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Endoscopy, Gastrointestinal

Endoscopy, Gastrointestinal: A minimally invasiv procedure used to visualize the digestive tract and perform diagnostic and therapeutic procedures.
It involves the insertion of a flexible tube with a light and camera at the end (endoscope) through the mouth or rectum to examine the esophagus, stomach, duodenum, small intestine, colon, and rectum.
Gastrointestinal endoscopy is an important tool for the detection and management of a variety of conditions, including ulcers, inflammation, bleeding, and cancers.
It also allows for biopsies, removal of polyps, and other interventions.
Endoscopy is considered a safe and effective method for evaluating and treating gastrointestinal disorders, though there is a small risk of complications such as perforation or bleeding.

Most cited protocols related to «Endoscopy, Gastrointestinal»

Data for this study were acquired from a recently completed placebo-controlled randomized trial of rosiglitazone for mild to moderately active ulcerative colitis (clinicaltrials.gov #NCT00065065) which has been described in greater detail previously.7 (link) The trial used a slight modification of the Mayo score to assess disease activity (Table 1). Specifically, the bleeding component as described in the Mayo index was modified such that a score of 3 required both visible blood in 50% or more of bowel movements and at least some bowel movements with blood alone.
The study included 105 patients with mild to moderately active disease defined as a total DAI score of 4 to 10, inclusively. Patients were randomized in a 1:1 ratio to receive either rosiglitazone 4 mg or placebo twice daily for 12 weeks. Disease activity was measured at randomization and every four weeks thereafter until week 12, however lower endoscopy was only completed at week 0 and week 12, such that only a partial Mayo score (9 point scale that excludes the endoscopic appearance of the mucosa) could be calculated at the interim visits. In the very early accrual period of the study, a follow-up visit was included at week 2. Without knowledge of the response rates in either arm, the Data and Safety Monitoring Board (DSMB) requested that the week 2 follow-up evaluation be eliminated with the hopes of minimizing the placebo response rate and maximizing recruitment and retention.6 (link), 8 (link), 9 (link) Eighteen patients completed the week 2 follow-up visit.
During the course of the study, patients could be treated with other conventional medications used to treat active ulcerative colitis including mesalamine, oral corticosteroids, immunomodulators, or topical therapies (mesalamine or corticosteroids) at stable doses. Use of corticosteroids at doses greater than 20mg per day of prednisone or the equivalent was an exclusion criterion. Steroid tapering was not permitted during the study.
In anticipation of this sub-study, at each visit we also included questions about change in disease activity compared to the previous visit and compared to the randomization visit on a global seven-point scale (Table 2). The choices included much better, moderately better, a little better, unchanged, a little worse, moderately worse, and much worse. Patients also graded their current disease activity at each visit on a 6 point Likert scale – perfect, very good (minimal symptoms), good (only mild symptoms), moderately active, moderately severe, or severe. Data on quality of life were measured with the Inflammatory Bowel Disease Questionnaire (IBDQ) authored by Dr. Jan Irvine under license from McMaster University, Hamilton, Canada.10 (link)
Publication 2008
Adrenal Cortex Hormones BLOOD Clinical Trials Data Monitoring Committees Defecation Endoscopy Endoscopy, Gastrointestinal Immunologic Adjuvants Inflammatory Bowel Diseases Mesalamine Mucous Membrane Patients Pharmaceutical Preparations Placebos Prednisone Retention (Psychology) Rosiglitazone Steroids Ulcerative Colitis

