Pure cystic groove pancreatitis: endosonographic appearance.

Intraductal aspiration: a promising new tissue-sampling technique for the diagnosis of suspected malignant biliary strictures

Brushing is the most commonly used technique for biliary sampling at ERCP, despite its limited sensitivity. To evaluate intraductal aspiration (IDA) as a new combined endoscopic technique for cytodiagnosis, its cellular adequacy, diagnostic accuracy for cancer detection, feasibility, and safety. Prospective, observational study. Single tertiary referral center. IDA cellular adequacy, diagnostic accuracy for cancer detection, feasibility, and safety. From April 2009 to September 2010, 42 consecutive patients with suspected malignant biliary stricture underwent ERCP, with tissue sampling obtained with IDA. IDA included performance of standard brushing in all patients. After standard brushing,…

Diagnostic performance of endoscopic ultrasound through‐the‐needle microforceps biopsy of pancreatic cystic lesions: Systematic review with meta‐analysis

Objectives Endoscopic ultrasound through-the-needle biopsy (EUS-TTNB) is a useful tool for differential diagnosis among pancreatic cystic lesions (PCLs). Cystic fluid cytology (CFC) is recommended by guidelines, but its diagnostic accuracy is about 50%. The aim of this meta-analysis is to assess the clinical impact of EUS-TTNB in terms of technical success (TS), histological accuracy (HA) and diagnostic yield (DY). Methods Original studies in English language on EUS-TTNB were searched in MEDLINE and EMBASE until October 2019. Diagnostic accuracy of EUS-TTNB for identification of mucinous PCLs was calculated using individual diagnostic data of patients who underwent CFC and surgery. Results …

Gastrointestinal Bleeding In Advanced Cancer Patients

sj-pdf-1-ueg-10.1177_2050640620924302 - Supplemental material for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency

Supplemental material, sj-pdf-1-ueg-10.1177_2050640620924302 for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency by Luca Barresi, Matteo Tacelli, Stefano Francesco Crinò Fabia Attili, Maria Chiara Petrone, Germana De Nucci, Silvia Carrara, Guido Manfredi, Gabriele Capurso, Claudio Giovanni De Angelis, Lucia Crocellà, Alberto Fantin, Maria Francesca Dore, Alessandra Tina Garribba, Ilaria Tarantino, Nicolò De Pretis, Danilo Pagliari, Gemma Rossi, Gianpiero Manes, Paoletta Preatoni, Ilenia Barbuscio, Fabio Tuzzolino, Mario Traina, Luca Frulloni, Guido Costamagna, Paolo Giorgio Arcidiac…

sj-pdf-1-ueg-10.1177_2050640620924302 - Supplemental material for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency

Supplemental material, sj-pdf-1-ueg-10.1177_2050640620924302 for Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency by Luca Barresi, Matteo Tacelli, Stefano Francesco Crinò Fabia Attili, Maria Chiara Petrone, Germana De Nucci, Silvia Carrara, Guido Manfredi, Gabriele Capurso, Claudio Giovanni De Angelis, Lucia Crocellà, Alberto Fantin, Maria Francesca Dore, Alessandra Tina Garribba, Ilaria Tarantino, Nicolò De Pretis, Danilo Pagliari, Gemma Rossi, Gianpiero Manes, Paoletta Preatoni, Ilenia Barbuscio, Fabio Tuzzolino, Mario Traina, Luca Frulloni, Guido Costamagna, Paolo Giorgio Arcidiac…

Endoscopic ultrasound through‐the‐needle biopsy diagnosis of a pancreatic lymphoepithelial cyst

White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology un…

An unusual case of postcholecystectomy syndrome.

