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[PMID]: 29488595
[Au] Autor:Calvopiña M; Flores J; Guaman I; Lara G; Abarca J
[Ad] Address:Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad De Las Américas, Quito, Ecuador.
[Ti] Title:Anemia crónica grave por Ancylostoma duodenale en Ecuador. Diagnóstico por duodenoscopia. [Chronic and severe anemia caused by Ancylostoma duodenale in Ecuador. Diagnosis by duodenoscopy].
[So] Source:Rev Chilena Infectol;34(5):499-501, 2017 Oct.
[Is] ISSN:0717-6341
[Cp] Country of publication:Chile
[La] Language:spa
[Ab] Abstract:For 11 years, a 38-year-old male residing in a subtropical region of Ecuador, was repeatedly diagnosed with chronic anemia, and treated with blood transfusions in a hospital of province of Cotopaxi, Ecuador. He was transferred to Quito for severe anemia, having hemoglobin of 4 g/dL. Duodenoscopy was performed and adult nematodes, identified later as Ancylostoma duodenale, were observed. The patient was successfully treated with albendazole for five consecutive days and given blood transfusions. In the control visit at eight months, without anemia and no hookworm ova in the stool examined were found.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[St] Status:In-Data-Review

  2 / 3509 MEDLINE  
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[PMID]: 29352618
[Au] Autor:Lucchina N; Recaldini C; Macchi M; Molinelli V; Montanari M; Segato S; Novario R; Fugazzola C
[Ad] Address:Department of Radiology, University Hospital, Varese, Italy. Electronic address: natalie.lucchina@hotmail.it.
[Ti] Title:Point Shear Wave Elastography of the Spleen: Its Role in Patients with Portal Hypertension.
[So] Source:Ultrasound Med Biol;44(4):771-778, 2018 Apr.
[Is] ISSN:1879-291X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The goals of the study described here were to evaluate the feasibility and reproducibility of measuring spleen stiffness (SS) using point shear wave elastography in a series of cirrhotic patients and to investigate whether SS, liver stiffness (LS) and other non-invasive parameters are correlated with the presence of esophagogastric varices (EVs). Fifty-four cirrhotic patients with low-grade EVs or without EVs at esophago-gastro-duodenoscopy were enrolled. They underwent abdominal ultrasound and Doppler ultrasound of hepatic vessels simultaneously with p-SWE of the liver and spleen. In 42 patients, the accuracy of LS and SS, as well as of platelet count and spleen longitudinal diameter, in predicting the presence of EVs was evaluated. The technical success was 90.74% for LS (49/54 patients) and 77.78% for SS (42/54 patients). Inter-observer agreement for SS measurement was high. Both LS and SS correlated with esophago-gastro-duodenoscopy: LS had the highest accuracy in predicting the presence of EVs (area under the receiver operating characteristic curve [AUROC] = 0.913); SS had the lowest accuracy (AUROC = 0.675); platelet count and spleen diameter had intermediate accuracy (AUROC = 0.731 and 0.729, respectively). SS did not have an advantage over LS in predicting low-grade EVs and cannot be proposed as a useful tool in the diagnostic process of cirrhotic patients who require screening esophago-gastro-duodenoscopy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Data-Review

