Optimising the performance and interpretation of small bowel capsule endoscopy

Small bowel capsule endoscopy has become a commonly used tool in the investigation of gastrointestinal symptoms and is now widely available in clinical practice. In contrast to conventional endoscopy, there is a lack of clear consensus on when competency is achieved or the way in which capsule endoscopy should be performed in order to maintain quality and clinical accuracy. Here we explore the evidence on the key factors that influence the quality of small bowel capsule endoscopy services

Bronchoscopy masks mitigate aerosols during upper gastrointestinal endoscopies

Background and study aims: Upper gastrointestinal endoscopies are considered aerosol-generating procedures (AGP) that risk spread of airborne diseases such as SARS-CoV-2. We aimed to investigate where clinically approved bronchoscopy masks applied to patients during esophagogastroduodenoscopies can mitigate spread of aerosols and droplets.Patients and methods: This study included patients undergoing routine upper gastrointestinal endoscopy in a standard endoscopy room and used a particle counter to measure size and number of particles 10 cm from the mouths of 49 patients undergoing upper gastrointestinal endoscopies, of whom 12 wore bronchoscopy masks and 37 did not (controls). Particle counts in the aerosol (≤ 5 µm diameter) and droplet (> 5 µm-diameter) size ranges were measured and averaged over the duration of procedures.Results: The use of bronchoscopy masks offers a 47% reduction (P = 0.01) in particle count for particles < 5 μm in diameter over the procedure duration (aerosols).Conclusions: Bronchoscopy masks or similar are a simple, low-cost mitigation technique that can be used during outbreaks of respiratory diseases such as COVID-19 to improve safety and reduce fallow times

Covid-19 pandemic impact on colonoscopy service and suggestions for managing recovery

Abstract Background and aim As the post-peak phase of the epidemic is approaching, there is an urgent need of an action plan to help resume endoscopy activity. To manage the Covid-19 pandemic-imposed backlog of postponed colonoscopy examinations, an efficient approach is needed. The practice of on-demand sedation with benzodiazepines and/or opiates will allow most patients to complete a water-aided examination with minimal or no sedation. Other methods reported to minimize patient discomfort during colonoscopy can be used, in addition to water-aided techniques. Unsedated or minimally sedated patients who do not require recovery or require a shorter one allow rapid turnaround. The practice obviates the need for assistance with deep sedation from anesthesiologists, who may be in short supply. Trainee education in water-aided colonoscopy has been demonstrated to confer benefits. This review provides some insights into the impact of Covid-19 on endoscopy services, challenges ahead, and possible solutions to help recovery of colonoscopy work and training

Cytosponge procedures produce fewer respiratory aerosols and droplets than oesophagogastroduodenoscopies

Esophagogastroduodenoscopies (EGD) are aerosol-generating procedures that may spread respiratory pathogens. We aim to investigate the production of airborne aerosols and droplets during Cytosponge procedures, which are being evaluated in large-scale research studies and National Health Service (NHS)implementation pilots to reduce endoscopy backlogs. We measured 18 Cytosponge and 37 EGD procedures using a particle counter (diameters = 0.3–25 μm), taking measurements 10 cm from the mouth. Two particle count analyses were performed: whole procedure and event-based. Direct comparison with duration-standardized EGD procedures shows that Cytosponge procedures produce 2.16× reduction (P < 0.001) for aerosols and no significant change for droplets (P = 0.332). Event-based analysis shows that particle production is driven by throat spray (aerosols: 138.1× reference, droplets: 16.2×), which is optional, and removal of Cytosponge (aerosols: 14.6×, droplets: 62.6×). Cytosponge burping produces less aerosols than EGD (2.82×, P < 0.05). Cytosponge procedures produce significantly less aerosols and droplets than EGD procedures and thus reduce two potential transmission routes for respiratory viruses

Recommendations of the Chilean association for digestive endoscopy for the management of gastric pre-malignant lesions

