Endoscopy In Patients Research Articles

Relationship, association and distribution of Helicobacter pylori infection in endoscopy patients at a Tertiary Hospital in Makurdi, Benue State, Nigeria to the symptoms of nausea and vomiting

The distribution of H. pylori obtained from patients referred for endoscopy at Benue State University Teaching Hospital (BSUTH) Makurdi, Benue State, Nigeria in relation to nausea and vomiting was examined in this study. To isolate H. pylori, gastric biopsy samples were obtained from the antrum of 80 consenting patients, and questionnaires were administered to them. The biopsies were placed in Brain Heart Infusion (BHI) broth and were used for isolation. Genomic Deoxyribonucleic Acid (gDNA) was extracted from the biopsies using ReliaPrep spin column method and used for singleplex Polymerase Chain Reaction (PCR). Out of the 80 patients, 24 (30%) had H. pylori infection as detected by 16S rRNA PCR. There was no significant association between infection and nausea/vomiting (OR = 5.622, 95% CI: 0.683-46.274; p = 0.076), or infection and hematemesis, common symptoms reported by patients (OR = 0.911, 95% CI: 0.304 - 2.729; p = 0.870). The research sheds light on the infection, prevalence and distribution of H. pylori in endoscopy referral patients at BSUTH, with respect to nausea and vomiting, and provides valuable information for both clinicians and researchers.

Quality of life among patients with gastroesophageal reflux disease at Tuyen Quang general Hospital in 2023

Objectives: To assess the quality of life among patients with gastroesophageal reflux disease at Tuyen Quang General Hospital in 2023. Research participants and methods: Cross-sectional descriptive study was conducted with 200 patients from March 2023 to June 2023. The Quality of Life in Reflux and Dyspepsia patients (QOLRAD) was used to interview patients for gastrointestinal examination and endoscopy at Tuyen Quang General Hospital. Results: The average quality of life score among patients was 4.33 - 4.46. In which all fields were at a good level, not too different from the bad level, the average score in the item eating/drinking (4.33), the items of sleep disorders (4.36), the item of emotion (4.39), the item of physical/social (4.39), vitality domain (4.46). Conclusion: The quality of life of patients with gastroesophageal reflux disease at Tuyen Quang General Hospital in 2023 is at a good level in all items.

CHOICE OF TREATMENT TACTICS FOR PATIENTS WITH CHRONIC DISEASES OF THE NOSE AND SIDE PANELS AND DACRIOCYSTITIS BY ENDOSCOPIC SURGERY

Tear separation is a fairly significant group among all eye diseases and is distinguished by the fact that it occupies a high place in the structure of diseases. According to a number of authors, 8-25.6% of outpatients suffer from lacrimation. In this article, the practice of surgical removal of rhinosinusitis passing through the side cavities of the nose under the endoscope in patients with dacryocystitis is given.

Türkiye'de Cerrahi Alanına Yönelik Hasta Şikayetleri: Dijital Platformdaki Yorumların Analizi

Aim: The purpose of the research is to examine patient complaints made on the internet site "sikayetvar" regarding the field of surgery in Turkey. The study also aims to identify common themes in patient complaints about the surgery department, better define the patient population making complaints, and systematically examine the reasons for complaints.
 Materials and Methods: In the research designed as a retrospective, the complaints made to the complaintvar.com website were examined using the content analysis method, which is one of the qualitative research methods. In the research, 359 posts on the internet about the general surgery department in Turkey, made on the complaintvar.com site, between January 1, 2023 and November 1, 2023, were examined. Complaints made; They are classified according to gender, whether they are public or private hospitals, whether they are inpatients, outpatients or emergency patients, type of surgical procedure, whether only surgical intervention is performed, whether they are related to other departments, the number of views of the complaint and the subject of the complaint.
 Results: In the study, 335 (93.3%) of the complaints were related to the procedures performed in general surgery. It was observed that they received a response to 74 (20.6%) of the complaints. It was observed that the complaints from all outpatient clinic patients were significantly higher than the complaints from ward, surgery and endoscopy patients (p

Early detection of nasopharyngeal carcinoma: performance of a short contrast-free screening magnetic resonance imaging.