Morphine versus methadone in the pain treatment of advanced-cancer patients followed up at home

PURPOSE The aim of this study was to evaluate the analgesic and adverse effects and the doses of methadone in comparison to morphine. PATIENTS AND METHODS A prospective randomized study was performed in a sample of 40 patients with advanced cancer who required strong opioids for their pain management. Patients were treated with sustained-release morphine or methadone in doses titrated against the effect administered two or three times daily according to clinical need. Opioid doses, adjuvant medications, symptoms associated with opioid therapy, pain intensity, and pain mechanisms were recorded. The opioid escalation indices in percentage (OEI%) and milligrams (OEImg) were calculated. The eff…

Thyroid ectopia of the liver: An unusual diagnosis with contrast-enhanced EUS (with video)

No abstract available

Reliability of grading preoperative pancreatic neuroendocrine tumors on EUS specimens: a systematic review with meta-analysis of aggregate and individual data

Background and aims: Therapy and prognosis of pancreatic neuroendocrine tumors (PanNETs) are strictly related to the Ki-67 index, which defines tumor grading. The criterion standard for the assessment of grading of PanNETs is EUS-guided FNA (EUS-FBAFNA) or EUS-guided fine-needle biopsy sampling (EUS-FNB). Because data on diagnostic accuracy of EUS-FNA and EUS-FNB are heterogeneous, we aimed to analyze the variability in concordance between EUS grading and surgical grading. Methods: The MEDLINE, SCOPUS, and EMBASE databases were searched until November 2021 to identify studies reporting the concordance rate between EUS grading and surgical grading. The study was conducted in accordance with …

Investigation of an opioid response categorization in advanced cancer patients

The aim of this study was to investigate a possible distinction in three categories of opioid response and to identify possible factors associated with a poor response. A prospective survey was carried out in 105 consecutive patients requiring morphine for at least 4 weeks before death. Mean pain intensity, opioid doses and symptom intensity at weekly intervals, pain syndromes, and the presence of psychological distress were assessed. Opioid escalation index (OEI%) was calculated from the parameters recorded. Three categories were considered, including (1) patients with slow increments of opioid dose and a mean analgesic 10-cm visual analogue scale (VAS) less than 4 (responders), (2) patien…

Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency

BACKGROUND: Autoimmune pancreatitis (AIP) is a rare, and relatively new, form of chronic pancreatitis. The management of AIP can vary considerably among different centres in daily clinical practice. OBJECTIVES: The aim of this study is to present a picture of epidemiological, clinical characteristics, outcomes, and the real-life practice in terms of management in several academic and non-academic centres in Italy. METHODS: Data on the clinical presentation, diagnostic work-up, treatments, frequency of relapses, and long-term outcomes were retrospectively collected in a cohort of AIP patients diagnosed at 14 centres in Italy. RESULTS: One hundred and six patients were classified as type 1 AI…

Methadone response in advanced cancer patients with pain followed at home

Concerns about the safety of therapy with methadone, which may arise because of its pharmacokinetic characteristics and inappropriate dosing, may deter clinicians from using this drug, especially in elderly patients. Experience is accumulating that the drug may be used safely and successfully if low doses are given initially and care is taken in the titration of the dose against the pain. A prospective study was carried out in a consecutive sample of 45 advanced cancer patients followed at home, who had never received other strong opioids for their pain. Patients were treated with an oral liquid preparation of methadone, which was administered 2-3 times daily, according to need. Doses were …

Correction: Pure cystic groove pancreatitis: endosonographic appearance.

Risk Factors for Rate of Relapse and Effects of Steroid Maintenance Therapy in Patients With Autoimmune Pancreatitis: Systematic Review and Meta-analysis

Background & Aims: Risk for relapse after induction of remission with steroid therapy has been studied extensively in patients with autoimmune pancreatitis (AIP), but findings have been equivocal. We performed a systematic review and meta-analysis to estimate the relapse rate of AIP after initial remission after steroid treatment and to identify factors associated with relapse. Methods: Three reviewers searched MEDLINE, SCOPUS, and EMBASE until July 2018 to identify studies on rate of relapse of AIP after induction of remission with steroid therapy. A pooled estimate was calculated using the DerSimonian and Laird method for a random-effects model. This study was conducted in accordance …