The effect of photo-documentation of the ampulla on neoplasm detection rate during esophagogastroduodenoscopy

Endoscopy ◽  
2018 ◽  
Vol 51 (02) ◽  
pp. 115-124 ◽  
Author(s):  
Jae Park ◽  
Chul-Hyun Lim ◽  
Yu Cho ◽  
Bo-In Lee ◽  
Young-Seok Cho ◽  
...  
Keyword(s):  
Detection Rate ◽  
First Year ◽  
Detection Rates ◽  
Upper Gi ◽  
Asymptomatic Patients ◽  
Examination Time ◽  
Significant Difference ◽  
Photo Documentation ◽  
The Mean ◽  
Upper Gastrointestinal

Abstract Background A few studies have investigated quality indicators of esophagogastroduodenoscopy (EGD) for identifying upper gastrointestinal (GI) malignancy. The current study aimed to evaluate whether the rate of ampulla photo-documentation could be associated with the detection of upper GI neoplasms. Methods We used data from 111 962 asymptomatic patients who underwent EGD performed by 14 endoscopists at a health promotion center. The rate of ampulla photo-documentation was calculated by reviewing EGD photos archived during each endoscopist’s first year of working at the center. The detection of neoplasms during a 7-year period was investigated. We examined the association between the rate of ampulla photo-documentation and the rate of neoplasm detection. Results The mean rate of ampulla photo-documentation was 49.0 % (range 13.7 % – 78.1 %) during endoscopists’ first year of working at the center. Endoscopists’ rates of ampulla photo-documentation significantly correlated with the detection of total neoplasms (R2 = 0.57, P = 0.03) and small neoplasms (R2 = 0.58, P = 0.03). There was a significant difference in the detection rates of upper GI neoplasms between high (n = 7) and low (n = 7) ampulla observers (odds ratio [OR] 1.31, 95 % confidence interval [CI] 1.03 – 1.68; P = 0.03). The ampulla photo-documentation rate of each endoscopist significantly correlated with the examination time for a normal EGD (R2 = 0.55; P = 0.04). In multivariate analysis, high ampulla photo-documentation rate was a predictor of neoplasm detection (OR 1.33, 95 %CI 1.03 – 1.70). Conclusions The ampulla photo-documentation rate was significantly associated with the detection rate for both total and small upper GI neoplasms. Ampulla photo-documentation should be considered as a quality indicator of EGD.

scholarly journals Evaluation of image-enhanced endoscopic technology using advanced diagnostic endoscopy for the detection of early gastric cancer: a pilot study

2017 ◽  
Vol 05 (09) ◽  
pp. E825-E833 ◽  
Author(s):  
Daisuke Yamaguchi ◽  
Shinya Kodashima ◽  
Mitsuhiro Fujishiro ◽  
Satoshi Ono ◽  
Keiko Niimi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Detection Rate ◽  
Blue Laser ◽  
Color Variation ◽  
Detection Rates ◽  
Diagnostic Endoscopy ◽  
Screening Endoscopy ◽  
Significant Difference ◽  
Upper Gastrointestinal

Abstract Background and study aims Image-enhanced endoscopy (IEE) plays an important role in early detection and detailed examination of early gastric cancer (EGC). The current study aimed to clarify the efficacy of IEE using advanced diagnostic endoscopy for EGC detection without magnification. Patients and methods We performed endoscopic examinations without magnification in patients referred to our hospital with a diagnosis of upper gastrointestinal tumor detected through routine screening endoscopy. In this study, we used three IEE technologies: narrow-band imaging; blue laser imaging; and i-scan optical enhancement. The detection rates for EGC between IEE and white-light imaging (WLI) were compared. Results Between July 2013 and June 2014, 156 patients were enrolled. Among upper gastrointestinal tumors, we analyzed endoscopic examination results of 119 lesions that were histologically diagnosed as EGC in 109 patients. The EGC detection rate in the IEE plus WLI groups was 77.3 %. Although the EGC detection rate in the IEE group was higher than that in the WLI group (80.0 % vs. 70.3 %), there was no significant difference between these two modalities. An important detection factor using IEE was tumor circumference, where the rate of detection in the anterior wall and lesser curvature was significantly higher than that in the posterior wall and greater curvature (P = 0.046). An important detection factor using WLI was color variation, where the rate of occurrence of a reddened or pale tumor was significantly higher than that of normal colored tumors (P = 0.030). Conclusions The detection rate of EGC without magnification was similar between the IEE group and the WLI group. Important detection factors differed between IEE and WLI; therefore, the IEE and WLI modalities have different characteristics regarding EGC detection. Consequently, we propose to use both IEE and WLI in the evaluation of EGC.

