DOCSLIB.ORG

The British Society of Gastroenterology

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The British Society of Gastroenterology Gut: first published as 10.1136/gut.28.10.A1328 on 1 October 1987. Downloaded from Gut, 1987, 28, A1328-A1412 The British Society of Gastroenterology The Jubilee Meeting of the British Society of Gastroenterology was held in the University of London on 15-18 September 1987 under the Presidency of Mr John Alexander-Williams. Below are printed the abstracts of the 364 oral and poster communications selected for presentation at the meeting. Hospital, London, and Amersham Inter- paratuberculosis and M avium. Restricted INFLIAMMATORY BOWEL DISEASE national, Bucks) "'Indium labelled leuco- total DNA from a CD mycobacterial cytes are an accurate means of detecting bacillary isolate was used to generate a Enteral nutrition in severe colitis inflammation, particularly inflammatory genomic library in pGEM-1. Resulting bowel disease (IBD). Tc 99m as an alterna- specific cloned DNA probes precisely dis- SS C RAO, C [) HOLDSWORITH, ANI) A R W tive radioisotope offers advantages of con- tinguished different mycobacteria on the FORREST (Gastroinitestinial U,iit and Depart- venience, lower radiation dose, and basis of restriction fragment length poly- meait of Clinical Chemistry, Royal Hallam- theoretically higher image resolution. A morphisms (RFLP). A novel insertional shire Hospital, Sheffield) Small intestinal new Tc 99m chelate, HMPAO (hexamethyl element of about 1-5 kb (pMB22) was absorption and tolerance of enteral nutri- propylene amine oxime) is a moderately identified, repeated 1()-20) times through- tion was assessed prospectively in nine efficient leucocyte label with selectivity for out the mycobacterial genome. DNA patients with severe colitis. After admis- neutrophil leucocytes. We evaluated restricted and probed with pMB22 gave a sion, the patients were starved for 24 hours abnormal scans after reinjections of auto- multiple banding pattern RFLP identical in during which stool output was collected. logous Tc 99m HMPAO leucocytes in 32 the DNA from each of three independent Thereafter 2 I/day of Fortison standard subjects with proven or suspected IBD. The CD, and three Johne's disease M para solution was given enterally via a fine bore normal distribution of radioactivity is isolates, but not other mycobacterial DNA tube for six days, after which patients ate a similar to that seen with indium labelled suggesting a specific relationship between normal diet. During enteral feeding, a 5 g d cells, with additional activity in urine soon this insertional element and pathogenicity. xylose test and a five day faccal fat estima- after injection, and some bowel distribution Similar studies on nanogram quantities of tion were carried out. Stool output, symp- in normal subjects after four hours. DNA from one CD spheroplast isolate tom scores, daily weight, Hb, ESR and Occasional activity in the gall bladder indi- using a novel cloned DNA probe for Mpara http://gut.bmj.com/ albumin were also monitored throughout cates that this normal bowel activity follows 16S ribosomal RNA identified the sphero- the 10 day study period and prednisolone biliary excretion of free complex. Bowel plasts as mycobacterial but distinct from any sulphate was given intravenously. One hour activity resulting from labelled neutrophil known mycobacteria so far examined. blood xylose and five hour urinary xylose migration to inflamed areas could be identi- Crohn's disease derived mycobacterial values were normal in all except one patient fied much earlier than four hours, however, isolates appear heterogenous. with Crohn's disease. Fat absorption was and as a result IBD could be confidently normal in every patient. In spite of enteral diagnosed. Twenty five of 32 patients had feeding, there was a