. Unidad cerrada: 20,1%. Ninguna traqueostomía. Cicatrización del lecho por segunda. Sin complicaciones. Edema de lengua: 2 pacientes. Conclusiones: la cirugía robótica favorece la exéresis con baja morbilidady máxima preservación de tejidos sanos. Disminuye: edema posoperatorio, uso colgajos para reparar el lecho, traqueotomía temporaria, tiempo de internación. La videoendoscopia de deglución demuestra utilidad para determinar la deglución segura. Limitante del presente trabajo es el tamaño de la muestra. Es importante incrementar el número de pacientes para valorizar supervivencia y calidad de vida.


Background: robotic surgery is an alternative to open surgery, CO2 laser microsurgery, or chemoradiation for the upper aero-digestive tract. This system allows surgeons to use the open surgical technique in a minimally invasive approach through the mouth to treat benign and malignant disorders. Different treatments are currently used with similar oncologic outcomes. Objective: the aim of this study was to introduce a surgical tool through transoral approach, report the initial experience with the use of the robotic system, evaluate respiratory and digestive functional preservation and analyze the variables associated with shorter hospital length of stay. Material and methods: A total of 24 patients (13 women and 11 men, mean age 55.08 years [16-82]) were included. Eight patients had chronic inflammatory disease, four had benign tumors and 12 had cancer. The variables considered in robotic surgery were hospital length of stay, place of postoperative care, complications, respiratory and swallowing function and use of reconstructive techniques. Flexible endoscopic evaluation of swallowing was performed to document safe function. Results: mean length of stay was 1.92 days; 83.3% stayed for one day; 79.9% were admitted to the general ward and 20.1% stayed in intensive or intermediate care units. None of the patients required tracheostomy. Healing of the surgical bed occurred by secondary intention. There were no complications. Tongue edema occurred in two patients. Conclusions: robotic surgery favors tumor removal with low morbidity and maximum preservation of healthy tissues while reducing postoperative edema, use of flaps for reconstruction, temporary tracheostomy and hospital length of stay. Flexible endoscopic evaluation of swallowing is useful to determine safe swallowing function. The main limitation of our study is the sample size. It is important to increase the number of patients to evaluate survival and quality of life.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias de Cabeça e Pescoço/cirurgia , Argentina , Período Pós-Operatório , Cirurgia Geral/métodos , Deglutição , Endoscopia por Cápsula
16.
Rev. esp. enferm. dig ; 112(6): 429-433, jun. 2020. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-199789

RESUMO

BACKGROUND: Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract and is also an important cause of bloody stool and anemia in children. However, there are few data about video capsule endoscopy (VCE) for MD in children. This study aimed to evaluate the diagnostic value of VCE for MD in children. MATERIALS AND METHODS: children who underwent VCE for obscure gastrointestinal bleeding from October 1st 2015 to August 31st 2019 at the Children's Hospital of Fudan University were included in this retrospective study. Medical data, VCE data and Meckel's scans, etc. were collected for each patient. RESULTS: sixteen patients were diagnosed with MD by VCE, including 13 males and 3 females. The age of the patients ranged from 4 years to 13 years, with an average of 7.8 ± 2.7 years. Lower gastrointestinal tract bleeding was the main symptom for patients with MD, including hematochezia (75 %) and melena (25 %). Of the VCE findings, 14 patients had double lumen signs and 2 showed protruding lesions. Among the 16 patients diagnosed with MD by VCE, 14 patients were diagnosed with MD by Meckel's scan, 3 with MD by abdominal enhanced CT and 14 patients were diagnosed with MD by surgery. During the follow-up, bleeding occurred sporadically in patient 12 and the reason is still unknown. CONCLUSIONS: VCE is useful for the diagnosis of MD and should be used as a valuable and less invasive examination to confirm or establish a diagnosis


No disponible


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Divertículo Ileal/diagnóstico por imagem , Endoscopia por Cápsula , Cápsulas Endoscópicas , Reprodutibilidade dos Testes , Seguimentos
17.
Colorectal Dis ; 22(6): 621-624, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32403190

