O jejum prolongado, utilizado como preparação para a gastroscopia em equinos, não proporciona um completo esvaziamento gástrico. Para avaliar a eficácia da lavagem gástrica e de três procinéticos na preparação para o exame gastroscópico, foram utilizados seis equinos adultos, sem alterações clínicas, que passaram por quatro horas de jejum e quatro protocolos: G1- lavagem gástrica; G2- betanecol (0,04mg/kg VO); G3- metoclopramida (0,12mg/kg SC) e G4- lidocaína (1,3mg/kg IV). Após a lavagem ou administração de uma das medicações (duas horas após o betanecol ou uma hora após as demais) foi realizada a gastroscopia. As avaliações foram feitas por um profissional que conhecia o grupo experimental dos equinos (P1) e outro que desconhecia a informação (P2), sem diferença estatística entre suas avaliações. Em todos os exames foi observado conteúdo gástrico, com predominância de conteúdo líquido no G1 e de sólido a misto nos demais. Para o P1, a média de visualização da mucosa aglandular foi 95,0±0,0% no G1, 74,1±17,4% no G2, 88,3±4,0% no G3 e 90,0±6,3% no G4, com diferença estatística entre G1 e G2 e entre G2 e G4. Para a mucosa glandular, a média de visualização foi de 45,8±8,6% no G1, 29,1±10,6% no G2, 31,6±10,3% no G3 e 34,1±9,1% no G4, com diferença estatística entre G1 e G2. Na classificação geral, o melhor exame foi o do G1 e o pior o do G2. Conclui-se que a lavagem gástrica pode ser usada como preparação para o exame gastroscópico em equinos. De acordo com o protocolo testado, o betanecol é o menos indicado para esta finalidade. Embora sejam necessários mais estudos, o uso de procinéticos antes do exame gastroscópico em equinos mostra-se promissor, com resultados semelhantes aos observados com períodos de jejum mais prolongados. / Prolonged fasting in horses (12 - 24 hours), as a preparation for gastroscopy, does not permit complete gastric emptying. Six healthy adult horses were used to evaluate the efficacy of gastric lavage and the use of three prokinetics. Horses with held from feed for four hours were submitted to four protocols: G1 - gastric lavage; G2 - bethanechol (0,04mg/kg PO); G3 - metoclopramide (0,12mg/kg SC) and G4 - lidocaine (1,3mg/kg IV). Gastroscopy was performed: immediately (G1); two hours following admnistration (G2); one hour following administration (G3 and G4). To reduce bias gastric examination was conducted by two professionals: the first (P1), aware of the protocol and the second (P2) was kept blind. No significant difference was seen between them. Gastric content was predominantly liquid in G1 and solid or mixed in the other three groups. The average observation of the aglandular mucosa of P1 was: 95,0±0,0% for G1, 74,1±17,4% for G2, 88,3±4,0% for G3 and 90,0±6,3% for G4. Significant difference was observed between G1 and G2 and between G2 and G4. Observation of the glandular mucosa was: 45,8±8,6% for G1, 29,1±10,6% for G2, 31,6±10,3% for G3 and 34,1±9,1% for G4. Groups G1 and G2 were significantly different. Considering all classification criteria, G1 and G2 protocols permitted respectively the best and worst evaluations. It was concluded that gastric lavage is indicated for preparing horses for gastroscopy, the bethanechol protocol here tested is the least indicated. Although more studies are necessary, the use of prokinectics prior to gastroscopy in horses seems promising, producing results similar to those observed in long fasting periods.

