Journal - Endoscopy (Germany )

Journal - Endoscopy (Germany )

Journal - Endoscopy (Germany )

Abstract :

The abstracts from this year's Digestive Disease Week (DDW) show that endoscopic is consistently playing a prominent role in current gastroenterology. The topic of tumor diagnosis and treatment overlaps considerably with other review areas - e. g., endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography (ERCP), and colonoscopy. This review therefore focuses on the following topics: enhanced imaging, endoscopic mucosal resection (EMR), and palliative stent therapy. Endoscopy with tissue sampling is increasingly becoming an integral part of transitional research, in collaboration with molecular biologists and geneticists, among others. This role is unlikely to be challenged by any of the rapidly improving pure imaging modalities, and may well become a core role for endoscopy in the years to come. Abstracts from this category are not included in this overview.

Journal - Endoscopy (GERMANY )

Journal - Endoscopy (Germany )

Abstract :

Gastroduodenal ulcerations still account for the majority of nonvariceal gastrointestinal hemorrhage. The causative roles of Helicobacter pylori and nonsteroidal anti-inflammatory drugs (NSAIDs) are still being discussed, but the role of H. pylori appears less significant in the complicated ulcers, while NSAIDs are increasingly implicated. The two factors do not appear to potentiate each other, and some data suggest that H. pylori should not be eradicated in the context of an NSAID-related ulcer hemorrhage. The role of triage and risk assessment was highlighted in several of last year's publications, and increasing attention has been given to the cost aspects of peptic ulcer bleeding. There have been few comparative therapeutic trials, but several reports from Japan make a case for ethanol injection as an alternative to other injection agents. However, a randomized comparative trial is needed to further define the role of this technique. Radiological embolization techniques and minimally invasive surgery are increasingly becoming viable options in patients with complex cases, and a multidisciplinary approach is perhaps even more crucial today than ever before.

Journal - Endoscopy (GERMANY )

Abstract :

BACKGROUND AND STUDY AIMS: The implementation of endoscopy databases in Norway has been slow, and no commercial system has been successfully introduced. MATERIAL AND METHODS: To determine the current status in this area a questionnaire survey was conducted with replies received from 58 of the 67 hospitals to which the questionnaire was sent. RESULTS: Only 40% of the units had one or more personal computers available, but video endoscopes will soon be standard equipment at most Norwegian hospitals. For managing administrative data, a large majority of endoscopy units used a general-purpose hospital information system, but endoscopy data are dealt with manually in 72% of the units. The endoscopy report itself was produced manually in 93% of the units. When asked to rank various features of database systems according to their relative importance, the endoscopists stated that ease of use and simplification of routine chores were the most important aspects, while advanced storage and research features were less crucial. CONCLUSION: In Norwegian hospitals, the use of minimal endoscopic database systems that offer a high level of integration with existing hospital systems appears to be the most promising approach.

Journal - Endoscopy (GERMANY )

Abstract :

BACKGROUND AND STUDY AIMS: In the process of revising our written patient information, we wanted to incorporate some patient feedback into the text, and to compare the new brochures with the old one in terms of procedure-related anxiety and general patient satisfaction. PATIENTS AND METHODS: A total of 136 patients were asked about their present sources of information and issues they would like more information on. New brochures were developed for upper endoscopy, colonoscopy, and endoscopic retrograde cholangiopancreatography (ERCP), and 235 consecutive patients were then randomized to receive either the new brochures or the old one. Before the endoscopy procedure, the patients' sources of information, level of anxiety (on a five-point Likert scale) and general satisfaction with the written information was assessed. In addition, 89 patients completed a similar questionnaire after completing the endoscopic procedure, recording their degree of anxiety and discomfort during the procedure, and the appropriateness of the written information they had received. RESULTS: The written brochure was regarded as providing important information by 79% of the patients, while only 31% felt they had received important information from their referring doctor. The general level of anxiety was 2.0 (slightly anxious) with both brochures, with a mean score of 2.1 and 1.9 for the old brochure and the new one, respectively (P = 0.04). Previous endoscopy, male sex and high age were associated with a lower anxiety score. The post-endoscopy response indicated that the patients had received a realistic description of the procedure. The new brochures were rated as "excellent" or "very good" by 87% of the respondents. CONCLUSIONS: We have developed a new set of information brochures which appear to serve the purpose of providing adequate information, without causing patients undue anxiety.

Journal - Endoscopy (GERMANY )

Abstract :

The Scandinavian Association of Digestive Endoscopy course in advanced practical endoscopy has been arranged on a regular basis since 1980, representing a joint Scandinavian effort to offer hands-on endoscopy training with expert supervision at major endoscopy centers. The course has been aimed at gastroenterologists with previous endoscopic experience, focusing on special techniques, practical hints and expert solutions in special cases. Three days of practical training throughout Scandinavia are completed with two days of review lectures, case reports and special techniques. An inquiry among previous course participants indicates that the course has indeed been of practical value for their daily work, and that personal training as well as watching "experts at work" were useful for their ensuing endoscopic practice. The course model does, however, require close co-operation with the endoscopy units hosting the practical part of the course.

Journal - Scandinavian journal of gastroenterology (NORWAY )

Abstract :

Serum pepsinogen has been suggested as a risk marker for the development of gastrointestinal side effects of non-steroidal anti-inflammatory drugs (NSAIDs). The relation between serum levels of pepsinogen A (PGA) and pepsinogen C (PGC) and endoscopic findings in association with short-term NSAID use was investigated in two double-blind, crossover studies in healthy volunteers. Thirty-two male subjects with a median age of 23 years were given naproxen, oxindanac, or piroxicam for 2 weeks. Upper endoscopy was performed by the same investigator before and after each treatment period, scoring mucosal injection and erosive and hemorrhagic lesions separately on 150-mm visual analogue scales. Blood samples for pepsinogen analyses were drawn before each endoscopy. PGA and PGC were analyzed by means of solid-phase radioimmunoassays. Significant amounts of gastroduodenal mucosal lesions were found in all treatment periods, whereas neither PGA nor PGC changed during treatment. Moreover, the initial levels of serum pepsinogen also failed to predict the subsequent development of gastroduodenal lesions. The risk of a type-II error was small in this study, and our results therefore do not support the use of PGA or PGC as a risk marker in this context.

Journal - Scandinavian journal of gastroenterology (NORWAY )