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Results for “Endoscopy, Digestive System”

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At least 397 records · Page 22Linked to original sources
PubMed2001

Light-induced autofluorescence spectroscopy for the endoscopic detection of esophageal cancer.

BACKGROUND: Any innovative optical system that facilitates the early endoscopic detection of neoplastic change in the GI mucosa has the potential to greatly improve survival and quality of life for patients prone to have GI malignancies develop. The present article describes light-induced autofluorescence spectroscopy with violet-blue excitation light for in vivo diagnosis of cancerous tissue of the esophagus during routine endoscopy. METHODS: One hundred twenty-nine endogenous fluorescence spectra were obtained from normal mucosa and malignant lesions in 9 patients with squamous cell cancer and 4 with adenocarcinoma of the esophagus. Following spectrographic measurements, biopsy specimens were obtained for definitive classification of the spectra. A special light source capable of delivering either white or violet-blue light for excitation of tissue autofluorescence by means of an endoscope was used. Endogenous fluorescence spectra emitted by tissues were detected with a fiberoptic probe and analyzed with a spectrograph. RESULTS: Squamous cell cancer and adenocarcinoma of the esophagus exhibit specific changes in the emitted fluorescence spectra as compared with normal mucosa. Based on the results obtained in earlier studies, malignant and benign spectra were differentiated with the aid of a mathematical algorithm. By using this algorithm, a sensitivity of 97% and specificity of 95% were obtained for the diagnosis of esophageal carcinoma. CONCLUSIONS: Light-induced fluorescence spectroscopy is useful for the endoscopic detection of squamous cell cancer and adenocarcinoma of the esophagus. This spectroscopic study provides a basis for the design of a simplified autofluorescence imaging system for detection of esophageal neoplasms.

Adenocarcinoma↗
PubMed1983

A randomized comparison of midazolam and diazepam for sedation in upper gastrointestinal endoscopy.

One hundred and eighty-five patients were allocated at random to receive pethidine with diazepam (in an emulsion), or pethidine with midazolam i.v. as sedation for upper gastrointestinal endoscopy. Sedation and conditions for examination were comparable and satisfactory in both groups. Midazolam produced more amnesia (P = less than 0.001), and scored higher in patients' opinion (P = less than 0.001); it was associated with a slightly greater frequency of venous sequelae, but the difference in thrombophlebitis was not statistically significant. Recovery of sensory--motor performance, as assessed by Trieger test, was still incomplete 2 h after endoscopy with both drug regimens.

Adolescent↗
PubMed2003

[Quality of hygiene in endoscope reprocessing--the fundamentals of indicator-assisted quality management in gastroenterology].

High level disinfection and infection control in reprocessing gastrointestinal endoscopes is a critical security factor for patients in gastrointestinal health care. National and international guidelines for an adequate high quality disinfection of gastrointestinal endoscopes have been developed aiming to obtain infection control. The German Medical Association has recently published recommendations on quality assurance in gastrointestinal endoscopy including standardised procedures for disinfection and infection control. A prospective study was carried out in a large urban area in both private practices and hospitals to identify and characterise flaws and limitations in disinfection of gastrointestinal endoscopes by measuring a set of indicators of the quality of structures, processes and outcomes. Moreover, the influence of information and continuous medical education on the quality of disinfection and infection control were to be evaluated. The bacterial contamination of endoscopes after reprocessing was measured as a relevant outcome quality indicator. The results revealed substantial flaws in cleaning and disinfection procedures in gastrointestinal endoscopy under routine clinical conditions. Overall, 49 and 39 percent of all (pre- and post-interventionally, resp.) checked endoscopes were contaminated by one or more bacteria. More often failures were discovered in the optic rinse system than in the cleaning/disinfection and the final rinse and drying process. A substantial failure rate was detected in gastrointestinal endoscope reprocessing under routine conditions according to the reprocessing procedure. Compared to manual and semi-automatic cleaning and disinfection, the full automatic cleaning and disinfection machines (RDG-E) showed the best results. Though their cleaning process remains improveable, it seems advisable to prefer RDG-E-machines for disinfection and infection control in gastrointestinal endoscopy. Continuous quality control of disinfection should be obtained by introducing regular microbiological examinations of the reprocessed endoscopes. Negative microbiological controls of the contamination of endoscopes are suitable quality indicators of a quality management system aiming to improve the quality of structures, processes and outcomes in gastroenterological health care.