scholarly journals Comparison of colonoscopy after colonic diverticulitis and positive fecal immunochemical tests for the detection of colorectal neoplasia

2021 ◽  
Vol 09 (03) ◽  
pp. E331-E337
Author(s):  
Dai Nakamatsu ◽  
Tsutomu Nishida ◽  
Shinji Kuriki ◽  
Li-sa Chang ◽  
Kazuki Aochi ◽  
...  
Keyword(s):  
Detection Rate ◽  
Colorectal Neoplasia ◽  
Acute Diverticulitis ◽  
Colonic Diverticulitis ◽  
Detection Rates ◽  
Positive Group ◽  
Asymptomatic Patients ◽  
Polyp Detection Rate ◽  
Adenoma Detection ◽  
Acute Colonic Diverticulitis

Abstract Background and study aims The relationship between acute colonic diverticulitis and colorectal cancer (CRC) is unclear, but colonoscopy is recommended to exclude malignancy. We compared the detection rates for colorectal neoplasia in patients with colonic diverticulitis and asymptomatic patients who had positive fecal immunochemical tests (FITs). Patients and methods In total, 282 patients with acute colonic diverticulitis were hospitalized in our hospital from February 2011 to December 2019. Of them, 143 patients with diverticulitis and 1819 with positive FITs patients during the same period underwent colonoscopy without a prior colonoscopy within 5 years. We retrospectively compared these patients in terms of the invasive CRC rate, advanced neoplasia detection rate (ANDR), adenoma detection rate (ADR), and polyp detection rate (PDR). Results Compared to the diverticulitis group, the FIT-positive group had a significantly higher CRC rate (0 vs 2.7 %, P = 0.0061), ANDR (5.6 vs. 14.0 %, P = 0.0017), ADR (19.6 vs. 53.2 %, P < .0001), and PDR (44.1 vs. 91.0 %, P < .0001). Using 1:1 propensity score matching based on age and sex, we obtained 276 matched patients in both groups. After matching, no difference was found in the CRC rate (0 vs 0.7 %) or ANDR (5.8 vs 7.3 %) between groups, but the ADR and PDR were significantly higher in the FIT-positive group (20.3 vs 43.5 %, P < .0001; 45.7 % vs 86.2 %, P < .0001). Conclusion Patients with acute diverticulitis had lower ADRs and PDRs than patients with positive FITs.

A Comparative study between Dexmedetomidine versus Propofol for sedation in upper GI endoscopy procedure considering effect on intraoperative vital data, patient amnesia and onset of recovery after the procedure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Day Case ◽  
Upper Gi ◽  
Significant Difference ◽  
Upper Gi Endoscopy ◽  
Upper Gastrointestinal

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P &lt; 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P &lt; 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.

scholarly journals Comparison of Changes in Number of Hyperreflective Dots After İntravitreal Ranibizumab or Dexamethasone İmplant in Patients with Branch Retinal Vein Occlusion