significant reduction in abnormal scans showing inflamed bowel. stool weight (p<0)(01) and stool frequency The resolution of small bowel involvement Adhesion of colitic E coli (EC) to isolated on September 26, 2021 by guest. Protected copyright. (p<0O001) over the 1i) day period. There is clearly superior to that with indium leuco- human colonocytes was a signiticant improvement in symptom cytes. No false positives or false negatives scores (p<0(0l), ESR (p<t)05) and per- were encountered. D A BURKE AND A T R AXON (Gastroenterology centage weight loss (p<0.05). Serum Unit, The General Infirmary, Leeds) Tissue albumin improved [32 (28-37 g/l) v 28 culture and buccal epithelial cell adhesion (23-36 g/l), median (range)l. All patients assays have shown that E coli (EC) isolated achieved medical remission and one under- Use of cloned DNA probes to identify from patients with ulcerative colitis possess went an elective panproctocolectomy. We Crohn's disease microbial isolates an adhesive property. In this study human conclude that even in severe colitis, small colonocytes have been used to assess in vitro intestinal absorption is normal, enteral JJ MCFADDEN, J THOMPSON, E GREEN, S J adhesion. Colonocytes from mucosal biop- feeding is well tolerated and parenteral HAMPSON, J L STANFORD, AND J HERMON- sies were isolated by gentle agitation in the nutrition should not normally be necessary. TAYLOR (Department ofSurgery, St George's presence of hyaluronidase at 37°C. The test Hospital Medical School, and of Medical bacterial suspension was incubated with the Microbiology, the Middlesex Hospital isolated colonocytes in Ham FIO at 37°C for Diagnosing inflammatory bowel disease Medical School, London) Crohn's disease 30 minutes. Adhesion was assessed under (IBD) with Tc 99m HPMAO labelled (CD) microbial isolates in longterm cultures phase contrast and expressed as the number leucocytes from several laboratories have included of bacteria adherent to brush border (BB) bacillary forms of mycobacteria, as well as and BB/basolateral (BL) adhesion ratio. M E RODDIE, M PETERS, M J CARROI.I., J CALAM, the scant growth of apparant spheroplasts The BB score of 12 colitic EC isolates to H J F HODGSON, AND P J lAVENDER (Depts of whose identity has been uncertain. Conven- colitic colon, mean=2()3, is significantly Radiology and Medicine, Royal Post- tional tests do not readily distinguish higher than control EC, mean=-028, graduate Medical School, Hammersmith between some mycobacteria such as M p=(0.Ol. The BB/BL ratio of colitic EC, A 1328 Gut: first published as 10.1136/gut.28.10.A1328 on 1 October 1987. Downloaded from 7he British Society of Gastroenterology A1329 mean=0-33 compared with a mean of 0-1 J ALEXANDER-WILI-IAMS (T/ic Gen1eral required a further 14 SP between 12 and 36 for control EC is significantly higher, Hospital, Birmingham) From a series of 59 (median 18) months after the initial SP. All p (0001. Buccal epithelial cell adhesive patients with enterocutaneous fistulae com- but one of the previous SPs were patent. No ability correlates with both the BB adhesion plicating Crohn's disease, 31 occurred in 23 postoperative complications arose from the index and the BB/BL ratio, p=0)001. This patients within a month of operation. SP sites. Intraperitoneal abscess developed study shows that colitic EC have a greater Four were referred having presented the in one patient from a duodenal leak. Our ability to adhere to human colitic colon than fistula within 10 days of appendicectomy by further experience indicates that SP is an controls. The higher BB/BL ratio for colitic surgeons inexperimented in Crohn's effective and safe procedure which has a EC suggests that adhesion is specifically disease. All were ileocutaneous, three had place in minimal surgery of both active and directed to the brush border. These data