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Therapeutic colonoscopy

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https://www.readbyqxmd.com/read/29147133/allopurinol-in-combination-with-thiopurine-induces-mucosal-healing-and-improves-clinical-and-metabolic-outcomes-in-ibd
#1
Brigitte Moreau, Pierre Clement, Yves Theoret, Ernest G Seidman
Background: Thiopurines, azathioprine (AZA) and 6-mercaptopurine (6-MP) are common maintenance medications for inflammatory bowel disease (IBD). Excessive methylation via thiopurine methyltransferase (TPMT) frequently causes therapeutic failure. Allopurinol reduces excessive 6-methyl-mercaptopurine (6-MMP) while enhancing 6-thioguanine (6-TGN) levels. The aim of this study was to evaluate clinical, metabolic and endoscopic impact of allopurinol in combination with low-dose thiopurine in IBD...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29136128/the-proton-activated-receptor-gpr4-modulates-intestinal-inflammation
#2
Yu Wang, Cheryl de Vallière, Pedro H Imenez Silva, Irina Leonardi, Sven Gruber, Alexandra Gerstgrasser, Hassan Melham, Achim Weber, Katharina Leucht, Lutz Wolfram, Martin Hausmann, Carsten Krieg, Koray Thomasson, Onur Boyman, Isabelle Frey-Wagner, Gerhard Rogler, Carsten A Wagner
BACKGROUND AND AIMS: During active inflammation tissue intraluminal intestinal pH is decreased in patients with inflammatory bowel disease (IBD). Acidic pH may play a role in IBD pathophysiology. Recently, proton sensing G-protein coupled receptors were identified, including GPR4, OGR1 (GPR68), and TDAG8 (GPR65). We investigated whether GPR4 is involved in intestinal inflammation. METHODS: The role of GPR4 was assessed in murine colitis models: chronic dextran sulphate sodium (DSS) administration and by crossbreeding into an IL-10 deficient background for development of spontaneous colitis...
November 9, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29130220/-current-research-progress-and-thinking-of-fecal-microbiota-transplantation-for-the-treatment-of-gastrointestinal-disorders
#3
Ning Li, Hongliang Tian
Fecal microbiota transplantation (FMT), also known as fecal bacteriotherapy or fecal infusion, consists of injection of a liquid filtrate of feces from a healthy donor into the gastrointestinal tract of a recipient individual. FMT has been proposed as a therapeutic approach for functional diseases of the gastrointestinal tract by reestablishment of a wide diversity of intestinal flora. Clostridium difficile infection (CDI) treatment guideline from American Gastroenterology Association (AGA) recommends that FMT can be used as the treatment protocols of relapse CDI...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29122850/differential-preventive-activity-of-sulindac-and-atorvastatin-in-apc-min-fccc-mice-with-or-without-colorectal-adenomas
#4
Wen-Chi L Chang, Christina Jackson, Stacy Riel, Harry S Cooper, Karthik Devarajan, Harvey H Hensley, Yan Zhou, Lisa A Vanderveer, Minhhuyen T Nguyen, Margie L Clapper
OBJECTIVE: The response of subjects to preventive intervention is heterogeneous. The goal of this study was to determine if the efficacy of a chemopreventive agent differs in non-tumour-bearing animals versus those with colorectal tumours. Sulindac and/or atorvastatin was administered to Apc(+/Min-FCCC) mice with known tumour-bearing status at treatment initiation. DESIGN: Male mice (6-8 weeks old) underwent colonoscopy and received control chow or chow with sulindac (300 ppm), atorvastatin (100 ppm) or sulindac/atorvastatin...