Although contrast-enhanced magnetic resonance imaging (MRI) detects early-stage nasopharyngeal carcinoma (NPC) not detected by endoscopic-guided biopsy (EGB), a short contrast-free screening MRI would be desirable for NPC screening programs. This study evaluated a screening MRI in a plasma Epstein-Barr virus (EBV)-DNA NPC screening program. EBV-DNA-screen-positive patients underwent endoscopy, and endoscopy-positive patients underwent EGB. EGB was negative if the biopsy was negative or was not performed. Patients also underwent a screening MRI. Diagnostic performance was based on histologic confirmation of NPC in the initial study or during a follow-up period of at least 2 years. The study prospectively recruited 354 patients for MRI and endoscopy; 40/354 (11.3%) endoscopy-positive patients underwent EGB. Eighteen had NPC (5.1%), and 336 without NPC (94.9%) were followed up for a median of 44.8 months. MRI detected additional NPCs in 3/18 (16.7%) endoscopy-negative and 2/18 (11.1%) EGB-negative patients (stage I/II, n = 4; stage III, n = 1). None of the 24 EGB-negative patients who were MRI-negative had NPC. MRI missed NPC in 2/18 (11.1%), one of which was also endoscopy-negative. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI, endoscopy, and EGB were 88.9%, 91.1%, 34.8%, 99.4%, and 91.0%; 77.8%, 92.3%, 35.0%, 98.7%, and 91.5%; and 66.7%, 92.3%, 31.6%, 98.1%, and 91.0%, respectively. A quick contrast-free screening MRI complements endoscopy in NPC screening programs. In EBV-screen-positive patients, MRI enables early detection of NPC that is endoscopically occult or negative on EGB and increases confidence that NPC has not been missed.

A convenient machine learning model to predict full stomach and evaluate the safety and comfort improvements of preoperative oral carbohydrate in patients undergoing elective painless gastrointestinal endoscopy

Background and aims Assessment of the patient’s gastric contents is the key to avoiding aspiration incidents, however, there is no effective method to determine whether elective painless gastrointestinal endoscopy (GIE) patients have a full stomach or an empty stomach. And previous studies have shown that preoperative oral carbohydrates (POCs) can improve the discomfort induced by fasting, but there are different perspectives on their safety. This study aimed to develop a convenient, accurate machine learning (ML) model to predict full stomach. And based on the model outcomes, evaluate the safety and comfort improvements of POCs in empty- and full stomach groups. Methods We enrolled 1386 painless GIE patients between October 2022 and January 2023 in Nanjing First Hospital, and 1090 patients without POCs were used to construct five different ML models to identify full stomach. The metrics of discrimination and calibration validated the robustness of the models. For the best-performance model, we further interpreted it through SHapley Additive exPlanations (SHAP) and constructed a web calculator to facilitate clinical use. We evaluated the safety and comfort improvements of POCs by propensity score matching (PSM) in the two groups, respectively. Results Random Forest (RF) model showed the greatest discrimination with the area under the receiver operating characteristic curve (AUROC) 0.837 [95% confidence interval (CI): 79.1–88.2], F1 71.5%, and best calibration with a Brier score of 15.2%. The web calculator can be visited at https://medication.shinyapps.io/RF_model/. PSM results demonstrated that POCs significantly reduced the full stomach incident in empty stomach group (p < 0.05), but no differences in full stomach group (p > 0.05). Comfort improved in both groups and was more significant in empty stomach group. Conclusions The developed convenient RF model predicted full stomach with high accuracy and interpretability. POCs were safe and comfortably improved in both groups, with more benefit in empty stomach group. These findings may guide the patients’ gastrointestinal preparation.

Endoscopic underwater detection and resection of anal squamous intraepithelial lesions in non-anesthetized patients – a feasibility study and comparison with standard surgical treatment

Background Anal squamous intraepithelial lesions (ASILs) correspond to premalignant changes preceding the development of anal squamous cell carcinoma. Objective To describe a new endoscopic technique to detect and remove ASILs in non-anesthetized patients and compare it with standard surgical treatment. Methods For endoscopic treatment, high resolution (HR) flexible endoscopes with a distal attachment were used. Underwater inspection of the anal canal was performed in near-focus mode with white light and narrow-band imaging. Detected lesions were resected with a diathermia snare after local injection of xylocaine/adrenaline. We did a retrospective comparison of all patients who underwent endoscopic or standard surgical treatment for ASILs at Ersta hospital in Stockholm between 2018 and 2020. Patient files were reviewed for number of lesions, treatments until macroscopic radicality, degree of dysplasia, bleeding, pain and other complications. Results Endoscopic (n = 37) and surgical (n = 43) treatment displayed comparable number of lesions per patient (p = .37). The number of procedures until macroscopic radicality was higher for endoscopy than surgery (p = .04). However, in endoscopic follow up of 12 of the surgically treated patients, residual ASIL was found in 10 cases. Post-procedural bleeding requiring healthcare occurred in two endoscopy patients and one surgically treated patient. Conclusions Underwater resection using a HR flexible endoscope in non-anesthetized is a new, feasible and well tolerated method for ASILs treatment. Its efficacy and risk of complications seem comparable to standard surgical treatment while avoiding general anesthesia. However, minor lesions might be overlooked at surgery.

