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Endoscopy Unit (endoscopy + unit)
Selected AbstractsNO EVIDENCE FOR PATIENT-TO-PATIENT TRANSMISSION OF HEPATITIS C VIRUS DURING UPPER GASTROINTESTINAL ENDOSCOPY: MOLECULAR STUDIES ON THREE ACUTE HEPATITIS C PATIENTSDIGESTIVE ENDOSCOPY, Issue 3 2009Takayuki Toda Background:, The risk of patient-to-patient transmission of hepatitis C virus (HCV) during endoscopy remains controversial. Using molecular approaches, we examined the possibility of patient-to-patient transmission of HCV in three patients who developed acute hepatitis C 1,6 months after examination by upper gastrointestinal endoscopy (UGIE) in a hospital endoscopy unit in Japan. Methods:, For the source of HCV infection, we used frozen sera obtained from potential candidates who underwent UGIE earlier than three index patients on the same days in the same unit. HCV genotype was determined by multiplex polymerase chain reaction (PCR) with genotype-specific primers. The 1087-nucleotide (nt) sequence of the NS5B region of the HCV genome was compared between index patients and their HCV-viremic candidates. Results:, The three index patients were exclusively infected with HCV of genotype 1b. Among a total of 60 candidate patients who underwent UGIE earlier than the index patients, 14 were positive for anti-HCV, of whom 12 had detectable HCV-RNA (1b, n = 9; 2a, n = 1; 2b, n = 2) on sera collected during each UGIE. Shared identity within the 1087-nt NS5B sequence was less than 95.0% between index patients and HCV/1b-infected candidates (n = 3, 1 and 5, respectively). None of the remaining 46 candidates who were negative for anti-HCV at UGIE examination tested positive for HCV-RNA, nor seroconverted to anti-HCV on their sera, which most likely excludes the possibility of HCV viremia despite the anti-HCV-negative serology at UGIE examination. Conclusion:, The present study suggests that patient-to-patient transmission of HCV during UGIE is infrequent. [source] Use of endoscopy in diagnosis and management of patients with dysphagia in an African settingDISEASES OF THE ESOPHAGUS, Issue 3 2010H. M. Y. Mudawi SUMMARY The objectives of this study were to define the utility of esophagogastroduodenoscopy in the diagnosis and management of patients presenting with dysphagia and to determine the relative incidence of the various causes of dysphagia in Sudan. This is a prospective, cross-sectional, descriptive, hospital-based study carried out at the endoscopy unit of Soba University Hospital, Khartoum, Sudan. All patients complaining of dysphagia underwent upper gastrointestinal endoscopy with therapeutic intervention when necessary. A total of 114 patients were enrolled in the study, with a mean age of 47 years SD ± 19 and a male to female ratio of 1 : 1.04. A benign condition was diagnosed in 56% of the cases; this included esophageal strictures in 21% of the cases and achalasia in 14%. Malignant causes were mainly due to esophageal cancer (40.4%) and cancer of the stomach cardia (3.5%). Therapeutic intervention was attempted in 83% of the cases. Risk factors predictive of a malignant etiology were age over 40 years (P < 0.000), dysphagia lasting between 1 month and 1 year (P < 0.000), and weight loss (P < 0.000). A barium study was performed in 35 cases (31%) prior to endoscopic examination and proved to be inaccurate in three cases (8.6%). Upper gastrointestinal endoscopy in our African setting is an accurate and useful investigation in the diagnosis and management of patients presenting with dysphagia. Patients over the age of 40 years presenting with dysphagia and weight loss are more likely to have a neoplastic disease and should be referred for urgent endoscopy. [source] Reducing admission times in the endoscopy unitINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2006Deborah Dobree-Carey RGN Pre-procedural admission of outpatients to a day-case endoscopy facility is time-consuming. Collecting and recording routine but necessary information distracts nurses from spending time that could be used to counsel patients. This study assessed whether patients can record some pre-procedural details and whether such self-recording quickens nurse admission times. A new admission document was devised and posted to patients. Patients completed personal/administrative details and information about drugs and allergies and brought the document with them when attending for outpatient endoscopy. Endoscopy nurses anonymously timed 100 admissions, 50 using the new admission form and 50 using the old admission form. Overall, the median (range) time to admit using the old form was 6 (3,15.5) min. Using the new form, the median time to admit was lower at 4 (0.5,10) min. No patient completing the new form reported any particular difficulties. An admission document that patients partially complete at home leads to a faster pre-procedural admission in the endoscopy unit. This allows more nursing time to discuss patients' anxieties and answer patient queries, helps to prevent delays and facilitates increased capacity in the endoscopy unit. [source] Clinical trial: music reduces anxiety levels in patients attending for endoscopyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2009H. EL-HASSAN Summary Background, Patients attending for endoscopy are generally anxious and worried. Aims, To examine whether music reduced anxiety levels in patients attending for endoscopic procedures. Methods, Prospective randomized controlled trial of 180 patients (M:F 81:99). The effect of age (, or >51 years) and procedure (gastroscopy or flexible sigmoidoscopy/colonoscopy) on anxiety levels (state-trait anxiety inventory) on arrival in the unit and immediately before the endoscopy procedure, after listening to music or no music (control group) for the same period. Results, At baseline, anxiety levels were not influenced by age (,51 years, n = 56:42.21 ± 9.18; >51 years, n = 124:39.99 ± 10.13 (P = 0.15) or procedure: gastroscopy, n = 87:39.43 ± 9.9, flexible sigmoidoscopy/colonoscopy: n = 93:41.86 ± 9.75 (P = 0.98). No difference was found in anxiety scores in the control group (n = 88) at baseline and immediately pre-endoscopy (P = 0.243), but music led to a significant reduction in anxiety scores (n = 92), which was maintained for all age groups irrespective of procedure (all P < 0.0001). Conclusions, Anxiety levels in patients attending for endoscopy were not influenced by age or procedure, but were significantly reduced by listening to music compared to controls. The availability of music within the endoscopy unit is a simple strategy that will improve the well-being of patients. [source] Are patients' sedation preferences at gastroscopy influenced by preceding patients' decisions?ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2004A. Olithselvan Summary Background :,When patients choose sedation or no sedation for gastroscopy, it is unknown whether the decision and experience of preceding patients on the same endoscopy list influence such decisions. Aim :,To address this question in an endoscopy unit, where pre- and postprocedure patients are free to communicate. Methods :,The order and sedation decisions of 503 out-patients attending diagnostic gastroscopy lists were analysed. One hundred patients completed a preprocedural questionnaire about sedation preferences. Results :,Three hundred and fifteen (63%) patients chose no sedation. Men were more likely to be unsedated, 170 (72%), than women 158 (59%) (,2 = 9.1, P < 0.01). Age did not influence decisions. If the first patient on an endoscopy list requested sedation, 36% of subsequent patients were also sedated. This was similar to 38% of subsequently sedated patients on lists where the first patient was unsedated. Similar proportions of subsequent patients requested sedation when comparing lists where the first two patients were both sedated or both unsedated and when comparing lists where the first three patients were all sedated or all unsedated. Ninety per cent of the patients completing preprocedural questionnaires had made sedation choices before arrival; the remaining undecided patients had unsedated endoscopies. Conclusions :,Patients' sedation decisions are not influenced by preceding patients' decisions. Most patients attending for out-patient gastroscopy have already decided about sedation. [source] Registered nurse-administered propofol sedation for endoscopyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2004S. C. Chen Summary Propofol has several attractive properties that render it a potential alternative sedative agent for endoscopy. Compared with meperidine and midazolam, it has an ultra-short onset of action, short plasma half-life, short time to achieve sedation, faster time to recovery and discharge, and results in higher patient satisfaction. Shorter times to achieve sedation enhance efficiency in the endoscopy unit. Multiple studies have documented the safe administration of propofol by non-anaesthesiologists. Administration by registered nurses is more cost-effective than administration by anaesthesiologists. However, the administration of propofol by a registered nurse supervised only by the endoscopist is controversial because the drug has the potential to produce sudden and severe respiratory depression. More information is needed on how training nurses and endoscopists should proceed to give propofol, as well as the optimal level of monitoring to ensure the safety of nurse-administered propofol. [source] MODIFIED ENDOSCOPIC CONGO RED TEST: A RAPID METHOD TO VISUALIZE GASTRIC ACID SECRETIONDIGESTIVE ENDOSCOPY, Issue 1 2003Ervin Tóth Background:, The conventional endoscopic Congo red test (CRT) permits visualization of acid-producing mucosa. However, the CRT has not been disseminated into clinical endoscopy, which is partly due to the substantial prolongation of the gastroscopic examination. Methods:, Five healthy volunteers and 551 patients were included in a study designed to develop a more rapid approach based on the CRT. In this modified endoscopic Congo red test (MCRT), 0.2 µg/kg of pentagastrin was given intravenously to stimulate gastric acid production. The technical feasibility, tolerability, reproducibility, and inter- and intra-observer reliability of the MCRT were evaluated. Results:, The MCRT was as effective as the CRT (i.e. 6 µg/kg of pentagastrin was administered intramuscularly) in visualizing the extent of acid-producing gastric mucosa. Moreover, the MCRT significantly reduced the duration of examination by 63% (almost 8 min), compared to the CRT. Conclusions:, This MCRT is a simple, inexpensive, well-tolerated and reproducible method with low inter- and intra-observer variability and is well suited for endoscopy units with high workloads. [source] Biopsy forceps: Reusable or disposable?JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2006Zvi Fireman Abstract Reusable and disposable biopsy forceps are both widely available for use in gastrointestinal endoscopy units. Biopsy forceps have design and material features that may interfere with cleaning, and reusable devices must be designed to function safely and effectively following sterilization in a healthcare setting. During the last decade, endoscopic accessories have evolved from reusable to disposable in many parts of the world. Although use of disposable devices helps reduce the potential risk of cross-contamination and spread of infection, there remains the factor of cost. Major concerns for reuse of endoscopic accessories center on two main areas: sterility, and the capability of the equipment to perform its function satisfactorily after repeated uses and sterilizations. Reusable biopsy forceps perform a designated number of procedures, thus becoming more cost-effective than disposable forceps, which are impossible to clean and sterilize. The potential risk of infectious disease transmission must be taken into account. There is also the consideration that reprocessing of disposable forceps may damage or destroy the fragile devices. [source] | ||||||||||