  3 / 3509 MEDLINE  
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[PMID]: 29280782
[Au] Autor:Abu-El-Haija M; Kumar S; Quiros JA; Balakrishnan K; Barth B; Bitton S; Eisses JF; Foglio EJ; Fox V; Francis D; Freeman AJ; Gonska T; Grover AS; Husain SZ; Kumar R; Lapsia S; Lin T; Liu QY; Maqbool A; Sellers ZM; Szabo F; Uc A; Werlin SL; Morinville VD
[Ad] Address:Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
[Ti] Title:Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee.
[So] Source:J Pediatr Gastroenterol Nutr;66(1):159-176, 2018 01.
[Is] ISSN:1536-4801
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas committee performed a MEDLINE review using several preselected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed. The authorship met to discuss the evidence, statements, and voted on recommendations. A consensus of at least 75% was required to approve a recommendation. RESULTS: The diagnosis of pediatric AP should follow the published INternational Study Group of Pediatric Pancreatitis: In Search for a CuRE definitions (by meeting at least 2 out of 3 criteria: (1) abdominal pain compatible with AP, (2) serum amylase and/or lipase values ≥3 times upper limits of normal, (3) imaging findings consistent with AP). Adequate fluid resuscitation with crystalloid appears key especially within the first 24 hours. Analgesia may include opioid medications when opioid-sparing measures are inadequate. Pulmonary, cardiovascular, and renal status should be closely monitored particularly within the first 48 hours. Enteral nutrition should be started as early as tolerated, whether through oral, gastric, or jejunal route. Little evidence supports the use of prophylactic antibiotics, antioxidants, probiotics, and protease inhibitors. Esophago-gastro-duodenoscopy, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography have limited roles in diagnosis and management. Children should be carefully followed for development of early or late complications and recurrent attacks of AP. CONCLUSIONS: This clinical report represents the first English-language recommendations for the management of pediatric AP. Future aims should include prospective multicenter pediatric studies to further validate these recommendations and optimize care for children with AP.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[St] Status:In-Data-Review
[do] DOI:10.1097/MPG.0000000000001715

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[PMID]: 29327262
[Au] Autor:Itskoviz D; Levi Z; Boltin D; Vilkin A; Snir Y; Gingold-Belfer R; Niv Y; Dotan I; Dickman R
[Ad] Address:Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, 39 Jabotinski Street, 49100, Petah Tikva, Israel. mditskov@gmail.com.
[Ti] Title:Risk of Neoplastic Progression Among Patients with an Irregular Z Line on Long-Term Follow-Up.
[So] Source:Dig Dis Sci;, 2018 Jan 11.
[Is] ISSN:1573-2568
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Barrett's esophagus (BE) is a known complication of gastroesophageal reflux disease. In a previous study, we described a high prevalence of intestinal metaplasia (IM) in patients with an irregular Z line. However, the clinical importance of this finding is unclear. GOALS: To evaluate the long-term development of BE and relevant complications in patients diagnosed with an irregular Z line, with or without IM, on routine esophago-gastro-duodenoscopy (EGD). METHODS: In our previously described cohort, 166 out of 2000 consecutive patients were diagnosed with an incidental irregular Z line. Of those with irregular Z line, 43% had IM. In this continuation study, patients' status was reassessed after a median follow-up of 70 months. Patients were divided into two groups: Patients with IM (IM-positive group) and without IM (IM-negative group). The incidence of long-term development of BE, dysplasia, and esophageal adenocarcinoma were compared between groups. RESULTS: At least one follow-up EGD was performed in 102 (61%) patients with an irregular Z line. Endoscopic evidence of BE was found in eight IM-positive patients (8/50 [16%]) and in one IM-negative patient (1/52 [1.9%]). Two (4%) IM-positive patients developed BE with low-grade dysplasia. None of the patients developed high-grade dysplasia, or esophageal adenocarcinoma. CONCLUSIONS: Patients with irregular Z line do not develop major BE complication in more than 5 years of follow-up.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180112
[Lr] Last revision date:180112
[St] Status:Publisher
[do] DOI:10.1007/s10620-018-4910-1

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[PMID]: 29294595
[Au] Autor:Kim NH; Park JH; Park DI; Sohn CI; Choi K; Jung YS
[Ad] Address:Preventive Healthcare Center, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
[Ti] Title:Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?
[So] Source:Korean J Intern Med;, 2018 Jan 05.
[Is] ISSN:2005-6648
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180103
[Lr] Last revision date:180103
[St] Status:Publisher
[do] DOI:10.3904/kjim.2016.421

