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Endotics system vs colonoscopy for the detection of polyps

World Journal of Gastroenterology 2010年第43期16卷 5452-5456页

作者： Emanuele Tumino Rodolfo Sacco Marco Bertini Michele Bertoni Giuseppe Parisi alfonso capria Operative Unit of Gastroenterology and Metabolic Diseases Department of Gastroenterology Pisa University Hospital Institute of Internal Medicine University of Foggia

AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation.

关键词： Colonoscopy Diagnosis Endotics system Polyps Sedation

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Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study

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World Journal of Gastroenterology 2009年第15期15卷 1843-1848页

作者： Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali alfonso capria Gastroenterology Department Pisa University Hospital Institute of Interna Medicine University of Foggia Department of Diagnostic and Interventional Radiology Pisa University Hospital

AIM:To prospectively evaluate the short and long term clinical impact of selective transarterial chemoembolization (TACE) on liver function in patients with hepatocellular carcinoma (HCC).To assess side effects in relation to treatments.To analyze the overall survival and HCC progression free survival probability. METHODS:One hundred and seventeen cirrhotic patients with HCC were enrolled.Baseline liver function included Child-Pugh score and serum levels of alanineaminotransferase (ALT),prothrombin time(PT)and bilirubin.According to Cancer Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems,71 patients were eligible for TACE; 32 had previously received treatment for HCC.No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions.While hospitalized, patient sunder went clinical,hematologicand ultrasonographic assessments.One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed"on demand".Liver function tests were checked in all patients every four months.RESULTS:After first TACE,the mean Child-Pugh score increased from a mean baseline 5.62±1.12 to 6.11±1.57 at discharge time (P<0.0001),decreasing after four months to 5.81±0.73 (not significant).ALT,PT and bilirubin significantly (P<0.0001)increased 24 h after TACE and progressively decreased until discharge. After the second TACE,variations in Child-Pugh score,ALT,PT and bilirubin were comparable to that described after the first TACE.No major complications were observed.The mean follow-up was 14.7±6.3 mo (median:16 mo).Only one patient died.No other patient experienced important long term worsening of clinical status.The overall survival probability at twenty-four months was 98.18%with a correspondent HCC progression free survival probability of 69%. CONCLUSION:Selectiv TAC Emayproduce significant,but transitory increases in ALT values, with no major i

关键词：肝动脉化疗栓塞术肝癌患者临床表现队列研究血清丙氨酸转氨酶肝动脉栓塞化疗肝功能试验肝硬化患者

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Treatment of active steroid-refractory inflammatory bowel diseases with granulocytapheresis: Our experience with a prospective study

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World Journal of Gastroenterology 2006年第14期12卷 2201-2204页

作者： Bresci Giampaolo Parisi Giuseppe Bertoni Michele Mazzoni Alessandro Scatena Fabrizio capria alfonso U.O. di Gastroenterologia U.O. di Immunoematologia Azienda Ospedaliera-Universitaria Pisana PisaItaly

瞄准：与活跃的类固醇倔强的煽动性的肠疾病(IBD ) 在 14 个病人与 granulocytapheresis (GCAP ) 的使用报导我们的经验以便在完成宽恕并且维持一个长持续没有症状的时期评估它的功效。方法：疾病的活动被临床的活动索引(蔡) 和内视镜... 详细信息

瞄准：与活跃的类固醇倔强的煽动性的肠疾病(IBD ) 在 14 个病人与 granulocytapheresis (GCAP ) 的使用报导我们的经验以便在完成宽恕并且维持一个长持续没有症状的时期评估它的功效。方法：疾病的活动被临床的活动索引(蔡) 和内视镜的索引(EI ) 在 ulcerative (UC ) 评估，当时由 Crohn 在 Crohn 的疾病(CD ) 的疾病活动索引(CDAI ) 。病人用 Adacolumn 系统被对待，有选择地绑在 granulocytes 和单核白血球的吸附列。GCAP 的一个会议 / 星期为 5 wk 被执行。类固醇在词首字母的脱落期间被停止。结果：所有病人完成了不显示出复杂并发症的五星期的功课。在最后会议的结束， 93% 病人显示出为 6 瞬间坚持了的疾病的临床的宽恕。在治疗的结束以后的九个月， 60% 案例维持了宽恕，当 23% 病人仍然在在 12 瞬间以后的临床的宽恕时。结论：就算我们有类固醇倔强的 IBD 的病人的数字不大，我们能断言 GCAP 很好被容忍并且有效特别在在治疗以后的开始的六个月内，在盒子的一个重要百分比。持续反应的率在 12 瞬间以后在 6 瞬间以后并且显著地稍微落下，然而，严重副作用的缺席能是为进一步评估治疗的新时间表的刺激。

关键词：类固醇耐火材料肠炎溃疡

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