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Narrow Band Imaging Enhances the Detection Rate of Penetration and Aspiration in FEES

AbstractNarrow band imaging (NBI) is widely used in gastrointestinal, laryngeal, and urological endoscopy. Its original purpose was to visualize vessels and epithelial irregularities. Based on our observation that adding NBI to common white light (WL) improves the contrast of the test bolus in fiberoptic endoscopic evaluation of swallowing (FEES), we now investigated the potential value of NBI in swallowing disorders. 148 FEES images were analyzed from 74 consecutive patients with swallowing disorders, including 74 with and 74 without NBI. All images were evaluated by four dysphagia specialists. Findings were classified according to Rosenbek ’s penetration-aspiration scale modified for evaluating these FEES images. Intra- and inter-rater reliability was determined as well as observer confidence. A better visualization of the bolus is the main advantage of NBI in FEES. This generally leads to sharper optical contrasts and better detect ion of small bolus quantities. Accordingly, NBI enhances the detection rate of penetration and aspiration. On average, identification of laryngeal penetration increased from 40 to 73% and of aspiration from 13 to 24% (eachp 
Source: Dysphagia - Category: Speech Therapy Source Type: research

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Authors: Akutagawa T, Shindo T, Yamanouchi K, Hayakawa M, Ureshino H, Tsuruoka N, Sakata Y, Shimoda R, Noguchi R, Furukawa K, Morita S, Iwakiri R, Kimura S, Matsumoto M, Fujimoto K Abstract A 67-year-old woman with recurrent gastrointestinal bleeding and aortic valve stenosis presented with spurting bleeding from angiodysplasia of the upper jejunum. As electrophoresis revealed decreased levels of high-molecular-weight (HMW) von Willebrand factor (VWF) multimers, she was diagnosed with Heyde's syndrome. After aortic valve replacement, her HMW VWF levels quickly recovered to normal, and the gastrointestinal bleeding ...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Cantel Medical (NYSE:CMN) said today that it closed its $60.8 million acquisition of German endoscope reprocessor BHT Hygienetechnik Holding. Gersthofen, Germany-based BHT, which employs about 100 people, put up sales of abut $24.5 million last year, according to Little Falls, N.J.-based Cantel. “Establishing leadership in our international markets is a key component of our strategy and this milestone will help us achieve this goal. The addition of BHT Group will enable us to become the market leader in automated endoscope reprocessors in Germany. We’re excited to combine BHT’s expertise an...
Source: Mass Device - Category: Medical Devices Authors: Tags: Endoscopic / Arthroscopic Mergers & Acquisitions Wall Street Beat Cantel Medical Corp. Source Type: news
In this study, we report a case of intestinal endometriosis diagnosed preoperatively by magnifying image-enhanced colonoscopy and target biopsy. A 45-year-old woman was referred to our hospital with abdominal pain in the left lower quadrant. Colonoscopy showed a submucosal tumor-like lesion of approximately 30 mm in diameter exhibiting surface reddening and granular changes in the sigmoid colon. Magnifying endoscopy revealed sparsely distributed round pits in the granules. The mucosal biopsy specimen from the granule provided the diagnosis of intestinal endometriosis. Segmental sigmoidectomy was performed, and pathological...
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research
No abstract available
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Invited Commentaries Source Type: research
No abstract available
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Invited Commentaries Source Type: research
Conclusions: The exposure-matching analysis permitted approval of an esomeprazole regimen not studied directly in clinical trials. Exposure-response for intragastric pH-permitted approval for the treatment of gastroesophageal reflux disease in children in whom it was not possible to evaluate the adult primary endpoint, mucosal healing assessed by endoscopy.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research
Objectives: The aim of the study was to determine whether esophageal baseline impedance (BI) values in children could be predictive of esophagitis. Materials and Methods: Multichannel intraluminal impedance (MII) tracings of children 3 to 17 years of age suspected of having gastroesophageal reflux and esophagitis, who had also undergone upper endoscopy with multiple esophageal biopsies, were reviewed. Patients with eosinophilic esophagitis were excluded. Esophagitis was assessed by macroscopic and microscopic parameters. Esophageal histology was reported by 2 blinded independent pathologists unaware of the MII results. Me...
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research
ABSTRACT: Exclusive enteral nutrition is effective in pediatric Crohn disease but challenging as maintenance therapy. There is interest in food-based therapies such as the specific carbohydrate diet (SCD) but paucity of data on efficacy and effect on mucosal healing, an evolving target of IBD therapy. We conducted a retrospective review of the mucosal healing effect of the SCD in pediatric Crohn disease (CD). The endoscopic findings for children younger than 18 years with CD treated exclusively with the SCD or modified SCD (mSCD; SCD + addition of “illegal foods”) were reviewed before and after the diet. Il...
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Short Communication: Gastroenterology: Inflammatory Bowel Disease Source Type: research
Conclusions: This pilot study shows, for the first time, increased capillary blood flow in the duodenum of UC patients that was unrelated to inflammatory markers or disease activity. Thus, early vascular changes can be assessed using pCLE during endoscopy.
Source: Journal of Pediatric Gastroenterology and Nutrition - Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research
ConclusionModeling the upper airway in OSA patients is feasible and holds promise in aiding patient‐specific surgical treatment. Level of EvidenceNA. Laryngoscope, 2017
Source: The Laryngoscope - Category: ENT & OMF Authors: Tags: Sleep Medicine Source Type: research
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