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Endoscopic ultrasonography-guided celiac plexus neurolysis in patients with unresectable pancreatic cancer: An update

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World Journal of Gastrointestinal Endoscopy 2021年第10期13卷 460-472页

作者： Guillermo Pérez-Aguado Diego Martinez-Acitores de la Mata Carlos Marra-López Valenciano ignacio fernandez-urien sainz Department of Gastroenterology Complejo Hospitalario Insular Materno Infantil de Gran CanariaLas Palmas de Gran CanariaLas Palmas 35016Spain Department of Gastroenterology Endoscopy UnitComplejo Hospitalario de Navarra CHNPamplona Navarra 31008Spain Department of Gastroenterology Endoscopy UnitAgencia Sanitaria Costa del SolMálaga 29603Spain

Pancreatic cancer produces disabling abdominal pain,and the pain medical management for pancreatic cancer is often challenging because it mainly relies on the use of narcotics(major opioids).However,opioids often provide suboptimal pain relief,and the use of opioids can lead to patient tolerance and several side effects that considerably reduce the quality of life of pancreatic cancer ***-guided celiac plexus neurolysis(EUS-CPN)is an alternative for pain control in patients with nonsurgical pancreatic cancer;EUS-CPN consists of the injection of alcohol and a local anesthetic into the area of the celiac plexus to achieve chemical ablation of the nerve ***-CPN via the transgastric approach is a safer and more accessible technique than the percutaneous *** have reviewed most of the studies that evaluate the efficacy of EUSCPN and that have compared the different approaches that have been performed by *** efficacy of EUS-CPN varies from 50%to 94%in the different studies,and EUS-CPN has a pain relief duration of 4–8 *** factors are involved in its efficacy,such as the onset of pain,previous use of chemotherapy,presence of metastatic disease,EUS-CPN technique,type of needle or neurolytic agent used,*** to this review,injection into the ganglia may be the best technique,and a good visualization of the ganglia is the best predictor for a good EUS-CPN response,although more studies are ***,any of the 4 different techniques could be used to perform EUS-CPN effectively with no differences in terms of complications between the techniques,but more studies are *** effect of EUS-CPN on pain improvement,patient survival and patient quality of life should be evaluated in well-designed randomized clinical *** research also needs to be performed to clarify the best time frame in performing a EUS-CPN.

关键词： Pancreatic cancer Endosonography Celiac plexus neurolysis Opioids Echoendoscopy

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Navigating medial patellotibial ligament reconstruction:Clinical perspectives and surgical strategies

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World Journal of Clinical Cases 2025年第1期13卷 6-10页

作者： Juan Pablo Zicaro ignacio Garcia-Mansilla Division of Knee Hospital Italiano de Buenos AiresBuenos Aires 1109Argentina

The surgical approach for patellar instability usually refers to reconstruction of the medial patellofemoral ligament associated with an osteotomy of the tibial tuberosity or a trochleoplasty when *** medial patellotibial ligament and the medial patellomeniscal ligament are secondary stabilizers of the *** this,both the medial patellotibial and patellofemoral ligaments aid in patellar rotation and tilt when the knee is flexed beyond 45°.The medial patellotibial ligament plays a particularly important role in the final stages of stretching in extension and between 40 degrees to 90 degrees of *** clinical relevance and surgical indications for medial patellotibial ligament reconstruction associated with medial patellofemoral ligament reconstruction are still *** editorial explores the surgical indications and clinical results for medial patellotibial ligament reconstruction to improve readers’understanding of this technique,especially because reported clinical outcomes have remained sparse.

关键词： Medial patellotibial ligament Patellar instability Reconstruction Surgical

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Esophageal capsule endoscopy

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World Journal of Gastroenterology 2008年第34期14卷 5254-5260页

作者： ignacio fernandez-urien Cristina Carretero Raul Armendariz Miguel Muoz-Navas Department of Gastroenterology University of Navarra

Capsule endoscopy is now considered as the first imaging tool for small bowel examination. Recently, new capsule endoscopy applications have been developed, such as esophageal capsule endoscopy and colon capsule endoscopy. Esophageal capsule endoscopy in patients with suspected esophageal disorders is feasible and safe, and could be also an alternative procedure in those patients refusing upper endoscopy. Although large-scale studies are needed to confirm its utility in GERD and cirrhotic patients, current results are encouraging and open a new era in esophageal examination.

