Factors related to the development of cat scratch colon during colonoscopy.

Cat scratch colon (CSC) is an entity characterized by bright red linear tears which appear in the colonic mucosa during colonoscopy. Although they do not generally have clinical implications, cases of secondary pneumoperitoneum have been reported. To date, the prevalence, associated diseases, and factors that determine the appearance of CSC have not been adequately determined. We report a series of 20 cases of CSC found in 10715 consecutive colonoscopies. Demographic data, indication for the colonoscopy, endoscopy findings, and complications related to the procedure were recorded. Older age and male sex were significantly associated with CSC. In 15 of the 20 cases the CSC was related to diversion colitis, and 5 cases appeared in patients with collagenous colitis. In patients with diversion colitis, the longer the time elapsed since surgery, the greater the risk of these lesions occurring. None of the patients with CSC had complications related to the colonoscopy.

Occupational risk prevention in endoscopy units: a pending issue.

UNLABELLED: The degree of Knower and compliance with occupational risk prevention measures in the Spanish gastrointestinal endoscopy units is unknown. AIM: 1. To assess compliance with occupational risk prevention measures in GIE units. 2. To determine which factors influence the fulfillment of occupational risk prevention measures. METHODS: a validated survey was supplied to 300 GIE units, including questions on: 1. General occupational risk prevention measures; 2. occupational risk prevention measures during disinfection; 3. occupational risk prevention measures during examination. The following Hospital or GIE Unit characteristics were evaluated: Type of hospital according to the Spanish National Health Service; Number of hospital beds; Advanced diagnostic and therapeutic procedures performed and; Centers providing training in the field of endoscopy. RESULTS: response: 196 GIE units (65%). 104 GIE units (53% CI95%: 46-60) fulfill less than 50% of the occupational risk prevention measures studied.The RR of less than 50% of the ORP measures being fulfilled is 1.975 times higher at public hospitals than at private facilities (CI95%: 1.11-3.52). None of the remaining factors analyzed proved to have a significant influence. CONCLUSIONS: compliance with occupational risk prevention measures in Spanish GIE units is inadequate and must be improved. Public hospitals in Spain comply with fewer occupational risk prevention measures than their private counterparts.

Prevención de riesgos laborales en unidades de endoscopia. Una asignatura pendiente / No disponible

En la actualidad desconocemos el grado de conocimiento y aplicación de medidas de prevención de riesgos laborales en las Unidades de Endoscopia Españolas. Objetivo: valorar la aplicación de la prevención de riesgos laborales en las unidades de endoscopia y establecer los factores que determinan su cumplimiento. Diseño: se pasó un cuestionario validado a 300 unidades de endoscopia. Se incluían preguntas sobre: Medidas generales de pre - vención de riesgos laborales, medidas de prevención durante la desinfección y medidas de prevención durante las exploraciones. Se valoraron el tipo de hospital en función de su adscripción al sistema público de salud, el tamaño de los hospitales según el número de camas, la realización o no de técnicas avanzadas y la realización de docencia de endoscopia o no. Se estimó el porcentaje de cumplimiento de cada medida con un intervalo de confianza del 95% y se realizó una regresión logística para determinar los factores que determinan su cumplimiento. Resultados: respondieron 196 unidades (65%). 104 (53% CI95%: 46-60) cumplían menos del 50% de las medidas de PRL estudiadas. Los Hospitales Españoles de titularidad pública tienen un RR 1,975 veces mayor (IC95%: 1.11-3.52) de aplicar menos del 50% de las medidas de PRL frente a los privados. El resto de los factores estudiados no mostraron influencia significativa. Conclusiones: la aplicación de medidas de prevención de riesgos laborales en las unidades de endoscopia españolas no es adecuada y debe ser mejorada. Los hospitales públicos cumplen con menor número de medidas que los privados(AU)

The degree of Knower and compliance with occupational risk prevention measures in the Spanish gastrointestinal endoscopy units is unknown. Aim: 1. To assess compliance with occupational risk prevention measures in GIE units. 2. To determine which factors influence the fulfillment of occupational risk prevention measures. Methods: a validated survey was supplied to 300 GIE units, including questions on: 1. General occupational risk prevention measures; 2. occupational risk prevention measures during disinfection; 3. occupational risk prevention measures during examination. The following Hospital or GIE Unit characteristics were evaluated: Type of hospital according to the Spanish National Health Service; Number of hospital beds; Advanced diagnostic and therapeutic procedures performed and; Centers providing training in the field of endoscopy. Results: response: 196 GIE units (65%). 104 GIE units (53% CI95%: 46-60) fulfill less than 50% of the occupational risk prevention measures studied. The RR of less than 50% of the ORP measures being fulfilled is 1.975 times higher at public hospitals than at private facilities (CI95%: 1.11-3.52). None of the remaining factors analyzed proved to have a significant influence. Conclusions: compliance with occupational risk prevention measures in Spanish GIE units is inadequate and must be improved. Public hospitals in Spain comply with fewer occupational risk prevention measures than their private counterparts(AU)

Normal values in ambulatory oesophageal pH monitoring at two levels in Spain.

