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At least 1,513 records · Page 84Linked to original sources
PubMed2005

Choice of age cut-off for endoscopy in dyspepsia in developing countries according to incidence of gastric cancer.

Endoscopic examination of all patients with dyspepsia is hard to perform, because of high annual prevalence of dyspepsia and limited resource availability, especially in developing countries. Aim was to establish age cut off for upper endoscopy in dyspeptic patients without alarming features according on incidence of gastric cancer in western Herzegovina in Bosnia and Herzegovina. Group of 2697 (1536 males, 1161 females) patients over 15 with chronic dyspepsia without alarming features and symptoms of gastroesophageal reflux disease, had been referred for a diagnostic upper endoscopy during 4 years. Study was prospective. All 34 gastric cancers were diagnosed in male patients above 55 years, and in female ones above 60. In the same age groups two thirds of gastric ulcers were found out. If the age cut off for dyspeptic patients had been 55 years for male and 60 for female gender, the workload could be decreased by 50%. The choice of alternative approaches is possible, depending on the level of diagnostic uncertainty, the patient and his physician are prepared to accept. Age cut off determines diagnostic approach in chronic dyspepsia, and greatly decreases the endoscopy workload.

Adolescent↗
PubMedDate not supplied

Current trends in minimally invasive neurosurgery: neuro-endoscopy.

Minimal invasive neurosurgery refers to the technological advances accomplished in refining surgical access thus enabling neurosurgeons to reduce the morbidity and improve the accuracy and quality of neurosurgical procedures. Neuro-endoscopy comprises a promising minimal invasive technique being applied in an increasing amount of cases as diseases of cerebrospinal fluid dynamics, brain and spinal tumours, cysts, infections, evacuation of haematomas et al. Representing an important scientific modality neuro-endoscopy favours the rapid recovery of the patient and improves its postoperative quality of life. Personnel training is compulsory so that a safe operative performance is performed. Greater experience in the field would be necessary for broadened applications. Neuro-endoscopy presents exciting scientific possibilities in the future.

Brain Neoplasms↗
PubMed2006

[The application of high-resolution endoscopy in non-erosive reflux disease].

OBJECTIVES: To establish the diagnosis standards of the non-erosive reflux disease (NERD) using high-resolution endoscopy. The diagnostic standards are established by observing the evolution of main endoscopic appearance of NERD with high-resolution endoscopy, in conjunction with 24 h monitoring of the pH and proton-pump inhibitor experiments. METHODS: Patients with gastroesophageal reflux disease symptoms and healthy volunteers were enrolled. All the individuals were assessed with high-resolution endoscopy and 24 h ambulatory pH monitoring. Patients with negative 24 h ambulatory pH monitoring or with positive 24 h ambulatory pH monitoring but negative endoscopic appearance were undertaken proton-pump inhibitor test. RESULTS: The individuals were divided into 3 groups: 19 in erosive esophagitis, 62 in non-erosive group, and 24 were healthy volunteers. The shapes of Z-lines are divided into 6 types: sharply circle, sparsely serration, serration, tattered, triangular extension and lingulate extension. The percentage of each type in non-erosive group was 6.5%, 6.5%, 6.5%, 11.2%, 61.2%, and 8.1% respectively. The percentage of sharply circle, sparsely serration and triangular extension Z-lines were 25.0%, 58.3% and 16.7% respectively in the control group. There were more serration, fractured, triangular extension, and tongue-like extension Z-lines in the non-erosive group than in the control group. The difference was significant (P < 0.05). The appearance of the cardia membrane below the Z-line was categorized into four types: flatted, rough, concavo-convex and villiform. In the control group, the percentage of flatted, rough and concavo-convex types were 16.6%, 54.2%, and 29.2% respectively. In the non-erosive group, cardia membrane of rough, concavo-convex and villiform shapes were 16.1%, 9.7%, and 74.2% respectively. There were more shapes of villiform types in the non-erosive group than in the control group. The difference was significant (P < 0.05). The sensitivity and specificity of high resolution endoscopic test in diagnosing NERD was 77.8% and 6/8 respectively. CONCLUSIONS: High resolution endoscopic test will raise the diagnostic rate of NERD. NERD was divided into non-erosive esophagitis and symptomatic gastroesophageal reflux disease.

Adolescent↗
PubMed2006

[Erythromycin improves quality of endoscopy for acute upper gastrointestinal bleeding].

