A seven-year follow-up of discharged patients after out-of-hospital cardiac arrest with respect to ST-segment elevation myocardial infarction

Introduction. The aim of this multicentre prospective study was to describe the seven-year survival of patients, from the region of East Bohemia, after out-of-hospital cardiac arrest (OHCA), occurring between 2002 and 2004. The main focus of this study was on the survival of patients with ST-segment elevated myocardial infarction (STEMI). Patients and Methods. A total 718 patients with OHCA were included in the study. Of these patients, 149 were admitted to hospital. The main cohort of our study consisted of 53 patients (41 men; median 59; average 58±13), who survived acute hospitalization. In these patients, STEMI was the main cause of OHCA in 15 cases (28%), whereas without STEMI was found in 38 cases (72%). Patients who survived hospitalization were periodically followed-up at six-monthly intervals. Results. In the first follow-up year, 42 patients survived (79% of 53 patients), in the third year 38 patients (72%), in the fifth year 33 patients (62%) and in the seventh year 31 patients (59%). Ninety-four percent of patients were in good neurological condition after the seventh follow-up year. The whole period of seven years was survived by 12 (80%) out of 15 patients with STEMI, and by 19 (50%) out of 38 patients without STEMI. In patients who survived the seventh year after STEMI, direct percutaneous coronary intervention was performed in 11 cases. Conclusions. Fifty-nine percent of patients discharged from hospital after OHCA survived until the seventh year. The highest rate of survival during this period was seen in patients with STEMI, i.e. in 80%

approach EDITORIAL

Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectom

Enteroscopy: will it achieve the complete journey?

Ce n'est que depuis ces 10 à 15 dernières années que l'endoscopie de l'intestin grêle et d'autres nouvelles techniques d'imagerie ont été intégrées à la pratique clinique en routine. De nos jours, de nombreuses méthodes d'endoscopie sont disponibles. Dans cette revue, nous préconisons l'entéroscopie poussée (comme investigation de premier choix) et essayons de montrer que cette technique, l'endoscopie par capsule sans fil et l'entéroscopie per-opératoire ne sont pas en compétition mais constituent plutôt des techniques complémentaires

Peutz-Jeghers syndrome: Diagnostic and therapeuticapproach

Peutz-Jeghers syndrome (PJS) is an inherited, autosomal dominant disorder distinguished by hamartomatous polyps in the gastrointestinal tract and pigmented mucocutaneous lesions. Prevalence of PJS is estimated from 1 in 8300 to 1 in 280 000 individuals. PJS predisposes sufferers to various malignancies (gastrointestinal, pancreatic, lung, breast, uterine, ovarian and testicular tumors). Bleeding, obstruction and intussusception are common complications in patients with PJS. Double balloon enteroscopy (DBE) allows examination and treatment of the small bowel. Polypectomy using DBE may obviate the need for repeated urgent operations and small bowel resection that leads to short bowel syndrome. Prophylaxis and polypectomy of the entire small bowel is the gold standard in PJS patients. Intraoperative enteroscopy (IOE) was the only possibility for endoscopic treatment of patients with PJS before the DBE era. Both DBE and IOE facilitate exploration and treatment of the small intestine. DBE is less invasive and more convenient for the patient. Both procedures are generally safe and useful. An overall recommendation for PJS patients includes not only gastrointestinal multiple polyp resolution, but also regular lifelong cancer screening (colonoscopy, upper endoscopy, computed tomography, magnetic resonance imaging or ultrasound of the pancreas, chest X-ray, mammography and pelvic examination with ultrasound in women, and testicular examination in men). Although the incidence of PJS is low, it is important for clinicians to recognize these disorders to prevent morbidity and mortality in these patients, and to perform presymptomatic testing in the first-degree relatives of PJS patients

Double balloon enteroscopy and acute pancreatitis

Double balloon enteroscopy (DBE) is a new technique, first published and introduced into clinical practice in 2001 by Yamamoto, the inventor of this outstanding method. DBE allows complete visualization, biopsy and treatment of the small bowel. Nowadays, we have some experience of this method for evaluation of the complication rate. Severe complications are described in 1%-1.7% of patients. Acute pancreatitis is a rare complication of the investigation. The incidence of acute pancreatitis after diagnostic DBE is 0.3% in most studies. More than 50 cases of acute pancreatitis have been described in the literature so far. On the contrary, hyperamylasemia after DBE seems to be a rather common condition. Association with acute pancreatitis is supposed to be possible, but not obligatory. The causal mechanism of post-DBE acute pancreatitis is uncertain, and there are several theories in the literature. The most probable cause seems to be a mechanical straining of the endoscope with over-tube on the pancreas or in the papillary area

The importance of upper gastrointestinal lesions detected with capsule endoscopy in patients with obscure digestive bleeding.

Study aims: Small bowel capsule endoscopy (SBCE) is the first line procedure for detecting small bowel lesions in patients with an obscure gastrointestinal bleeding (OGIB). Missed upper gastro - intestinal (UGI) lesions at the initial endoscopy may account for the so-called OGIB. This retrospective study was designed to assess the role of SBCE in detecting missed UGI lesions. Methods: All consecutive SBCE that were performed in the last year for patients with OGIB were included in our study. We evaluated the visibility of the gastric mucosa, the anatomic landmarks, the presence of UGI lesions as well as their clinical importance. The SBCE findings were compared with the reports of previous UGI endoscopies. Results: 118 patients (45 males, 73 females, mean age 61 ± 19 years) were included in the analysis. The indication for SBCE was obscure overt and occult OGIB in 60 and in 58 patients, respectively. SBCE identified lesions in the small bowel in 42% of the patients. An excellent visibility of gastric mucosa was observed in 83/118 cases (70.3%). SBCE identified gastric lesions with potential clinical significance (high bleed potential) in 25/118 (21.2%) patients. In 12/118 (10.2%) patients the UGI lesions detected by SBCE were considered as the only potential source of bleeding. Conclusions: In patients with OGIB, SBCE detected not only small bowel lesions but also significant UGI lesions that were missed or underestimated at the initial endoscopy in 21% of cases. It is therefore necessary to carefully read the gastric images when performing an SBCE.Journal ArticleMulticenter Studyinfo:eu-repo/semantics/publishe