Indexación: Web of Science; Scielo.An expert panel analyzed the available evidence and reached a consensus to release 24 recommendations for primary and secondary prevention of gastric cancer (CG) in symptomatic patients, with indication for upper GI endoscopy. The main recommendations include (1) Search for and eradicate H. pylori infection in all cases. (2) Systematic gastric biopsies (Sydney protocol) in all patients over 40 years of age or first grade relatives of patient with CG, to detect gastric atrophy, intestinal metaplasia or dysplasia. (3) Incorporate the OLGA system (Operative Link on Gastritis Assessment) to the pathological report, to categorize the individual risk of CG. (4) Schedule endoscopic follow-up according to the estimated risk of CG, namely annual for OLGA III- IV, every 3 years for OLGA I- II or persistent H. pylori infection, every 5 years for CG relatives without other risk factors and no follow-up for OLGA 0, H. pylori (-). (4) Establish basic human and material resources for endoscopic follow-up programs, including some essential administrative processes, and (5) Suggest the early CG/total CG diagnosis ratio of each institution and the proportion of systematic recording of endoscopic images, as quality indicators. These measures are applicable using currently available resources, they can complement any future screening programs for asymptomatic population and may contribute to improve the prognosis of CG in high-risk populations.http://ref.scielo.org/f2gm5

Narrow band imaging and serology in the assessment of premalignant gastric pathology

Background: Patient outcomes in gastric adenocarcinoma are poor due to late diagnosis. Detecting and treating at the premalignant stage has the potential to improve this. Helicobacter pylori is also a strong risk factor for this disease.Aims: Primary aims were to assess the diagnostic accuracy of magnified narrow band imaging (NBI-Z) endoscopy and serology in detecting normal mucosa, H. pylori gastritis and gastric atrophy. Secondary aims were to compare the diagnostic accuracies of two classification systems using both NBI-Z and white light endoscopy with magnification (WLE-Z) and evaluate the inter-observer agreement.Methods: Patients were prospectively recruited. Images of gastric mucosa were stored with histology and serum for IgG H. pylori and Pepsinogen (PG) I/II ELISAs. Blinded expert endoscopists agreed on mucosal pattern. Mucosal images and serological markers were compared with histology. Kappa statistics determined inter-observer variability for randomly allocated images among four experts and four non-experts.Results: 116 patients were prospectively recruited. Diagnostic accuracy of NBI-Z for determining normal gastric mucosa was 0.87(95%CI 0.82–0.92), H. pylori gastritis 0.65(95%CI 0.55–0.75) and gastric atrophy 0.88(95%CI 0.81–0.94). NBI-Z was superior to serology at detecting gastric atrophy: NBI-Z gastric atrophy 0.88(95%CI 0.81-0.94) vs PGI/II ratio

Validation of a new optical diagnosis training module to improve dysplasia characterization in inflammatory bowel disease:a multicenter international study

Background and aims Inflammatory bowel disease (IBD) increases risk of dysplasia and colorectal cancer. Advanced endoscopic techniques allow for the detection and characterization of IBD dysplastic lesions, but specialized training is not widely available. We aim to develop and validate an online training platform to improve the detection and characterization of colonic lesions in IBD: OPTIC-IBD. Methods We designed a web-based learning module that includes surveillance principles, optical diagnostic methods, approach to characterization, classifications of colonic lesions, utilizing still images and videos. We invited gastroenterologists from Canada, Italy, and the UK, with a wide range of experience. Participants reviewed 24 educational videos of IBD colonic lesions, predicted histology, and rated their confidence. The primary endpoint was to improve accuracy in detecting dysplastic lesions following training on the platform. Furthermore, participants were randomized 1:1 to get additional training or not, with a final assessment occurring after 60 days. Diagnostic performance for dysplasia and rater confidence were measured. Results One hundred seventeen participants completed the study and were assessed for the primary endpoint. Diagnostic accuracy improved from 70.8% to 75.0% (p 0.002) following training, with the greatest improvements seen in less experienced endoscopists. Improvements in both accuracy and confidence were sustained after 2 months of assessment, although the group randomized to receive additional training did not improve further. Similarly, participants’ confidence in characterizing lesions significantly improved between pre- and post-course (

