Article Title: Colonoscopy related adverse events in patients with abnormal stool-based tests-A systematic review of literature and meta-analysis of outcomes.
Article Note: CRediT ( a contributorship list at the end of the document. All names are indexed as authors on Pubmed. Byline: , Peter Vaughan, Helen Mohan, Nigel D'Souza, Lena WS Ngu, Henry Ferguson, ...Deena Harji, Neil P. J. Cripps, Sarah C. Mills, James Docherty, Steven Brown, Laura Hancock, Michael M. Davis
Hemangiomas are blood vessel malformations due to endothelial cell proliferation and vasculogenesis. There are two types of hemangiomas, capillary and cavernous. Capillary hemangiomas are ...characterized by thin-walled spaces lined with endothelial cells and are usually found in the perianal skin and small bowel. In contrast, cavernous hemangiomas are larger and are characterized by thick-walled spaces lined by multiple layers of endothelial cells and are usually found in the colon and rectum. There are as few as 200 documented cases of cavernous hemangiomas in the literature. Below we describe a rare case of a cavernous hemangioma incidentally found on screening colonoscopy. A 69-year-old man with a history external hemorrhoids presented for screening colonoscopy. The patient s only complaint on presentation was constipation. The patient had stable vital signs and normal labs, including a hemoglobin of 15.4.
Purpose: Accurate and convenient evaluation tools are essential to document endoscopic competence in Gastroenterology training programs. The Direct Observation of Procedural Skills (DOPS), Global ...Assessment of Gastrointestinal Endoscopic Skills (GAGES), and Assessment of Endoscopic Competency (ACE) are widely used validated competency assessment tools for gastrointestinal endoscopy. However, studies comparing these 3 tools are lacking, leading to lack of standardization in this assessment. Through simulation, this study seeks to determine the most reliable, comprehensive, and user-friendly tool for standardizing endoscopy competency assessment. Methods: A mixed-methods quantitative-qualitative approach was utilized with sequential deductive design. All nine trainees in a gastroenterology training program were assessed on endoscopic procedural competence using the Simbionix Gi-bronch- mentor high-fidelity simulator, with 2 faculty raters independently completing the 3 assessment forms of DOPS, GAGES, and ACE. Psychometric analysis was used to evaluate the tools' reliability. Additionally, faculty trainers participated in a focused group discussion (FGD) to investigate their experience in using the tools. Results: For upper GI endoscopy, Cronbach's alpha values for internal consistency were 0.53, 0.8, and 0.87 for ACE, DOPS, and GAGES, respectively. Inter-rater reliability (IRR) scores were 0.79 (0.43-0.92) for ACE, 0.75 (-0.13-0.82) for DOPS, and 0.59 (-0.90-0.84) for GAGES. For colonoscopy, Cronbach's alpha values for internal consistency were 0.53, 0.82, and 0.85 for ACE, DOPS, and GAGES, respectively. IRR scores were 0.72 (0.39-0.96) for ACE, 0.78 (- 0.12-0.86) for DOPS, and 0.53 (-0.91- 0.78) for GAGES. The FGD yielded three key themes: the ideal tool should be scientifically sound, comprehensive, and user- friendly. Conclusion: The DOPS tool performed favourably in both the qualitative assessment and psychometric evaluation to be considered the most balanced amongst the three assessment tools. We propose that the DOPS tool be used for endoscopic skill assessment in gastroenterology training programs. However, gastroenterology training programs need to match their learning outcomes with the available assessment tools to determine the most appropriate one in their context. Keywords: simulation, training, competence, endoscopy, gastroenterology