关键词： Capsule endoscopy Esophagus Gastroe-sophageal reflux disease Varices Esophagoscopy PillCam ESO

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Multicenter,randomized study to optimize bowel for colon capsule endoscopy

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World Journal of Gastroenterology 2017年第48期23卷 8615-8625页

作者： David Kastenberg Wilmot C Burch Jr David P Romeo Pankaj K Kashyap David C Pound Neophytos Papageorgiou ignacio Fernández-urien sainz Carly E Sokach Douglas K Rex Division of Gastroenterology Thomas Jefferson University Franklin Gastroenterology PLLC Dayton Gastroenterology Inc. Pinnacle Research Group LLC Indianapolis Gastroenterology and hepatology Department of Gastroenterology American Medical Center Department of Gastroenterology Servicio de Digestivohospital de Navarra Sidney Kimmel Medical College at Thomas Jefferson University Indiana University hospital

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation *** This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system(Pill Cam? COLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the Control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,CCE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,Control = 77.3%;P = 0.88) and individual segments. In the Study group,CCE completion was superior(Study = 90.9%,Control = 76.9%;P = 0.048) and colonic transit was more often < 40 min(Study = 21.8%,Control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,Control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study *** A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior CCE completion.

关键词： Bowel preparation Purgative Capsule endoscopy Endoscopy Capsule colonoscopy Large intestine

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Colon capsule endoscopy

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World Journal of Gastroenterology 2008年第34期14卷 5265-5268页

作者： ignacio fernandez-urien Cristina Carretero Ana Borda Miguel Muoz-Navas Department of Gastroenterology University of Navarra

Wireless capsule endoscopy has become the first imaging tool for small bowel examination. Recently, new capsule endoscopy applications have been developed, such as esophageal capsule endoscopy and colon capsule endoscopy. Clinical trials results have shown that colon capsule endoscopy is feasible, accurate and safe in patients suffering from colonic diseases. It could be a good alternative in patients refusing conventional colonoscopy or when it is contraindicated. Upcoming studies are needed to demonstrate its utility for colon cancer screening and other indications such us ulcerative colitis. Comparative studies including both conventional and virtual colonoscopy are also required.

关键词： Capsule endoscopy Colon Polyp Colon cancer Screening Colonoscopy

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Role of videocapsule endoscopy for gastrointestinal bleeding

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World Journal of Gastroenterology 2008年第34期14卷 5261-5264页

作者： Cristina Carretero ignacio fernandez-urien Maite Betes Miguel Muoz-Navas Department of Gastroenterology University of Navarra

Obscure gastrointestinal bleeding (OGIB) is defi ned as bleeding of an unknown origin that persists or recurs after negative initial upper and lower endoscopies. Several techniques, such as endoscopy, arteriography, scintigraphy and barium radiology are helpful for recognizing the bleeding source; nevertheless, in about 5%-10% of cases the bleeding lesion cannot be determined. The development of videocapsule endoscopy (VCE) has permitted a direct visualization of the small intestine mucosa. We will analyze those techniques in more detail. The diagnostic yield of CE for OGIB varies from 38% to 93%, being in the higher range in those cases with obscure-overt bleeding.

关键词： Capsule endoscopy Bleeding Small bowel Obscure Hemorrhage

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Endoscopic ultrasound-guided drainage of pelvic collections and abscesses

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World Journal of Gastrointestinal Endoscopy 2010年第6期2卷 223-227页

作者： ignacio fernandez-urien Juan J Vila Francisco JavierJimenez Endoscopy Unit Gastroenterology DepartmentHospital de Navarra

Pelvic abscesses are usually the end stage in the progression of an *** may occur from surgical complications,generalized abdominal infections such as appendicitis or diverticulitis,or from localized infections such as pelvic inflammatory disease or inflammatory bowel *** surgery has been considered as the treatment of choice by some authors,pelvic abscesses can be managed by non-invasive methods such as ultrasound and computed tomography-guided *** development of therapeutic linear echoendoscopes has allowed the endoscopist to perform therapeutic ***,endoscopic ultrasonography(EUS)-guided drainage of pelvic collections has been demonstrated to be feasible,efficient and *** allows the endoscopist to insert stents and drainage catheters into the abscess cavity which drains through the large *** article reviews technique, current results and future prospects of EUS-guided drainage of pelvic lesions.