resection and one a stricturoplasty; all inactive CD, provided no distal obstructing support the view that EC may have a role in resolved. lesions are overlooked. the pathogenesis of this disease. Suture line leakage accounted for 18 fistulae and nine, presumed to be caused by operative trauma, originated from a dis- Delayed-release 5-aminosalicylic acid sected area of gut not affected by Crohn's (5-ASA) and sulphasalazine (SSZ) in the disease. Previous reports suggest that the treatment of mild to moderate ulcerative majority of such fistulae will heal spontane- colitis (UC) relapse ously. In this series, however, only 12 of the I IVER 27 resolved without further operation. S A RIl EY, V MAN!, M J GOODMAN, AND L A The principal predisposing factors in Effect of hepatic artery embolisation on I URNBER(G (University Departmenit of suture line leakage were adjacent septic survival in carcinoid syndrome Medicine, Hope Hospital, Salford; Leigh foci, hypoproteinaemia and colonic anasto- Infirinary, atid Bury General Hospital, mosis. In some severely compromised M COUPE, A HEMMiN(iWAY, Ii J F HIODGSON, Manchester) Sulphasailazine is of benefit in patients a primary stoma with delayed ANI) 1) J AL ISON (Depis of Medicine antd( UC relapse but side effects may limit its use. anastomosis might avoid leakage. Radiology, Royal Postgraduate Medicial 5-ASA appears less toxic. We have there- In another series of patients having exten- School, Hammersmith Hospital, Lonidon) fore compared SSZ, equivalent dose 5-ASA sive dissections, occult operative trauma Hepatic artery embolisation relieves and high dose 5-ASA in mild to moderate has been rendered overt by CO, distension systemic hormonally mediated symptoms in UC relapse. of the gut and underwater inspection (cycle the carcinoid syndrome, and local symp- Sixty one patients (32M:29F, aged 20-78 tyre puncture manoeuvre). All such toms of hepatic pain. We documcnt here the years) were randomly allocated to either detected bowel breaches have been sutured effect of this procedure on survival in a SSZ 2 g, 5-ASA 80X) mg or 5-ASA 2-4 g daily without subsequent fistulae. We suggest retrospective survey of 63 patients with in a double blind four week trial. One that routine adoption of the insufflation carcinoid syndrome seen in one centre over http://gut.bmj.com/ patient defaulted leaving 19 SSZ, 20 5-ASA manoeuvre might have prevented five of the 10 years.
Load more

Recommended publications
  • The Practice of Gastrointestinal Motility Laboratory During COVID-19 Pandemic
    J Neurogastroenterol Motil, Vol. 26 No. 3 July, 2020 pISSN: 2093-0879 eISSN: 2093-0887 https://doi.org/10.5056/jnm20107 JNM Journal of Neurogastroenterology and Motility Review The Practice of Gastrointestinal Motility Laboratory During COVID-19 Pandemic: Position Statements of the Asian Neurogastroenterology and Motility Association (ANMA-GML-COVID-19 Position Statements) Kewin T H Siah,1,2* M Masudur Rahman,3 Andrew M L Ong,4,5 Alex Y S Soh,1,2 Yeong Yeh Lee,6,7 Yinglian Xiao,8 Sanjeev Sachdeva,9 Kee Wook Jung,10 Yen-Po Wang,11 Tadayuki Oshima,12 Tanisa Patcharatrakul,13,14 Ping-Huei Tseng,15 Omesh Goyal,16 Junxiong Pang,17 Christopher K C Lai,18 Jung Ho Park,19 Sanjiv Mahadeva,20 Yu Kyung Cho,21 Justin C Y Wu,22 Uday C Ghoshal,23 and Hiroto Miwa12 1Department of Medicine, Yong Loo Lin School of Medicine, The National University of Singapore, Singapore; 2Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore; 3Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh; 4Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore; 5Duke-NUS Medical School, Singapore; 6School of Medical Sciences, Universiti Sains Malaysia, Malaysia; 7St George and Sutherland Clinical School, University of New South Wales, Kogarah, NSW, Australia; 8Department of Gastroenterology and Hepatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 9Department of Gastroenterology, GB Pant Hospital, New Delhi, India;
