Effect of comprehensive management combined with cognitive intervention on patient cooperation and complications during digestive endoscopy

BACKGROUND As lifestyles continue to change worldwide,the incidence of digestive tract carcinoma has gradually increased.Digestive endoscopy is an important tool that can assist in the diagnosis,treatment,and surgical intervention for this disease.However,the examination process is affected by many factors,and patient cooperation is often poor,which can increase the risk of complications.AIM To explore the effects of integrated management and cognitive intervention on cooperation and complications in patients undergoing endoscopy for early gastrointestinal neoplasms.METHODS A total of 354 patients with early stage gastrointestinal cancer who underwent digestive endoscopy procedures between January and December 2023 at our hospital were divided into observation and control groups(177 patients in each group)in a randomized controlled blind trial.The control group received routine interventions,while the observation group received comprehensive integrated management combined with cognitive interventions.We compared the changes in adverse mood,discomfort,examination time,cooperation with the examination,and complications before and after the intervention between the two groups.RESULTS The self-rated anxiety and depression scale scores were lower in the observation group than in the control group(P<0.05).The visual analog scale scores for discomfort during intubation and examination were also lower in the observation group than in the control group(P<0.05).Furthermore,the examination time was shorter in the observation group than in the control group(P<0.05),and the degree of cooperation(94.35%)was higher in the observation group than in the control group(84.75%;P<0.05).Lastly,the incidence rates of gastrointestinal adverse reactions(10.17%vs 20.34%),choking agitation(14.69%vs 24.86%),abdominal pain(8.47%vs 18.08%),and muscle tension(5.08%vs 14.12%)were all lower in the observation group than in the control group(P<0.05).CONCLUSION Integrated management and cognitive intervention in early gastrointestinal neoplasm endoscopy alleviate mood,reduce discomfort,shorten examinations,improve cooperation,and reduce complications.

Gastritis: Sociodemographic, Clinical, Endoscopic and Histological Aspects, about 593 Cases at the Digestive Endoscopy Unit of the General Hospital Idrissa Pouye

Introduction: Gastritis is a very common and widely distributed condition worldwide. It represents one of the most common pathological entities in gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP). Materials and Method: This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) reports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. Results: The reports of 593 patients were analyzed. The mean age was 45 years old (range 8 - 88 years old) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of cases. The endoscopic appearance was normal in 229 patients (39%). The endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). H. pylori was present in 404 patients (68%). Conclusion: Gastritis is usually found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.

Profile of Endoscopic Lesions and Prevalence of <i>H. pylori</i>Infection at the Digestive Endoscopy Unit of Panzi General Reference Hospital in Bukavu

Introduction: Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of H. pylori infection. Material and Methods: This is a retrospective, descriptive and analytical study, ranging from the 16th of December 2014 to the 16th of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. Results: fifty-five percent of these patients were women. 66% of the patients were under 50 years of age. Their major symptom was epigastric pain (89.2%), the most observed endoscopic lesion was erythematous gastritis (82%) therefore we have noticed 21.5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, NSAID and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). Helicobacter pylori gastritis was the most frequent (61.30%) and Helicobacter pylori were present in 63% of gastric biopsies. Conclusion: Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.

Hemostatic effect of topical hemocoagulase spray in digestive endoscopy

AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy.METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group(n = 39) or a control group(n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared.RESULTS: Successful hemostasis was achieved in 39(100%) patients of the study group and in 47(94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups(16.7% vs 35.0%, P = 0.477), but the rates oflate bleeding(0% vs 15.8%, P = 0.048) and overall complications(P = 0.032) were significantly lower in the study group.CONCLUSION: Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis.

Carbon dioxide for gut distension during digestive endoscopy:Technique and practice survey

AIM:To assess the adoption of Carbon dioxide(CO2)insufflation by endoscopists from various European countries,and its determinants.METHODS:A survey was distributed to 580 endoscopists attending a live course on digestive endoscopy.RESULTS:The response rate was 24.5%.Fewer than half the respondents(66/142,46.5%)were aware of the fact that room air can be replaced by CO2 for gut distension during endoscopy,and 4.2%of respondents were actually using CO2 as the insufflation agent.Endoscopists aware of the possibility of CO2 insufflation mentioned technical difficulties in implementing the system and the absence of significant advantages of CO2 in comparison with room air as barriers to adoption in daily practice(84%and 49%of answers,respectively;two answers were permitted for this item).CONCLUSION:Based on this survey,adoption of CO2 insufflation during endoscopy seems to remain relatively exceptional.A majority of endoscopists were not aware of this possibility,while others were not aware of recent technical developments that facilitate CO2 implementation in an endoscopy suite.

