Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ENDOSCOPY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed1994

Occupational exposure to Helicobacter pylori for the endoscopy professional: a sera epidemiological study.

OBJECTIVES: The purpose of this prospective study was to determine if medical and nursing staff in the United States who are regularly involved in endoscopic procedures are at an increased risk of acquiring Helicobacter pylori infection. METHODS: One hundred and twenty-two gastroendoscopists and endoscopy nurses attending an advanced gastroendoscopy course (17 women, 105 men) completed a questionnaire consisting of past medical and professional history. Serum from each subject was collected and tested using a validated ELISA assay (sensitivity 99%, specificity 96%). H. pylori prevalence in the experimental group was compared to that of 510 blood donors. RESULTS: In all age groups, H. pylori positivity was significantly higher among the study subjects compared with controls. Caucasian subjects, when matched to controls for age, race, and level of education, had significantly higher rates of H. pylori positivity. Foreign-born subjects, when compared to US-born subjects, also had higher rates of H. pylori positivity. There was no statistical difference of H. pylori positivity with respect to gender, years involved in endoscopy, or number of endoscopies performed monthly. CONCLUSION: H. pylori infection is more common in gastroendoscopists and endoscopy nurses than the general population and should be viewed as an occupational hazard.

Adult↗
PubMed1994

The upper gastrointestinal endoscopy report.

In summary, the endoscopy report is the permanent documentation and communication of the endoscopic procedure. The computerized endoscopy report system has, of necessity, improved our standardization of terminology and report content. Computerization of the endoscopy report has opened the door to easier auditing and quality review, as well as easier tracking and recall for research and teaching purposes. Nonetheless, the components of the endoscopy report have not changed. As with all communication, our goal should be clear, accurate, and concise expression.

Communication↗
PubMed1994

Complications of upper gastrointestinal endoscopy and their management.

The tremendous growth in the use of gastrointestinal endoscopy has necessarily produced complications of the procedures. In general, overall reported complication rates for diagnostic endoscopy are extremely low (0.13%-0.24%) reflecting these procedures' overall safety. However, many of these reports are likely to underestimate the true complication rate. Therapeutic procedures have substantially higher complication rates, the most frequent of which is perforation. Esophageal dilation, achalasia pneumatic dilation, and esophageal endoprosthesis placement carry the highest risk of perforation, 0.25%, 3.3%, and 7% to 15%, respectively. The outcomes research movement will revolutionize the future practice of endoscopy. Practice guidelines for endoscopy will not be determined by expert panels, but will be established empirically by outcomes research. Accurate complication rates will be determined from studies with complete and timely collection of intervention, confounding factors, and outcome. Finally, risk factors will be established by studies of appropriate design and power.

Endoscopy, Digestive System↗
PubMedDate not supplied

Audit of patients' experiences after endoscopy of the upper alimentary tract.

This study comprises an audit of the experiences of upper alimentary endoscopy by 400 patients examined in 15 hospitals. The patients were asked to complete a 19-section questionnaire regarding their experience of the endoscopy before, during and after the procedure. The audit was carried out in order to evaluate the patients' understanding of the investigation and to determine the impact of the findings on the patients' level of anxiety. Of the 400 patients, 304 (76.0%) returned the questionnaire; overall satisfaction was revealed with the decision to proceed with endoscopy and with the procedure itself, as well as the reassurance provided by the investigation. The study thus supports the role of open-access endoscopy.

Adolescent↗
PubMed1993

Are clinical patterns of dyspepsia a valid guideline for appropriate use of endoscopy? A report on 2253 dyspeptic patients.