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Publication 2009
Colonoscopes Colonoscopy Endoscopy, Gastrointestinal Intestines Nurses Polyps
Chronic DILI is defined at 6 months after DILI onset as one of the following: (i) for subjects with normal or unknown baseline liver biochemistries, a serum AST, ALT, alkaline phosphatase, INR or total bilirubin that is persistently elevated on two separate occasions; (ii) for liver DILI subjects, a serum AST, ALT, alkaline phosphatase, INR or total bilirubin level that exceeds 1.25 times the baseline value on two separate occasions; (iii) any evidence of portal hypertension such as ascites on imaging, varices on upper endoscopy or clinical evidence of hepatic encephalopathy; (iv) any histological evidence of persistent liver injury at least 6 months after DILI onset; or (v) any radiological evidence of chronic liver disease such as ascites, hepatomegaly, nodular liver or intra-abdominal varices. Subjects with pre-existing chronic HBV or HCV infection, liver transplant recipients since the baseline visit and patients with cirrhosis or clinical evidence of portal hypertension before starting the suspect medication are excluded from the chronic DILI protocol.
Subjects with chronic DILI are seen at 12 and 24 months after the baseline visit wherein incremental medical history, medication use, laboratory and imaging studies and questionnaires are completed. A final written narrative is also generated by the site investigator summarizing the course of the DILI episode. For subjects who die during follow-up, a death narrative recording whether the death was attributable to a liver or non-liver related cause is generated by the site investigator for review by the causality committee.
Publication 2009
Abdominal Cavity Alkaline Phosphatase Ascites Bilirubin Endoscopy, Gastrointestinal Hepatic Encephalopathy Hepatitis C Injuries Liver Liver Cirrhosis Liver Diseases Liver Transplantations Patients Pharmaceutical Preparations Portal Hypertension Serum Transplant Recipients Varices Vision X-Rays, Diagnostic
The guideline was developed according to a well-documented methodology that is universal to ESHRE guidelines (Vermeulen, 2014 ).
In short, 18 key questions were formulated by the Guideline Development Group (GDG), with input from patient organizations (Fertility Europe, Miscarriage Association UK), and structured in PICO format (Patient, Intervention, Comparison, Outcome). For each question, databases (PUBMED/MEDLINE and the Cochrane library) were searched from inception to 31 March 2017, with a limitation to studies written in English. From the literature searches, studies were selected based on the PICO questions, assessed for quality and summarized in evidence tables and summary of findings tables (for interventions with at least two studies per outcome). Cumulative live birth rate, live birth rate and pregnancy loss rate (or miscarriage rate) were considered the critical outcomes. GDG meetings were organized where the evidence and draft recommendations were presented by the assigned GDG member, and discussed until consensus was reached within the group.
Each recommendation was labelled as strong or conditional and a grade was assigned based on the strength of the supporting evidence (High ⊕⊕⊕⊕ – Moderate ⊕⊕⊕○ Low ⊕⊕○○ – Very low ⊕○○○). In the absence of evidence, the GDG formulated no recommendation or a good practice points (GPP) based on clinical expertise (Table I).

Interpretation of strong versus conditional recommendations in the GRADE approach.*

Implications forStrong recommendationConditional recommendation
PatientsMost individuals in this situation would want the recommended course of action, and only a small proportion would not.The majority of individuals in this situation would want the suggested course of action, but many would not.
Clinicians

Most individuals should receive the intervention. Adherence to this recommendation according to the guideline could be used as a quality criterion or performance indicator.

Formal decision aids are not likely to be needed to help individuals make decisions consistent with their values and preferences.

Recognize that different choices will be appropriate for individual patients and that you must help each patient arrive at a management decision consistent with his or her values and preferences.

Decision aids may be useful in helping individuals to make decisions consistent with their values and preferences.

Policy makersThe recommendation can be adopted as policy in most situations.Policy making will require substantial debate and involvement of various stakeholders.

*Andrews et al. (2013) (link).

