Colorectal cancer screening and surveillance in patients with inflammatory bowel disease in 2021

The detection of dysplasia in patients with inflammatory bowel disease(IBD)continues to be important given the increased risk of colorectal cancer in this population.Therefore,in 2017,we performed a review and update of the recommendations for the management and follow-up of patients with IBD based on the clinical practice guidelines of various scientific societies.The present manuscript focuses on new aspects of the detection,follow-up,and management of dysplasia according to the latest studies and recommendations.While chromoendoscopy with targeted biopsy continues to be the technique of choice for the screening and detection of dysplasia in IBD,the associated difficulties mean that it is now being compared with other techniques(virtual chromoendoscopy),which yield similar results with less technical difficulties.Furthermore,the emergence of new endoscopy techniques that are still being researched but seem promising(e.g.,confocal laser endomicroscopy and full-spectrum endoscopy),together with the development of devices that improve endoscopic visualization(e.g.,Endocuff Vision),lead us to believe that these approaches can revolutionize the screening and follow-up of dysplasia in patients with IBD.Nevertheless,further studies are warranted to define the optimal follow-up strategy in this patient population.

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

Background:Health personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings.There is a need to know what rapid diagnostic technologies are available,have been properly assessed,and are being implemented to improve control of these diseases in the urban context.This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty.Main body:A scoping review was conducted.Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases,diagnostics evaluations,rapid tests,and urban setting.The review was limited to studies published between 2000 and 2016 in English,Spanish,French,and Portuguese.Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography.A total of 179 documents of the 7806 initially screened were included in the analysis.Malaria(n=100)and tuberculosis(n=47)accounted for the majority of studies that reported diagnostics performance,impact,and implementation outcomes.Fewer studies,assessing mainly performance,were identified for visceral leishmaniasis(n=9),filariasis and leptospirosis(each n=5),enteric fever and schistosomiasis(each n=3),dengue and leprosy(each n=2),and Chagas disease,human African trypanosomiasis,and cholera(each n=1).Reported sensitivity of rapid tests was variable depending on several factors.Overall,specificities were high(>80%),except for schistosomiasis and cholera.Impact and implementation outcomes,mainly acceptability and cost,followed by adoption,feasibility,and sustainability of rapid tests are being evaluated in the field.Challenges to implementing rapid tests range from cultural to technical and administrative issues.Conclusions:Rapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection.However,most evidence comes from malaria rapid diagnostics,with variable results.While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies,more evidence on performance of current tests or development of new alternatives is needed for dengue,Chagas disease,filariasis,leptospirosis,enteric fever,human African trypanosomiasis,schistosomiasis and cholera.