Planning and community development: case studies

Planning and Comunity Development: Case Studies, presents the findings of the inter-university Seminar held on 28?29 July 2011 and organized by researchers from the Technical University of Madrid and the University of California, Berkeley, who were fortunate to have the presence of the renowned Professor John Friedmann. Professors, researchers and PhD students from our research groups presented their works as scientific communications that were enriched by the debate among the different researches who attended the Seminar. All of them appear in the picture below in front of the gate of Haviland Hall at UC Berkeley. This book analyses the concept of planning and its evolution so far, leading to the conceptualization of governance as an expression of the planning practice. It also studies the role of social capital and cooperation as tools for the community development. The conceptual analysis is complemented by the development of six case studies that put forward experiences of planning and community development carried out in diverse social and cultural contexts of Latin-America, Europe and North America. This publication comes after more than 20 years of work of the researchers that met at the seminar. Through their work in managing development initiatives, they have learned lessons and have contribute to shape their own body of teaching that develops and analyses the role of planning in public domain to promote community development. This knowledge is synthesized in the model Planning as Working With People, that shows that development is not effective unless is promoted in continuous collaboration with all the actors involved in the process

Research advances in Risaralda. An overview of 8 experiences

I am honored to present to you this remarkable book, a testament to the invaluable research conducted in the fields of Health, Law, Engineering, and Administrative Sciences. Each chapter within these pages represents the culmination of extensive investigations carried out by dedicated scholars affiliated with the Red Universitaria de Risaralda (RUN), a network comprising 15 esteemed higher education institutions. Risaralda has emerged as a thriving hub for higher education, bolstered by its strategic geographical location, high quality of life, rich biodiversity, and competitive development. Today, Pereira ranks third in the index of university cities, with a student enrollment rate exceeding 63%. Close to 50,000 students pursue academic programs within the department. Notably, three institutions have achieved accreditation for their excellence in education, positioning Risaralda among the most competitive regions in terms of accredited academic programs. As we celebrate the 20th anniversary of the Red Universitaria de Risaralda in 2023, it is with great pride that we reflect on its pivotal role in fostering collaboration among public and private higher education institutions. Our mission has been twofold: attracting students to our region and supporting sustainable development and quality of life for our community. The mesa de investigación (research committee) has diligently coordinated the necessary actions to unite our researchers, facilitating an integrated approach to various disciplines and themes associated with the challenges faced in our region.CONTENT Introduction...................................................................................................................5 CHAPTER ONE. Tobacco Use and Social Skills in Children from Two Schools in Pereira, Colombia .......................................................................................................9 Angélica María Blanco Vanegas, Natalia Jeaneth Carmona Valencia and Ángela Liceth Pérez Rendón CHAPTER TWO. Lesbian visibility: between control and family silence.................................................35 Mireya Ospina Botero and Carolina Carmona Castilla CHAPTER THREE. New centralities in the city of Pereira, 1990-2019 .......................................................65 Cesar Augusto Castaño Galvis CHAPTER FOUR. Bibliometric analysis of scientific publications on the effect of roots on slope stability ...........................................................................................................95 Alejandro Alzate Buitrago, Raúl Alberto Gaviria Valencia, César Augusto Peñuela Meneses, Carlos Alberto Ospina Parra CHAPTER FIVE. Sustainability of local agri-food systems in a municipality of the Eje Cafetero, Colombia...............................................................................................131 Jaime Cardona Ocampo, Orlando Ospina Salazar and Julia Arredondo Botero CHAPTER SIX. Organizational strategies aimed at the Emberá Chamí unified indigenous reservation, Inamurcito community located in the municipality of Pueblo Rico, Risaralda............................................................................................................163 Carla Johana Martínez García and Yenny Marcela Vélez Herrera CHAPTER SEVEN. Psychomotor profile of children between 4 and 5 years old in the city of Pereira, Colombia ...................................................................................................199 Jhonatan Gonzalez-Santamaría and Claudia Jimena Lopez-Garcia CHAPTER EIGHT. Analysis of assembly tasks without the use of vision: an opportunity for the design of support technologies in manufacturing environments.....................217 Gustavo Adolfo Peña Marín, Carlos Andrés Quintero Diaztagle and Juan Diego Gallego Góme