6 research outputs found
Endoscopic diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH): European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2021
Bowel preparation for small bowel capsule endoscopy - The later, the better!
In small bowel capsule endoscopy (SBCE), the presence of residue may compromise diagnostic accuracy. Background
In small bowel capsule endoscopy (SBCE), the presence of residue may compromise diagnostic accuracy.
Aims
To assess differences in quality of visualisation and diagnostic yield of SBCE using 3 different preparation protocols.
Methods
Prospective, randomized, blind, pilot study. Protocol A:Clear liquids diet the day before the examination with fasting from 8p.m.; Protocol B:Protocol Aâ+â2 pouches of MoviprepÂź(polyethylene glycol electrolyte solutionâ+âsodium ascorbate) in 1âL of water from 8p.m. of the day before the examination; Protocol C: Protocol Aâ+â2 pouches of MoviprepÂź in 1âL of water consumed after real-time confirmation of capsule arrival at small bowel.
Small bowel preparation was classified by two experienced physicians, considering the percentage of the examination during which mucosal observation was adequate: Excellent(>90%); Good(90â75%); Fair(75â50%); Poor(<50%).
Results
101 patients randomized to the 3 protocols (A 37, B 31, C 33 patients). Protocol C had an excellent/good small bowel preparation in a higher percentage of examinations for both readers(Reader 1-A:37.8% vs B:45.2% vs C:78.8%, pâ=â0.002 and Reader 2 âA:37.8% vs B:41.9% vs C:75.8%, pâ=â0.003). Also, protocol C had a higher detection of angioectasia (A:5.4% vs B:9.7% vs C:27.3%, pâ=â0.022).
Conclusions
The administration of MoviprepÂź after the capsule had reached the small bowel was associated with a better small bowel preparation and a higher detection of angioectasia
A Saliency-based Unsupervised Method for Angiectasia Detection in Endoscopic Video Frames
Re-bleeding and its predictors after capsule endoscopy in patients with obscure gastrointestinal bleeding in long-term follow-up
Discharge protocol in acute pancreatitis: an international survey and cohort analysis.
There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) pâ<â0.001), and a lower rate of readmission due to recurrent AP episodes (pâ=â0.005). There was no difference in median discharge CRP level among the international cohorts (pâ=â0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (nâ=â35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care