O jejum prolongado, utilizado como preparação para a gastroscopia em equinos, não proporciona um completo esvaziamento gástrico. Para avaliar a eficácia da lavagem gástrica e de três procinéticos na preparação para o exame gastroscópico, foram utilizados seis equinos adultos, sem alterações clínicas, que passaram por quatro horas de jejum e quatro protocolos: G1- lavagem gástrica; G2- betanecol (0,04mg/kg VO); G3- metoclopramida (0,12mg/kg SC) e G4- lidocaína (1,3mg/kg IV). Após a lavagem ou administração de uma das medicações (duas horas após o betanecol ou uma hora após as demais) foi realizada a gastroscopia. As avaliações foram feitas por um profissional que conhecia o grupo experimental dos equinos (P1) e outro que desconhecia a informação (P2), sem diferença estatística entre suas avaliações. Em todos os exames foi observado conteúdo gástrico, com predominância de conteúdo líquido no G1 e de sólido a misto nos demais. Para o P1, a média de visualização da mucosa aglandular foi 95,0±0,0% no G1, 74,1±17,4% no G2, 88,3±4,0% no G3 e 90,0±6,3% no G4, com diferença estatística entre G1 e G2 e entre G2 e G4. Para a mucosa glandular, a média de visualização foi de 45,8±8,6% no G1, 29,1±10,6% no G2, 31,6±10,3% no G3 e 34,1±9,1% no G4, com diferença estatística entre G1 e G2. Na classificação geral, o melhor exame foi o do G1 e o pior o do G2. Conclui-se que a lavagem gástrica pode ser usada como preparação para o exame gastroscópico em equinos. De acordo com o protocolo testado, o betanecol é o menos indicado para esta finalidade. Embora sejam necessários mais estudos, o uso de procinéticos antes do exame gastroscópico em equinos mostra-se promissor, com resultados semelhantes aos observados com períodos de jejum mais prolongados. / Prolonged fasting in horses (12 - 24 hours), as a preparation for gastroscopy, does not permit complete gastric emptying. Six healthy adult horses were used to evaluate the efficacy of gastric lavage and the use of three prokinetics. Horses with held from feed for four hours were submitted to four protocols: G1 - gastric lavage; G2 - bethanechol (0,04mg/kg PO); G3 - metoclopramide (0,12mg/kg SC) and G4 - lidocaine (1,3mg/kg IV). Gastroscopy was performed: immediately (G1); two hours following admnistration (G2); one hour following administration (G3 and G4). To reduce bias gastric examination was conducted by two professionals: the first (P1), aware of the protocol and the second (P2) was kept blind. No significant difference was seen between them. Gastric content was predominantly liquid in G1 and solid or mixed in the other three groups. The average observation of the aglandular mucosa of P1 was: 95,0±0,0% for G1, 74,1±17,4% for G2, 88,3±4,0% for G3 and 90,0±6,3% for G4. Significant difference was observed between G1 and G2 and between G2 and G4. Observation of the glandular mucosa was: 45,8±8,6% for G1, 29,1±10,6% for G2, 31,6±10,3% for G3 and 34,1±9,1% for G4. Groups G1 and G2 were significantly different. Considering all classification criteria, G1 and G2 protocols permitted respectively the best and worst evaluations. It was concluded that gastric lavage is indicated for preparing horses for gastroscopy, the bethanechol protocol here tested is the least indicated. Although more studies are necessary, the use of prokinectics prior to gastroscopy in horses seems promising, producing results similar to those observed in long fasting periods.

This study tested the hypothesis that administration of deracoxib, a cyclooxygenase-2 specific (COX-2) inhibitor, would result in lower gastric lesion scores than administration of buffered aspirin and gastric lesion scores similar to placebo when administered to healthy dogs for 28 days. Twenty-four, healthy, random source dogs were divided into three groups. Group I received buffered aspirin, 23.6 mg/kg PO q 8h, group II received deracoxib, 1.6 mg/kg PO q 24h and placebo twice daily PO q 8h after deracoxib administration, and group III received placebo PO q 8h. Gastroscopy was performed on days -7, 6, 14, and 28 of treatment. Four regions of the stomach (pylorus, incisura, cardia, and body) were evaluated separately and lesions scored on a scale of 1 (mucosal hemorrhage) to 12 (perforating ulcer) by an observer unaware of which treatments the dogs received. Dogs were observed every 8 hours for vomiting, diarrhea and anorexia. Feces were scored from 1-5 (scores <4 were considered diarrhea). Lesion scores for each group, at each location, and total scores, at each time period, were