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Original articles
Impact of reimbursement policy in Belgium on the referral pattern and diagnostic yield of capsule endoscopy. A single-centre studyPrice: €10,00 |
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Introduction : Since the first of July 2008, capsule endoscopy
(CE) is partially reimbursed for patients with obscure gastro -
intestinal bleeding (OGIB).
Objective : To evaluate the impact of reimbursement of CE on
the referral pattern and the diagnostic yield of CE.
Methods : We retrospectively selected data from patients who
underwent a CE in the University Hospital of Ghent between July
2002 and June 2009. Following data were analysed : number of
CEs, indication, number of transfusion-dependent patients,
haemoglobin level and relevance of the CE findings.
Results : There was an increase in the number of patients
referred for CE after the first of July 2008. Simultaneously, the
number of relevant findings was decreasing. Between July 2002
and June 2003, 66.7% of the capsule endoscopies showed relevant
bowel lesions. Over the last 2 years, the diagnostic yield has been
decreasing to 40.5% in the period July 2007-June 2008 and only
30.2% in the period July 2008-June 2009. Transfusion need and
haemoglobin level at the moment of CE had a significant influence
on the diagnostic yield (P [Product Details...] |
Lessons from a 20 year experience of Home Parenteral Nutrition in adult patientsPrice: €10,00 |
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Background : Home Parenteral Nutrition (HPN) is a method
commonly used in patients with Chronic Intestinal Failure (CII)
related to benign or malignant diseases. We report the experience
from a 20 year programme of HPN in a single academic centre.
Methods : In this study, we have reviewed characteristics and
outcome of a group of patients enrolled in a HPN program between
1987 and 2007. Focus was given to the prevalence and severity of
cholestasis in these patients as well as on their oral food behaviour.
Results : In 20 years, 125 patients were included in a HPN programme
; 65 patients had benign diseases (BD) and 60 advanced
cancer (AC). Short bowel was the most common indications in
patients with BD. Almost 40% of patients with BD were weaned off
HPN. Median survival was excellent in BD patients and extremely
short in AC. Death related to HPN was very rare. Cholestasis has
been observed in 84% of patients but it was mild to moderate in the
majority of cases. Hyperphagia was observed in 50% of the
patients with BD on long-term HPN.
Conclusions : This study confirms that HPN is the first line
therapy in CII due to BD. Patients with AC should be carefully
selected. Cholestasis is frequent but mostly without clinical impact.
Half of the patients with CII due to BD become hyperphagic
allowing to reduction of parenteral intake. The role of a multi -
disciplinary nutrition support team is essential for optimizing
HPN. (Acta gastro enterol. belg., 2010, 73, 451-456). [Product Details...] |
Prospective randomized study comparing double layer and Tannenbaum stents in distal malignant biliary stenosisPrice: €10,00 |
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Aim : Do patients with hyperplastic polyps (HP) have an
increased risk for developing adenomas and colorectal cancer
(CRC) ? A study was done to detect the number of patients
developing adenomas and CRC.
Material and methods : From 1990-1995 all patients with a HP
diagnosed via endoscopy and significant follow-up were studied.
The patients were separated in three groups ; Group 1 HP in
patients with previous adenoma and/or CRC. Group 2 HP with a
concurrent adenoma and/or CRC. Group 3 patients with only HP.
Results : Group 1 consisted of 20 patients, group 2 of 39 patients,
and group 3 of 136 patients The follow-up was 12.5, 12.6, and
13.4 years respectively. In group 1 there was one patient with an
adenoma in the index investigation. In group 2 adenomas were seen
coinciding to hyperplastic polyp(s) in 29 patients, while in 11 cases
there was a colorectal cancer. Obviously patients in group 3 only
had hyperplastic polyps. In group 1 7 patients previously had an
adenoma and 12 previously had colorectal cancer. Four patients in
group 3 developed cancer : 13, 14, 15, and 15 years after the detection
of a hyperplastic polyp. In group 2 only one patient developed
cancer in the cecum 9 years after the index investigation. In the
four patients of group 3 who developed cancer no one previously
had a serrated adenoma at revision of the original histology.
Twelve patients developed an adenoma.
Conclusion : Only five CRC’s developed in patients with HP.
Thus, at the best the risk for developing CRC in patients with HP
is not very high and equals that of adenomas. (Acta gastro enterol.
belg., 2010, 73, 441-444). [Product Details...] |
What is the consequence of hyperplastic polyps ? Do adenomas and colorectal cancer develop in these patients ? A clinical studyPrice: €10,00 |
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Introduction : Since the first of July 2008, capsule endoscopy
(CE) is partially reimbursed for patients with obscure gastro -
intestinal bleeding (OGIB).
Objective : To evaluate the impact of reimbursement of CE on
the referral pattern and the diagnostic yield of CE.
Methods : We retrospectively selected data from patients who
underwent a CE in the University Hospital of Ghent between July
2002 and June 2009. Following data were analysed : number of
CEs, indication, number of transfusion-dependent patients,
haemoglobin level and relevance of the CE findings.
Results : There was an increase in the number of patients
referred for CE after the first of July 2008. Simultaneously, the
number of relevant findings was decreasing. Between July 2002
and June 2003, 66.7% of the capsule endoscopies showed relevant
bowel lesions. Over the last 2 years, the diagnostic yield has been
decreasing to 40.5% in the period July 2007-June 2008 and only
30.2% in the period July 2008-June 2009. Transfusion need and
haemoglobin level at the moment of CE had a significant influence
on the diagnostic yield (P [Product Details...] |
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Acta Gastro-Enterologica Belgica is indexed in NCBI/PubMed.
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica