Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Endoscopy ; 41(11): 979-87, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19866396

RESUMO

BACKGROUND: Endoscopic ultrasonography (EUS) has evolved over the past 20 years with the emergence of novel diagnostic and therapeutic indications. Our goal was to identify the best evidence supporting the use of EUS. MATERIALS AND METHODS: A six-step approach was employed to develop recommendations using accepted methodology. Twenty-two experienced endosonographers identified topics and reviewed studies using MeSH (medical subject headings) terminology and free text in PubMed. Medline and society abstracts were reviewed if necessary. The quality of evidence, the strength of recommendations, and level of consensus were graded and voted on. RESULTS: Consensus was reached for several clinical scenarios for which the impact of EUS findings was supported by a high level of evidence. These included diagnosis and staging of esophageal cancer, differential diagnosis of subepithelial lesions, thickened gastric folds, assessment of peritoneal involvement in patients with gastric cancer, mucosa-associated lymphoid tissue lymphoma, diagnosis of common bile duct/gallbladder stones, diagnosis of chronic pancreatitis, differential diagnosis of a solid mass in patients with chronic pancreatitis, differential diagnosis of pancreatic cyst, rectal cancer staging, and diagnosis and staging of non-small-cell lung cancer. The recommendations were adopted by the Brazilian Society of Gastrointestinal Endoscopy. Several indications continue to emerge and require additional validation.


Assuntos
Conferências de Consenso como Assunto , Endossonografia , Medicina Baseada em Evidências , Humanos
3.
Arq Gastroenterol ; 38(3): 168-71, 2001.
Artigo em Português | MEDLINE | ID: mdl-11924600

RESUMO

BACKGROUND: Colorectal cancer is an important cause of death in western countries. Screening methods are based on flexible sigmoidoscopy, a cheap, effective, and less painful procedure, but some important lesions on the right colon can be missed. AIM: Evaluate how many important lesions would be missed if colonoscopy indicated only for patients with distal lesions identified during flexible sigmoidoscopy. MATERIAL AND METHODS: All consecutive colonoscopy performed in the Endoscopy Unit of the Gastroenterology Division of Federal University of São Paulo, SP, Brazil, with polyps and cancer suspicious lesions were reviewed. Patients with a second procedure, inflammatory bowel disease or colonic surgery were excluded. RESULTS: We reviewed 101 patients with 38 possible cancer lesions and 70 polyps. The mean age was 62 years (SD 13.7 years) and 45 were male. Forty five lesions were in the right colon, namely 23 adenomas, 10 adenocarcinomas, 1 lymphoma and 11 benign lesion. Among such lesions, 28 were isolated in the right colon (16 adenomas and 7 adenocarcinomas). CONCLUSION: In our study 23 patients (22.77%) had adenomas or adenocarcinomas isolated in the right colon, that would be missed if flexible sigmoidoscopy was used alone.


Assuntos
Neoplasias do Colo/patologia , Colonoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias do Colo Sigmoide/patologia , Sigmoidoscopia
4.
Arq Gastroenterol ; 36(3): 148-53, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10751902

RESUMO

With increased use of percutaneous endoscopic gastrostomy, it became clear that neurologically impaired patients might benefit from its use. From August 1996 to July 1997, we performed 19 percutaneous endoscopic gastrostomies in patients with neurological sequelae, who were incapable to maintain their nutritional status by oral ingestion or had repeated episodes of aspiration. Sixteen patients were followed prospectively, from 30 days to 11 months (median: 6.4 months). Average weight (38.2 kg to 44.8 kg), BMI (14.8 kg/m2 to 17.8 kg/m2), weight/height ratio (23.5 kg/cm to 28 kg/cm), mid-upper arm circumference (19.4 cm to 21.6 cm) and triceps skinfold thickness (10.3 mm to 12.6 mm) were significantly increased (P < 0.01). Before percutaneous endoscopic gastrostomy, there were 10 (10/16, 62.5%) patients with grade III thinness. In this group, 3/10 patients (30%) showed improvement to grade I (two individuals) and II (one patient). All but five patients (68.75%) were below the fifth percentile of normal distribution for mid-upper arm circumference. One patient (6.2%) showed improvement of her status (between 25th and 50th percentiles). Four patients (25%) started the follow-up below the fifth percentile for normal distribution of triceps skinfold thickness, and showed no improvement. There were no early complications secondary the procedure. Late complications included granulation tissue on ostomy site (18.8%) and ostomy infection (6.2%). Statistical analysis showed significant improvement of anthropometric data. Percutaneous endoscopic gastrostomy is a simple, highly successful and safe procedure, when performed in neurologically impaired patients. It is efficient as a long-term enteral feeding method.


Assuntos
Doenças do Sistema Nervoso Central/complicações , Nutrição Enteral/métodos , Gastrostomia , Distúrbios Nutricionais/terapia , Estado Nutricional , Adolescente , Adulto , Idoso , Antropometria , Humanos , Pessoa de Meia-Idade , Distúrbios Nutricionais/etiologia , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...