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in English | IEC | ID: iec-101

in Portuguese | IEC | ID: iec-100

in English | IEC | ID: iec-77

in English | IEC | ID: iec-71

in English | IEC | ID: iec-63

in English | IEC | ID: iec-61

World J Gastroenterol ; 27(40): 6794-6824, 2021 Oct 28.
Article in English | MEDLINE | ID: mdl-34790008


The development of artificial intelligence (AI) has increased dramatically in the last 20 years, with clinical applications progressively being explored for most of the medical specialties. The field of gastroenterology and hepatology, substantially reliant on vast amounts of imaging studies, is not an exception. The clinical applications of AI systems in this field include the identification of premalignant or malignant lesions (e.g., identification of dysplasia or esophageal adenocarcinoma in Barrett's esophagus, pancreatic malignancies), detection of lesions (e.g., polyp identification and classification, small-bowel bleeding lesion on capsule endoscopy, pancreatic cystic lesions), development of objective scoring systems for risk stratification, predicting disease prognosis or treatment response [e.g., determining survival in patients post-resection of hepatocellular carcinoma), determining which patients with inflammatory bowel disease (IBD) will benefit from biologic therapy], or evaluation of metrics such as bowel preparation score or quality of endoscopic examination. The objective of this comprehensive review is to analyze the available AI-related studies pertaining to the entirety of the gastrointestinal tract, including the upper, middle and lower tracts; IBD; the hepatobiliary system; and the pancreas, discussing the findings and clinical applications, as well as outlining the current limitations and future directions in this field.

Barrett Esophagus , Gastroenterology , Artificial Intelligence , Diagnostic Imaging , Endoscopy , Humans
Turk J Gastroenterol ; 32(10): 879-887, 2021 10.
Article in English | MEDLINE | ID: mdl-34787093


BACKGROUND: The Coronavirus-2019 disease (COVID-19) pandemic has markedly restricted endoscopic and clinical activities in gastroenterology (GI), with a negative impact on trainee education. We aimed to inve stigate how and to what extent has GI trainees in Turkey are affected by the current pandemic in terms of general, psychological, and educational status. METHODS: We conducted a web-based survey sent electronically to 103 official GI trainees in Turkey from 37 centers. The 32-item survey included questions to capture demographic (5-questions), endoscopic (7-questions), personal protective equipment (PPE) (3-questions), psychological and general well-being (11-questions), and educational (6-questions) data. RESULTS: Ninety-six (93.2%) trainees completed the survey, of which 56.3% (n = 54) reported a decrease in independently performed endoscopic procedures. Due to pandemic, 91.7% of standard diagnostic endoscopic procedures, 57.2% of standard therapeutic procedures, and 67.7% of advanced endoscopic procedures were decreased. Out of 96 respondents, we detected signs of anxiety in 88.5%, exposure concern in 92.7%, concerns for prolongation of training period in 49%, loss of concentration and interest in 47.9%, and burnout syndrome in 63.5%. Female gender (odds-ratio: 3.856, 95% confidence interval: 1.221-12.174, P = .021) was the only independently associated factor with pandemic-related anxiety. CONCLUSIONS: COVID-19 pandemic has led to high amounts of anxiety and non-negligible rates of burnout syndrome among GI trainees, with a significant reduction in endoscopic activities. More effort and novel strategies are required to deliver sufficient competence and general-psychological well-being to GI trainees.

COVID-19 , Endoscopy/statistics & numerical data , Fellowships and Scholarships , Gastroenterology/education , Pandemics , Adult , Education, Medical, Graduate , Female , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2 , Surveys and Questionnaires , Turkey/epidemiology
Sci Rep ; 11(1): 21725, 2021 11 05.
Article in English | MEDLINE | ID: mdl-34741071


SARS-CoV-2 enters the intestine by the spike protein binding to angiotensin-converting enzyme 2 (ACE2) receptors in enterocyte apical membranes, leading to diarrhea in some patients. Early treatment of COVID-19-associated diarrhea could relieve symptoms and limit viral spread within the gastrointestinal (GI) tract. Diosmectite, an aluminomagnesium silicate adsorbent clay with antidiarrheal effects, is recommended in some COVID-19 management protocols. In rotavirus models, diosmectite prevents pathogenic effects by binding the virus and its enterotoxin. We tested the trapping and anti-inflammatory properties of diosmectite in a SARS-CoV-2 model. Trapping effects were tested in Caco-2 cells using spike protein receptor-binding domain (RBD) and heat-inactivated SARS-CoV-2 preparations. Trapping was assessed by immunofluorescence, alone or in the presence of cells. The effect of diosmectite on nuclear factor kappa B (NF-kappaB) activation and CXCL10 secretion induced by the spike protein RBD and heat-inactivated SARS-CoV-2 were analyzed by Western blot and ELISA, respectively. Diosmectite bound the spike protein RBD and SARS-CoV-2 preparation, and inhibited interaction of the spike protein RBD with ACE2 receptors on the Caco-2 cell surface. Diosmectite exposure also inhibited NF-kappaB activation and CXCL10 secretion. These data provide direct evidence that diosmectite can bind SARS-CoV-2 components and inhibit downstream inflammation, supporting a mechanistic rationale for consideration of diosmectite as a management option for COVID-19-associated diarrhea.