The guideline draft and an invitation to participate in the stakeholder review was published on the ESHRE website. In addition, all relevant stakeholders received a personal invitation to review by e-mail. We received 307 comments from 23 reviewers, representing 15 countries, two national societies (Royal College of Obstetricians and Gynaecologists, and Italian Society of Gynecology and Obstetrics Sigo – L’Associazione degli Ostetrici e Ginecologi Ospedalieri Italiani – Associazione Ginecologi Universitari Italiani) and one international research group (ESHRE/European Society for Gynaecological Endoscopy[ESGE] CONgenital UTerine Anomalies Group). All comments were processed by the GDG, either by adapting the content of the guideline and/or by replying to the reviewer. The review process was summarized in the review report which is published on the ESHRE website (www.eshre.eu/guidelines).
This guideline will be considered for update 4 years after publication, with an intermediate assessment of the need for updating 2 years after publication.
Publication 2018
cDNA Library Endoscopy, Gastrointestinal Europeans Fertility Gynecologist Needs Assessment Obstetrician Patients Spontaneous Abortion Uterine Anomalies
This multicenter retrospective study was implemented to examine the factors related to recurrence or refractoriness of CRS in the Japanese population from 2011 to 2012. ‘Recurrent’ CRS was defined as CRS that presented recurring nasal polyps or sinusitis (nasal symptoms) after ESS. ‘Refractory’ CRS was defined as recurrent CRS that was not cured by any medical treatment after ESS. This study was conducted in 15 institutions of Japan and related facilities participating in the grants‐in‐aid program (Ministry of Health, Labour and Welfare Grant; Japan Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis [JESREC] Study). The study was approved by the ethics committee of each institution participating in the JESREC Study.
We assessed patients with CRS (including CRSwNP and CRSsNP) treated with ESS from January 2007 to December 2009 in the 15 institutions. The diagnosis of sinus disease was based on patient history, clinical examination, nasal endoscopy, and computed tomography (CT) of the sinuses, according to the guidelines of the European Position Paper on Rhinosinusitis and Nasal Polyps 1. Our study excluded patients treated with systemic or topical corticosteroids before surgery, patients whose information on systemic or topical corticosteroids was unknown, patients who were followed up for <28 days after surgery, patients whose white blood cell counts were 10 000/μl or more, as well as patients from which there was no pathological specimen.
Preoperative demographic and medical history including sex, age, age of onset, reaction to drugs, history of smoking, complications, and drug allergies were obtained from each patient. Rhinology specialists assessed all participants on seven symptoms and signs before surgery: nasal polyps, viscous rhinorrhea, postnasal drip, facial pain, hyposmia, anosmia, and closure of the olfactory cleft. Blood samples were taken to perform complete blood counts and measure 10 types of antigen‐specific IgE. CT findings were graded according to the Lund–MacKay method 13. Recurrence of CRS was defined as the presence of nasal polyps or nasal symptoms in nasal endoscopy.
Publication 2015
Adrenal Cortex Hormones Antigens BLOOD Complete Blood Count Diagnosis Drug Allergy Drug Reaction, Adverse Endoscopy, Gastrointestinal Eosinophil Europeans Facial Pain Hyposmia Institutional Ethics Committees Japanese Leukocyte Count Nasal Polyps Nose Ocular Refraction Operative Surgical Procedures Patients Physical Examination Recurrence Rhinorrhea Sense of Smell Sinus Disease, Paranasal Sinuses, Nasal Sinusitis Specialists Viscosity X-Ray Computed Tomography

Most recents protocols related to «Endoscopy, Gastrointestinal»

Example 12

As a proof of concept, the patient population of this study is patients that (1) have moderate to severe ulcerative colitis, regardless of extent, and (2) have had an insufficient response to a previous treatment, e.g., a conventional therapy (e.g., 5-ASA, corticosteroid, and/or immunosuppressant) or a FDA-approved treatment. In this placebo-controlled eight-week study, patients are randomized. All patient undergo a colonoscopy at the start of the study (baseline) and at week 8. Patients enrolled in the study are assessed for clinical status of disease by stool frequency, rectal bleeding, abdominal pain, physician's global assessment, and biomarker levels such as fecal calprotectin and hsCRP. The primary endpoint is a shift in endoscopy scores from Baseline to Week 8. Secondary and exploratory endpoints include safety and tolerability, change in rectal bleeding score, change in abdominal pain score, change in stool frequency, change in partial Mayo score, change in Mayo score, proportion of subjects achieving endoscopy remission, proportion of subjects achieving clinical remission, change in histology score, change in biomarkers of disease such as fecal calprotectin and hsCRP, level of adalimumab in the blood/tissue/stool, change in cytokine levels (e.g., TNFα, IL-6) in the blood and tissue.