AIM: Upper oesophageal pH monitoring may play a significant role in the study of extra-oesophageal GERD, but limited normal data are available to date. Our aim was to develop a large series of normal values of proximal oesophageal acidification. METHODS: 155 healthy volunteers (74 male) participated in a multi-centre national study including oesophageal manometry and 24 hours oesophageal pH monitoring using two electrodes individually located 5 cm above the LOS and 3 cm below the UOS. RESULTS: 130 participants with normal manometry completed all the study. Twelve of them were excluded for inadequate pH tests. Twenty-seven subjects had abnormal conventional pH. The remaining 91 subjects (37 M; 18-72 yrs age range) formed the reference group for normality. At the level of the upper oesophagus, the 95th percentile of the total number of reflux events was 30, after eliminating the meal periods 22, and after eliminating also the pseudo-reflux events 18. Duration of the longest episodes was 5, 4 and 4 min, respectively (3.5 min in upright and 0.5 min in supine). The upper limit for the percentage of acid exposure time was 1.35, 1.05 and 0.95%, respectively. No reflux events were recorded in the upper oesophagus in 8 cases. CONCLUSION: This is the largest series of normal values of proximal oesophageal reflux that confirm the existence of acid reflux at that level in healthy subjects, in small quantity and unrelated to age or gender. Our data support the convenience of excluding pseudo-reflux events and meal periods from analysis.

Colon en arañazo de gato. Una entidad poco conocida / No disponible

No disponible

Factors that impact health-related quality of life in adults with celiac disease: a multicenter study.

AIM: To evaluate the factors involved in the impairment of health-related quality of life (HRQOL) in patients with celiac disease. METHODS: A multicenter, cross-sectional prospective study was performed in patients with celiac disease who completed two HRQOL questionnaires: the gastrointestinal quality of life index (GIQLI) and the EuroQol-5D (EQ). RESULTS: Three hundred and forty patients (163 controlled with a gluten-free diet, and 177 newly diagnosed with a normal diet) were included. The GIQLI score was significantly better in patients on a gluten-free diet (GFD) than in non-treated patients on their usual diet, both in terms of the overall score (3.3 vs 2.7, respectively; P < 0.001), as well as on the individual questionnaire dimensions. Both the preference value of the EQ as the visual analogue scale were significantly better in treated than in non-treated patients (0.93 vs 0.72 P < 0.001 and 80 vs 70 P < 0.001, respectively). Variables significantly associated with a worse HRQOL score were female gender, failure to adhere to a GFD, and symptomatic status. CONCLUSION: In untreated celiac disease, the most important factors that influence patient perception of health are the presence of symptoms and a normal diet. HRQOL improves to levels similar to those described in the general population in celiac disease patients well controlled with a GFD.

[Internet use to obtain health information among patients attending a digestive diseases office]. / Uso médico de Internet entre los pacientes de una consulta general de enfermedades del aparato digestivo.

INTRODUCTION: The use of the Internet to gain health information has increased in Spain. This is changing the way patients access medical information and, in turn, the physician-patient relationship. OBJECTIVES: To analyze the use of the Internet for medical purposes by patients attending a digestive diseases office and to determine the profile of patients seeking this information. MATERIAL AND METHODS: A questionnaire was administered to consecutive patients attending a general digestive diseases office for the first time. RESULTS: Four hundred twenty-three patients completed the questionnaire (56% women, 44% men, mean age 42.63 [15.994] years). A total of 2.4% had only not completed basic education, 14% had completed basic education, 32.8% had completed high school, 50.6% had university degrees, and 0.2% did not answer. More than three-quarters (76.4%) had a computer at home and 72% had internet access. Forty-two percent looked for health information on the internet. Seventeen percent had searched for specific information on their illnesses before consulting and 66% believed the internet is a good resource for obtaining medical information. Seventy percent would be interested in a specific web page on digestive disease topics and 75% would use e-mail to consult with their physicians. The group that most frequently looked for medical information consisted of patients aged 45 years or younger with secondary school or university education. CONCLUSIONS: In our environment, patients with digestive diseases routinely use the Internet to search for medical information. These patients have a high degree of confidence in the information obtained and would be interested in a specific website devoted to diseases of the digestive system. The patients that most frequently searched for health information were aged less than 45 years old and had secondary school education or university degrees.

Uso médico de Internet entre los pacientes de una consulta general de enfermedades del aparato digestivo / Internet use to obtain health information among patients attending a digestive diseases office

No disponible

Hematoma disecante de esófago: una rara complicación de la hemodiálisis / Dissecting hematoma of the esophagus: a rare complication of hemodialysis

No disponible

Reliability of the Spanish version of a brief questionnaire on patient satisfaction with gastrointestinal endoscopy.

BACKGROUND: There has not been a validated questionnaire available in Spanish to evaluate patient satisfaction with gastrointestinal endoscopy. Our aim was to evaluate the external validity and internal consistency of the Spanish version of a questionnaire on patient satisfaction with gastrointestinal endoscopy elaborated by the American Society for Gastrointestinal Endoscopy. DESIGN: Prospective questionnaire validation study. PATIENTS AND METHODS: A total of 485 consecutive patients referred to two different hospitals for endoscopy were interviewed by telephone. Internal consistency was studied using Cronbach's alfa test and corrected item-total correlations (CITC). External validity was determined using a mailed questionnaire completed by 185 patients-correlations between telephone and postal responses were calculated, as well as the correlation with the total score obtained. RESULTS: Cronbach's alfa was 0.82 and mean CITC was 0.59. Weighted kappa values for the same questionnaire items performed by telephone or mail varied between 0.51 and 0.81. Total score correlation was 0.78. Internal consistency and external validity were not affected by differences in the administration of the questionnaire (mail or by telephone), different interviewers, type of endoscopy, or source of patients. CONCLUSIONS: The Spanish version of the ASGE questionnaire on satisfaction with endoscopy is valid, reliable, and reproducible.