2021 ◽  
Author(s):  
Aylin Karalezli ◽  
Sema Kaderli ◽  
Ahmet Kaderli ◽  
Cansu Kaya ◽  
Sabahattin Sul
Keyword(s):  
First Year ◽  
Intravitreal Ranibizumab ◽  
Retinal Layers ◽  
Vein Occlusion ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Purpose: To compare the effect of intravitreal ranibizumab (IVR) or intravitreal dexamethasone implants (IVD) on regression of hyperreflective dots (HRDs) on optical coherence tomography (OCT) B-scan in patients with branch retinal vein occlusion (BRVO). Methods: 37 eyes of 37 patients with cystoid macular edema who received IVR or IVD and followed up for at least 12 months were included in this study. The patients were divided into three groups according to intravitreal treatment. Group 1 consisted of 12 eyes who received only IVD, group 2 consisted of 10 eyes who received only IVR on a pro re nata and group 3 consisted of 15 eyes who received both IVD and IVR. OCT parameters (CMT, number of HRDs, status of external limiting membrane (ELM) and ellipsoid zone (EZ)) and best-corrected visual acuity (BCVA) were compared between the groups over the follow-up time. HRDs were categorized as HRD in inner retinal layers (from the internal limiting membrane to the inner nuclear layer) or HRD in outer retinal layers (from the outer plexiform layer to the outer border of the photoreceptor layer).Results: There was no significant difference between groups in terms of BCVA, CMT, HRDs in the inner and the outer retinal layers at baseline visit. (p˃0.05 for all) Comparing the baseline values in all groups, a significant decrease was observed in CMT in the first year. (For group 1; p=0.013, group 2; p=0.010; group 3, p<0.001) The BCVA was significantly increased after 1 year in all groups. (p=0.001, p=0.006, p<0.001) The mean number of HRDs in inner and outer retinal layers were significantly decreased in group 1 and group 3. (For group 1; p<0.001, p=0.001, for group 3; p<0.001, p<0.001) However, there was no significant difference in terms of the mean number of HRDs in inner and outer retinal layers for group 2. (p=0.134, p=0.477) At the first year, the number of HRDs in inner and outer retinal layers was significantly lower in group 1 and group 3 than group 2. (For inner HRDs; group 1 vs. group 2 p=0.007, group 2 vs. group 3 p<0.001. For outer HRDs group 1 vs. group 2 p<0.001, group 2 vs. group 3 p<0.001.) The BCVA was higher in group 3 than group 2 at 1year. (p=0.048). There was no significant difference in terms of post-treatment CMT and the number of HRDs between group 1 and group3 in posthoc tests (p=0.621, p=0.876, and p=0.632).Conclusion: The reduction in HRDs at 12 months and better BCVA after IVD intimates that the HRDs should be considered as inflammatory markers in the follow-up of CME in BRVO. Thus, IVD injection could be more appropriate for patients with higher HRDs after BRVO.

scholarly journals MRI-directed biopsy for primary detection of prostate cancer in a population of 223 men: MRI In-Bore vs MRI-transrectal ultrasound fusion-targeted techniques

2021 ◽  
Author(s):  
Maurizio Del Monte ◽  
Stefano Cipollari ◽  
Francesco Del Giudice ◽  
Martina Pecoraro ◽  
Marco Bicchetti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Focal Therapy ◽  
Malignant Cells ◽  
Median Percentage ◽  
Detection Rates ◽  
Biopsy Core ◽  
Significant Difference ◽  
Chi Squared