November 9, 2017: Gut
https://www.readbyqxmd.com/read/29094497/iron-deficiency-anemia-in-older-adults-a-review
#5
REVIEW
Etienne Joosten
Anemia in older adults is a risk factor for numerous negative outcomes. There is no standard definition, but in most studies, anemia is defined as a hemoglobin value <12 g/dL for women and <13 g/dL for men. Absolute iron deficiency anemia is defined as the combination of anemia and the absence of total body iron. Serum ferritin is the most frequently used diagnostic parameter, but its concentration increases with age and in the presence of inflammatory diseases. Other laboratory tests, such as transferrin saturation, soluble transferrin receptor and the soluble transferrin receptor/ferritin index might provide useful information, but there is a wide variety in the cut-off values and interpretation of the results...
November 2, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29019557/colonoscopy-randomized-comparative-study-of-insufflation-with-carbon-dioxide-versus-air
#6
Luiz Gustavo DE-Quadros, Roberto Luiz Kaiser-Júnior, Valter Nilton Felix, Lucio Villar, Josemberg Marins Campos, Vinicius Quintiliano Moutinho Nogueira, André Teixeira, Idiberto José Zotarelli-Filho
BACKGROUND: In Brazil, an increasing number of people are submitted to colonoscopy, either for screening or for therapeutic purposes. AIM: To evaluate whether there are advantages of using carbon dioxide (CO2) over air for insufflation. METHODS: Two hundred and ten of 219 patients were considered eligible for this study and were randomized into two groups according to the gas insufflation used: Air Group (n=104) and CO2 Group (n=97). The study employed a double-blind design...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/29019424/endoscopy-for-patients-affected-by-inflammatory-bowel-disease-bowel-preparation-and-sedation
#7
Cristina Bezzio, Paolo Andreozzi, Valentina Casini, Gianpiero Manes, Simone Saibeni
Endoscopy has a key role in the management of inflammatory bowel disease (IBD). It is helpful in the diagnosis, in case of relapse, refractoriness, before therapeutic changes, after surgery as well as in the assessment of mucosal healing and in the surveillance of colo-rectal cancer. IBD patients are intended to undergo several times the examination during their lifespan. Bowel preparation and sedation highly contribute to high-quality colonoscopy. Areas covered: Few studies addressed preparation and sedation in the field of IBD...
October 17, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28991857/impact-of-histological-and-endoscopic-remissions-on-clinical-recurrence-and-recurrence-free-time-in-ulcerative-colitis
#8
Ana Ponte, Rolando Pinho, Sónia Fernandes, Adélia Rodrigues, Luís Alberto, João Carlos Silva, Joana Silva, Jaime Rodrigues, Mafalda Sousa, Ana Paula Silva, Luísa Proença, Teresa Freitas, Sónia Leite, João Carvalho
BACKGROUND: Clinical and endoscopic remissions constitute the therapeutic goals in ulcerative colitis (UC). Histological healing is currently not a target in UC. This study aims to determine the impact of the definition of endoscopic remission (Mayo endoscopic subscore [MSe] 0-1) and histological activity in the recurrence of UC and recurrence-free survival time. METHODS: Patients with UC in clinical remission (partial Mayo score ≤ 1) and endoscopic remission (MSe ≤ 1) who underwent colonoscopy with biopsies between March 2010 and December 2013 were included...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28975147/diagnostic-and-therapeutic-treatment-modalities-for-acute-lower-gastrointestinal-bleeding-a-systematic-review
#9
REVIEW
Kathryn Oakland, Jennifer Isherwood, Conor Lahiff, Petra Goldsmith, Michael Desborough, Katherine S Colman, Richard Guy, Raman Uberoi, Michael F Murphy, James E East, Sally Hopewell, Vipul Jairath
BACKGROUND AND STUDY AIMS:  Investigations for lower gastrointestinal bleeding (LGIB) include flexible sigmoidoscopy, colonoscopy, computed tomographic angiography (CTA), and angiography. All may be used to direct endoscopic, radiological or surgical treatment, although their optimal use is unknown. The aims of this study were to determine the diagnostic and therapeutic yields of endoscopy, CTA, and angiography for managing LGIB, and their influence on rebleeding, transfusion, and hospital stay...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28954046/adenoma-detection-rate-evaluation-and-quality-of-colonoscopy-in-the-center-west-region-of-brazil
#10
Daniela Medeiros Milhomem Cardoso, Marco Aurélio Silveira Botacin, Marilia Adriano Mekdessi
BACKGROUND: Colorectal cancer is the third commonest cancer in men and the second in women worldwide. Peculiarities of its evolution allow secondary prevention measures through colonoscopy, with high diagnostic and therapeutic capacity. In this context, the quality indicators of the procedure become important, among them the adenoma detection rate (ADR). OBJECTIVE: To relate the ADR in a medium risk population subjected to colonoscopy with sociodemographic, technical and histopathological indicators...