FIG. 72 describes an exemplary process of what would occur in clinical practice, and when, where, and how the ingestible device will be used. Briefly, a patient displays symptoms of ulcerative colitis, including but not limited to: diarrhea, bloody stool, abdominal pain, high c-reactive protein (CRP), and/or high fecal calprotectin. A patient may or may not have undergone a colonoscopy with diagnosis of ulcerative colitis at this time. The patient's primary care physician refers the patient. The patient undergoes a colonoscopy with a biopsy, CT scan, and/or MRI. Based on this testing, the patient is diagnosed with ulcerative colitis. Most patients are diagnosed with ulcerative colitis by colonoscopy with biopsy. The severity based on clinical symptoms and endoscopic appearance, and the extent, based on the area of involvement on colonoscopy with or without CT/MRI is documented. Treatment is determined based on diagnosis, severity and extent.

For example, treatment for a patient that is diagnosed with ulcerative colitis is an ingestible device programmed to release a single bolus of a therapeutic agent, e.g., 40 mg adalimumab, in the cecum or proximal to the cecum. Prior to administration of the treatment, the patient is fasted overnight and is allowed to drink clear fluids. Four hours after swallowing the ingestible device, the patient can resume a normal diet. An ingestible device is swallowed at the same time each day. The ingestible device is not recovered.

In some embodiments, there may be two different ingestible devices: one including an induction dose (first 8 to 12 weeks) and a different ingestible device including a different dose or a different dosing interval.

In some examples, the ingestible device can include a mapping tool, which can be used after 8 to 12 weeks of induction therapy, to assess the response status (e.g., based on one or more of the following: drug level, drug antibody level, biomarker level, and mucosal healing status). Depending on the response status determined by the mapping tool, a subject may continue to receive an induction regimen or maintenance regimen of adalimumab.

In different clinical studies, the patients may be diagnosed with Crohn's disease and the ingestible devices (including adalimumab) can be programmed to release adalimumab in the cecum, or in both the cecum and transverse colon.

In different clinical studies, the patients may be diagnosed with illeocolonic Crohn's disease and the ingestible devices (including adalimumab) can be programmed to release adalimumab in the late jejunum or in the jejunum and transverse colon.

