Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn's disease of the small bowel, occult gastrointestinal bleeding...Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn's disease of the small bowel, occult gastrointestinal bleeding, non steroidal anti inflammatory drug induced smallbowel disease, carcinoid tumors of the small bowel,gastro intestinal stromal tumors of the small bowel andother disease affecting the small bowel. Capsule endoscopy has been compared to traditional small bowelseries, computerized tomography studies and pushenteroscopy. The diagnostic yield of capsule endoscopyhas consistently been superior in the diagnosis of smallbowel disease compared to the competing methods(small bowel series, computerized tomography, pushenteroscopy) of diagnosis. For this reason capsule en-doscopy has enjoyed a meteoric success. Image qualityhas been improved with increased number of pixels,automatic light exposure adaptation and wider angle ofview. Further applications of capsule endoscopy of other areas of the digestive tract are being explored. Theincreased transmission rate of images per second hasmade capsule endoscopy of the esophagus a realisticpossibility. Technological advances that include a double imager capsule with a nearly panoramic view of the colon and a variable frame rate adjusted to the movement of the capsule in the colon have made capsuleendoscopy of the colon feasible. The diagnostic ratefor the identification of patients with polyps equal to orlarger than 6 mm is high. Future advances in technology and biotechnology will lead to further progress.Capsule endoscopy is following the successful moderntrend in medicine that replaces invasive tests with lessinvasive methodology.展开更多
AIM: To assess the level of undiagnosed coeliac disease (CD) in relatives of patients affected by the condition. METHODS: We collected blood from 914 relatives of probands. We screened these individuals by ELISA for I...AIM: To assess the level of undiagnosed coeliac disease (CD) in relatives of patients affected by the condition. METHODS: We collected blood from 914 relatives of probands. We screened these individuals by ELISA for IgA and IgG tTG antibodies, confirming any positive IgA tTG results with an IgA EMA and looked for evidence of IgA deficiency in those who were IgG tTG positive alone, and performed IgG1 EMA in these individuals. We undertook HLA typing where positive screening was found, and this confirmed a strong prevalence of HLA- DQ2 in the coeliac population. Follow-up small intestinal biopsy was undertaken in cases with positive serological screening, wherever possible. RESULTS:Use of this serological screening algorithm revealed a prevalence of undiagnosed CD in 5%-6% of first degree relatives of probands. CONCLUSION:Our data suggests that first degree relatives of individuals with CD should be screened for this condition.展开更多
文摘Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn's disease of the small bowel, occult gastrointestinal bleeding, non steroidal anti inflammatory drug induced smallbowel disease, carcinoid tumors of the small bowel,gastro intestinal stromal tumors of the small bowel andother disease affecting the small bowel. Capsule endoscopy has been compared to traditional small bowelseries, computerized tomography studies and pushenteroscopy. The diagnostic yield of capsule endoscopyhas consistently been superior in the diagnosis of smallbowel disease compared to the competing methods(small bowel series, computerized tomography, pushenteroscopy) of diagnosis. For this reason capsule en-doscopy has enjoyed a meteoric success. Image qualityhas been improved with increased number of pixels,automatic light exposure adaptation and wider angle ofview. Further applications of capsule endoscopy of other areas of the digestive tract are being explored. Theincreased transmission rate of images per second hasmade capsule endoscopy of the esophagus a realisticpossibility. Technological advances that include a double imager capsule with a nearly panoramic view of the colon and a variable frame rate adjusted to the movement of the capsule in the colon have made capsuleendoscopy of the colon feasible. The diagnostic ratefor the identification of patients with polyps equal to orlarger than 6 mm is high. Future advances in technology and biotechnology will lead to further progress.Capsule endoscopy is following the successful moderntrend in medicine that replaces invasive tests with lessinvasive methodology.
基金Supported by grants from Coeliac UK and Action Research
文摘AIM: To assess the level of undiagnosed coeliac disease (CD) in relatives of patients affected by the condition. METHODS: We collected blood from 914 relatives of probands. We screened these individuals by ELISA for IgA and IgG tTG antibodies, confirming any positive IgA tTG results with an IgA EMA and looked for evidence of IgA deficiency in those who were IgG tTG positive alone, and performed IgG1 EMA in these individuals. We undertook HLA typing where positive screening was found, and this confirmed a strong prevalence of HLA- DQ2 in the coeliac population. Follow-up small intestinal biopsy was undertaken in cases with positive serological screening, wherever possible. RESULTS:Use of this serological screening algorithm revealed a prevalence of undiagnosed CD in 5%-6% of first degree relatives of probands. CONCLUSION:Our data suggests that first degree relatives of individuals with CD should be screened for this condition.