    [Show full text]
  • Chapter 156: Upper Gastrointestinal Bleeding
    8/23/2018 Principles and Practice of Hospital Medicine, 2e > Chapter 156: Upper Gastrointestinal Bleeding Stephen R. Rotman; John R. Saltzman INTRODUCTION Key Clinical Questions What is the timing and treatment of peptic ulcer disease? What are the factors in diagnosis and treatment of aortoenteric fistula? What treatments are available for each etiology of upper GI bleeding? What is the appropriate management and follow-up of variceal bleeding? How do you estimate the severity of bleeding so that you can triage appropriate patients to the ICU, medical floor, or observation unit? Which patients are more likely to rebleed and hence require continued observation in the hospital aer their bleeding has apparently stopped, and for how long? Upper gastrointestinal (GI) bleeding is responsible for over 300,000 hospitalizations per year in the United States. An additional 100,000 to 150,000 patients develop upper GI bleeding during hospitalizations. The annual cost of treating nonvariceal acute upper GI bleeding in the United States exceeds $7 billion. Upper GI bleeding is defined as a bleeding source in the GI tract proximal to the ligament of Treitz. The presentation varies depending on the nature and severity of bleeding and includes hematemesis, melena, hematochezia (in rapid upper GI bleeding), and anemia with heme-positive stools. Bleeding can be associated with changes in vital signs, including tachycardia and hypotension including orthostatic hypotension. Given the range of presentations, pinpointing the nature and severity of GI bleeding may be a challenging task. The natural history of nonvariceal upper GI bleeding is that 80% of patients will stop bleeding spontaneously and no further urgent intervention will be needed.
    [Show full text]
  • Adherence to Surveillance Guidelines Following Colonic Polypectomy Is Abysmal
    170 Original Article Adherence to surveillance guidelines following colonic polypectomy is abysmal Frederick H. Koh1, Dedrick K. H. Chan1,2, Jingyu Ng3, Ker-Kan Tan1,2 1Division of Colorectal Surgery, University Surgical Cluster, National University Hospital, National University Health Systems, Singapore, Singapore; 2Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; 3Division of Colorectal Surgery, Department of General Surgery, Ng Teng Fong General Hospital, Singapore, Singapore Contributions: (I) Conception and design: FH Koh, KK Tan; (II) Administrative support: All authors; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: FH Koh, DK Chan, J Ng; (V) Data analysis and interpretation: FH Koh, DK Chan, J Ng; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Ker-Kan Tan. Division of Colorectal Surgery, University Surgical Cluster, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore. Email: [email protected]. Background: Surveillance guidelines following excision of colonic tubular adenomas are well established. However, adherence to the guidelines are rarely audited. The aim of our study was to evaluate the rate of compliance to the recommended guidelines following polyp removal. Methods: A review of a prospectively collected colonoscopy database in a single tertiary institution was conducted for all patients who underwent polypectomy in 2008. We excluded patients who were diagnosed with or had prior history of colorectal malignancy. The frequency of subsequent colonoscopic were evaluated against the recommended guidelines based on the clinico-histological characteristics of the removed polyps. Results: There were 419 colonoscopies with polypectomies performed in 2008.
    [Show full text]
  • Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
    TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object.