关键词： Endoscopic ultrasound Abscess Collection Pelvis Drainage

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Z-line examination by the PillCam^(TM) SB:Prospective comparison of three ingestion protocols

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World Journal of Gastroenterology 2010年第1期16卷 63-68页

作者： ignacio fernandez-urien Erika Borobio Inmaculada Elizalde Rebeca Irisarri Juan Jose Vila Jesus Maria Urman Javier Jimenez Department of Gastroenterology Hospital of Navarra

AIM:To evaluate the Z-line visualization by the PillCamTM SB2 using three different ingestion protocols. METHODS:Ninety consecutive patients undergoing small bowel capsule endoscopy(SBCE)between January and May 2008 were included in the study. They swallowed the capsule in the standing(Group A= 30),supine(Group B=30)and right supine positions (Group C=30).Baseline patient characteristics, difficulties in capsule ingestion,esophageal transit times(ETT)and Z-line visualization were noted. RESULTS:No significant differences were found between the groups with regard to baseline patient characteristics,ingestion difficulties and complete SB examinations(P>0.05).At least 1 frame of the Z-line was detected in 15.8%,46.7%and 90%of patients in groups A,B and C,respectively(P<0.001).The average number of Z-line images was 0.21±0.53,3.23 ±6.59 and 5.53±7.55 and the mean%of the Z-linedetected was 71.3,25.1 and 8.3,in groups A,B and C, respectively(both P<0.001).ETT times were longer in the supine group followed by the right supine and the standing groups(median of 237 s vs 64 s and 39 s, respectively;P<0.001). CONCLUSION:Z-line visualization in patients undergoing SBCE can be accurately achieved in most cases when the capsule is swallowed in the right supine position.

关键词： Barrett Capsule endoscopy Esophagus Gastroesophageal reflux disease Ingestion Varices Z-line

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Touristic urbanization and greening of coastal dune fields:A long-term assessment of a temperate sandy barrier of Argentina

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Journal of Geographical Sciences 2025年第1期 206-230页

作者： GARZO Pedro Andrés DADON José Roberto ISLA Federico ignacio Instituto de Investigaciones Marinas y Costeras (IIMyC-CONICET/UNMDP) Instituto de Geología de Costas y del Cuaternario Dr.Enrique J.Schnack (IGCC-CIC/UNMDP) Universidad de Buenos Aires Facultad de Arquitectura Dise?o y Urbanismo Centro de Investigaciones Gestión de Espacios Costeros (GEC-FADU/UBA) Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)

Dune barrier systems represent highly sought-after coastal landscapes for tourism and urban development around the world. However, a century ago, they were considered hazardous environments due to their great dynamic nature. As a result, stabilization practices were considered necessary. The systematic introduction of fast-growing exotic trees helped stabilize the sand, making it easier for tourism urbanization to take place, but also leading to erosion processes. This paper aims to assess long-term changes in vegetation cover over a large temperate barrier in Argentina. This complex region includes urban resorts, afforestation zones, and protected areas. A GIS-based geospatial analysis was conducted using a large satellite database(> 350 images), and the future evolution of the vegetation was modeled. The results revealed two primary spatiotemporal patterns associated with a gradual expansion of vegetation cover, accompanied by a concurrent reduction in sandy areas. In 1986, the dune area comprised 75% more surface than vegetation, whereas in 2021, it represented 60% less than vegetation. Furthermore, the 2050 scenario suggests a potential 40% reduction of dunes in certain areas. It is necessary to enhance management actions aimed at maintaining dune mobility and ensuring local and regional sediment balance. Long-term management strategies must focus on restoring native plant communities and controlling invasive species, and avoiding new dune fixation initiatives based on the introduction of exotic species.

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Capsule endoscopy capture rate: Has 4 frames-per-second any impact over 2frames-per-second?

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World Journal of Gastroenterology 2014年第39期20卷 14472-14478页

作者： ignacio fernandez-urien Cristina Carretero Erika Borobio Ana Borda Emilio Estevez Sara Galter Begoa Gonzalez-Suarez Benito Gonzalez Marisol Lujan Jose Luis Martinez Vanessa Martínez Pedro Menchén Javier Navajas Vicente Pons Cesar Prieto Julio Valle Department of Gastroenterology Hospital de Navarra 31008 Pamplona Spain Department of Gastroenterology Clínica Universidad de Navarra 31008 Pamplona Spain Department of Gastroenterology Hospital Juan Canalejo 26131 La Coru?a Spain Department of Gastroenterology Hospital de Tarrasa 08509 Barcelona Spain Department of Gastroenterology Hospital del Mar 08509 Barcelona Spain Department of Gastroenterology Hospital General de Valencia 46367 Valencia Spain Department of Gastroenterology Hospital Puerta de Hierro 28816 Madrid Spain Department of Gastroenterology Hospital La Fe 46367 Valencia Spain Department of Gastroenterology Hospital Gregorio Mara?ón 28816 Madrid Spain Department of Gastroenterology Complejo Hospitalario de Toledo 45591 Toledo Spain

AIM: To compare the current capsule and a new prototype at 2 and 4 frames-per-second, respectively, in terms of clinical and therapeutic impact.

关键词： Capsule endoscopy Small bowel Diagnostic accuracy Frames Lesions Landmarks

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