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[PMID]: 28449424
[Au] Autor:Bang BW; Park JS; Kim HK; Shin YW; Kwon KS; Kwon HY; Baek JH; Lee JS
[Ad] Address:Divisions of Gastroenterology, Inha University School of Medicine, Incheon, Korea.
[Ti] Title:Fecal Microbiota Transplantation for Refractory and Recurrent Infection: A Case Series of Nine Patients.
[So] Source:Korean J Gastroenterol;69(4):226-231, 2017 Apr 25.
[Is] ISSN:2233-6869
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Background/Aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. Results: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. Conclusions: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.
[Mh] MeSH terms primary: Clostridium Infections/therapy
Enterocolitis, Pseudomembranous/therapy
Fecal Microbiota Transplantation
[Mh] MeSH terms secundary: Aged
Aged, 80 and over
Anti-Bacterial Agents/therapeutic use
Clostridium Infections/diagnosis
Clostridium Infections/drug therapy
Colonoscopy
Duodenoscopy
Enterocolitis, Pseudomembranous/diagnosis
Enterocolitis, Pseudomembranous/drug therapy
Fecal Microbiota Transplantation/adverse effects
Feces/microbiology
Female
Humans
Male
Middle Aged
Pneumonia, Aspiration/etiology
Recurrence
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Anti-Bacterial Agents)
[Em] Entry month:1801
[Cu] Class update date: 180102
[Lr] Last revision date:180102
[Js] Journal subset:IM
[Da] Date of entry for processing:170428
[St] Status:MEDLINE
[do] DOI:10.4166/kjg.2017.69.4.226

  7 / 3509 MEDLINE  
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[PMID]: 29262947
[Au] Autor:Loots E; Clarke DL; Newton K; Mulder CJ
[Ad] Address:Department of Surgery, Inkosi Albert Luthuli Central Hospital, Durban, South Africa; Department of Surgery, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, Durban, South Africa. emilloots@hotmail.com.
[Ti] Title:Endoscopy services in KwaZulu-Natal Province, South Africa, are insufficient for the burden of disease: Is patient care compromised?
[So] Source:S Afr Med J;107(11):1022-1025, 2017 Oct 31.
[Is] ISSN:0256-9574
[Cp] Country of publication:South Africa
[La] Language:eng
[Ab] Abstract:BACKGROUND: Endoscopy services are central to the diagnosis and management of many gastrointestinal (GI) diseases. OBJECTIVE: To evaluate the adequacy of endoscopy services in the public sector hospitals of KwaZulu-Natal (KZN) Province, South Africa, in 2016. METHODS: A cross-sectional study was performed using a questionnaire completed by the clinical heads of endoscopy units in the public hospitals in KZN. RESULTS: The heads of 11 of the 12 endoscopy units responded. Two units were in tertiary-level hospitals and nine in regional hospitals. A total of 22 353 endoscopic procedures were performed annually, averaging 2 032 cases per annum per centre; they were performed by 89 endoscopists, of whom 72 (80.1%) were general surgeons. There were 0.06 registered gastroenterologists (GEs) per 100 000 population. Each endoscopist performed an average of 263 endoscopies per annum. There were 1.18 endoscopy rooms available per unit, and two units had on-site fluoroscopy available. The average waiting period for an upper endoscopy was 27 (range 7 - 60) days, for colonoscopy 29 (range 7 - 90) days and for duodenoscopy/endoscopic retrograde cholangiopancreatography 13 (range 4 - 20) days. This included patients with alarm symptoms for GI cancers. Equipment breakages interrupted most services, except for one hospital that had a service contract. Unit heads cited lack of equipment, trained staff and maintenance contracts as major shortcomings. CONCLUSIONS: Endoscopy units in KZN are not adequately equipped to deal with the endoscopy workload and services are plagued by frequent disruptions, which impact negatively on service delivery. There is a need to train more GEs. Patient care is compromised in these public hospitals.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171221
[Lr] Last revision date:171221
[St] Status:In-Data-Review
[do] DOI:10.7196/SAMJ.2017.v107i11.12484