Antibiotic Resistance Rates for Helicobacter pylori in Rural Arizona: A Molecular-Based Study.

Helicobacter pylori (H. pylori) is a common bacterial infection linked to gastric malignancies. While H. pylori infection and gastric cancer rates are decreasing, antibiotic resistance varies greatly by community. Little is known about resistance rates among rural Indigenous populations in the United States. From 2018 to 2021, 396 endoscopy patients were recruited from a Northern Arizona clinic, where community H. pylori prevalence is near 60%. Gastric biopsy samples positive for H. pylori (n = 67) were sequenced for clarithromycin- and metronidazole-associated mutations, 23S ribosomal RNA (23S), and oxygen-insensitive NADPH nitroreductase (rdxA) regions. Medical record data were extracted for endoscopic findings and prior H. pylori history. Data analysis was restricted to individuals with no history of H. pylori infection. Of 49 individuals, representing 64 samples which amplified in the 23S region, a clarithromycin-associated mutation was present in 38.8%, with T2182C being the most common mutation at 90%. While the prevalence of metronidazole-resistance-associated mutations was higher at 93.9%, the mutations were more variable, with D95N being the most common followed by L62V. No statistically significant sex differences were observed for either antibiotic. Given the risk of treatment failure with antibiotic resistance, there is a need to consider resistance profile during treatment selection. The resistance rates in this population of American Indian patients undergoing endoscopy are similar to other high-risk populations. This is concerning given the high H. pylori prevalence and low rates of resistance testing in clinical settings. The mutations reported are associated with antibiotic resistance, but clinical resistance must be confirmed.

Development and validation of a prognostic score to identify the optimal candidate for preemptive TIPS in patients with cirrhosis and acute variceal bleeding.

Baveno VII workshop recommends the use of preemptive TIPS (p-TIPS) in patients with cirrhosis and acute variceal bleeding (AVB) at high- risk of treatment failure. However, the criteria defining "high-risk" have low clinical accessibility or include subjective variables. We aimed to develop and externally validate a model for better identification of p-TIPS candidates. The derivation cohort included 1554 patients with cirrhosis and AVB who were treated with endoscopy plus drug (n = 1264) or p-TIPS (n = 290) from 12 hospitals in China between 2010 and 2017. We first used competing risk regression to develop a score for predicting 6-week and 1-year mortality in patients treated with endoscopy plus drugs, which included age, albumin, bilirubin, international normalized ratio, white blood cell, creatinine, and sodium. The score was internally validated with the bootstrap method, which showed good discrimination (6wk/1y concordance-index: 0.766/0.740) and calibration, and outperformed other currently available models. In the second stage, the developed score was combined with treatment and their interaction term to predicate the treatment effect of p-TIPS (mortality risk difference between treatment groups) in the whole derivation cohort. The estimated treatment effect of p-TIPS varied substantially among patients. The prediction model had good discriminative ability (6wk/1y c -for-benefit: 0.696/0.665) and was well calibrated. These results were confirmed in the validation dataset of 445 patients with cirrhosis with AVB from 6 hospitals in China between 2017 and 2019 (6-wk/1-y c-for-benefit: 0.675/0.672). We developed and validated a clinical prediction model that can help to identify individuals who will benefit from p-TIPS, which may guide clinical decision-making.

Does Manual Abdominal Pressure During Colonoscopy Put Endoscopy Staff and Patients at Risk?: Experiences of Endoscopy Nurses and Technicians.