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Patent 2024
Abdominal Pain Adalimumab Adrenal Cortex Hormones Biological Markers Biopsy BLOOD Cecum Colonoscopy C Reactive Protein Crohn Disease Cytokine Diarrhea Diet Endoscopy Endoscopy, Gastrointestinal Feces Homo sapiens Immunoglobulins Immunosuppressive Agents Jejunum Leukocyte L1 Antigen Complex Medical Devices Mesalamine Mucous Membrane Neoadjuvant Therapy Patient Care Management Patients Pharmaceutical Preparations Placebos Primary Care Physicians Safety Therapeutics Tissues Transverse Colon Treatment Protocols Tumor Necrosis Factor-alpha Ulcerative Colitis X-Ray Computed Tomography
Spearman’s rank correlation coefficient was used to determine the correlations of the OHAT score with the results of swallowing endoscopy and swallowing angiography. Welch’s t-test was applied for comparisons between the no/single-pneumonia episode group and the multiple-pneumonia episode group.
The study was approved by the Fukuoka Gakuen Research Ethics Committee (permission no. 314).
Publication 2023
Angiography Endoscopy, Gastrointestinal Ethics Committees, Research Pneumonia
Two authors (MX and YZ) independently extracted the following data: (1) anastomotic leakage, (2) defecation frequency, (3) anastomotic stricture, (4) reoperation, (5) postoperative mortality within 30 days, (6) fecal urgency, (7) incomplete defecation, (8) use of antidiarrheal medication, and (9) quality of life. We recorded the results of bowel function outcomes at 3, 6, 12, and 24 months following stoma retraction (or without stoma surgery). We considered the most common and concerning anastomotic leakage and defecation frequency as the primary outcome indicators, and the rest were secondary outcome indicators. Anastomotic leakage is defined as a significant crack at the edge of the anastomosis, leakage of bowel contents seen in the pelvis on imaging or endoscopy, or purulent discharge from the pelvic drainage tube. The defecation frequency was determined based on the patient-described average number of daily bowel movements.
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Publication 2023
Anastomotic Leak Antidiarrheals Defecation Drainage Endoscopy, Gastrointestinal Feces Intestinal Contents Patient Discharge Patients Pelvis Second Look Surgery Stenosis Surgical Anastomoses Surgical Stoma Vision
This study was institutionally approved by the Kyoto Prefectural University of Medicine, and each participant provided written informed consent. A total of 117 patients who underwent curative surgery for AEG, classified as Siewert type I or II, at our institute between 2000 and 2016 were included in this study. We precisely defined Siewert type based on pathological mapping and macroscopic measurements of the distance between the tumour epicentre and the esophagogastric junction. Furthermore, we retrospectively analysed clinicopathological features and prognostic outcomes. Finally, we evaluated the compatibility of our findings with the eighth edition of the AJCC/UICC TNM classification system for AEG [7 , 15 ].
The postoperative follow-up program at our institution comprises a regular physical examination as well as laboratory blood tests and chest X-rays every three or six months. Endoscopy and ultrasonography, or computed tomography, were performed annually for the first five years, if possible. All enrolled patients underwent pathological or macroscopic curative resection (R0). Histological types were classified as differentiated (papillary adenocarcinoma, or moderately or well-differentiated adenocarcinoma) or undifferentiated (poorly differentiated or undifferentiated adenocarcinoma, signet-ring cell carcinoma, or mucinous adenocarcinoma) based on the 15th edition of the Japanese Classification of Gastric Carcinoma [16 ]. Patients with bulky metastatic lymph nodes underwent neoadjuvant chemotherapy (NAC). The regimen of NAC was S-1 and cisplatin according to Japanese gastric cancer guidelines [16 ]. Patients who underwent NAC were 10.2% (12/117) of all patients. Patients with pStage II or high underwent postoperative S-1 adjuvant chemotherapy for one year according to the ACTS-GC (Adjuvant Chemotherapy Trial of TS-1 for Gastric Cancer) study [17 (link)].
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Publication 2023
Adenocarcinoma Carcinoma, Signet Ring Cell Chemotherapy, Adjuvant Cisplatin Dietary Fiber Endoscopy, Gastrointestinal Esophagogastric Junction Gastric Cancer Hematologic Tests Japanese Mucinous Adenocarcinoma Neoadjuvant Chemotherapy Neoplasms Nodes, Lymph Operative Surgical Procedures Papillary Adenocarcinoma Patients Pharmaceutical Preparations Physical Examination Radiography, Thoracic SERPINA3 protein, human Treatment Protocols Ultrasonography X-Ray Computed Tomography
Place, duration, and design of the study
This prospective single-center study was performed in our department between May 2021 and December 2021.
Ethics
Informed consent was obtained for all patients. The examinations were only performed after a careful explanation of the characteristics, non-invasiveness, and aim of the study. The study was approved by the Ethics Committee of Centro Hospitalar Universitário do Porto (Number: 2021.93 [075-DEFI/078-CE]) and the design complies with the Declaration of Helsinki ethical standards.
Inclusion criteria
Adulthood, OD concomitant with SARS-CoV-2 documented infection), subjective persistence of OD, and a cognitive status that allowed the patient to sign an informed consent and to self-treat with the medical therapeutic proposed.
Exclusion criteria
Chronic rhinosinusitis, recent head trauma with loss of consciousness, olfactory complaints before documented COVID-19, gestation, prior nasal surgery, known olfactory bulb lesion on imaging, neurologic or psychiatric disease, or inability to tolerate nasal endoscopy.
Evaluation
Our evaluation consisted of several steps: A general assessment of days before the onset of hyposmia, co-morbidities, a subjective assessment using the Portuguese Language Olfactory Disorders Questionnaire [12 (link)], and a VAS toward subjective impairment of hyposmia in quality of life. Our VAS consisted of an 11-point scale ranging between 0 and 10, being “not a problem” on the left end of the scale (number 0) and “worst problem in my life” on the right end of the scale (number 10). An objective assessment of olfactory thresholds using the Sniffin´ Sticks threshold test with n-butanol: 16 levels in 48 pens were also performed [13 (link)]. The nasal status assessment was performed by nasal endoscopy for exclusion of nasal pathology and evaluation of Lund-Kennedy score - when a polyp score ≥ 1 was seen, the patient was excluded from our cohort while follow-up and further management were maintained in parallel. Also, all patients underwent olfactory training and adjuvant therapy using the strategy described in the protocol described by Sousa et al. [14 (link)].
Variables evaluated
Age, gender, relevant comorbidities, date of perceived onset of OD, olfactory thresholds, and VAS (related to OD). Patients were re-evaluated after three months, and data was collected.
Statistical analysis
Collected data were analyzed using SPSS version 26 (Statistical Package for Social Studies) - IBM, USA. For numerical values, the range, mean, and standard deviations were calculated. The differences between the two mean values were used using the Mann-Whitney U test. Differences in mean values before and after the intervention were done by Wilcoxon signed ranks test. The correlation between VAS and olfactory thresholds was done using Pearson’s correlation coefficient. To access the confounding variables, ANCOVA analysis was also performed. All reported p-values are two-tailed, with a p-value ≤ 0.05 indicating statistical significance.
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Publication 2023
argipressin, Asu(1,6)- Butyl Alcohol Cognition COVID 19 Craniocerebral Trauma Endoscopy, Gastrointestinal Ethics Committees Gender Hyposmia Language Disorders Mental Disorders Nose Olfaction Disorders Olfactory Bulb Patients Pharmaceutical Adjuvants Physical Examination Polyps Pregnancy Sense of Smell Sousa Surgical Procedure, Nasal Systems, Nervous Therapeutics Vision