We studied 2253 consecutive dyspeptic patients, without clinical evidence of organic disease, who were referred to our open access endoscopy service. The aim was to assess whether the various clinical patterns of dyspepsia can be considered a valid guideline for the appropriate use of endoscopy. According to the symptomatological patterns, our patients were defined as sufferers from 1) ulcer-like (973 patients), 2) reflux-like (857), and 3) dysmotility-like dyspepsia (423). In our patient population, which reflects the general population of our city, the dysmotility-like type of dyspepsia was the least frequent (19%), whereas the ulcer-like (43%) and the reflux-like (38%) dyspepsia were almost equivalent. A negative endoscopy (35.7%) occurred significantly (p < 5 x 10(-4)) more often in dysmotility-like than in ulcer-like (26.3%) and reflux-like dyspepsia (25.7%). Furthermore, in dysmotility-like dyspepsia, we observed no malignancies in patients less than 60 yr old, and no gastric ulcers in patients less than 50 yr old. In the latter subgroup of patients (under 50 yr), duodenal ulcers and esophagitis were rare (occurring in only one and five, respectively, out of 145 patients). In ulcer-like and reflux-like dyspepsia, abnormal endoscopic findings occurred frequently (in 73.5% and 74.1%, respectively), and no relationship with patients' age was observed. Our data indicate that patients under 50 yr old with dysmotility-like dyspepsia can be considered a kind of population for which endoscopy is inappropriate. However, because the prevalence of dysmotility-like dyspepsia was 19% (423/2253) in our patient sample, and only 7.15% of them were under 50 yr old (161/2253), we can obtain only a small percentage of reduction in endoscopic service load if the guideline of age < 50 yr is adopted.

Adult↗
PubMed1993

The safety and clinical utility of esophagogastroduodenoscopy for acute gastrointestinal bleeding after myocardial infarction: a six-year study of 42 endoscopies in 34 consecutive patients at two university teaching hospitals.

The risks versus benefits of panendoscopy performed soon after myocardial infarction were studied. At Robert Wood Johnson University Hospital from January 1986 through December 1991 and at Princeton Medical Center from January 1990 through December 1991, 82 patients developed overt gastrointestinal bleeding (1.2% of all myocardial infarctions) and 14 patients developed occult gastrointestinal bleeding (0.2% of all myocardial infarctions) within 3 weeks after myocardial infarction. Thirty-four of the patients underwent 42 panendoscopies within 3 weeks of myocardial infarction. Indications for the initial endoscopy included hematemesis in 25, melena without hematemesis in four, red blood per rectum in three, and occult blood in the stool in two. The initial panendoscopy, on average, was performed 6.2 +/- 7.5 (SD) days after myocardial infarction. The 34 initial panendoscopies provided the diagnosis in 27 (79%), and clinically helpful information in four (12%). Common diagnoses were duodenal ulcer in 11, hemorrhagic gastritis in four, and hemorrhagic esophagitis in three. Three complications were due to the initial endoscopy, including fatal ventricular tachycardia, near respiratory arrest, and hypotension. These complications occurred in three (37.5%) of eight patients who were significantly unstable before endoscopy. No (0%) complications occurred in the 26 relatively clinically stable patients undergoing the initial endoscopy. This difference in complication rate was statistically significant (p < 0.01, Fisher's exact test). We conclude that recent myocardial infarction is not an absolute contraindication to panendoscopy. In this retrospective study, the benefits exceeded the risks of panendoscopy in medically stable patients with significant gastrointestinal bleeding. Panendoscopy should be performed with monitoring by electrocardiography and pulse oximetry after stabilization of vital signs, which may require transfusion of blood products, supplemental oxygen administration, endotracheal intubation, and mechanically assisted ventilation. Panendoscopy in highly unstable patients had a high complication rate in this study.

Aged↗
PubMed1996

A preliminary study of patients' concerns related to GI endoscopy.

OBJECTIVES: In addition to the well known complications of bleeding and perforation, GI endoscopy also can produce discomfort, anxiety, and dissatisfaction. In this pilot study, our objective was to obtain information on the fears and concerns of patients about to undergo endoscopy and to assess the relationship of such worries to patient satisfaction and difficulty with the procedure. METHODS: At our two referral hospitals, 793 unsedated patients (45% men, 55% women, average 58 yr) were interviewed by GI nurses before the intended procedure. Information on procedure-related concerns and difficulty/satisfaction with the procedure was obtained. RESULTS: Sixty percent of our sample reported preprocedure concerns, most often: 1) finding out what is wrong (18%); 2) pain (12%); and 3) finding cancer (4%). New York patients were more concerned than North Carolina patients with finding out what was wrong (23 vs 12%) although patients at both sites were equally concerned about having pain during the procedure (12%); women (16%), younger patients (16%), and those about to have their first procedure (17%) reported more concerns about pain. Regression analysis indicated that women and persons having no or fewer procedures were more likely to report a concern. Having had previous endoscopic procedures predicted greater satisfaction with subsequent endoscopies. Finally, a high level of preprocedure concerns was associated with perceived difficulties related to the procedure. CONCLUSIONS: We believe that, by considering patient demographics, asking about previous experiences with endoscopy, and eliciting special concerns, the nurse or physician can focus patient education in a fashion that may reduce anticipatory anxiety.