evaluated for the effects of time and treatment using a Kruskal-Wallis test. Total dog days of vomiting and dog days of diarrhea in each group were compared using a Wilcoxon rank sums test. Significance was determined at p<0.05. Significantly higher median total gastric lesion scores were found in the aspirin group compared to the deracoxib or placebo groups on days 6, 14, and 28. There were no significant differences in median total gastric lesion scores between the deracoxib or placebo groups at any time during the study. There was no location effect on gastric lesion scores and there was no significant change in gastric lesion scores over time in any of the groups during treatment. Significantly more dog-days of vomiting occurred in the aspirin group as compared to the deracoxib group. No significant differences were found between groups for dog-days of diarrhea. In this study, the administration of deracoxib to healthy dogs resulted in significantly lower gastric lesion scores compared to dogs receiving aspirin and lesion scores similar to those receiving placebo. / Master of Science

Familial Amyloidosis with Polyneuropathy was first recognized in Portugal and reported by Andrade in 1952. The disease is rare, but clustering of the patients has been reported from Portugal, Japan and northern Sweden. The gastrointestinal involvement in the Swedish form of the disease was studied in this investigation. In a study of 52 patients on their first admission 47 displayed gastrointestinal symptoms in the form of severely altered bowel habits (intractable diarrhea and/or constipation). Steatorrhea was found in 30 out of 52 patients (58%) and an impaired d-xylose absorption in 26 out of 50 patients (52%). The steatorrhea was correlated to the degree of peripheral polyneuropathy as expressed by EMG-score. No relation could be established between steatorrhea or impaired d-xylose absorption with oral lactose and glucose tolerance tests indicating an intact entero- cyte function. A follow-up study comprising 21 patients demonstrated that all patients ultimately developed gastrointestinal symptoms and that the prevalence of diarrhea became higher with the duration of the disease. In this study steatorrhea became more frequent and was significantly related to the duration. Bile acid breath test, fecal fat determination and d-xylose tests were performed on 13 patients. Six patients with results indicating an increased bile acid deconjugation in the small bowel were treated with antibiotics for one week, after which the results had returned to normal in all. Four out of five patients with impaired d-xylose absorption before treatment also returned to normal after antibiotics. Three patients with diarrhea 3-7 times daily were considerably relieved after treatment both concerning general well-being and bowel movements. The results give strong evidence that bacterial overgrowth of the small intestine is important in causing gastrointestinal dysfunction in this disease. A histopathological study of the small intestinal mucosa on 27 patients showed that 84 percent were amyloid positive. The degree of amyloid infiltration did not correlate to the symptomatic state, steatorrhea or impaired d-xylose absorption. The surface ultrastructure was normal in all of 21 investigated cases. Radiographical and endoscopi cal studies were performed on 43 patients altogether. Evidence of gastric stasis was found in 7 out of 37 patients investigated by means of gastric x-ray and in 7 out of 28 patients at gastroscopy. No characteristic radiological appearance of the disease could be shown in the small intestine, the colon or the gall bladder. Nine patients who were operated on with the construction of an enterostomy were reported. The diversion of the fecal stream when the patients had diarrhea and were incontinent meant a considerable relief. / <p>S. 1-46: sammanfattning, s. 47-128: 6 uppsatser</p> / digitalisering@umu

published_or_final_version / Nursing Studies / Master / Master of Nursing