RESUMO

AIM: The coronavirus pandemic has led to significant challenges for healthcare delivery across the globe. Non-emergency endoscopic activity in the UK has been postponed, raising concerns of increased delays in the diagnosis of colorectal cancer and a surge in demand once services resume. Measures to mitigate this risk must be considered. METHOD: This paper reviews various investigative modalities for colorectal disease which could be deployed during cessation of colonoscopy services. We focus on colon capsule endoscopy (CCE) due to its relevance during the COVID-19 pandemic and its ability to triage patients effectively to further endoscopic investigations. RESULTS: CT of the abdomen and pelvis has been suggested as a triage tool while access to colonoscopy is limited. However, CT may lead to the spread of COVID-19 as patients attend the hospital, and it exposes them to the risks of radiation. Faecal immunochemistry tests have been demonstrated as a good predictor of colonic pathology and could be safely used to risk stratify patients when prioritizing colonoscopy. CCE is a safe and innovative technology for investigating the colon. Procedures can be carried out in the community and can be conducted safely during the coronavirus pandemic. It has been shown to be an accurate detector of colonic neoplasia and can reduce demand for colonoscopy. CONCLUSION: As colonoscopy services resume, they will probably experience high demand leading to further delays for patients. CCE could be used to reduce the number of patients requiring colonoscopy and triage those requiring further endoscopic investigations appropriately.


Assuntos
Endoscopia por Cápsula/métodos , Neoplasias Colorretais/diagnóstico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Triagem/métodos , Betacoronavirus , Colonoscopia/métodos , Humanos , Imunoquímica/métodos , Sangue Oculto , Pandemias
18.
Rev. esp. enferm. dig ; 112(5): 373-379, mayo 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195591

RESUMO

INTRODUCCIÓN: la calprotectina fecal es un parámetro útil a la hora de decidir si un paciente se puede beneficiar de la realización de estudios endoscópicos. No obstante, cierto número de individuos sintomáticos y con cifras elevadas de este marcador no tendrán lesiones endoscópicas. El objetivo de este estudio es determinar qué factores se asocian a cifras alteradas de calprotectina fecal en pacientes con estudios endoscópicos de intestino delgado y colon normales. MÉTODOS: estudio prospectivo y observacional de pacientes con síntomas digestivos. Se ha analizado la asociación de diferentes variables con cifras alteradas de calprotectina y estudios endoscópicos (cápsula de intestino delgado y colonoscopia) negativos. RESULTADOS: se incluyen 143 pacientes (98 mujeres - 68,5 %), con una edad media 40,06 ± 16,42 (15-82) años. El consumo de tabaco y la toma de antiinflamatorios no esteroideos se asoció a la presencia de cifras alteradas de calprotectina y estudios endoscópicos negativos (p: 0,029 y p: 0,006). Los valores medios de calprotectina fecal fueron significativamente mayores entre los fumadores, consumidores de antiinflamatorios y pacientes con test positivo de sobrecrecimiento bacteriano de intestino delgado. El tabaquismo (OR: 3,505; p: 0,028), la toma de antiinflamatorios (OR: 3,473; p: 0,021) y el sobrecrecimiento bacteriano (OR: 3,172; p: 0,013) son factores de riesgo independientes para presentar una calprotectina alterada sin lesiones endoscópicas. No se obtuvo asociación con ninguna otra variable. CONCLUSIONES: el consumo de tabaco y de antiinflamatorios no esteroideos tiene una fuerte asociación con la presencia de valores elevados de calprotectina en ausencia de lesiones endoscópicas. Se ha observado también asociación con el sobrecrecimiento bacteriano de intestino delgado


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Idoso de 80 Anos ou mais , Biomarcadores/análise , Fezes/química , Intestino Delgado/microbiologia , Endoscopia Gastrointestinal/métodos , Endoscopia por Cápsula , Fatores de Risco , Estudos Prospectivos , Crescimento Bacteriano
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