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Sökning: L773:1097 6779

  • Resultat 11-20 av 23
  • Föregående 1[2]3Nästa
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11.
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12.
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13.
  • Lindström, Eva, et al. (författare)
  • Pin within a bile duct stone.
  • 2002
  • Ingår i: Gastrointestinal Endoscopy. - Mosby. - 1097-6779. ; 55:7, s. 912-912
  • Tidskriftsartikel (refereegranskat)
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14.
  • Marschall, HU (författare)
  • Response
  • 1999
  • Ingår i: Gastrointestinal endoscopy. - 1097-6779. ; 49:6, s. 818-819
  • Tidskriftsartikel (refereegranskat)
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15.
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16.
  • Silva, Francisco Baldaque, et al. (författare)
  • Endoscopic assessment and grading of Barrett's esophagus using magnification endoscopy and narrow-band imaging: accuracy and interobserver agreement of different classification systems (with videos).
  • 2011
  • Ingår i: Gastrointestinal endoscopy. - 1097-6779. ; 73:1, s. 7-14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Three different classification systems for the evaluation of Barrett's esophagus (BE) using magnification endoscopy (ME) and narrow-band imaging (NBI) have been proposed. Until now, no comparative and external evaluation of these systems in a clinical-like situation has been performed. Objective: To compare and validate these 3 classification systems. Design: Prospective validation study. Setting: Tertiary-care referral center. Nine endoscopists with different levels of expertise from Europe and Japan participated as assessors. Patients: Thirty-two patients with long-segment BE. Interventions: From a group of 209 standardized prospective recordings collected on BE by using ME combined with NB!, 84 high-quality videos were randomly selected for evaluation. Histologically, 28 were classified as gastric type mucosa, 29 as specialized intestinal metaplasia (SIM), and 27 as SIM with dysplasia/cancer. Assessors were blinded to underlying histology and scored each video according to the respective classification system. Before evaluation, an educational set concerning each classification system was carefully studied. At each assessment, the same 84 videos were displayed, but in different and random order. Main Outcome Measurements: Accuracy for detection of nondysplastic and dysplastic SIM. Interobserver agreement related to each classification. Results: The median time for video evaluation was 25 seconds (interquartile range 20-39 seconds) and was longer with the Amsterdam classification (P < .001). In 65% to 69% of the videos, assessors described certainty about the histology prediction. The global accuracy was 46% and 47% using the Nottingham and Kansas classifications, respectively, and 51% with the Amsterdam classification. The accuracy for nondysplastic SIM identification ranged between 57% (Kansas and Nottingham) and 63% (Amsterdam). Accuracy for dysplastic tissue was 75%, irrespective of the classification system and assessor expertise level. Interobserver agreement ranged from fair (Nottingham, kappa = 0.34) to moderate (Amsterdam and Kansas, kappa = 0.47 and 0.44, respectively). Limitation: No per-patient analysis. Conclusions: All of the available classification systems could be used in a clinical-like environment, but with inadequate interobserver agreement. All classification systems based on combined ME and NBI, revealed substantial limitations in predicting nondysplastic and dysplastic BE when assessed externally. This technique cannot, as yet, replace random biopsies for histopathological analysis. (Gastrointest Endosc 2011;73:7-14.)
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17.
  • Spada, Cristiano, et al. (författare)
  • Second-generation colon capsule endoscopy compared with colonoscopy
  • 2011
  • Ingår i: Gastrointestinal Endoscopy. - Mosby. - 1097-6779. ; 74:3, s. 581-589
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Colon capsule endoscopy (CCE) represents a noninvasive technology that allows visualization of the colon without requiring sedation and air insufflation. A second-generation colon capsule endoscopy system (PillCam Colon 2) (CCE-2) was developed to increase sensitivity for colorectal polyp detection compared with the first-generation system. Objective: To assess the feasibility, accuracy, and safety of CCE-2 in a head-to-head comparison with colonoscopy. Design and Setting: Prospective, multicenter trial including 8 European sites. Patients: This study involved 117 patients (mean age 60 years). Data from 109 patients were analyzed. Intervention: CCE-2 was prospectively compared with conventional colonoscopy as the criterion standard for the detection of colorectal polyps that are >= 6 mm or masses in a cohort of patients at average or increased risk of colorectal neoplasia. Colonoscopy was independently performed within 10 hours after capsule ingestion or on the next day. Main Outcome Measurements: CCE-2 sensitivity and specificity for detecting patients with polyps >= 6 mm and >= 10 mm were assessed. Capsule-positive but colonoscopy-negative cases were counted as false positive. Capsule excretion rate, level of bowel preparation, and rate of adverse events also were assessed. Results: Per-patient CCE-2 sensitivity for polyps >= 6 mm and >= 10 mm was 84% and 88%, with specificities of 64% and 95%, respectively. All 3 invasive carcinomas were detected by CCE-2. The capsule excretion rate was 88% within 10 hours. Overall colon cleanliness for CCE-2 was adequate in 81% of patients. Limitations: Not unblinding the CCE-2 results at colonoscopy; heterogenous patient population; nonconsecutive patients. Conclusion: In this European, multicenter study, CCE-2 appeared to have a high sensitivity for the detection of clinically relevant polypoicl lesions, and it might be considered an adequate tool for colorectal imaging. (Gastrointest Enclose 201174:581-9.)
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  • Toth, Ervin, et al. (författare)
  • Evaluation of gastric acid secretion at endoscopy with a modified Congo red test.
  • 2002
  • Ingår i: Gastrointestinal Endoscopy. - Mosby. - 1097-6779. ; 56:2, s. 254-259
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Markedly decreased or absent gastric acid production is associated with a number of clinically significant conditions, and identification of patients with hypo/achlorhydria may be important. However, current methods of assessing impaired acid secretion are unreliable, time-consuming, and/or complex. The aim of this prospective study was to evaluate a modified endoscopic Congo red test for the diagnosis of hypo/achlorhydria by correlation with a standard gastric acid secretory test. METHODS: One hundred six consecutive outpatients with or without dyspeptic symptoms referred for endoscopy were evaluated by using a modified endoscopic Congo red test and a standard test of gastric acid secretion. The modified endoscopic Congo red test suggested hypo/achlorhydria when there was no color shift or a shift of small extent (less than one third of fundic mucosa). Hypo/achlorhydria by the standard gastric acid secretory test was defined as a maximal acid output of less than 6.9 mmol/hour in men and 5.0 mmol/hour in women. RESULTS: The accuracy of the modified endoscopic Congo red test for the diagnosis of hypo/achlorhydria was 0.98 (95% CI [0.93, 0.99]). The sensitivity was 1.0 (95% CI [0.92, 1.00]) and specificity 0.96 (95% CI [0.88, 0.99]). All patients tolerated the modified endoscopic Congo red test well. CONCLUSION: The modified endoscopic Congo red is an accurate, simple, fast, inexpensive, and well-tolerated chromoendoscopic method for identification of patients with hypo/achlorhydria during routine upper endoscopy.
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  • Resultat 11-20 av 23
  • Föregående 1[2]3Nästa
 
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