Twenty four patients with acute upper gastrointestinal bleeding undergoing endoscopy were assessed. Thirteen received erythromycin before the examination and 11 did not. The cleansing effect was bad in 2/6, satisfactory in 4/3 and good in 7/2 patients (erythromycin/non erythromycin group respectively). The need for repeat endoscopy was in 3 and 8 patients respectively. In conclusion erythromycin given before endoscopy improves quality of endoscopic examination in patients with upper gastrointestinal bleeding.

Acute Disease↗
PubMed1991

Endoscopy of esophageal cancers.

In this review about endoscopy of esophageal cancers, two main chapters are considered. Diagnostic endoscopy deals with the modalities, characteristic features and caveats essential for accurate assessment of esophageal malignancies. Therapeutic endoscopy deals with the palliative endoscopic treatment of the disease. Endoscopic dilatation, intubation and laser photocoagulation are discussed. It is stressed that these techniques should be tailored to each individual situation, especially if combination therapies (multimodality protocols) are considered.

Adenocarcinoma↗
PubMed1991

[What is the role of endoscopy in the diagnosis and treatment of tumors of the upper urinary tract?].

17 patients with upper urinary tract tumours were investigated by endoscopy. 3 patients (Group I) with fibrous or fibroepithelial polyps were treated via a retrograde approach and did not develop any recurrences. 2 patients (Group II) developed unexplained haematuria: the diagnosis of high-grade carcinoma was confirmed by endoscopy and they were treated by nephroureterectomy. 12 patients (Group III) with low grade non-invasive urothelial carcinoma, in whom radical surgical was not indicated, were treated conservatively via the percutaneous (13 tumours) or retrograde (1 tumour) endoscopic approach. The local recurrence rate was 33% (4 out of 12 tumours) for a mean follow-up of 22 months. The recurrences were treated by repeated endoscopy in 3 patients, and by nephroureterectomy in 1 patient. Endoscopic treatment of upper urinary tract tumours should be reserved for benign tumours and selected cases of low-grade, non-invasive urothelial carcinoma.

Adult↗
PubMed1991

[The main indications for lower endoscopies].

There are three main groups of indications of lower digestive tract endoscopy: (1) endoscopy may be performed to detect adenomatous polyps and thus prevent colorectal cancer by systematic excision of these polyps before they become invasive malignancies; (2) it may also be performed in patients whose symptoms (e.g. pain, diarrhoea or anaemia) may be due to a lesion of the colon. It usually provides evidence of such diseases as colorectal adenocarcinoma, ulcerative colitis, Crohn's disease, pseudomembranous colitis, post-irradiation colitis, collagen colitis, ischaemic colitis or colonic angiodysplasia; (3) finally, emergency endoscopy can be used in case of rectal haemorrhage, where it is often completed by haemostasis, or in case of volvulus, where it removes the occlusion.

Colitis↗
PubMed1990

[Radiology and endoscopy in the diagnosis of colorectal cancer].

Over a 5-year period, 64 patients with a primary colorectal carcinoma were studied by means of radiographic or endoscopic diagnostic techniques. The overall accuracy rates of the barium contrast enema and endoscopy were 86% and 93%, respectively. A comparison of diagnostic accuracy between radiology and endoscopy yield a 75% correlation rate. Whenever possible, both radiology and digestive endoscopy should be carried out to assess the diagnosis of colorectal carcinoma.

Barium Sulfate↗
PubMed1990

Ambulatory 24-hour pH-metry in the diagnosis of gastroesophageal reflux disease. Determination of criteria and relation to endoscopy.

The results of ambulatory 24-h esophageal pH monitoring in 67 patients with gastroesophageal reflux symptoms (endoscopic esophagitis, n = 44; normal endoscopy, n = 23) were compared with those of 27 normal subjects without reflux symptoms. Patients with reflux symptoms had significantly increased gastroesophageal reflux compared with normal subjects. Acid reflux time was significantly (p less than 0.001) correlated with the severity of endoscopic esophagitis. Linear discriminant analysis was used to differentiate, for each reflux variable, between patients and controls. When the percentage of overall time at pH below 4 was used as a single determinant of gastroesophageal reflux, the sensitivity and specificity were 81% and 85%, respectively, with 4% as upper limit of normal. Pathologic reflux was found in 61% of the patients with negative endoscopy. Long-term ambulatory pH-metry is of clinical value in detecting pathologic reflux in symptomatic patients with negative endoscopy.