Adolescent↗
PubMed1995

[Endoscopy of the upper gastrointestinal tract in HIV disease].

Gastrointestinal (GI) symptoms are part of the most frequent complaints in HIV disease. A methodical effort is required to identify treatable syndromes. Progressive immunodeficiency is associated with increased prevalence of opportunistic or non-opportunistic infections and neoplasms. Dysphagia and odynophagia, in the majority due to candida esophagitis, are best evaluated by endoscopy. In the presence of diarrhea, upper GI endoscopy is indicated if evaluations of stool and endoscopy of the lower GI tract are negative and may uncover proximal small-bowel infection by Cryptosporidium, Microsporidium or Mycobacterium avium. HIV-associated neoplasias (Kaposi's sarcoma, non-Hodgkin lymphomas), not rarely affecting the upper GI tract and sometimes leading to obstruction or bleeding, are reliably diagnosed only by endoscopy. Since visible lesions mostly are nonspecific and normal-appearing mucosa may harbor pathogens, biopsies for pathology and cultures are crucial for correct diagnosis in GI diseases of HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1997

Risk factors for Barrett's esophagus in community-based practice. GORGE consortium. Gastroenterology Outcomes Research Group in Endoscopy.

OBJECTIVES: Endoscopy is often performed in patients with gastroesophageal reflux (GER) disease because of concern about the presence of Barrett's esophagus (BE). The purpose of this study was to determine whether the duration of GER symptoms and/or a history of esophagitis was associated with an increased risk of BE. METHODS: This was an observational, prospective, community-based study. Consecutive patients undergoing elective endoscopy because of GER symptoms were enrolled. Endoscopy reports and pathological findings were reviewed to classify patients as having no esophagitis, esophagitis, or probable BE. Correlations with duration of symptoms and a history of esophagitis were analyzed. RESULTS: In all, 701 of 2641 patients (27%) undergoing elective endoscopy had GER symptoms, and 77 of these patients had probable BE. Compared with patients with GER symptoms for less than 1 yr, the odds ratio for BE in patients with GER symptoms for 1-5 years was 3.0 and increased to 6.4 in patients with symptoms for more than 10 yr (p < 0.001). A history of esophagitis was not an independent risk factor for BE (p = 0.17). CONCLUSIONS: Prevalence of BE is strongly associated with duration of GER symptoms.

Adolescent↗
PubMed1997

Conscious sedation in the endoscopy setting.

Endoscopy patients are adequately managed under CS and require attentive and skilled nurses to manage their care owing to the complexity of the procedures performed and the health status of this unique population. Endoscopy nurses need expert skills in assessing patient's respiratory and cardiac status to prevent complications and intervene successfully in emergency situations. Endoscopy personnel need to assess for and know how to treat complications that can arise from the procedure or from oversedation. The emergency endoscopy patient presents a challenge to the team and requires effective team coordination.

Procedural Sedation↗
PubMed1997

Efficacy of tele-endoscopy in a rural capitated market.

PURPOSE: To attempt to quantify the potential for success of tele-endoscopy as a component of the VTMEDNET Plus telemedicine implementation, a multi-part prospective study was undertaken by faculty of the Vermont Initiative for Rural Health Informatics and Telemedicine. METHOD: The study was comprised of three separate parts, evaluation of image quality, cost analysis, and identification of referring providers needs and attitudes regarding tele-endoscopy. FINDINGS: The image quality was satisfactory to support remote diagnosis in most cases; there was significant cost savings in a managed care environment; referring providers were generally positive about the attributes of tele-endoscopy. CONCLUSION: Tele-endoscopy is a viable and cost-effective component within a telemedicine system.

Capitation Fee↗
PubMed1997

[Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients].

Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect.