September 21, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28944067/intestinal-microbiota-is-altered-in-patients-with-colon-cancer-and-modified-by-probiotic-intervention
#11
Ashley A Hibberd, Anna Lyra, Arthur C Ouwehand, Peter Rolny, Helena Lindegren, Lennart Cedgård, Yvonne Wettergren
OBJECTIVE: The colonic microbiota is altered in patients with colorectal cancer (CRC). We investigated the microbiota composition of patients with colon cancer compared with controls devoid of neoplastic or inflammatory disease and the potential to modify the colonic microbiota with probiotics. DESIGN: Biopsy samples were obtained from the normal mucosa and tumour during colonoscopy from 15 patients with colon cancer. Subsequent patient-matched samples were taken at surgery from the tumour and nearby mucosa from the patients with cancer, eight of whom had received two daily tablets totalling 1...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/28932721/clinical-significance-of-preoperative-virtual-colonoscopy-for-evaluation-of-the-proximal-colon-in-patient-with-obstructive-colorectal-cancer
#12
Jae-Hyuk Heo, Chun-Geun Ryu, Eun-Joo Jung, Jin-Hee Paik, Dae-Yong Hwang
PURPOSE: Virtual colonoscopy is the most recently developed tool for detecting colorectal cancers and polyps, but its effectiveness is limited. In our study, we compared the result of preoperative virtual colonoscopy to result of preoperative and postoperative colonoscopy. We evaluated also the accuracy of preoperative virtual colonoscopy in patients who had obstructive colorectal cancer that did not allow passage of a colonoscope. METHODS: A total of 164 patients who had undergone preoperative virtual colonoscopy and curative surgery after the diagnosis of a colorectal adenocarcinoma between November 2008 and August 2013 were pooled...
August 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28924602/factors-defining-expertise-in-screening-colonoscopy
#13
Kinesh Patel, Anna Pinto, Omar Faiz, Matt Rutter, Siwan Thomas-Gibson
BACKGROUND AND STUDY AIMS:  There is very little literature defining characteristics of expert endoscopists. It is hypothesised that previously undetermined human factors may correlate with high performance in screening colonoscopists. The aim of this study was to determine factors contributing towards expertise in screening colonoscopy. MATERIALS AND METHODS:  A focus group was used to hypothesise skills considered to be relevant to high performance in colonoscopy...
September 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28919192/magnetic-resonance-index-of-activity-maria-and-clermont-score-are-highly-and-equally-effective-mri-indices-in-detecting-mucosal-healing-in-crohn-s-disease
#14
Anthony Buisson, Bruno Pereira, Marion Goutte, Maud Reymond, Christophe Allimant, Hélène Obritin-Guilhen, Gilles Bommelaer, Constance Hordonneau
BACKGROUND: Magnetic resonance index of activity (MaRIA) and Clermont score are currently the two main MRI indices that have been validated compared to endoscopy in Crohn's disease (CD). AIMS: To compare the accuracy of MaRIA and Clermont score in assessing CD mucosal healing. METHODS: Fourty-four CD patients underwent prospectively and consecutively MRI and colonoscopy. RESULTS: Considering 207 segments, MaRIA>7 and Clermont score>8...