Für eine optimale Prävention und die Beurteilung verschiedener Krankheitsverläufe ist eine regelmäßige, ambulant durchgeführte Gastroskopie erforderlich. Diese wird am Universitätsklinikum Leipzig (UKL) als orale Gastroskopie angeboten. Dabei können die Patienten, sofern keine medizinische Kontraindikation besteht, gemäß der Leitlinie zwischen einer Untersuchung mit oder ohne Sedierung wählen. Eine weitere Wahlmöglichkeit für die Patienten, um eine Sedierung und die damit einhergehenden Risiken zu vermeiden, stellt das Angebot der nasalen Gastroskopie dar. Von September 2016 bis März 2017 führten wir die prospektive klinische Studie „Besteht die Notwendigkeit der Verfügbarkeit nasaler Gastroskopie in der Routinediagnostik“ in der interdisziplinären zentralen Endoskopie am UKL durch. Konkret hatte diese Studie das Ziel, Aufschluss über den möglichen Patientenwunsch einer Wahloption der nasalen Methode unter den ambulanten Patienten des UKLs zu geben. Darüber hinaus sollte mit der Studie ermittelt werden, welche Gründe die Patienten für ihre Entscheidung angeben, ob bereits Vorerfahrungen bestehen, wie sich ggf. bestehende Vorerfahrungen auf die Entscheidung auswirken und ob die dann durchgeführte Untersuchung die Präferenz für eine zukünftige Untersuchung verändern würde. Die nasale Gastroskopie hat sich in der durchgeführten Untersuchung als eine sichere und von Patienten gut tolerierte Alternative zur oralen Gastroskopie herausgestellt. Mit der Möglichkeit der Verminderung sedierungsassoziierter Risiken, der Senkung der anfallenden Kosten sowie der Ermöglichung einer gastroskopischen Untersuchung bei Patienten, bei denen die Durchführung der oralen Gastroskopie nicht möglich ist, könnte die nasale Gastroskopie einen großen Gewinn für die Endoskopie darstellen.:Inhaltsverzeichnis I Abkürzungsverzeichnis 1 Bibliographische Beschreibung . 2 Einleitung 2.1 Hintergrund 2.2 Historische Entwicklung und Erscheinungsformen der Gastroskopie 2.2.1 Orale Gastroskopie 2.2.2 Nasale Gastroskopie 2.2.3 Sedierung während der Gastroskopie 2.2.4 Aktuelle Studienlage 2.3 Fragestellung der Studie 3 Publikation 4 Zusammenfassung der Arbeit 5 Literaturverzeichnis 6 Anlage 1 – Fragebogen an die Patienten und Patientinnen 7 Anlage 2 – Fragebogen an die behandelnden Ärzte II Darstellung des eigenen Beitrags III Erklärung über die Eigenständigkeit der Arbeit IV Verzeichnis der wissenschaftlichen Veröffentlichungen und Vorträge

Darbo tikslas. Įvertinti endoskopinio tyrimo reikšmę neužkrečiamųjų ligų diagnostikai arkliams. Darbo uždaviniai. Susipažinti su užsienio autorių publikuojama literatūra, apie endoskopinių tyrimų pritaikymą veterinarinėje medicinoje; įvertinti, kokiems tikslams naudojami endoskopijos metodai; įvertinti, kuris endoskopinis tyrimas dažniausiai atliekamas; įvertinti, kokios patologijos dažniausiai aptinkamos; nustatyti, pagal kokius simptomus atliekamas endoskopinis tyrimas. Tyrimo metodika. Tyrimas buvo atliekamas 2011 – 2013 metais magistrantūros studijų metais LSMU VA Stambiųjų gyvūnų klinikose. Tyrimo metu buvo atliekami endoskopiniai tyrimai: gastroskopija, bronchoskopija, laringoskopija. Tyrimo įranga – videoendoskopo sistema VIDEO MED. Iš viso konsultuoti 169 pacientai, iš jų 35 pacientams buvo atliktas endoskopinis tyrimas. Tyrimas buvo atliekamas remiantis klinikiniais simptomais. Rezultatai. Endoskopiniu tyrimu tirti 35 pacientai, kuriems pasireiškė būdingi klinikiniai simptomai. Gastroskopija buvo atlikta 17 pacientų (49 proc.), bronchoskopija atlikta 12 arklių (34proc.), o laringoskopija – 6 arkliams (17 proc.). Tyrimo metu nustatytos šios patologijos: EGUS, LOPL, gerklų paralyžius. Arklių skrandžio opų sindromas buvo nustatytas visiems 17 pacientų, kuriems buvo atliekama gastroskopija, tai sudaro 100 proc. LOPL nustatyta 10 pacientų iš 18, kuriems buvo atliekamas kvėpavimo takų endoskopinis tyrimas, tai sudaro 56 proc. Gerklų paralyžius buvo nustatytas visiems 6... [toliau žr. visą tekstą] / Objectives of the research paper. To get acquainted with material, about the appliance of endoscopic diagnosis in veterinary medicine, published by foreign authors; to study what these are the aims to use endoscopy methods; to discover the most highly endoscopic diagnosis used; to research what most common cases of pathology are diagnosed; to identify which symptoms are clues to determine an endoscopic diagnosis. Methodology. The research was carried out in 2011 – 2013, during the years of obtaining Master’s Degree in Heavy Animals clinics at LHSU VA. The following diagnoses of endoscopy were made in the course of the research: gastroscopy, bronchoscopy, laryngoscopy. The research equipment used was a video endoscopy system VIDEO MED. In total 169 patients were consulted and 35 out of the total were examined using endoscopy. The study was carried out on the basis of clinical symptoms. Results. 35 patients with clinical symptoms were examined using the method of endoscopy. Gastroscopy was carried out on 17 patients which make 49 per cent, bronchoscopy – 12 horses ( 34 per cent), laryngoscopy – 6 horses (17 per cent). During the research, the following cases of pathology were diagnosed: EGUS, COPD, laryngeal paralysis. Gastric ulcer syndrome in horses was diagnosed in all 17 patients (100 per cent), which underwent the medical examination. COPD was diagnosed in 10 patients out of 18 examined by the method of endoscopy, which makes 56 per cent. Laryngeal paralysis was... [to full text]

