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Narrow band imaging and white light endoscopy in the characterization of a polypectomy scar:A single-blind observational study

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World Journal of Gastroenterology 2018年第45期24卷 5179-5188页

作者： Fausto Riu Pons Montserrat Andreu Javier Gimeno Beltran Marco Antonioálvarez-Gonzalez Agustín Seoane Urgorri Josep Maria Dedeu luis barranco priego Xavier Bessa Gastroenterology Department Hospital del MarBarcelona 08003Spain IMIM(Hospital del Mar Medical Research Institute) Barcelona 08003Spain Department of Medicine Autonomous University of BarcelonaBarcelona 08003Spain Pompeu Fabra University Barcelona 08003Spain Pathology Department Hospital del MarBarcelona 08003Spain.

AIM To assess the incremental benefit of narrow band imaging(NBI) and white light endoscopy(WLE), randomizing the initial technique for the detection of residual neoplasia at the polypectomy scar after an endoscopic piecemeal mucosal resection(EPMR).METHODS We conducted an observational study in an academic center to assess the incremental benefit of NBI and WLE randomly applied 1:1(NBI-WLE or WLE-NBI) in the follow-up of a post-EPMR scar by the same *** A total of 112 EPMR scars were included. The median baseline polyp size was 20 mm(interquartile range: 14-30). At first review, NBI and WLE showed good sensitivity(85.0% vs 78.9%), specificity(77.1% vs 84.2%) and overall accuracy(80.0% vs 82.5%). NBI after WLE(WLE-NBI group) improved accuracy, but this difference was not statistically significant [area under the curve(AUC): 86.8% vs 81.6%, P = 0.15]. WLE after NBI(NBI-WLE group) did not improve accuracy(AUC: 81.4% vs 81.1%, P = 0.9). Overall, recurrence was found in 39/112(34.8%) *** Although no statistically significant differences were found between the two techniques at the first postEPMR assessment, the use of NBI after WLE may improve residual neoplasia detection. Nevertheless, biopsy is still required in the first scar review.

关键词： Colonoscopy Narrow band imaging Endoscopic mucosal resection

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Evaluation of an educational telephone intervention strategy to improve non-screening colonoscopy attendance:A randomized controlled trial

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World Journal of Gastroenterology 2020年第47期26卷 7568-7583页

作者： Agustin Seoane Xenia Font Juan C Perez Rocio Perez Carlos F Enriquez Miriam Parrilla Faust Riu Josep M Dedeu luis E barranco Xavier Duran Ines A Ibanez Marco A Alvarez Digestive Department Endoscopy UnitHospital del MarParc de Salut MarBarcelona 08003Spain Colorectal Cancer Research Group IMIM(Hospital del Mar Medical Research Institute)Barcelona 08003Spain Department of Medicine Autonomous University of BarcelonaBarcelona 08003Spain Consulting Service on Methodology for Biomedical Research IMIM(Hospital del Mar Medical Research Institute)Barcelona 08003Spain

BACKGROUND Colonoscopy attendance is a key quality parameter in colorectal cancer population screening *** these programmes,educative interventions with bidirectional contact carried out by trained personnel have been proved to be an important tool for colonoscopy attendance improvement,and because of its huge clinical and economic impact,they have been widely ***,outside of this population programmes,educative measures to improve colonoscopy attendance have been poorly studied and no navigation interventions are usually *** To investigate the clinical and economic impacts of an educational telephone intervention on colonoscopy attendance outside colorectal cancer screening *** This randomized controlled trial included consecutive patients referred to colonoscopy from primary care centres from November 2017 to May *** intervention group(IG)received a telephone intervention,while the control group(CG)did *** assigned to the IG received an educational telephone call 7 d before the colonoscopy *** intervention was carried out by two nurses with deep endoscopic knowledge who were previously trained for a telephone educational intervention for *** impact on patient compliance with preparedness protocols related to bowel cleansing,antithrombotic management,and sedation scheduling was also evaluated.A second call was conducted to assess patient ***-to-treat(ITT)and perprotocol(PP)analyses were *** A total of 738 and 746 patients were finally included in the IG and CG *** hundred thirteen(83%)patients were contacted in the *** non-attendance rate was lower in the IG,both in the ITT analysis(IG 8.4%vs CG 14.3%,P<0.001)and in the PP analysis(4.4%vs 14.3%,P<0.001).In a multivariable analysis,belonging to the control group increased the risk of nonattendance in both,the ITT analysis(OR 1.81,95%CI:1.27 to 2.58,P=0.001)and the PP analysis(O

关键词： Colonoscopy Quality improvement No-show patients Nursing education Patient compliance Telephone intervention

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Higher cardiovascular risk scores and liver fibrosis risk estimated by biomarkers in patients with metabolic-dysfunction-associated fatty liver disease

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World Journal of Hepatology 2022年第8期14卷 1633-1642页

作者： Giovanni Alejandro Salgado Alvarez Samanta Mayanin Pinto Galvez Uriel Garcia Mora Ana Delfina Cano Contreras Cristina Durán Rosas Bryan Adrián priego-Parra Arturo Triana Romero Mercedes Amieva Balmori Federico Roesch Dietlen Sophia Eugenia Martinez Vazquez Ines Osvely Mendez Guerrero luis Alberto Chi-Cervera Raúl Bernal Reyes Leonardo Alberto Martinez Roriguez Maria Eugenia Icaza Chavez Jose Maria Remes Troche Instituto de Investigaciones Médico-biologicas Universidad VeracruzanaVeracruz 91700VeracruzMexico Department of Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMéxico 14080MéxicoMexico Clínica de Especialidades Gastrointestinales y Hepáticas Hospital Star MedicaMerida 97133YucatanMexico Department of Gastroenterologia Sociedad Española de BeneficenciaPachuca 42000HidalgoMexico Department of Gastroenterologia Clínica de Rehabilitación Metabólica Digestiva y HepáticaMexico 14080MexicoMexico Department of Gastroenterologia Hospital Star Médica de MéridaMerida 97133YucatanMexico

BACKGROUND The definition of metabolic-dysfunction-associated fatty liver disease(MAFLD)allows identification of metabolically complicated *** risk scores are related to cardiovascular risk(CVR)scores and could be useful for the identification of patients at risk of systemic *** To evaluate the relationship between MAFLD and CVR using the Framingham risk score in a group of Mexican *** Cross-sectional,observational and descriptive study carried out in a cohort of 585 volunteers in the state of Veracruz with MAFLD *** risk of liver fibrosis was calculated with aspartate aminotransferase-to-platelet ratio index,nonalcoholic fatty liver disease score and fibrosis-4,as well as with transient hepatic elastography with Fibroscan~?.The CVR was determined by the Framingham *** One hundred and twenty-five participants(21.4%)with MAFLD criteria were evaluated,average age 54.4 years,63.2%were women,body mass index 32.3 kg/m~*** Framingham CVR was high in 43 patients(33.9%).Transient elastography was performed in 55.2%of volunteers;39.1%with high CVR and predominance in advanced fibrosis(F3–F4).The logistic regression analysis showed that liver fibrosis,diabetes and hypertension independently increased *** One of every three patients with MAFLD had a high CVR,and in those with high fibrosis risk,the CVR risk was even greater.

关键词： Fatty liver Cardiovascular risk Hepatic steatosis Fibrosis Liver disease

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Outcome in obscure gastrointestinal bleeding after capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第11期5卷 551-558页

作者： Alex Caas-Ventura Lucia Márque Xavier Bessa Josep Maria DedeuDepartment of Gastroenterology Hospital del Mar Research Institute Pompeu Fabra University Marc Puigvehí Sílvia Delgado-Aros Ines Ana Ibáez Agustin Seoane luis barranco Felipe Bory Montserrat Andreu Begoa González-Suárez Department of Gastroenterology Hospital del Mar Research InstitutePompeu Fabra University Endoscopic Unit Gastroenterology DepartmentICMDiM. Hospital Clínic

AIM: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. METHODS: Patients who were referred to Hospital del Mar(Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid antiinflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings(significant or non-significant), work-up and patient out-comes were analyzed from electronic charts. Variables were compared by χ 2 analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-Meier curves and Cox regression model. RESULTS: There were 105 patients [45.7% women, median age of 72 years old(interquartile range 56-79)] and a median follow-up of 326 d(interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1%(55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients(69.5%), OGIB was resolved. Multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios(HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above(HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE(HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding. CONCLUSION: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions.

关键词： Capsule endoscopy Obscure gastrointestinal bleeding Small bowel Angiodysplasia Enteroscopy

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