August 31, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28877032/bowel-endometriosis-a-diagnostic-and-therapeutic-challenge
#15
Beng Kwang Ng, Su Ee Phon, Ani Amelia Zainuddin, Wendy Yin Ling Ng, Nordashima Abd Shukor, Pei Shan Lim
Bowel endometriosis is the most common extragenital manifestation of endometriosis. Clinical suspicion is of utmost importance for achieving its diagnosis. Management of this condition is, however, always challenging to the gynaecologist. We report a case of bowel endometriosis in which the patient presented with dyschezia and haematochezia prior to her menses for the past 2 years. A 44-year-old para two woman presented with worsening dysmenorrhea and dyspareunia. She also experienced dyschezia and haematochezia prior to her menses for the past 2 years...
September 6, 2017: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/28865668/management-of-colonoscopic-perforations-a-systematic-review
#16
REVIEW
Alexander T Hawkins, Kenneth W Sharp, Molly M Ford, Roberta L Muldoon, M Benjamin Hopkins, Timothy M Geiger
BACKGROUND: Perforation during colonoscopy is a rare but well recognized complication with significant morbidity and mortality. We aim to systematically review the currently available literature concerning care and outcomes of colonic perforation. An algorithm is created to guide the practitioner in management of this challenging clinical scenario. DATA SOURCES: A systematic review of the literature based on PRISMA-P guidelines was performed. We evaluate 31 articles focusing on findings over the past 10 years...
August 26, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28839877/colonic-lesion-characterisation-skills-among-uk-endoscopists-and-the-impact-of-a-brief-training-intervention
#17
P Basford, G Longcroft-Wheaton, Reiji Higashi, Toshio Uraoka, P Bhandari
OBJECTIVE: To assess UK gastroenterology registrars' and consultants' competence in in vivo characterisation of polyps, plus the impact of a dedicated colonic lesion characterisation training intervention. DESIGN: Prospective evaluation of a computer-based colonic lesion training module. SETTING: Three UK general hospitals. PATIENTS: High-quality endoscopic images obtained during colonoscopy in a previous study. INTERVENTIONS: 30 min computer-based training module covering in vivo characterisation of colonic lesions viewed under white light, chromoendoscopy and magnification chromoendoscopy...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28830134/split-dose-bowel-preparation-for-colonoscopy-2-liters-polyethylene-glycol-with-ascorbic-acid-versus-sodium-picosulfate-versus-oral-sodium-phosphate-tablets
#18
Seok Won Lee, Chang Seok Bang, Tae Young Park, Ki Tae Suk, Gwang Ho Baik, Dong Joon Kim
Background/Aims: Adequate bowel preparation is an essential factor affecting the visibility of colonic mucosa and safety of related therapeutic interventions. The aim of this study was to assess the efficacy, tolerability, and safety of three bowel preparation agents -2 L polyethylene glycol with ascorbic acid (PEGA), sodium picosulfate magnesium citrate (SPMC), and oral sodium phosphate tablet (NaP)- for morning colonoscopy. Methods: Here, we analyzed the medical records of patients who had taken bowel preparation agents using the split-dose method and undergone colonoscopy in a single hospital...
August 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28829527/does-caffeine-improve-respiratory-rate-during-remifentanil-target-controlled-infusion-sedation-a-case-report-in-endoscopic-sedation
#19
Fabio Sbaraglia, Mariella De Riso, Maria Elena Riccioni, Guido Costamagna, Maria Sammartino
Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc)...
March 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28816375/adenocarcinoma-of-the-colon-presenting-as-a-submucosal-tumor
#20
Hourin Cho, Shigeki Sekine, Masau Sekiguchi
A 64-year-old woman underwent colonoscopy for abdominal discomfort and a protruded lesion measuring approximately 10 mm was detected in the descending colon. The tumor was entirely covered by normal-appearing mucosa and was regarded as a submucosal tumor (SMT). A small adenomatous polyp was present beside the SMT (Figure 1). For precise histological assessment of the SMT and therapeutic purpose of the coexisted polyp, we performed complete resection of the lesions by endoscopic submucosal dissection. This article is protected by copyright...
August 17, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
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