Although it is not a new method endoscopy has undergone incredible development in recent years. The examination is however very unpleasant for a patient, which is why health care staff should be well trained, particularly for child patients. The aim of the thesis was to map the specifics of nursing care for children undergoing endoscopic examination of the gastrointestinal tract. We approached the whole issue from the point of view of caring staff ? nurses. In the theoretical part we first described the gastrointestinal tract anatomy, endoscopy development and types of endoscopic examination. Then we dealt with the role of a nurse in the care for child patients undergoing these examinations. We formed three goals for the research. Goal 1: To find out how nurses prepare child patients for the individual endoscopic examinations. Goal 2: To verify whether nurses caring about a child patient undergoing gastrointestinal tract endoscopy are specifically trained. Goal 3 served as the output of the work: To elaborate recommendation for nurses preparing child patients for the individual endoscopic examinations. We chose quantitative research for collection of the necessary information. A questionnaire designed for nurses caring for child patients was the data collection technique. The questionnaire was anonymous, distributed at paediatric clinics of faculty hospitals of Moravian region. 104 questionnaires suitable for processing returned from 140 issued. The research has shown that nurses working at the clinics where the research was performed master the correct nursing care for child patients undergoing endoscopic examination of the gastrointestinal tract. Nevertheless the fact that most information is gained upon practical experience, with low emphasis on initial and repeated training of nurses also results from the research. A recommendation was elaborated upon the gathered information in the form of a standard nursing procedure proposal.

No description available.

Os desfechos clínicos e oncológicos dos pacientes submetidos à ressecção endoscópica do câncer gástrico precoce (CGP), considerando os critérios de indicação, comparados à cirurgia, não foram relatados em revisões sistemáticas. A pesquisa foi desenvolvida para estabelecer os desfechos de curto e longo prazos da ressecção endoscópica comparada à cirurgia no tratamento do CGP, elevando as informações para o nível de evidência 2a, melhor respaldando a prática clínica. A revisão sistemática com metanálises foi procedida utilizando-se as bases Medline, Embase, Cochrane, LILACS, Scopus e CINAHL. Onze coortes retrospectivas foram selecionadas para análise qualitativa e quantitativa. Todos os estudos incluem pacientes com CGP e comparam os desfechos nos dois braços. Os dados envolveram 2654 pacientes que preenchiam os critérios absolutos ou expandidos para ressecção endoscópica. Diferentes modalidades de tratamento endoscópico foram avaliadas, principalmente os procedimentos de ressecção, como endoscopic mucosal resection (EMR) e endoscopic submucosal dissection (ESD). As informações basearam-se nas características dos participantes, critérios de inclusão e exclusão, tipos de intervenções e desfechos (diferentes taxas de sobrevida, eventos adversos, ressecção completa, recorrência e mortalidade). As análises dos riscos absolutos dos desfechos foram feitas com o software RevMan, computando-se as diferenças de risco (DR) das variáveis dicotômicas. Dados de DR e intervalo de confiança de 95% (IC) foram calculados utilizando-se o teste de Mantel-Haenszel e a inconsistência foi qualificada e reportada em ?2 e método Higgins (I2). A análise de sensibilidade foi feita quando a heterogeneidade era maior que 50%. Todas as análises basearam-se inicialmente no modelo de efeito fixo. Dados de sobrevida de 3 anos estavam disponíveis em seis estudos (n = 1197). Não houve DR após os dois tratamentos (DR = 0,01, IC 95% = -0,02 a 0,05). A sobrevida de 5 anos (n = 2310) não demonstrou diferença significativa entre os grupos analisados (DR = 0,01, IC 95% = -0,01 a 0,03). A