Therapeutic Profile and Prognostic Factors of Patients Suffering from Upper Digestive Bleeding at Sikasso Regional Hospital

Introduction: Upper digestive hemorrhage is one of the main digestive emergencies and remains a major cause of morbidity and mortality in Mali. The aim of this study was to describe the therapeutic profile and outcome of patients suffering from upper digestive haemorrhage. Methodology: This was a prospective study carried out in the internal medicine department of the Sikasso Regional Hospital from August 2022 to July 2023. All adult patients presenting with upper digestive haemorrhage and having given their consent, were included. Data were analyzed using SPSS version 21 software. Results: Sixty-three patients were enrolled. The mean age was 49.7 ± 18.99 years, with a male-female sex ratio of 2.2. Ruptured esophageal varices (37.5%) and peptic ulcer (25%) were the main etiologies. Pharmacological treatment was dominated by proton pump inhibitors (85.7%). Hemostasis endoscopy accounted for 3.17%. The evolution was marked by hemorrhagic arrest (69.84%), recurrence of hemorrhage (11.11%) and death (19.04%), the main cause of which was hemorrhagic shock (58.3%). We found no statistically significant relationship between prognosis and etiologies (P = 0.11), and length of hospital stay (P = 0.18). Conclusion: Hemostasis endoscopy remains a challenge for Sikasso Hospital. A holistic strategy of communication and community awareness-raising, combined with adequate technical facilities, will help to improve patient care and outcomes.

Prevention program for the COVID-19 in a children’s digestive endoscopy center

The pneumonia caused by the coronavirus disease-2019(COVID-19)outbreak in Wuhan,China constitutes a public health emergency of international concern.The gastrointestinal symptoms of vomiting,diarrhea and abdominal pain and the detection of COVID-19 nucleic acid from fecal specimens in a small number of patients suggest the possibility of transmission via the gastrointestinal tract.People of all ages are vulnerable to this virus,including children.Digestive endoscopy is an invasive procedure during which children cannot wear masks;therefore,they have higher risks of exposure to COVID-19,and the digestive endoscopy center is a relatively high-risk area for COVID-19 infection.Based on these factors and in combination with related policies and regulations,a prevention and control program for the COVID-19 pneumonia in a children's digestive endoscopy center was established to prevent the COVID-19 nosocomial infection.

Patients’ Lived Experience and Injuries Observed during Upper Digestive Endoscopy at KARA Teaching Hospital (Togo)

Background: Endoscopy remains the most performant medical exam exploring the upper digestive tract;but depending on patients, its tolerance is variable. Objective: This study aimed at describing the experience and evaluating the tolerance, acceptability and injuries observed during upper gastrointestinal endoscopy. Methods: This is a prospective and descriptive study carried out from April to July 2017 in the digestive endoscopy unit of the Kara teaching hospital (Togo). The gastroscopy was performed by the same operator (Hepatogastroenteroloogist). The premedication was done with direct intravenous injection of 10 mg of Metoclopramide hydrochloride and viscous Lidocaine oral gel. Previously, essential information about the examination course was given to patients after obtaining their verbal consent. Patients’ impressions of the experience, tolerance and acceptability were collected on a survey sheet, before and after the examination. Results: One hundred and eleven patients were included, 62 women and 49 men. The average age was 45.9 years (15 - 88 years), and the sex ratio (F/M) was 1.2. Most of the patients (89.2%) were experiencing the gastroscopy for the first time, and the main reason was epigastralgia in 55%. The examination duration was good at 88.3% and tolerance was good at 72.1%. Tingling, irritation, pain or sore throat feelings were noted in 13.5%. Patients agreeing to make an ulterior UDE if necessary were up to 92.8%. Observed injuries were dominated by antral erythematous gastropathy (28.8%). Conclusion: UDE is well tolerated among our patients and its acceptability is high. Injuries are dominated by inflammatory pathologies of the stomach in our population.

Foreign Bodies from the Upper Digestive Tract at University Hospital Center Gabriel Touré: The Contribution of Digestive Endoscopy

Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of University hospital center Gabriel Touré. The study was retrospective from January 2007 to October 2017 in the endoscopic center of the service of gastroenterology of University hospital center Gabriel Touré and concerned the patients who have been addressed at this center for foreign bodies. We collated 44 patients who ingested foreign bodies among 2750 digestive endoscopies, that is to say, a frequency of 0.16%. In patient’s history, we found caustic obstruction in 2.3% of patients. The foreign body ingestion was accidental in 97.7% of cases. Pieces of money were more frequent (54.4%). In 86.4%, the foreign bodies were into the esophagus. Upper digestive endoscopy performed foreign bodies extraction in 88.6 of cases. In 9.1%, the elimination was spontaneous on 72 hours. Surgeon was indicated in 2.3% of patients. The evolution was favorable in 97.7% of patients. One patient died by digestive bleeding. Conclusion: Foreign bodies ingestion is frequent in children. The upper digestive endoscopy can do the diagnosis and the management.