COVID-19/drug therapy , Chemokine CXCL10/metabolism , NF-kappa B p50 Subunit/metabolism , SARS-CoV-2 , Silicates/chemistry , Adsorption , Aluminum Compounds/chemistry , Angiotensin-Converting Enzyme 2/metabolism , Anti-Inflammatory Agents , Binding Sites , Caco-2 Cells , Chromatography, Liquid , Clay , Diarrhea/etiology , Diarrhea/therapy , Enterocytes/metabolism , Gastroenterology , Humans , Magnesium Compounds/chemistry , Mass Spectrometry , Molecular Docking Simulation , Molecular Dynamics Simulation , Protein Binding/drug effects , Protein Domains , Rotavirus , Silicates/metabolism
Pediatr Clin North Am ; 68(6): 1147-1155, 2021 12.
Article in English | MEDLINE | ID: mdl-34736581


Social determinants of health (SDH) as outlined by Healthy People 2020 encompasses 5 key domains: economic, education, social and community context, health and health care, and neighborhood and built environment. This article emphasizes pediatric populations and some of the existing SDH and health care disparities seen in pediatric gastroenterology. We specifically review inflammatory bowel disease, endoscopy, bariatric surgery, and liver transplantation. We also examine the burgeoning role of telehealth that has become commonplace since the coronavirus disease 2019 era.

Child Welfare/statistics & numerical data , Gastroenterology/organization & administration , Health Equity/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Social Determinants of Health , Child , Health Services Accessibility/organization & administration , Health Status Disparities , Humans , Socioeconomic Factors , United States
Pediatr Clin North Am ; 68(6): 1157-1169, 2021 12.
Article in English | MEDLINE | ID: mdl-34736582


Pediatric gastroenterologists took on a variety of challenges during the coronavirus disease 2019 pandemic, including learning about a new disease and how to recognize and manage it, prevent its spread among their patients and health professions colleagues, and make decisions about managing patients with chronic gastrointestinal and liver problems in light of the threat. They adapted their practice to accommodate drastically decreased numbers of in-person visits, adopting telehealth technologies, and instituting new protocols to perform endoscopies safely. The workforce pipeline was also affected by the impact of the pandemic on trainee education, clinical experience, research, and job searches.

COVID-19/epidemiology , Child Welfare/statistics & numerical data , Gastroenterology/organization & administration , Health Equity/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Social Determinants of Health , Child , Health Services Accessibility/organization & administration , Health Status Disparities , Humans , Socioeconomic Factors , United States
World J Gastroenterol ; 27(37): 6191-6223, 2021 Oct 07.
Article in English | MEDLINE | ID: mdl-34712027


Artificial intelligence (AI) is an umbrella term used to describe a cluster of interrelated fields. Machine learning (ML) refers to a model that learns from past data to predict future data. Medicine and particularly gastroenterology and hepatology, are data-rich fields with extensive data repositories, and therefore fruitful ground for AI/ML-based software applications. In this study, we comprehensively review the current applications of AI/ML-based models in these fields and the opportunities that arise from their application. Specifically, we refer to the applications of AI/ML-based models in prevention, diagnosis, management, and prognosis of gastrointestinal bleeding, inflammatory bowel diseases, gastrointestinal premalignant and malignant lesions, other nonmalignant gastrointestinal lesions and diseases, hepatitis B and C infection, chronic liver diseases, hepatocellular carcinoma, cholangiocarcinoma, and primary sclerosing cholangitis. At the same time, we identify the major challenges that restrain the widespread use of these models in healthcare in an effort to explore ways to overcome them. Notably, we elaborate on the concerns regarding intrinsic biases, data protection, cybersecurity, intellectual property, liability, ethical challenges, and transparency. Even at a slower pace than anticipated, AI is infiltrating the healthcare industry. AI in healthcare will become a reality, and every physician will have to engage with it by necessity.

Gastroenterology , Liver Diseases , Artificial Intelligence , Humans , Machine Learning , Prognosis
Sci Rep ; 11(1): 20987, 2021 10 25.
Article in English | MEDLINE | ID: mdl-34697319


Acid suppressants are widely-used classes of medications linked to increased risks of aerodigestive infections. Prior studies of these medications as potentially reversible risk factors for COVID-19 have been conflicting. We aimed to determine the impact of chronic acid suppression use on COVID-19 infection risk while simultaneously evaluating the influence of social determinants of health to validate known and discover novel risk factors. We assessed the association of chronic acid suppression with incident COVID-19 in a 1:1 case-control study of 900 patients tested across three academic medical centers in California, USA. Medical comorbidities and history of chronic acid suppression use were manually extracted from health records by physicians following a pre-specified protocol. Socio-behavioral factors by geomapping publicly-available data to patient zip codes were incorporated. We identified no evidence to support an association between chronic acid suppression and COVID-19 (adjusted odds ratio 1.04, 95% CI 0.92-1.17, P = 0.515). However, several medical and social features were positive (Latinx ethnicity, BMI ≥ 30, dementia, public transportation use, month of the pandemic) and negative (female sex, concurrent solid tumor, alcohol use disorder) predictors of new infection. These findings demonstrate the value of integrating publicly-available databases with medical data to identify critical features of communicable diseases.