Objectives: To compare the detection rates of overall prostate cancer (PCa) and clinically significant PCa (csPCa) and the median percentage of cancer per biopsy core between MRI-guided In-bore and MRI-TRUS fusion-targeted biopsy (TBx). Methods: In this retrospective study, 223 patients who underwent prostate multiparametric MRI (mpMRI) and subsequent MR-directed biopsy were included. For PCa and csPCa detection rate (DR), contingency tables were tested via the Pearson’s chi-squared to explore the variance of the outcome distribution. The percentage of cancer per biopsy core was tested with a two-tailed Mann-Withney test. Results: One hundred and seventeen and 106 patients underwent MRI-TRUS fusion or MRI In-bore TBx, respectively. 402 MRI biopsy targets were identified, of which 206 (51.2%) were biopsied with the MRI-TRUS TBx and 196 (48.8%) with the MRI In-bore TBx technique. Per-patient PCa and csPCa detection rates were 140/223 (62.8%) and 97/223 (43.5%), respectively. PCa-DR was 73/117 (62.4%) and 67/106 (63.2%) for MRI-TRUS and MRI In-Bore TBx (p = 0.9), while csPCa detection rate reached 50/117 (42.7%) and 47/106 (44.3%), respectively (p = 0.81). The median per-patient percentage of malignant tissue within biopsy cores was 50% (IQR: 27–65%) for PCa and 60% (IQR: 35–68%) for csPCa, with a statistically significant difference between the techniques. Conclusion No statistically significant difference in the detection rate of MRI In-bore and MRI-TRUS fusion TBx was found. MRI In-bore TBx showed higher per-core percentage of malignant cells. Advances in knowledge MRI In-bore biopsy might impact risk stratification and patient management considering the higher per-core percentage of malignant cells, especially for patients eligible for active surveillance or focal therapy.

scholarly journals Detection of SFTS Virus RNA and Total Antibodies in Wild Animals, Jiangsu, China, 2014-2019

2021 ◽  
Author(s):  
Shuyi Liang ◽  
Zhifeng Li ◽  
Nan Zhang ◽  
Xiaochen Wang ◽  
Jianli Hu
Keyword(s):  
Detection Rate ◽  
Jiangsu Province ◽  
Enzyme Linked Immunosorbent Assay ◽  
Wild Animals ◽  
Detection Rates ◽  
Qrt Pcr ◽  
Virus Rna ◽  
Significant Difference ◽  
Severe Fever ◽  
Antibodies Detection

Abstract Background Severe fever with thrombocytopenia syndrome (SFTS) is a novel infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV). Currently, SFTS is endemic to some areas in China, and wild animals are considered to play important roles in the circulation of SFTSV in the environment. Wild animals monitoring for SFTSV has been fulfilled since 2014 in Jiangsu Province. We studied the results of the detection to provide basic data for better diagnosis of wild animals. Methods This research was conducted in Jiangsu Province from 2014 to 2019. Sera of wild animals (Rodents, pheasants and hedgehogs) were collected to detect SFTSV both RNA and total antibodies by qRT-PCR and enzyme-linked immunosorbent assay. Statistical analysis was performed by using SPSS 25.0 (Chicago, IL, USA).Results A total of 95.8% (1298/1355) of the specimens had the same SFTSV RNA and total antibodies detection results. However, there was a significant difference between the detection rates of SFTSV RNA and total antibodies, and the detection consistency was very poor. The detection rate of SFTSV total antibodies was highest in hedgehogs(19.54%).Conclusions SFTSV total antibodies testing was preferred method during wild animals surveillance. Also, hedgehog could be a competent reservoir for SFTSV.

scholarly journals Clinical and endoscopic spectrum of upper gastrointestinal manifestations in HIV patients

1970 ◽  
Vol 8 (1) ◽  
pp. 25-28 ◽  
Author(s):  
VN Ravikumar ◽  
K Rudresh ◽  
U Jalihal ◽  
R Satish ◽  
R Manjunath
Keyword(s):  
Weight Loss ◽  
Epigastric Pain ◽  
Cd4 Count ◽  
Common Finding ◽  
Upper Gi ◽  
Gi Symptoms ◽  
Mucosal Involvement ◽  
The Mean ◽  
Upper Gastrointestinal ◽  
Oesophageal Candidiasis