Endoscopy staff suffer work-related musculoskeletal disorders at a rate greater than or comparable to nurses and technicians in other subspecialities, which may be attributable to the widespread use of manual pressure and repositioning during colonoscopy. In addition to negatively impacting staff health and job performance, colonoscopy-related musculoskeletal disorder injuries may also signal potential risks to patient safety. To assess the prevalence of staff injury and perceived patient harm relating to the use of manual pressure and repositioning techniques during colonoscopy, 185 attendees of a recent national meeting of the Society of Gastroenterology Nurses and Associates were asked to recall experiencing injuries to themselves or observing injuries to other staff or patients during colonoscopy. A majority of respondents (84.9%, n = 157) reported either experiencing or observing staff injury, whereas 25.9% (n = 48) reported observing patient complications. Among respondents who perform manual repositioning and apply manual pressure during colonoscopy (57.3%, n = 106), 85.8% (n = 91) reported experiencing musculoskeletal disorders from performing these tasks; 81.1% (n = 150) reported no awareness of colonoscopy-specific ergonomics policies at their facility. Results highlight the relationship between the physical job requirements of endoscopy nurses and technicians, staff musculoskeletal disorders, and patient complications, and suggest that implementation of staff safety protocols may benefit patients as well as endoscopy staff.

Value of transrectal ultrasound-guided biopsy in endoscopy negative biopsy patients with rectal lesions

ObjectiveTo evaluate the value of transrectal ultrasound (TRUS) guided biopsy in endoscopy negative biopsy patients with rectal lesions.Methods150 endoscopy negative biopsy result rectal lesions adopted the transrectal ultrasound-guided biopsy. Based on whether the patients received contrast-enhanced ultrasound examination or not before the biopsies, all enrolled cases were divided into TRUS guided group and contrast-enhanced TRUS (CE-TRUS) guided group, and the safety and diagnostic performances were analyzed retrospectively.ResultsWe obtained adequate specimens in the majority of cases (98.7%,148/150); There were no complications identified in our study. 126 patients received contrast-enhanced TRUS examination before biopsy to evaluate vascular perfusion and necrosis. The sensitivity, specificity, PPV, NPV, and overall accuracy of all biopsies were 89.1%, 100%,100%, 70.4%, and 91.3% respectively; The sensitivity, specificity, PPV, NPV, and accuracy for TRUS-guided biopsy and CE-TRUS guided biopsy were 73.7%, 100%,100%, 50%,79.2% and 92.1%,100%,100%,75%,93.6% separately; The increase in correct diagnoses was significant (p < 0.05) between TRUS guided biopsy and CE-TRUS guided biopsy.ConclusionTRUS-guided biopsy is a reliable procedure that can be augmented by endoscopic biopsy techniques if the biopsy yields negative results. CE-TRUS might assist in the location of the biopsy and decrease sampling errors.

Comparison of endoscopic retrograde cholangiopancreatography outcomes between cap-fitted forward and side viewing endoscopes in patients with Billroth II anastomosis

BackgroundThere have been no previous studies that directly compared outcomes between cap-fitted forward-viewing and side viewing endoscopes (SE). This study aimed to compare the technical success rate and occurrence of adverse events between the side viewing and cap-fitted forward-viewing endoscope (CE) groups among patients with Billroth II anatomy who underwent ERCP.MethodsThe medical records of patients with a previous history of subtotal gastrectomy using Billroth II reconstruction who underwent ERCP at Yeungnam University Hospital between January 2004 and December 2020 were reviewed retrospectively. The patients were divided into CE and SE group. Propensity score matching analysis was performed to minimize selection bias.ResultsPropensity score matching resulted in 55 matched pairs for further analysis. Patients’ characteristics were comparable in the matched cohorts. Final success rate of selective bile duct cannulation was not significantly different between the SE and CE groups (98.2% vs. 94.5%, p = 0.308). The complete CBD stone removal rate in CBD stone and successful biliary drainage rate in malignant biliary obstruction were not significantly different between the two groups. The rate of total ERCP-related adverse events was higher in the CE group than in the SE group, but the difference was not statistically significant (10.9% vs. 7.3%, p = 0.507). Among adverse events, the rate of post-ERCP pancreatitis showed higher tendency in the CE group than in the SE group (10.9% vs. 5.5%, p = 0.297).ConclusionIn conclusion, CE seems to be equally effective as SE for ERCP in patients with Billroth II anatomy. However, attention should be paid to development of post ERCP complications, especially pancreatitis, when performed by CE.