Disinfection↗
PubMed1994

Endoscopic study of African AIDS patients with upper gastrointestinal symptoms.

This study was carried out to investigate the endoscopic and histopathological findings in AIDS patients in Mulago Hospital, in Uganda who present with upper gastrointestinal symptoms. Any observed morphological changes were biopsied. Duodenal contents were aspirated in each case for microscopic examination. Vomiting was reported in 100% of the patients, dysphagia and epigastric pain were reported in 89%. Other symptoms reported in decreasing frequency were odynophagia 46%, retrosternal chest pain 40%, haematemesis 10%, and hiccough 3%. Up to 74% of the patients had morphological changes in the oesophagus, while 28% showed changes in the stomach. Only 15% demonstrated changes in the duodenum. Duodenal aspirate revealed giardia lamblia 22%, Acid fast bacilli 7% and cryptosporidium 5%. Endoscopic findings were mostly observed in the oesophagus. Candida was the main pathogen detected. Also atrophic gastritis is a recognizable finding in these patients.

AIDS-Related Opportunistic Infections↗
PubMed2006

Quality of patient referral information for open-access endoscopic procedures.

BACKGROUND: Increased demand for endoscopic procedures has led to the provision of these services without prior consultation (open access). The need for accurate medical referral information for these patients is vital for patient safety. OBJECTIVE: To assess the accuracy of endoscopic referral information. DESIGN: Over a 4-month study period, patient referral forms were evaluated to determine the accuracy of medical information on patient referral forms by using direct interview with the patient and/or the caregiver. Inconsistencies were validated against medical records. SETTING: Large academic medical clinic. PATIENTS: A total of 868 open-access patient referrals for upper endoscopy and colonoscopy services. MAIN OUTCOME MEASUREMENTS: Referral information about medical diagnoses, medications, allergies, need for antibiotic administration, and current coagulopathies. RESULTS: Inaccurate medical referral information was provided to the endoscopist in 8.8% of referrals (n = 76). Among referrals containing errors, there were a total of 95 significant medical information errors, which, if left undetected by preprocedure review, could have resulted in serious adverse consequences for patients undergoing endoscopy. LIMITATIONS: Study limited to an academic clinical setting. CONCLUSIONS: Patient referrals for endoscopic services in an open-access referral system contain unacceptably high numbers of errors, which place patients at risk for adverse outcomes from endoscopic procedures.

Academic Medical Centers↗
PubMed2004

[Clinical analysis of 38 elderly patients with early double primary cancers].

OBJECTIVE: To study the clinical features and proper treatment of 38 elderly patients with early double primary cancers. METHODS: Thirty-eight elderly patients with early double primary cancers treated from January 1980 to March 2003 were retrospectively reviewed for involved organs, treatment and prognosis. RESULTS: Digestive tract was the most frequently involved, followed by urogenital system and lung. Long-term results of endoscopic mucosal resection (EMR), operation and radiotherapy were superior to other methods. The prognosis of gastrointestinal carcinoma was better than that of prostate carcinoma and hematopoietic system. The operation rate decreased with increasing age. The 5-year survival rates of EMR, operation and radiotherapy were 85.7%, 71.1% and 75.0%, respectively. The medium survival time was 120 months in first cancer and 39 months in the second primary cancer. The 5-year survival rates of the first cancer and second primary cancer were 88.6% and 53.8%. CONCLUSION: Yearly follow-up for elderly patients with endoscopy, beta ultrasonic scan and X-ray contribute to finding of early double primary cancers. Operation is the best treatment of early double primary cancers. Endoscopic mucosal resection is especially suitable for old patients with digestive tract and bladder cancer.

