Current practice in managing patients on anticoagulants and/or antiplatelet agents around the time of gastrointestinal endoscopy -- a nation-wide survey in Germany.

Anticoagulants and antiplatelet agents are widely used in the prophylaxis and management of thromboembolic and cardiovascular diseases. Gastrointestinal bleeding is a well-known complication of these agents. Modification of anticoagulant and antiplatelet therapy is often required in patients undergoing surgical procedures and specific recommendations for the perioperative period have been issued. Fewer data exist with regard to the use of these agents around the time of endoscopic procedures. A survey of the American Society for Gastrointestinal Endoscopy (ASGE), performed several years ago, showed a wide variation between endoscopists in the management of anticoagulants and antiplatelet ag…

Value of chromoendoscopy and magnification endoscopy in the evaluation of duodenal abnormalities: a prospective, randomized comparison.

Background and study aims Endoscopic staining methods are increasingly being used to evaluate lesions in the esophagus and colon. The aim of this prospective study was to investigate chromoendoscopy and magnification endoscopy for the evaluation of mucosal lesions in the duodenum. Patients and methods Consecutive patients were randomly assigned to undergo conventional endoscopy without staining (group A) or intravital staining of the duodenal mucosa with indigo carmine and evaluation with a conventional video endoscope (group B) or a magnification endoscope (group C). Visible lesions were characterized before and after staining, and biopsies were taken for histological assessment. Results A…

A double-blind, randomized, dose response study testing the pharmacological efficacy of synthetic porcine secretin

Background: Biologically derived porcine secretin has been used as a diagnostic agent in clinical gastrointestinal practice for many years. Pure synthetic porcine secretin is now available for investigational clinical use. Aim: To compare the pharmacology of synthetic porcine secretin and biologically derived porcine secretin in healthy volunteers. Methods: Secretin stimulation tests were performed in 12 volunteer subjects in a double-blind, randomized, Latin square crossover design study comparing three doses of synthetic porcine secretin (0.05, 0.2, and 0.4 μg/kg) with a standard dose of biologically derived porcine secretin (1 CU/kg). Duodenal aspirates were analysed for total volume and…

Diagnosis of a Pleural Mesothelioma by Endosonography-Guided Transgastric Fine-Needle Aspiration