Evaluation of paradoxical effect of small dose ketamine as adjuvant in deep sedation for endoscopy patients

ABSTRACT Background This study tested the hypothesis that use of ketamine as an ‎adjuvant to propofol in the induction of deep sedation for ‎endoscopy patients could lead, paradoxically, to faster ‎emergence.‎ Methods We conducted a single-center, prospective randomized ‎controlled study on 154 adult ASA I or II patients‎, admitted for ‎gastrointestinal endoscopies‎. Patients were sedated with 25 µg ‎fentanyl and 1 mg/kg propofol bolus over 30 s. Patients ‎were divided into two groups: Group P (n = 77), sedated with ‎propofol only, and Group PK (n = 77), who received additionally a ‎single dose of ketamine (0.1 mg/kg) at induction. If the patient ‎moved or Ramsay Sedation Score (RSS) regressed to <4, ‎increments of 0.25 mg/kg of propofol were given. After the end ‎of the procedure, emergence from sedation was assessed with ‎modified Aldrete score, 5 and 10 m after admission to the ‎recovery room.‎ Results Adding a small dose of ketamine did not significantly achieve ‎deep sedation (RSS ≥4) more quickly or result in lesser ‎propofol increments. Patients who received ketamine showed a ‎statistically significant improvement in the Modified Aldrete ‎score when recorded 5 min after admission to the recovery ‎room (Group P 8.73 ± 1.02, Group PK 9.1 ± 0.96, P value = ‎‎0.02), but not after 10 min (Group P 9.03 ± 0.74, Group PK ‎‎9.21 ± 0.8, P value = 0.146).‎ Conclusion Inclusion of a small single dose of ketamine in the induction of sedation for gastrointestinal endoscopy significantly improves emergence from sedation.

Patients’ readiness before undergoing gastrointestinal endoscopy: a descriptive study

To analyse patients' anxiety related to endoscopy. The descriptive study was conducted from July 23 to September 14, 2020, at the Endoscopy Unit of Dr Abdoer Rahem Situbondo General Region Hospital, Dr Koesnadi Bondowoso General Region Hospital and Ibnu Sina Gresik General Region Hospital, East Java, Indonesia. The sample comprised endoscopy patients of either gender aged >20 years. Data was collected using the Endoscopy Confidence Questionnaire. Of the 50 patients, 28(56%) were males and 22(44%) were females. The largest age group was 41-50 years 17(34%), followed by 31-40 years 13(26%). Overall, 48(96%) subjects were married. Abdominal pain was most common indication for the procedure 10(20%). Esophagogastroduodenoscopy was the procedure in 29(58%) patients, 42(84%) had no history of endoscopy, and 41(82%) were reluctant to undergo the procedure. Patients' anxiety rises before endoscopy. Nurses need to provide complete and clear information related to the procedure, including the less pleasant elements.

Point of Care Testing for SARS-COV-2 Antibodies before doing Endoscopy.

COVID-19 has taken the world by storm, creating much disparity among both healthcare and non-healthcare centres regarding the provision of services. The purpose of our study was to see the prevalence of the SARS-COV-2 exposure in the asymptomatic patients undergoing the endoscopic procedure, already triaged based on history and examination. Total 207 patients were enrolled during a time period of five months during October 2020 to April 2021 at Dr. Ziauddin Hospital Clifton campus, Karachi. In this prospective observational study patients undergoing endoscopic procedures were included after taking informed consent. The patients who already tested positive for COVID-19 by PCR were excluded. Patients were tested for Covid serology by immunochromatographic rapid serology test (ICT). Standard Operating Procedures for dealing with endoscopy patients during the COVID era were followed in all patients irrespective of antibody status. Total number of patients included was 207; males were 121 (58.5%). The mean age was 48.5 ± 17.55 (range 13 to 92). Forty eight patients (23.2%) were positive for either antibody suggesting exposure to the COVID-19 virus. Out of these combined IgM and IgG positivity was seen in 24 (11.5%), IgM mono antibody positivity was seen in 7 (3.38%) and 17 (8.21%) of the study population tested positive for IgG only. 15 out of 46 (32.6%) patients with chronic liver disease in the cohort were seropositive for COVID antibodies. About one-fourth of the patients undergoing the endoscopic procedure were tested positive for COVID antibodies of which a significant percentage had chronic liver disease. It stresses the need of observing standard precautions to prevent the spread of infection during these procedures, especially in the vulnerable population.