Adolescent↗
PubMed1997

[Virtual endoscopy with computed tomography of the anatomical structures of the middle ear].

INTRODUCTION: We applied the new technique of virtual endoscopy to the middle ear because this anatomical area is characterized by favorable contrast. MATERIALS AND METHODS: CT examinations of the petrous bone were obtained using 1.5 mm thick 1 coronal axis slices, with 1 mm or 1.5 mm table feed, 120 kV, 140-170 mA and 2 s scan time. The images were reconstructed with the high resolution algorithm for bony structures and a small field of view (9.6 cm), separately for the right and left petrous bone. The images were then transferred on a workstation and processed with the Navigator virtual endoscopic software (General Electric). A threshold value ranging -350 to -600 HU was applied. RESULTS: A series of images is acquired as the virtual endoscope moves from the external auditory canal to the middle ear cavity. Images of the anterior, medial, and posterior surfaces of the middle ear are presented. Different views of the ossicles are also presented. High quality images were always obtained for the middle ear structures, including the ossicles. CT endoscopy of the middle ear provides a new view of the anatomy of this complex area. It has some advantages and disadvantages; the former can be summarized as follows: -demonstration of areas which are difficult to show with endoscopy because of the presence of membrana tympani; -the virtual endoscope can be placed in several positions and therefore it can be inserted in all sites and tortuous places of anatomical cavity; -nice and effective demonstration of the ossicular chain including the stapes. The disadvantages are related to the fact that the endoscopic reconstruction (such as any other three-dimensional reconstruction) is a representation of surfaces where different densities are necessarily homogenized. CONCLUSIONS: CT virtual endoscopy of the middle ear can currently be considered a complementary technique to conventional CT because it permits better anatomical detailing of this complex region.

Ear, Middle↗
PubMed1976

[Endoscopy, a hobby for specialists--or more?].

In the years between 1958 and 1970, diagnostic endoscopy made decisive advances. In this period, the ground was prepared for operative endoscopy. This applies not only to the technical, but also to the psychological aspects. The fact that formerly hidden structures could now be directly inspected and ""grasped'', spurned the endoscopist to intensive activity. Polypectomy, papillotomy with the removal of gallstones and, increasingly, photocoagulation for the arrest of bleeding, have made in many cases classical surgical operations superfluous. In close cooperation and rapport with the surgeons, the indications for, but also the limitations of, the new procedure are being established. In addition to the more practical aspects, modern endoscopy has also created a bridge to better understanding of biochemical processes in the gastrointestinal tract. The possibility of being able to investigate the effects of newly discovered, analysed and synthesized gastrointestinal hormones has been considerably improved. Endoscopy, formerly considered, more or less, a hobby for a few specialists, has become a sort of intermediary system which is capable of providing excellent diagnostic information, of making possible elegant therapeutic measures and of producing new biochemical information. In this creative function, it is surpassed by virtually no other method. A pre-condition for this development was, however, that the endoscopist was not content to remain merely an observer of interesting views, but was, rather, an active physician, to whom the advantages to the patient of early detection of disease and suitable therapeutic measures were equally important as the useful information obtained on biochemical relationships.

Cholelithiasis↗
PubMed2006

Vascular evaluation in laryngeal diseases: comparison between contact endoscopy and laser Doppler flowmetry.

OBJECTIVE: To determine the efficacies of 2 methods for evaluating vascular changes in laryngeal diseases. DESIGN: Prospective comparative study. SETTING: University hospital. PATIENTS: Twenty-four adults planning to undergo laryngomicrosurgery for unilateral lesions in their vocal cords. INTERVENTION: Vascular evaluation was performed using contact endoscopy and laser Doppler flowmetry during laryngomicrosurgery. MAIN OUTCOME MEASURES: Morphological and physiological variables of the vascular changes. RESULTS: Contact endoscopy examinations revealed changes in the fine vascular network patterns in the vocal cords. Hypervascularity was present in patients with polyps but not in those with nodules, and the degree of vascularity was variable in patients with malignant neoplasms. Patients with papillomas and patients in the postradiation therapy group showed hypovascularity with losses in the capillary network. Laser Doppler flowmetry revealed high mean blood flows in patients with polyps, dysplasia, and malignant neoplasms, whereas patients with papillomas and those in the postradiation therapy group had low blood flows. The variables measured by laser Doppler flowmetry and endoscopy were strongly correlated. CONCLUSION: Evaluations of morphological and physiological changes of vascularity in laryngeal diseases are important for understanding their pathophysiology, and combining contact endoscopy and laser Doppler flowmetry is useful in such evaluations.