Amaç: Bu çalismada, farkli ön tanilarla endoskopi ve/veya kolonoskopi yapilan hastalardan islem sirasinda alinan örneklerde ve ayni hastalarin diskilarinda Entamoeba histolytica, Giardia ...intestinalis ve Cryptosporidium spp.'nin varliginin ELISA ve direkt mikroskobi yöntemleri ile arastirilmasi amaçlanmistir. Yöntemler: Endoskopi yapilan 49, kolonoskopi yapilan 39 hasta olmak üzere toplam 88 hastadan endoskopik ve kolonoskopik yikama/sürüntü materyali ve ayrica ayni hastalardan diski örnekleri alinmistir. Alinan tüm örnekler parazitoloji laboratuvarina ayni gün getirilerek direkt mikroskobik incelemeleri yapilmis, ELISA uygulanincaya kadar -20 degreesC'de saklanmistir. Bulgular: Tüm örnekler direkt mikroskobi ve ELISA yöntemi ile incelenmistir. ELISA yöntemiyle yapilan incelemelerde; diski örneklerinin, 2'sinde (%2,3) E. histolytica, 4'ünde (%4,5) ise G. intestinalis saptanmistir. Kolonoskopi yapilan hastalarin kolonoskopik yikama/sürüntü örneklerinin 6'sinda (%6,8) G. intestinalis, 1'inde (%1,1) Cryptosporidium spp. saptanmistir. Kolonoskopi yapilan hastalarin diski örneklerinin hiçbirinde ve endoskopik yikama/sürüntü örneklerinde ELISA ile parazit varligi saptanmamistir. Direkt inceleme yöntemiyle diski ve yikama/sürüntü örneklerinde parazit saptanmamistir. Endoskopi ve kolonoskopi yapilan hastalardan alinan yikama/sürüntü örneklerinde G. intestinalis görülme durumu istatistiksel olarak karsilastirildiginda aradaki fark anlamli bulunmustur (p<0,05). Endoskopi yapilan hastalarin diskilarinda G. intestinalis görülme durumu karsilastirildiginda cinsiyetler arasindaki fark önemli bulunmustur (p<0,05). Sonuç: Gastrointestinal sikayeti olan, ve endoskopi ve kolonoskopi yapilan hastalarda direkt mikroskobi ile diski incelemesi ile parazit varliginin arastirilmasi yetersiz kalabilmektedir. Diski örneginin direkt incelemesinin yaninda endoskopi ve kolonoskopi islemi sirasinda kolayca alinabilecek yikama/sürüntü materyallerinde parazit antijenlerinin arastirilmasinin tani koymada gerekli ve önemli oldugu düsünülmektedir. Anahtar Kelimeler: ELISA, endoskopi, kolonoskopi, Entamoeba histolytica, Giardia intestinalis, Cryptosporidium spp. Objective: In this study, it was aimed to investigate the presence of Entamoeba histolytica, Giardia intestinalis and Cryptosporidium spp. in the samples taken during the procedure from patients who underwent endoscopy and/or colonoscopy with different prediagnoses, and in the stools of the same patients, by ELISA and direct microscopy methods. Methods: A total of 88 patients' endoscopic and colonoscopic pre-washed materials, which consisted of 49 individuals who belong former group and 39 individuals to the next group, were, respectively, obtained, and the stool samples were also included to study from the same group. All the specimens were immediately transferred to the parasitology research laboratory within the same day and stored C until for the next step of ELISA applications. Results: All the samples were examined by direct microscopy and ELISA method. In the examinations performed using the ELISA method; E. histolytica was detected in 2 (2.3%) stool samples, and G. intestinalis was found in 4 (4.5%) stool samples. In the colonoscopic wash/swab samples of the patients who underwent colonoscopy, 6 (6.8%) G. intestinalis, 1 (1.1%) Cryptosporidium spp. detected. No parasites were detected by ELISA in any of the stool samples or endoscopic washing/swab samples of the patients who underwent colonoscopy. No parasites were detected in stool and wash/swab samples by the direct examination method. When the incidence of G. intestinalis in washing/swab samples taken from patients who underwent endoscopy and colonoscopy was statistically compared, the difference was found to be significant (p<0.05). When the incidence of G. intestinalis in the stools of patients who underwent endoscopy was compared, the difference between genders was found to be significant (p<0.05). Conclusion: In patients with gastrointestinal complaints and undergoing endoscopy and colonoscopy, investigation of the presence of parasites by stool examination with direct microscopy may be insufficient. In addition to the direct examination of the stool sample, it is thought that the investigation of parasite antigens in the wash/swab materials that can be easily taken during the endoscopy and colonoscopy procedure is necessary and critical in the diagnosis Keywords: ELISA endoscopy, colonoscopy, Entamoeba histolytica, Giardia intestinalis, Cryptosporidium spp.
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