Acids↗
PubMed1989

[Gastrointestinal hemorrhage--change in therapy concepts by endoscopy].

Since the introduction of endoscopy in diagnosis and treatment of gastrointestinal bleeding in the early seventies, emergency endoscopy has changed the therapeutic concept of this disease. At first the task of emergency endoscopy was limited to location of the bleeding site. In the eighties endoscopic hemostasis was established in many hospitals. In addition, preselection of patients who will benefit from surgery has become possible by endoscopic means. These factors have reduced significantly mortality due to GI bleeding.

Endoscopes, Gastrointestinal↗
PubMed1989

[Evaluation of exocrine pancreatic function by the haptocorrin degradation test of the duodenal fluid collected by endoscopy].

Two groups of biological methods are commonly used to evaluate the exocrine pancreatic function: tests which require tubes for the collection of duodenal juice and the tubeless tests which are indirect tests of pancreatic function. In this study we have attempted to improve a new test: the test of haptocorrin degradation (THD). This test measures the transfer of labelled cobalamin from haptocorrin to the intrinsic factor which is provoked by the degradation of the haptocorrin by proteases in the duodenal juice. We present the results of this test in 90 patients with chronic pancreatitis. THD was first assayed with basal duodenal juice collected by naso duodenal tubing during secretin cerulein stimulation. In this study the sensitivity and specificity of THD was 0.86 and 0.93, respectively. In the second part of this study we demonstrated that the means of collecting duodenal juice had no effect on the results of THD. Duodenal juice was collected during a secretin cerulein test or during a routine upper gastrointestinal endoscopy after pancreatic stimulation with secretin. The sensitivity and specificity of THD was 0.90 and 0.94, respectively, when duodenal juice was collected during endoscopy. THD was significantly correlated with the NBT-PABA test, steatorrhea, and with the activity of trypsin and chymotrypsin in the duodenal juice. In this study, NBT-PABA was less sensitive than THD for the diagnosis of chronic pancreatitis (sensitivity was 0.70 and 0.89, respectively). The specificity of THD was estimated at 0.94. THD seemed to be a valuable adjunct to test pancreatic function. As upper gastrointestinal endoscopy is usually performed in patients with proved or suspected chronic pancreatitis, THD seems to have a place of choice among the other tests of pancreatic exocrine function. Further evaluation of this test by a multicentric prospective trial is now needed.

Adult↗
PubMed1977

[Examinations of upper gastrointestinal bleeding - value of emergency endoscopy (author's transl)].

The treatment of the acute upper gastrointestinal bleeding can be improved by using standardized immediate actions, as there is endoscopy in emergency diagnostics. Endoscopy gives much higher certainty in pre-operative diagnostic, better possibility of planning and more exact timing of the operation. Therefore emergency endoscopy should be done in any case of acute upper gastro-intestinal bleeding.

Acute Disease↗
PubMed1988

[Value of esogastroduodenal endoscopy with staged biopsies in children with Crohn's disease].

An upper gastrointestinal endoscopy with multiple biopsies was performed in 19 children suspected of Crohn disease (CD) who had also undergone X-ray investigations and colonoscopy with multiple biopsies. Biopsies were performed in pathological and/or normal mucous areas. Upper gastrointestinal endoscopy showed macroscopic changes in 7 children (37%). Histologic examinations of the upper gastrointestinal tract were normal or showed only non specific changes in 12 cases (63%). Histopathologic changes specific for CD were found in 7 cases (37%), while specific histologic changes were identified at the rectal or colic level in 3 of these 7 cases only. Thus, upper gastrointestinal endoscopy with multiple biopsies was most useful for the diagnosis of CD, since it was the only diagnostic means in 4 cases. It should be systematically performed when CD is suspected.

Adolescent↗
PubMed1986

[Significance of endoscopy in inflammatory bowel diseases in childhood].