Aged↗
PubMed2000

Esophageal varices. II. TIPS (transjugular intrahepatic portosystemic shunt) and surgical therapy.

The role of surgery in the prevention and treatment of variceal hemorrhage is reviewed. Types of available surgery, their physiologic basis, and literature supporting their use are discussed in the context of the natural history of variceal hemorrhage. The evolution of transjugular intrahepatic portosystemic shunt (TIPS) as a treatment modality for variceal hemorrhage is reviewed. The effects of TIPS on portal and systemic hemodynamics and clinical usefulness in the management of variceal hemorrhage are discussed. A treatment algorithm for the integrated use of the various treatments is provided.

Endoscopy, Digestive System↗
PubMed1996

Intrahepatic biliary endoscopy in sclerosing cholangitis.

Sclerosing cholangitis is usually diagnosed by clinical findings coupled with radiographic imaging of the bile ducts by ERCP. Direct imaging of both the intra- and extrahepatic biliary tree provides an opportunity to further study this disorder and its potential complications such as biliary malignancy. However, endoscopic visualization of the intrahepatic bile ducts in sclerosing cholangitis is potentially limited by the size of available cholangioscopes and the presence of strictures. Below, we report our initial results using a 0.8-mm fiberoptic endoscope placed through a partially steerable 1.8-mm guide catheter. The system allows visualization of the intrahepatic biliary tree beyond areas of stricture in the more distal ducts.

Cholangitis, Sclerosing↗
PubMed2004

Wireless capsule video endoscopy: three years of experience.

AIM: To review and summarize the current literature regarding M2A wireless capsule endoscopy. METHODS: Peer reviewed publications regarding the use of capsule endoscopy as well as our personal experience were reviewed. RESULTS: Review of the literature clearly showed that capsule endoscopy was superior to enteroscopy, small bowel follow through and computerized tomography in patients with obscure gastrointestinal bleeding, iron deficiency anemia, or suspected Crohn's disease. It was very sensitive for the diagnosis of small bowel tumors and for surveillance of small bowel pathology in patients with Gardner syndrome or familial adenomatous polyposis syndrome. Its role in celiac disease and in patients with known Crohn's disease was currently being investigated. CONCLUSION: Capsule video endoscopy is a superior and more sensitive diagnostic tool than barium follow through, enteroscopy and entero-CT in establishing the diagnosis of many small bowel pathologies.

Contraindications↗
PubMed1995

The problem fellow.

Problems encountered in training GI fellows range from illnesses that affect patient care (impaired physician) to problems in the timely acquisition of the technical, cognitive, and personal skills required to perform endoscopy competently and independently. The key for fellowship programs in addressing potential problems is to develop a system that monitors fellows and provides regular feedback along with early intervention. The existence of such a program will benefit the program, the fellows, and the public.

Clinical Competence↗
PubMed2004

Toward more user-friendly electronic endoscopy information systems: role of accessories.

The needs placed on today's physician to improve efficiency in the endoscopy unit are nowhere more apparent than in transcribing endoscopy reports. In spite of the constant progress made in currently available electronic endoscopy information systems, the systems lack efficiency and ease of use. Both of these problems could be addressed through the linkage of electronic endoscopy information systems to currently available accessory systems. W review how the linkage of tablet personal computers, voice recognition systems, and web connectivity software, which facilitates communication with electronic-based medical records, can be helpful. The final answer, however, will have to await clinical trials.

Endoscopy, Digestive System↗
PubMed1995

A rational approach to giving antibiotic prophylaxis before endoscopy. Who needs it? Which procedures pose the greatest risk?