Background: Human Immunodeficiency Virus (HIV) infected patient frequently report upper gastrointestinal (GI) symptoms; however their prevalence and diagnostic approach is not well known. Objective: The objective of this study was to study clinical, endoscopic and histopathological changes in HIV infected patients with upper GI symptoms and their correlation with CD4 count. Materials and methods: We evaluated 50 HIV infected patients who presented to M.S. Ramaiah hospital with upper GI symptoms. All patients answered questionnaire assessing upper GI symptoms and underwent upper GI endoscopy. Mucosal biopsy was taken wherever mucosal abnormality seen. Results: In our study, the mean age of patients was 40.98 yrs, of which 80% were males. Vomiting (36%), epigastric pain (36 %), weight loss (34 %) and anorexia (34%) were the predominant symptoms. Esophagogastroduodenoscopy (EGD) findings revealed- Oesophageal candidiasis in 28.0%, esophagitis in 22.0%, gastritis in 20.0 %, duodenitis in 14 %, normal upper GI mucosa in 18 % patients. Oesophageal candidiasis was the most common finding on histopathological examination and the mean CD4 count was 157.92 cells/μl. Conclusion: Vomiting, epigastric pain, weight loss and anorexia were most frequent symptoms. Oral candidiasis was the most common oral lesion. Oesophageal candidiasis, oesophagitis and oesophageal ulcers were the common findings on EGD. Patient with CD4 count less than 200cells/μl had more frequent upper GI mucosal involvement than in patients with CD4 count more than 200. Majority of the patients with GI symptoms had upper GI mucosal changes and opportunistic infections. Thus endoscopic and histopathological evaluation is advisable for the early diagnosis and treatment of upper GI complications in patients with HIV infection. Key words: AIDS; Oesophageal candidiasis; Esophagogastroduodenoscopy; HIV; Upper gastrointestinal symptoms. DOI: 10.3126/kumj.v8i1.3217 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 25-28

scholarly journals Systematic review with meta-analysis: age-related malignancy detection rates at upper gastrointestinal endoscopy

2020 ◽  
Vol 13 ◽  
pp. 175628482095922
Author(s):  
Judith J. de Jong ◽  
Marten A. Lantinga ◽  
Ina M. E. Thijs ◽  
Philip R. de Reuver ◽  
Joost P. H. Drenth
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Detection Rates ◽  
Gi Endoscopy ◽  
Upper Gi ◽  
Age Related ◽  
Upper Gi Endoscopy ◽  
Age Limits ◽  
Upper Gi Malignancy ◽  
Upper Gastrointestinal

Background: Age is an important and objective risk factor for upper gastrointestinal (GI) malignancy. The accuracy of various age limits to detect upper GI malignancy is unclear. Determination of this accuracy may aid in the decision to refer symptomatic patients for upper GI endoscopy. The aim of this analysis was to synthesize data on upper GI malignancy detection rates for various age limits worldwide through meta-analysis. Methods: We searched MEDLINE, EMBASE, and Web of Science in November 2018. Selection criteria included studies addressing malignant findings at upper GI endoscopy in a symptomatic population reporting age at time of diagnosis. Meta-analyses were conducted to derive continent-specific cancer detection rates. Results: A total of 33 studies including 346,641 patients across 21 countries fulfilled the inclusion criteria. To detect >80% of malignant cases all symptomatic patients over 40 years of age should be investigated in Africa, over 50 years of age in South America and Asia, and over 55 years of age in North America and Europe. Conclusion: This systematic review and meta-analysis provides data on intercontinental variation in age at time of upper GI malignancy diagnosis in symptomatic patients referred for upper GI endoscopy. Guideline recommendations for age-based selection should be tailored to local age-related detection rates.

scholarly journals 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Alexandre Peltier ◽  
Fouad Aoun ◽  
Fouad El-Khoury ◽  
Eric Hawaux ◽  
Ksenija Limani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Biopsy ◽  
Detection Rate ◽  
Transrectal Ultrasound ◽  
Daily Practice ◽  
Cancer Detection Rate ◽  
Prior History ◽  
Detection Rates ◽  
Significant Difference

Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice.Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol.Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05). There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection.Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

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