Correlation of Platelet Count with Grading of Esophageal Varices in Cirrhotic Patients

Background/Aims: Cirrhosis represents a late stage of progressive hepatic fibrosis and is generally considered to be irreversible in its advanced stages. Esophageal varix is a complication of liver cirrhosis and is the consequence of portal hypertension. The aim of this study was to determine the correlation between the severity of thrombocytopenia and the presenting of esophageal varices (EVs) in cirrhotic patient. Patients and Methods: This study was a retrospective, descriptive, analytic and monocentric study, which was carried out at Gastroenterology Department, Khmer Soviet Friendship Hospital, Phnom Penh, Cambodia. It was conducted from 1st September 2020 to 31st January 2021. All patients were diagnosed as liver cirrhosis by clinic, biology and ultrasound. Patients’ data were noted in standardized questionnaire with information such as age, sex, address, laboratory result, and the result of endoscopic finding. All data were registered into a data set and then analyzed by SPSS program version 23. Results: 1445 patients were enrolled for gastroscopy. Only 303 patients (21%) were suggested for variceal screening after the exclusions. Male was predominant with sex ratio F/M (1/2.03). Patients’ age varied between 21 and 80 years old, with the mean age of 55 ± 11 years old. 199 patients (66%) were found with EVs, while EVs grade 1 and 2 without red signs were predominated, accounting to 22.8% and 19.5% respectively. The majority of the patients with platelet count between 50 - 99 giga/l had EVs vs platelet count > 150 giga/l had no EVs (p < 0.0001). The cut-off level of platelet with EVs was 123 giga/l with 75% sensitivity and 65% specificity and with large varices was 105 giga/l with 70% sensitivity and 63% specificity. Conclusion: Thrombocytopenia is a non-invasive parameter with high accuracy for the prediction of EVs in cirrhosis. The severity of thrombocytopenia increased as the grading of EVs increased. Thus, it can assist in triaging cirrhotic patients for endoscopy to identify EVs.

OGBN P02 Report of early experience from newly introduced Cytosponge service

Abstract Background Barrett's oesophagus (BO) is a pre cancerous lesion associated with increased risk of oesophageal adenocarcinoma through intermediary stages of increasing abnormalities on histology. Approximatley 3–6% of individuals with Gastro oesophageal reflux disease could have underlying BO. However, only 20% are diagnosed. This prevents early detection of oesophageal adenocarcinoma, which could provide an opportunity to prevent progression to cancer. Devising a feasible large scale screening tool which is safe and acceptable is challenging. Cytosponge is a non endoscopic diagnostic tool which utilises biomarker test for Trefoil factor 3 (TFF3), that identifies intestinal metaplasia which can increase detection of BO ten times over current standard of care. It also assesses for dysplasia (atypia and p53). Cytosponge is an North East London cancer alliance initiative. Our Trust introduced cytosponge as an NHS England clinical pilot. It was introduced to screen reflux patients initially, but was subsequently extended for BO surveillance to address the pandemic related backlog. Early identification of patients with BO or dysplasia will help proritise patients with highest risk, whilst minimizing the number of gastroscopies. We report the initial experience with the cytosponge service our Trust. The aim of this study was to assess the accuracy and safety of cytosponge. Methods We conducted a retrospective cross sectional study of patients referred for cytosponge test at a large acute care Centre in North East London from a prospectively maintained database. Adult patients who were either on endoscopic surveillance for Barrett's oesophagus as well as those with reflux disease were included. We assessed the successful detection of BO (determined by TFF3 positive), number of cases with dysplasia and the overall uptake of the cytosponge procedure . Demographic and clinical information were collected for each patient. Additionally, results of any previous endoscopies were recorded. Number of swallow attempts and failure in swallowing the Cytosponge were noted. ‘Failure to swallow’ was stated when the device could not be swallowed despite three attempts. Uptake of Cytosponge was assessed as the number of patients who successfully swallowed the capsule. The number of patients discharged following the test, or referred for endoscopy was assessed. Anonymized patient data was tabulated in a computerized database (Microsoft excel, 2016). Normally distributed data was presented as median with standard deviation (SD). Results 106 patients were referred for cytosponge test. 72 were on BO surveillance and 34 belonged to reflux cohort. 47 (44.34%) were females. Four patients (3.78%) failed to complete the procedure. 101 patients completed the test successfully within a median time of 20+/- 6 minutes. There were no reported adverse events. Median number of swallow attempts was one. 84 (79.25%) tests were performed without use of local anaesthetic. Intestinal metaplasia was confirmed by positive TFF3 in 41 (38.68%) patients. Nine (8.5%) had inadequate sample and were referred for a repeat test. Four (3.77%) results were equivocal. Low grade dysplasia was detected in five (4.71%) patients on BO surveillance. 11 patients were referred for urgent endoscopy. 24 of the 34 patients (70.58%) with reflux were discharged on the basis of cytosponge results. Three patients with BO were discharged due to old age. 20 BO patients determined as high clinical risk were referred for endoscopic assessment of which seven had urgent endoscopic assessment. Conclusions Cytosponge offers a minimally invasive, safe and effective method for prioritizing patients for endoscopy. This procedure can therefore aid in a more proactive approach in detecting and thereby treating dysplasia at an early stage. Cytosponge service can be efficiently run at an Acute Care Hospital by appropriate patient screening for suitability to undergo the test. This has helped reduce the number of endoscopies required, thereby reducing the pressures on endoscopy waiting lists.

