Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with oth...Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.展开更多
BACKGROUND Several strategies have been implemented to reduce or abolish the life-threatening risk of endoscopic retrograde cholangiopancreatography(ERCP)-related multidrug-resistant infections due to duodenoscopes co...BACKGROUND Several strategies have been implemented to reduce or abolish the life-threatening risk of endoscopic retrograde cholangiopancreatography(ERCP)-related multidrug-resistant infections due to duodenoscopes contaminations;among those strategies,serial microbiologic tests,thorough reprocessing schedules,and use of removable scope cap have been adopted,but the potential cross-infection risk was not eliminated.AIM To review available evidence in the field of single-use duodenoscopes(SUD)use for ERCP.METHODS An overview on ongoing clinical studies was also performed to delineate which data will become available in the next future.RESULTS One bench comparative study and four clinical trials performed with EXALT model-D(Boston Scientific Corp.,United States)have been identified.Of them,one is a randomized controlled trial,while the other three studies are prospective single-arm,cross-over studies.Pooled technical success rate(4 studies,368 patients)was 92.9%[95%confidence interval(CI):89.9-95.5;I2:11.8%].Pooled serious adverse event(4 studies,381 patients)rate was 5.9%[3.7%-8.5%;I2:0.0%].CONCLUSION Although few clinical trials are available,evidence is concordant in identifying an absolute feasibility and safety and feasibility for SUD use for ERCP.The expertise and quality of evidence in this field are going to be improved by further large clinical trials;data on cost-effectiveness and environmental impact will be needed for a worldwide spread of SUD use for ERCP.展开更多
文摘Helicobacter pylori(H. pylori) infection is very common and affects approximately half of the world population. It causes gastric diseases, but some authors have reported an association of H. pylori infection with other systemic manifestations beginning in 1994. The list of potential effects of H. pylori outside the stomach includes a number of extragastric manifestations and we focused on neurological, dermatological, hematologic, ocular, cardiovascular, metabolic, allergic, and hepatobiliary diseases. This review discusses these important reported manifestations that are not related to the gastrointestinal tract.
文摘BACKGROUND Several strategies have been implemented to reduce or abolish the life-threatening risk of endoscopic retrograde cholangiopancreatography(ERCP)-related multidrug-resistant infections due to duodenoscopes contaminations;among those strategies,serial microbiologic tests,thorough reprocessing schedules,and use of removable scope cap have been adopted,but the potential cross-infection risk was not eliminated.AIM To review available evidence in the field of single-use duodenoscopes(SUD)use for ERCP.METHODS An overview on ongoing clinical studies was also performed to delineate which data will become available in the next future.RESULTS One bench comparative study and four clinical trials performed with EXALT model-D(Boston Scientific Corp.,United States)have been identified.Of them,one is a randomized controlled trial,while the other three studies are prospective single-arm,cross-over studies.Pooled technical success rate(4 studies,368 patients)was 92.9%[95%confidence interval(CI):89.9-95.5;I2:11.8%].Pooled serious adverse event(4 studies,381 patients)rate was 5.9%[3.7%-8.5%;I2:0.0%].CONCLUSION Although few clinical trials are available,evidence is concordant in identifying an absolute feasibility and safety and feasibility for SUD use for ERCP.The expertise and quality of evidence in this field are going to be improved by further large clinical trials;data on cost-effectiveness and environmental impact will be needed for a worldwide spread of SUD use for ERCP.