avaliação de 551 pacientes não evidenciou desigualdade na sobrevida de 10 anos entre as diferentes abordagens (DR = -0,02, IC 95% = -0,15 a 0,10). Dados de complicação estavam presentes em oito estudos (n = 2439), e diferença significativa foi detectada (DR = -0,08, IC 95% = -0,10 a -0,05), demonstrando melhores resultados com a endoscopia. As taxas de ressecção completa foram analisadas em 536 pacientes. Evidenciou-se diferença significativa entre o tratamento endoscópico e cirúrgico (DR = -0,13, IC 95% = -0,17 a -0,09), validando melhores resultados no último grupo. A recorrência foi avaliada em cinco pesquisas (n = 1331) e não houve diferença entre as duas formas de terapêutica (DR = 0,01, IC 95% = -0,00 a 0,02). As taxas de mortalidade foram obtidas de quatro estudos (n = 1107), e não se evidenciou diferença entre os grupos envolvidos (DR = -0,01, IC 95% = -0,02 a 0,00). Conclui-se que as taxas de sobrevida de 3, 5 e 10 anos, recorrência e mortalidade são semelhantes em ambos os grupos. Considerando-se as taxas de complicação, a abordagem endoscópica confere resultados mais apropriados e, analisando-se as taxas de ressecção completa, ela é inferior à cirurgia / Clinical and oncological outcomes of endoscopic resection of early gastric cancer (EGC), considering the indication criteria, compared to surgery, have not been reported in systematic reviews. To address the short- and long-term outcomes of endoscopic resection compared to surgery in the treatment of EGC, a systematic review was performed, establishing the available data to an unpublished 2a strength of evidence, better handling clinical practice. A systematic review and meta-analysis using Medline, Embase, Cochrane, LILACS, Scopus and CINAHL databases were done. Eleven retrospective cohort studies were selected to quantitative and qualitative synthesis. All studies included patients diagnosed with EGC that compared outcomes considering endoscopic treatment and surgery. The included records involved 2654 patients with EGC that filled the standard or expanded indications for endoscopic resection. Different endoscopic treatment modalities were analyzed, mainly mucosal resection procedures such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), compared to surgery. Information of the selected studies was extracted on characteristics of trial participants, inclusion and exclusion criteria, types of interventions and outcomes (different survival rates, adverse events, complete resection, recurrence and mortality rates). The analysis of the absolute risks of the outcomes was performed using the software RevMan, by computing risk differences (RD) of dichotomous variables. Data on RD and 95% confidence interval (CI) for each outcome were calculated using the Mantel-Haenszel test and inconsistency was qualified and reported in X2 and the Higgins method (I2). Sensitivity analysis was performed when heterogeneity was higher than 50%. All pooled analyses were initially based on fixed-effects model. Three-year survival data were available for six studies (n = 1197). There were no RD in 3-year survival data after endoscopic and surgical treatment of EGC (RD = 0.01, 95% CI = -0.02 to 0.05). Five-year survival data (n = 2310) showed no evidence of a difference between the two groups (RD = 0.01, 95% CI = -0.01 to 0.03). The data analysis, in 551 patients, showed no difference in 10-year survival rates between the approaches (RD = -0.02 and 95% CI = -0.15 to 0.10). Complication data were identified in eight studies (n = 2439). A significant difference was detected (RD = -0.08, 95% CI = -0.10 to -0.05), demonstrating better results with endoscopic approach. Complete resection data was analyzed in 536 patients. It showed significant difference in complete resection rates between endoscopic and surgical treatment of EGC (RD = -0.13, 95% CI = -0.17 to -0.09), exhibiting improved results in the surgical group. Recurrence data were analyzed in five studies (n = 1331) and there was no difference between the approaches (RD = 0.01, 95% CI = -0.00 to 0.02). Mortality data were obtained in four studies (n = 1107), and there was no difference between treatment modalities (RD = -0.01, 95% CI = -0.02 to 0.00). This systematic review concludes that 3-, 5- and 10-year survival, recurrence and mortality rates are similar for both groups. Considering procedure-related complication rates, endoscopic approach achieves significantly better results and, analyzing complete resection data, it is considered worse than surgery