Remimazolam: Is the quest for the holy grail of sedation during diagnostic or endoscopic interventions over?

Remimazolam: Is the quest for the holy grail of sedation during diagnostic or endoscopic interventions over?

Effect of aromatherapy with lavender and damask rose extracts on anxiety in endoscopy patients: a randomised trial

Background: The endoscopy procedure may cause anxiety. Aim: This study aimed to assess the effects of aromatherapy comparing lavender oil and rose damask oil on relieving the anxiety of upper gastrointestinal endoscopy patients. Methods: 105 subjects were randomly allocated into three groups of aromatherapies: the lavender essential oil group; aromatherapy with rose damask essential oil group; and the control group. The data collection tool used was the Spielberger State-Trait Anxiety Inventory (STAI). In each experimental group, subjects inhaled two drops of lavender or rose damask essential oil. Findings: Results showed that after the intervention, there was a significant statistical difference in the mean anxiety level of the three groups (P=0.0001). The results demonstrated less anxiety after inhaling damask rose oil than lavender, but this difference was not statistically significant (P=0.62). Conclusions: The findings confirmed the positive effect of aromatherapy with damask rose and lavender extract oils on reducing the anxiety of patients before an endoscopy. Since complementary medicine is increasingly used in nursing care, aromatherapy can be applied as a supplementary method to alleviate anxiety in patients.

Biological functions and clinical significance of calprotectin. Review

Recently, in addition to clinical, endoscopic and morphological studies, the algorithm for the diagnosis of inflammatory bowel disease (IBD) also includes some serum and fecal biomarkers that help select patients for endoscopy, as well as distinguish between organic and functional (non‑inflammatory) diseases (for example, irritable bowel syndrome). Among the latter, the definition of fecal calprotectin (CP) is used mostly often, it is a well‑studied biomarker of inflammation due to its stability, reproducibility of analysis, low cost, and high diagnostic value. The presented review highlights the latest data on the main biological CP functions and the clinical application of its definition in inflammatory diseases of intestine, skin, joints, etc.&#x0D; It is shown that CP belongs to the family of calcium‑binding leukocyte S100 proteins and consists of two monomers: S100A8 and S100A9. CP is constitutively expressed by monocytes, dendritic cells, activated macrophages, keratinocytes of the oral cavity and squamous epithelium of the mucosa. Thus, the CP expression in a healthy person is limited by a small number of specialized cells and is usually activated during inflammation. Both subunits of CP, S100A8 and S100A9, have a wide range of intracellular and extracellular immunomodulatory properties, control the intracellular pathways of innate immune cells and are responsible for organizing the response to the inflammatory process.&#x0D; Determination of fecal CP enables distinguishing between non‑inflammatory and inflammatory bowel diseases, it is a non‑invasive inexpensive method, and the CP itself remains stable at room temperature in the feces for at least 3 days. In the diagnosis of IBD, fecal CP is a more sensitive marker than C‑reactive protein, which has made it an excellent (i.e., highly sensitive) biomarker for detecting intestinal inflammation in IBD and has contributed to its widespread use worldwide. The value of the level of fecal Cp &lt; 40 mg/g can reliably exclude IBD, and a value &gt; 250 mg/g dictates the need for endoscopic examination of the patient for IBD or raises the suspicion of its recurrence.&#x0D;