ICP-AES法测定电炉渣中二氧化硅

本文研究了采用酸溶的方式消解样品,ICP-AES光谱法测定电炉渣中二氧化硅的分析方法。采用浓盐酸和浓硝酸溶解电炉尾料样品,加入氢氟酸消解二氧化硅和硼酸络合氟离子,采用ICP-AES法测定电炉尾料样品中的二氧化硅含量。二氧化硅的相对标准偏差RSD为0.35%~0.58%,加标回收率为95.6%~102.3%。方法加标回收率好,满足分析方法要求。

COVID-19 and its effects on the digestive system

Coronavirus disease 2019(COVID-19)is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)with typical respiratory symptoms.SARS-CoV-2 invades not only the respiratory system,but also other organs expressing the cell surface receptor angiotensin converting enzyme 2.In particular,the digestive system is a susceptible target of SARS-CoV-2.Gastrointestinal symptoms of COVID-19 include anorexia,nausea,vomiting,diarrhea,abdominal pain,and liver damage.Patients with digestive damage have a greater chance of progressing to severe or critical illness,a poorer prognosis,and a higher risk of death.This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2.It also describes the characteristics of inflammatory bowel disease patients with SARSCoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures.Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis,treatment,and epidemic prevention and control.

Capsule endoscopy and panendoscopy:A journey to the future of gastrointestinal endoscopy

In 2000,the small bowel capsule revolutionized the management of patients with small bowel disorders.Currently,the technological development achieved by the new models of double-headed endoscopic capsules,as miniaturized devices to evaluate the small bowel and colon[pan-intestinal capsule endoscopy(PCE)],makes this non-invasive procedure a disruptive concept for the management of patients with digestive disorders.This technology is expected to identify which patients will require conventional invasive endoscopic procedures(colonoscopy or balloon-assisted enteroscopy),based on the lesions detected by the capsule,i.e.,those with an indication for biopsies or endoscopic treatment.The use of PCE in patients with inflammatory bowel diseases,namely Crohn’s disease,as well as in patients with iron deficiency anaemia and/or overt gastrointestinal(GI)bleeding,after a non-diagnostic upper endoscopy(esophagogastroduodenoscopy),enables an effective,safe and comfortable way to identify patients with relevant lesions,who should undergo subsequent invasive endoscopic procedures.The recent development of magnetically controlled capsule endoscopy to evaluate the upper GI tract,is a further step towards the possibility of an entirely non-invasive assessment of all the segments of the digestive tract,from mouth-to-anus,meeting the expectations of the early developers of capsule endoscopy.

TREATMENT OF MUCOUS MEMBRANE DISEASES OF THE DIGESTIVE TRACT WITH JING liE LIAN OIAO TANG——Therapeutic Effect in 168 Cases

From October 1985 to October 1987,weused Jing Jie Lian Oiao Tang(荆芥连翘汤)totreat 168 patients of mucous membrane diseasesof the digestive tract with good therapeutic ef-fect.CLINICAL DATASelection of CasesIn this series,all 168 cases are inpatientswith diseases of the mucous membrane from themouth to the colon,the diagnosis being con-firmed with endoscopy when necessary.41

Aortodigestive Fistula: A Rare Cause of Digestive Bleeding

Backgound: Aorto-digestive fistulas remain a fatal disease entity often occurring after vascular surgeries. Eso-gastro-duodenal endoscopy is essential to explore the upper digestive bleeding. The negativity of morphological examinations should not exclude the diagnosis. Diagnosis has benefited in recent years from developments in cross-sectional imaging: computed tomography (CT) and magnetic resonance imaging (MRI). The severity of bleeding is linked to the vital consequences (mortality close to 50% up to 100% in the absence of treatment), functional (30% amputation), and to the underlying infection itself correlated with the attack of the stent and the anastomosis. Patients: We report three cases of aorto-digestive fistulas treated at The University Hospital Hassan II to show the challenging diagnosis and therapeutic of such rare causes of upper digestive bleeding. Results: three patients were admitted to the emergency endoscopy unit for upper digestive bleeding, 2 of them had a medical history of Behcet Disease and two had past aortic aneurism surgery. The couple’s upper endoscopy and CT scan angiography made the diagnosis. Unfortunately, 2 patients died from fatal bleeding. Conclusion: Aortodigestive fistula is an extremely serious complication of aortic aneurisms and a rare cause of gastrointestinal bleeding. This diagnosis should be considered in any patient presenting with digestive bleeding with vascular disease or previous history of vascular stent.