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[PMID]: 29151478
[Au] Autor:Blockhaus C; Müller P; Vom Dahl S; Leonhardt S; Häussinger D; Gerguri S; Clasen L; Schmidt J; Kurt M; Brinkmeyer C; Kelm M; Shin DI; Makimoto H
[Ad] Address:Division of Cardiology, Pulmonary Diseases and Vascular Medicine, Department of Medicine, University Hospital Düsseldorf.
[Ti] Title:Low Incidence of Esophageal Lesions After Pulmonary Vein Isolation Using Contact-Force Sensing Catheter Without Esophageal Temperature Probe.
[So] Source:Int Heart J;, 2017 Nov 17.
[Is] ISSN:1349-3299
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Pulmonary vein isolation (PVI) is a cornerstone therapy for atrial fibrillation (AF). Although severe complications are rather rare, the development of an atrio-esophageal fistula (AEF) is a fatal complication with a very high mortality even after surgical treatment. The use of esophageal temperature probes (ETP) during PVI may protect the esophagus but it is still under debate since the ETP may also lead to esophageal lesions. The aim of this study was to evaluate the clinical safety of PVI using contact-force (CF) sensing catheter without esophageal temperature monitoring.We investigated 70 consecutive patients who underwent point-by-point PVI without usage of ETP and who underwent esophago-gastro-duodenoscopy (EGD) with detailed evaluation of the esophagus after the index PVI procedure. The operator attempted to keep CF within the 10-40 g range. The incidences of esophageal lesions (EDEL) detected by endoscopy were then analyzed.Two of 70 patients (2.9%) showed EDEL consisting of one longitudinal ulcer-like erythematous lesion with fibrin and a different one consisting of a round-shaped lesion surrounded by erythema and petechial hemorrhage. All EDEL healed within two weeks under high proton-pump inhibitor therapy without developing AEF as proven by a second EGD of the esophagus.Point-by-point PVI without usage of ETP showed a low incidence of EDEL (2.9%); atrio-esophageal fistula was absent. Further studies on the necessity of ETP under CF control are necessary.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:Publisher
[do] DOI:10.1536/ihj.16-382

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[PMID]: 29127130
[Au] Autor:Vaz AM; Cadilla AJ; Sousa D; Guerreiro H
[Ad] Address:Gastroenterology Department, Centro Hospitalar do Algarve, Faro, Portugal.
[Ti] Title:Eosinophilic oesophagitis and coeliac disease: is there an association?
[So] Source:BMJ Case Rep;2017, 2017 Nov 09.
[Is] ISSN:1757-790X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 25-year-old man was seen in outpatient clinic for progressive solid food dysphagia. He was already medicated with a proton pump inhibitor with no improvement. His blood tests showed a slight microcytic anaemia and peripheral eosinophilia. The oesophago-gastro-duodenoscopy showed longitudinal furrows in the distal two-thirds of the oesophagus and a concentric distal stenosis. The biopsies taken showed eosinophilic infiltrates consistent with eosinophilic oesophagitis. There was no improvement with topical fluticasone, so the patient was started on a systemic corticosteroid with resolution of dysphagia and of the oesophageal stenosis. He was kept on topical steroids for symptomatic control. On repeat endoscopy, the duodenal mucosa showed multiple papules that were biopsied. Histology showed features consistent with coeliacdisease. The patient was asymptomatic but there was evidence of iron deficiency anaemia, and so a gluten-free diet was started. Despite only a partial adherence to the diet, the iron deficiency anaemia resolved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171111
[Lr] Last revision date:171111
[St] Status:In-Process

  10 / 3509 MEDLINE  
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[PMID]: 29118840
[Au] Autor:Hopkins LE; Sunkersing J; Jacques A
[Ad] Address:Intensive Care Unit, Royal Berkshire NHS Foundation Trust, Reading, UK.
[Ti] Title:Too many pills to swallow: A case of a mixed overdose.
[So] Source:J Intensive Care Soc;18(3):247-250, 2017 Aug.
[Is] ISSN:1751-1437
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Propranolol is a highly lipid-soluble beta-receptor antagonist. We describe a case of mixed overdose, including propranolol, amlodipine and olanzapine, resulting in severe resistant hypotension which was successfully treated. A 21-year-old student ingested 6.4 g of propranolol, 280 mg of amlodipine and 560 mg of olanzapine. The patient was brought to the emergency department and exhibited signs of severe systemic toxicity - profound hypotension and circulatory collapse, respiratory depression and coma. The patient had conventional therapy but failed to respond to this and was therefore commenced on IntraLipid infusion, high-dose insulin infusion and inotrope infusion. An endoscopy was performed in intensive care which revealed a large drug beozar - this was removed. We believe that this combination of infusions with early endoscopy could be beneficial in treating similar patients in the future and present the first case of a propranolol drug bezoar.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171112
[Lr] Last revision date:171112
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.1177/1751143717693860


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