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More about "Endoscopy, Gastrointestinal"

Gastrointestinal endoscopy, also known as GI endoscopy or digestive tract endoscopy, is a minimally invasive medical procedure used to examine the upper and lower digestive system.
This procedure involves the insertion of a flexible tube called an endoscope, which contains a light and camera, through the mouth or rectum to visualize the esophagus, stomach, duodenum, small intestine, colon, and rectum.
Endoscopy is an important diagnostic and therapeutic tool for the detection and management of various gastrointestinal conditions, including ulcers, inflammation, bleeding, and cancers.
It allows for the collection of tissue samples (biopsies) and the removal of polyps, as well as other interventions.
Gastrointestinal endoscopy is generally considered a safe and effective method for evaluating and treating digestive disorders, though there is a small risk of complications, such as perforation or bleeding.
Advancements in endoscopic technology, such as the development of high-definition imaging and narrow-band imaging, have improved the accuracy and effectiveness of this procedure.
PubCompare.ai, an AI-driven platform, can optimize gastrointestinal endoscopy research by helping users locate the best protocols from scientific literature, pre-prints, and patents.
The platform's AI-powered comparisons can enhance the reproducibility and accuracy of endoscopy studies, making it a valuable tool for researchers and clinicians.
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These tools and techniques may be used in conjunction with or to support gastrointestinal endoscopy procedures and research.