Endoscopy makes an essential contribution as diagnostic tool in the clarification of unspecific inflammatory bowel disease in childhood. Important advantages of this method are detection of early lesions, classification of the type of inflammation, sight-guided biopsies and no exposure to X-rays. In 36 patients the diagnosis of Crohn's disease was proven by endoscopy alone in 66.6% of cases, by histology as sole criterion in 69.4%, and by X-ray examination alone in only 8.3% of cases. All 3 patients in whom the diagnosis of Crohn's disease was made exclusively by radiological means showed manifest involvement limited to the small bowel. However, even upper gastrointestinal endoscopy led to the detection of lesions characteristic of Crohn's disease in some cases. 36 colonoscopies were performed in 28 patients with ulcerative colitis. Typical lesions were detected endoscopically in 91.7%; corresponding histological changes were found in only 63.6%.

Adolescent↗
PubMed1985

[Emergency endoscopy in chronic liver diseases].

Emergency endoscopy has to be regarded as a method of high diagnostic value. Based on the resulting therapeutic consequences and with allowance for the prerequisites and contraindications, emergency endoscopy in chronic liver diseases is to be considered a purposeful method. If endoscopic treatment possibilities in bleedings of the gastrointestinal tract continue to improve, the demonstration of an improvement in prognosis by emergency endoscopy seems to be merely a question of time.

Duodenal Ulcer↗
PubMed1985

[Correlation between endoscopy and histology of 48 cases of superficial stomach cancer].

The relationship between different endoscopic (gross appearance, diameter, localization, morphological type according to the Japanese Endoscopic Society) and histological parameters (type of cancer according to Lauren, tumor infiltration, association with metaplastic chronic gastritis) were analyzed retrospectively in 48 patients operated on for early gastric cancer. Endoscopy and histology provided a preoperative diagnosis of malignancy in 89.6% of the cases. With endoscopy alone the results were 23% malignancy, 44% suspicious and 33 benign. The antrum was the preferential site and type III the most frequent form. 62% of early gastric cancers were of the intestinal type and the average age of the patients was higher than for the diffuse type. Metaplastic chronic gastritis was associated in 67% of the intestinal type and in 21.5% of the infiltrating type. The degree of tumor infiltration was related to the diameter of the lesion, irrespective of the histological type. Since a malignant or suspicious lesion was diagnosed in only 67% by endoscopy alone, it is imperative to perform several biopsies of all gastric lesions, including even the smallest: 11 cancers of type III and IIc in this series had a diameter inferior to 1 cm and had been classified endoscopically as benign.

Adult↗
PubMed1985

[Endoscopy for exploration for foreign bodies of the lower respiratory tract of the child. Apropos of 668 cases].

From 1980 to 1984, 335 foreign bodies (FB) were extracted from lower respiratory tract of children: two-thirds were boys, 77% were under 3 years of age, 79% presented signs of penetration. The FB was mainly of alimentary origin, particularly peanuts. Radiologic imaging provided inconstant signs, atelectasis increasing in frequency with duration after inhalation. Laryngeal and tracheal FB were rare (15 and 19 cases respectively), and the site of impaction was divided equally between the left and right bronchi. Multiple, sometimes bilateral FB are frequent and FB of a vegetable nature are of serious omen. During the same period, 283 endoscopies for suspected FB gave negative results, and FB was found in 6 of 50 cases undergoing endoscopy for repeated pulmonary infections. In this latter group the percentage of boys was lower and the age of the children a little higher than in the group with a detected FB. These findings suggest the need for endoscopy under general anesthesia and the use of a rigid tube in all suspected cases of FB in the lower respiratory tract.

Adolescent↗
PubMed1984

[Does the finding of a bilious mucous lake during endoscopy have physiopathological significance? Study of gastric pH during 24 hours].

The aim of this study was to determine if there was any relationship between the presence of bile in the stomach at endoscopy and the nycterohemeral variations of the gastric pH. Endoscopy and 24 hour gastric pH monitoring with radiotele-pHmetry were performed in 38 patients. These patients were then divided into two groups according to the color of the mucous lake at endoscopy: group A (15 patients) in which there was a clear mucous lake and group B (23 patients) in which a bilious mucous lake was found. In group A, spontaneous alkalinizations (SA) were uncommon and almost always lasted less than 30 min. In group B, SA were more frequent and more prolonged (p less than 0.01), especially those lasting more than 30 min (p less than 0.001). In this group, the number and duration of SA were significantly higher during the night. These results suggest that duodenogastric reflux may be responsible for the SA observed in patients with a bilious mucous lake. This hypothesis, however, needs further confirmation especially concerning the analysis of the gastric contents during the periods of alkalinization.

Adult↗