Although transient bacteremia occasionally occurs after many GI endoscopic procedures, the incidence of actual infection is low. However, in addition to endocarditis, peritonitis, abscesses, meningitis, portacaval anastomotic infection, and sepsis have been reported. Prophylaxis may reduce the risk of infection; whether it is needed depends on two factors: Is the procedure to be performed associated with an increased likelihood of infection? Does the patient have an underlying condition (such as valvular heart disease or immune system incompetence) that increases the risk of such an infection? Antibiotics that are frequently used for prophylaxis include amoxicillin or gentamicin and ampicillin.

Anti-Bacterial Agents↗
PubMed1996

Is sterile water irrigation safe during postoperative choledochoscopy? A prospective trial.

OBJECTIVE: To evaluate the safety of sterile water irrigation during postoperative choledochoscopy. DESIGN: Consecutive open study. SETTING: Teaching hospital, Taiwan. SUBJECTS: 60 patients who were to undergo choledochoscopy at least 4 weeks after choledochotomy. INTERVENTIONS: Sterile water was used to maintain a clear view of the biliary tree during fibreoptic choledochoscopy after removal of the T-tube. MAIN OUTCOME MEASURES: Changes in serum electrolyte concentrations and osmolality after the procedure. Morbidity. RESULTS: There were no significant differences between serum sodium, potassium, and chloride concentrations or osmolality measured before and after choledochoscopy. One patient developed haemobilia and two had transient chills and fever, and two had abdominal pain. There were no systemic signs of excessive water absorption. CONCLUSION: With careful monitoring sterile water can safely be used during postoperative choledochoscopy.

Adult↗
PubMed1999

Gastric injury following copper sulfate ingestion.

We report the presentation and management of a 25-month-old with copper sulfate ingestion. The child suffered a gastric mucosal burn, but had no evidence of systemic copper toxicity and experienced full recovery with conservative medical management. A literature review of copper sulfate poisoning is provided.

Burns, Chemical↗
PubMed1996

[Acute pancreatitis: diagnosis].

In the differential diagnosis of abdominal pain, acute pancreatitis may be diagnosed by its clinical features together with blood determinations and ultrasonographic findings. The primary diagnostic steps include the differentiation between biliary or non-biliary etiology of the disease. In biliary acute pancreatitis, ERCP with endoscopic sphincterotomy is recommended, although the benefit of this procedure has only been shown in patients with severe clinical courses. An early discrimination between edematous-interstitial pancreatitis [mild clinical course] and necrotizing pancreatitis [severe clinical course associated with local and systemic complications] is possible by daily CRP-monitoring. In necrotizing pancreatitis, contrast-enhanced computed tomography is the next diagnostic step, and the patient should be transferred to an intensive care unit. To differentiate between severe sterile pancreatitis and infected pancreatic necrosis, ultrasonographic or CT-guided fine needle aspiration of the pancreatic inflammatory mass is suggested. Infected pancreatic necroses are associated with systemic septic complications, which are the main mortality factor and the major reason for operative treatment of necrotizing pancreatitis.

Acute Disease↗
PubMedDate not supplied

Treatment of intrahepatic biliary stricture associated with hepatolithiasis.

Biliary stricture is a difficult complication in the management of hepatolithiasis. Resection of the hepatic segment containing biliary stricture(s) is ideal. Dilatation and stenting therapy with PTCSL in selective cases is a good adjuvant, sometimes alternative, therapy. We recommend a combination of multimodal treatment with a systemic approach to improve results. For recurrent or residual cases, PTCSL becomes the mainstay of treatment.

Adult↗
PubMed1991

A case of multiple cholangiogenic liver abscess due to residual biliary stone cured by percutaneous drainage controlled by CT and endoscopic papillotomy.

The case of a patient treated for multiple cholangiogenic liver abscess due to residual biliary stone after acute cholecystitis is reported. The multiple liver cyst was cured by percutaneous transhepatic double drainage controlled by CT as well as puncture and aimed local systemic antibiotic treatment. The residual gallbladder stone was removed by endoscopic papillotomy. A similar case has not been reported so far.

Ampulla of Vater↗