    [Show full text]
  • Prevalence of Angiodysplasia Detected in Upper Gastrointestinal Endoscopic Examinations
    Open Access Original Article DOI: 10.7759/cureus.14353 Prevalence of Angiodysplasia Detected in Upper Gastrointestinal Endoscopic Examinations Takumi Notsu 1 , Kyoichi Adachi 1 , Tomoko Mishiro 1 , Kanako Kishi 1 , Norihisa Ishimura 2 , Shunji Ishihara 3 1. Health Center, Shimane Environment and Health Public Corporation, Matsue, JPN 2. Second Department of Internal Medicine, Shimane University Faculty of Medicine, Izumo, JPN 3. Gastroenterology, Shimane University Hospital, Izumo, JPN Corresponding author: Kyoichi Adachi, [email protected] Abstract Background This study was performed to examine the prevalence of asymptomatic angiodysplasia detected in upper gastrointestinal endoscopic examinations and of hereditary hemorrhagic telangiectasia (HHT) suspected cases. Methodology The study participants were 5,034 individuals (3,206 males, 1,828 females; mean age 53.5 ± 9.8 years) who underwent an upper gastrointestinal endoscopic examination as part of a medical check-up. The presence of angiodysplasia was examined endoscopically from the pharynx to duodenal second portion. HHT suspected cases were diagnosed based on the presence of both upper gastrointestinal angiodysplasia and recurrent nasal bleeding episodes occurring in the subject as well as a first-degree relative. Results Angiodysplasia was endoscopically detected in 494 (9.8%) of the 5,061 subjects. Those with angiodysplasia lesions in the pharynx, larynx, esophagus, stomach, and duodenum numbered 44, 4, 155, 322, and 12, respectively. None had symptoms of upper gastrointestinal bleeding or severe anemia. Subjects with angiodysplasia showed significant male predominance and were significantly older than those without. A total of 11 (0.2%) were diagnosed as HHT suspected cases by the presence of upper gastrointestinal angiodysplasia and recurrent epistaxis episodes from childhood in the subject as well as a first-degree relative.
    [Show full text]
  • 4-Aminobenzoic Acid (PABA)
    SCCP/1008/06 EUROPEAN COMMISSION HEALTH & CONSUMER PROTECTION DIRECTORATE-GENERAL Directorate C - Public Health and Risk Assessment C7 - Risk assessment SCIENTIFIC COMMITTEE ON CONSUMER PRODUCTS SCCP Opinion on 4-Aminobenzoic acid (PABA) COLIPA n° S1 Adopted by the SCCP during the 8th plenary meeting of 20 June 2006 SCCP/1008/06 Opinion on 4-Aminobenzoic acid (PABA) ____________________________________________________________________________________________ TABLE OF CONTENTS 1. BACKGROUND ………………………………………………… 3 2. TERMS OF REFERENCE ……………………………………………….... 3 3. OPINION ………………………………………………… 4 4. CONCLUSION ………………………………………………… 48 5. MINORITY OPINION ………………………………………………… 48 6. REFERENCES ………………………………………………… 48 7. ACKNOWLEDGEMENTS ………………………………………………… 56 2 SCCP/1008/06 Opinion on 4-Aminobenzoic acid (PABA) ____________________________________________________________________________________________ 1. BACKGROUND PABA or 4-Aminobenzoic acid (PABA) is listed in Annex VII part 1 no. 1 on the List of permitted UV filters that may be used in cosmetic products. The maximum authorised concentration in finished cosmetic products is 5 %. No other limitations and requirements or conditions of use and warnings are required by the SCCP. In 2001, the Commission received inquiries from Denmark expressing its concern about the use of certain UV filters in cosmetic products. In this connection an opinion on PABA was missing, as the substance has been introduced into the Annexes of the cosmetics legislation based on safety evaluations from the Member States prior to the existence of the SCCNFP. Submission I on the UV-filter 4-Aminobenzoic acid (PABA) was submitted December 2005. 2. TERMS OF REFERENCE 1. Is 4-Aminobenzoic acid (PABA) safe for continued use as a UV filter in cosmetic products under the current restriction of 5.0 % as a maximum concentration? 2. Does the SCCP consider that the use of 4-Aminobenzoic acid (PABA) is safe for the consumer in a concentration up to 5 % when used in other cosmetic products than sunscreen products? 3.