COVID-19/epidemiology , COVID-19/therapy , Gastroesophageal Reflux/complications , Social Determinants of Health , Aged , Behavior , COVID-19/psychology , California , Case-Control Studies , Computational Biology/methods , Databases, Factual , Female , Gastroenterology , Gastroesophageal Reflux/drug therapy , Geography , Histamine H2 Antagonists/pharmacology , Humans , Incidence , Male , Middle Aged , Odds Ratio , Proton Pump Inhibitors/pharmacology , Risk Factors , Social Class
La Paz; 2003. 89 p. tab, graf. (BO).
Thesis in Spanish | LIBOCS, LIBOSP | ID: biblio-1309436


Es bien conocido que la malnutrición energético-proteica (MEP) es una situación muy frecuente entre lospacientes hospitalizazdos, tanto médicos como quirúrgicos. Los pacientes con enfermedades gastrointestinales y hépaticas constituyen un colectivo en el que el déficit nutricional es especialmente frecuente, como consecuencia de que su enfermedad de base afecta a órganos involucrados en la incorporación y el metablismo de los nutrientes. La frecuencia de MEP en una sala de gastroenterologia de un hospital europeo de tercer nivel se ha cifrado en alrededor de 70 porciento de los enfermos, delos que mas de la mitad tiene algún grado de desnutrición...

Nutritional Sciences/education , Nutritional Sciences/physiology , Gastroenterology , Gastroenterology/organization & administration , Food Service, Hospital
La Paz; Instituto de Gastroenterología; 1976. 108 p. ilus.
Monography in Spanish | LIBOCS, LIBOSP | ID: biblio-1306739


Escribir sobre historia del Proyecto Gastroenterología en el marco de cooperación bilateral entre el Japón y Bolivia, es una tarea noble porque así se rinde homenaje a diplomáticos, estadistas, académicos, médicos, técnicos y administrativos, que durante muchos años vienen trabajando silenciosamente por la salud y el bienestar del pueblo boliviano. Por otra parte, el tema me resulta familiar por haber ejercido funciones diplomáticas en la embajada de Bolivia en el Japón y continuando mi carrera en el Ministerio de Relaciones Exteriores y Culto, posición privilegiada que desde principios de la década del setenta me ha permitido realizar un continuo seguimiento del Proyecto de Gastroenterología

Gastroenterology , Bolivia , Pilot Projects , Research Design
La Paz; IGBJ; 2004. 57 p. ilus, tab, graf.
Monography in Spanish | LIBOCS, LIBOSP | ID: biblio-1306880


Esta constancia del recuerdo institucional pretende reflejar los momentos y personas, asi como la proyección hacia adelante

Academies and Institutes , Gastroenterology , Memory , Bolivia
Cochabamba; s.n; nov. 2003. 70 p. ilus, tab, graf.
Thesis in Spanish | LIBOCS, LIBOSP | ID: biblio-1306965


Los objetivos de la presente investigacion son elaborar un protocolo de acogida de enfermeria para la aplicacion en la prestacion de servicios al cliente que solicita atencion de salud en el Instituto Gastroenterologico Boliviano Japones. Identificar la percepcion del cliente sobre la acogida que recibe en la atencion de salud. Identificar la reaccion emocional de los clientes que solicitan servicios durante la acogida. Identificar las acciones que se realizan para la acogida de los pacientes que solicitan servicios. Diseñar un protocolo de acogida de enfermeria para el cliente que es internado en el IGBJ y Construir una guia de informacion para el usuario y un patron de cuidados de enfermeria en la acogida para el personal de enfermeria, como instrumentos complementarios de las acciones de acogida en la recepcion de los clientes que ingresan al IGBJ

Patient Admission , Gastroenterology/standards , Patient Care Management/standards , Bolivia
Cochabamba; UMSS; 1997. assim p.
Monography in Spanish | LIBOCS, LIBOSP | ID: biblio-1307694
Cochabamba; s.n; 2006. 56 p. ^eEmpastado.
Thesis in Spanish | LIBOCS, LIBOSP | ID: biblio-1307919


Entamoeba Histolytica y Giardia Lamblia, son los parásitos intestinales más comunes en el mundo. En general se cree que estas enfermedades parasitarias son problemas simples desde el punto de vista diagnóstico y terapeútico, sin embargo el exceso de confianza, puede ocasionar situaciones en las cuales se planteen problemas diagnósticos y en las que a pesar de las múltiples opciones terapeúticas, se observe persistencia de la colonización parasitaria. Se realizó un estudio prospectivo, transversal, descriptivo, con 134 pacientes, 70 portadores de amebas y 64 portadores de giardias.

Gastroenterology , Parasites , Entamoeba histolytica , Giardia