Application of closed-vessel microwave digestion method for the determination of multi-elements in environmental samples by sequential ICP-AES

A closed-vessel microwave digestion method is described for the rapid dissolution of environmental samples such as foods, soils and sediments. Depending on the sample type, 0.1-0.2 g sample was decomposed with HNO3/H2O2 or HNO3 / H2O2/HF acid mixture in a PTFE digestion vessel by using microwave heating for 2-3 min at 500W of microwave power. The solution, or to which 0.5 g of boric acid was added, was diluted to 25-50 ml and directly determined by sequential ICP-AES. The accuracy of the procedure was validated by the analysis of six standard reference materials for 10 elements. Ail results were in a good agreements with the certified values.

超级微波消解-ICP-AES法测定铑炭催化剂中铑含量

建立一种采用超级微波消解,ICP光谱法测定5%Rh/C催化剂中Rh含量的方法。通过单因素实验和正交优化,对称样量、酸体系、消解温度、消解时间等因素进行考察,确定最佳消解方法:约0.10 g试样在密闭消解罐中,以9 mL硝酸和1 mL过氧化氢为酸体系,240℃消解温度下保持40 min,经赶酸定容后,采用ICP-AES法测定溶液中的贵金属含量。该方法简便、快捷,消解试样完全且结果稳定,相对标准偏差小于1.0%。

超级微波消解-ICP-AES法测定铑粉中16种杂质元素

在高温高压条件下用盐酸-双氧水消解铑粉样品,采用电感耦合等离子体发射光谱仪(ICP-AES)测定其中16种杂质元素[1]。进行了光谱干扰研究、谱线选择、加标回收、精密度以及基体匹配比对试验。该方法简便、快速、准确,其测定范围为0.0005%~0.10%,RSD在1.88%~12.15%之间,加标回收率在92.0%~114.6%之间,不同方法结果对照数据吻合良好。该方法可满足铑粉中16种杂质元素的测定要求。

湿法消解-电感耦合等离子体原子发射光谱(ICP-AES)法测定水凝胶中Mg的含量

为了准确测定水凝胶样品中的金属元素含量,以Mg为例,通过优化电感耦合等离子体原子发射光谱(ICP-AES)仪参数,考察硝酸及硝酸-高氯酸湿法消解以及硝酸-微波消解法对于样品消解程度的不同,建立了湿法消解-ICP-AES法测定水凝胶中Mg绝对含量的方法。结果表明,在110℃下用硝酸消解2 h与硝酸-高氯酸(1∶1)以及硝酸-微波消解得到的溶液相比,Mg含量几乎没有明显差别。在选定条件下,方法的日内和日间精密度良好,相对标准偏差(RSD,n=3)分别为0.38%和1.2%;加标回收率为97.6%~98.2%。方法准确、适用、可靠,适用于水凝胶中Mg的绝对含量测定,可为水凝胶中金属元素的定量分析提供一种借鉴。

微波消解-氢化物发生ICP-AES法联合测定高温合金中痕量砷、锑、铋

提出了微波消解-氢化物发生电感耦合等离子体发射光谱法联合测定高温合金中痕量砷、锑、铋的新方法。用微波消解仪预处理样品,硫酸冒烟驱除硝酸、氢氟酸控制酸度,用抗坏血酸-硫脲作为还原剂,用硼氢化钾产生砷、锑、铋的氢化物,以ICP-AES测定。对各种试剂的用量、仪器测量条件、谱线选择等进行了实验和讨论。对高温合金样品的测定表明,方法检出限低,精密度高,结果准确可靠。

微波消解-ICP-AES技术测定土壤中微重金属元素探究

本实验通过酸液辅助微波消解样品,联合电感耦合等离子-原子发射(ICP-AES)技术,分析测定了土壤样品中重金属元素Cr、Zn、Mn、Cu的含量。结果表明,土壤中Cr、Mn、Cu、Zn含量分别为62.47 mg·kg^(-1)、284.50 mg·kg^(-1)、47.07 mg·kg^(-1)、98.98 mg·kg^(-1),未超过农用地土壤污染风险管控值。实验表明,该方法用于分析测定复杂样品中的金属元素含量,具有操作简单、分析迅速、灵敏度高、准确度好、检测限低等优点,具有广泛的应用价值。