    [Show full text]
  • Obscure Gastrointestinal Bleeding in Cirrhosis: Work-Up and Management
    Current Hepatology Reports (2019) 18:81–86 https://doi.org/10.1007/s11901-019-00452-6 MANAGEMENT OF CIRRHOTIC PATIENT (A CARDENAS AND P TANDON, SECTION EDITORS) Obscure Gastrointestinal Bleeding in Cirrhosis: Work-up and Management Sergio Zepeda-Gómez1 & Brendan Halloran1 Published online: 12 February 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review Obscure gastrointestinal bleeding (OGIB) in patients with cirrhosis can be a diagnostic and therapeutic challenge. Recent advances in the approach and management of this group of patients can help to identify the source of bleeding. While the work-up of patients with cirrhosis and OGIB is the same as with patients without cirrhosis, clinicians must be aware that there are conditions exclusive for patients with portal hypertension that can potentially cause OGIB. Recent Findings New endoscopic and imaging techniques are capable to identify sources of OGIB. Balloon-assisted enteroscopy (BAE) allows direct examination of the small-bowel mucosa and deliver specific endoscopic therapy. Conditions such as ectopic varices and portal hypertensive enteropathy are better characterized with the improvement in visualization by these techniques. New algorithms in the approach and management of these patients have been proposed. Summary There are new strategies for the approach and management of patients with cirrhosis and OGIB due to new develop- ments in endoscopic techniques for direct visualization of the small bowel along with the capability of endoscopic treatment for different types of lesions. Patients with cirrhosis may present with OGIB secondary to conditions associated with portal hypertension. Keywords Obscure gastrointestinal bleeding . Cirrhosis . Portal hypertension .
    [Show full text]
  • Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
    MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01
    [Show full text]
  • Biodegradable Esophageal Stents for the Treatment of Refractory Benign Esophageal Strictures
    INVITED REVIEW Annals of Gastroenterology (2020) 33, 1-8 Biodegradable esophageal stents for the treatment of refractory benign esophageal strictures Paraskevas Gkolfakisa, Peter D. Siersemab, Georgios Tziatziosc, Konstantinos Triantafyllouc, Ioannis S. Papanikolaouc Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Radboud University Medical Center, Nijmegen, The Netherlands; “Attikon” University General Hospital, Medical School, National and Kapodistrian University of Athens, Greece Abstract This review attempts to present the available evidence regarding the use of biodegradable stents in refractory benign esophageal strictures, especially highlighting their impact on clinical success and complications. A comprehensive literature search was conducted in PubMed, using the terms “biodegradable” and “benign”; evidence from cohort and comparative studies, as well as data from one pooled analysis and one meta-analysis are presented. In summary, the results from these studies indicate that the effectiveness of biodegradable stents ranges from more than one third to a quarter of cases, fairly similar to other types of stents used for the same indication. However, their implementation may reduce the need for re-intervention during follow up. Biodegradable stents also seem to reduce the need for additional types of endoscopic therapeutic modalities, mostly balloon or bougie dilations. Results from pooled data are consistent, showing moderate efficacy along with a higher complication rate. Nonetheless, the validity of these results is questionable, given the heterogeneity of the studies included. Finally, adverse events may occur at a higher rate but are most often minor. The lack of high-quality studies with sufficient patient numbers mandates further studies, preferably randomized, to elucidate the exact role of biodegradable stents in the treatment of refractory benign esophageal strictures.
    [Show full text]
  • Angiodysplasia of Colon Or GI Tract
    Angiodysplasia of Colon or GI Tract Background Phillips first described a vascular (blood vessel) abnormality that caused bleeding from the large bowel in a letter to the London Medical Gazette in 1839. During the 1920s, cancers were considered the major source of GI bleeding/hemorrhage. However, in the 1940s and 1950s, diverticular disease was recognized as an important source of bleeding. In 1951, Smith described active bleeding from a diverticulum visualized through a sigmoidoscope. Galdabini first used the name angiodysplasia in 1974; however, confusion about the exact nature of these lesions resulted in a multitude of terms that included AVM = arteriovenous malformation, hemangioma, telangiectasia, and vascular ectasia. These terms have varying pathophysiologies, with a common presentation of GI bleeding and may be used interchangeably by many physicians. Angiodysplasia is a degenerative lesion of previously healthy blood vessels found most commonly in the right-side of colon. 77% of angiodysplasias are located in the cecum and ascending colon, 15% are located in the jejunum and ileum (small intestine), and the remainder are distributed throughout the GI tract. These lesions typically are nonpalpable and small (<5 mm). Angiodysplasia is the most common vascular abnormality of the GI tract. After diverticulosis, it is the second leading cause of lower GI bleeding in patients older than 60 years. Angiodysplasia may account for approximately 6% of cases of lower GI bleeding. It may be observed incidentally at colonoscopy in as many as 0.8% of patients older than 50 years. The prevalence for upper GI lesions is approximately 1-2%. Small bowel angiodysplasia may account for 30-40% of cases of GI bleeding of obscure origin.