Adult↗
PubMed1991

Endoscopic diagnosis of submucosal gastric lesions. The results after routine endoscopy.

The accurate diagnosis of submucosal gastric lesions is difficult. In an attempt to study this problem, the endoscopic records for 8 consecutive years (July 1976-June 1984) were scanned with the help of a computer-based registration of the endoscopic findings. The examinations were identified in which the endoscopic diagnosis indicated the presence of a submucosal tumor. Fifty-four such patients were found in 15,104 routine examinations, giving an incidence of 0.36%. Six patients were lost to follow-up, so the study is based on 48 patients. The most common reason these patients underwent endoscopy was abdominal pain. Five patient groups were identified: (a) nine patients were correctly diagnosed as having gastric wall neoplasia at the initial endoscopy + biopsy; (b) in an additional 13 patients, the suspected gastric wall neoplasia was verified by further nonoperative diagnostic procedures; (c) five patients were found to have benign non-neoplastic gastric disease; (d) five patients had extra-gastric disease that pressed against the gastric wall; (e) in 14 patients a further work-up indicated that the initial endoscopy was false-positive. These five groups were confirmed by additional diagnostic procedures (including laparotomy) and a follow-up time of more than 5 years or autopsy. Two patients refused further examinations and died shortly afterward. No autopsies were performed. Based on our data, it would seem that in the vast majority of patients the suspicion of a submucosal gastric lesion at endoscopy indicates the presence of a serious condition.

Biopsy↗
PubMedDate not supplied

Intraoperative endoscopy of the gastrointestinal tract: clinical necessity or lack of preoperative preparation?

Intraoperative gastrointestinal endoscopy is an evolving technique that has received limited attention in the literature through case and small series reports. This literature does contain some papers in which the method was employed instead of conventional endoscopy, but, in general, intraoperative endoscopy has been effectively used as an aid to the surgeon to locate pathology not otherwise detectable and to enhance diagnosis and therapy at laparotomy. The procedure will not be required often, but when used, has the potential to be of as much service to the surgeon as a scalpel or retractor. As more surgeons are being trained in gastrointestinal endoscopy, the indications and uses will surely expand.

Colonoscopy↗
PubMed1988

Fluorescein endoscopy. A technique for noninvasive assessment of intestinal ischemia.

Late diagnosis contributes significantly to the mortality and morbidity of mesenteric ischemia. Although flexible endoscopy permits noninvasive assessment of the colon, ischemic colitis is often difficult to differentiate from nonspecific proctitis/colitis or mucosal changes seen in inflammatory bowel diseases. Intravenously administered fluorescein sodium (FSC) has long been used intraoperatively to assess bowel viability because its uptake is inversely proportional to the degree of intestinal ischemia. The authors wished to determine if FSC could be used to augment conventional endoscopy in an attempt to identify and monitor ischemic areas of the bowel within reach of the endoscope. Segmental mesenteric ligation of canine rectum was performed, and serial transanal biopsies obtained. Endoscopy was performed after intravenous FSC administration, using a rigid proctoscope, with a long-wave ultraviolet light source inserted into the lumen of the scope. Areas of nonspecific-appearing proctitis did not take up FSC and were easily differentiated from well-perfused areas by their failure to fluoresce. Ischemic areas were monitored in this manner over a 28-day period. Complete resolution of ischemic mucosal changes occurred with late stricture formation. In humans, the sigmoid and left colon are the areas most frequently affected by ischemic colitis. Because long-wave ultraviolet light is not transmitted through glass fibers, a different light source was needed for potential clinical application. To this end, a single fiber of an argon laser was inserted through the instrument channel of a colonoscope, resulting in greater fluorescence than seen with the ultraviolet light. FSC endoscopy appears to be a sensitive and accurate method of detecting and monitoring ischemic colitis and has many potential clinical applications.

Adult↗