    [Show full text]
  • Advances in Flexible Endoscopy
    Advances in Flexible Endoscopy Anant Radhakrishnan, DVM KEYWORDS Flexible endoscopy Minimally invasive procedures Gastroduodenoscopy Minimally invasive surgery KEY POINTS Although some therapeutic uses exist, flexible endoscopy is primarily used as a diagnostic tool. Several novel flexible endoscopic procedures have been studied recently and show prom- ise in veterinary medicine. These procedures provide the clinician with increased diagnostic capability. As the demand for minimally invasive procedures continues to increase, flexible endos- copy is being more readily investigated for therapeutic uses. The utility of flexible endoscopy in small animal practice should increase in the future with development of the advanced procedures summarized herein. INTRODUCTION The demand for minimally invasive therapeutic measures continues to increase in hu- man and veterinary medicine. Pet owners are increasingly aware of technology and diagnostic options and often desire the same care for their pet that they may receive if hospitalized. Certain diseases, such as neoplasia, hepatobiliary disease, pancreatic disease, and gastric dilatation–volvulus, can have significant morbidity associated with them such that aggressive, invasive measures may be deemed unacceptable. Even less severe chronic illnesses such as inflammatory bowel disease can be asso- ciated with frustration for the pet owner such that more immediate and detailed infor- mation regarding their pet’s disease may prove to be beneficial. Minimally invasive procedures that can increase diagnostic and therapeutic capability with reduced pa- tient morbidity will be in demand and are therefore an area of active investigation. The author has nothing to disclose. Department of Internal Medicine, Bluegrass Veterinary Specialists 1 Animal Emergency, 1591 Winchester Road, Suite 106, Lexington, KY 40505, USA E-mail address: [email protected] Vet Clin Small Anim 46 (2016) 85–112 http://dx.doi.org/10.1016/j.cvsm.2015.08.003 vetsmall.theclinics.com 0195-5616/16/$ – see front matter Ó 2016 Elsevier Inc.
    [Show full text]
  • Pharmaceutical Appendix to the Tariff Schedule 2
    Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. ABACAVIR 136470-78-5 ACIDUM LIDADRONICUM 63132-38-7 ABAFUNGIN 129639-79-8 ACIDUM SALCAPROZICUM 183990-46-7 ABAMECTIN 65195-55-3 ACIDUM SALCLOBUZICUM 387825-03-8 ABANOQUIL 90402-40-7 ACIFRAN 72420-38-3 ABAPERIDONUM 183849-43-6 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABATACEPTUM 332348-12-6 ACITEMATE 101197-99-3 ABCIXIMAB 143653-53-6 ACITRETIN 55079-83-9 ABECARNIL 111841-85-1 ACIVICIN 42228-92-2 ABETIMUSUM 167362-48-3 ACLANTATE 39633-62-0 ABIRATERONE 154229-19-3 ACLARUBICIN 57576-44-0 ABITESARTAN 137882-98-5 ACLATONIUM NAPADISILATE 55077-30-0 ABLUKAST 96566-25-5 ACODAZOLE 79152-85-5 ABRINEURINUM 178535-93-8 ACOLBIFENUM 182167-02-8 ABUNIDAZOLE 91017-58-2 ACONIAZIDE 13410-86-1 ACADESINE 2627-69-2 ACOTIAMIDUM 185106-16-5 ACAMPROSATE 77337-76-9
    [Show full text]