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1
Zacca, Rodrigo. "Comparação entre diferentes modelos de obtenção de velocidade crítica em nadadores juvenis." Revista Brasileira de Fisiologia do Exercício 8, no. 2 (June 10, 2009): 52. http://dx.doi.org/10.33233/rbfe.v8i2.3555.
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Velocidade Crítica (VC): máxima intensidade sustentável por um período prolongado sem alcançar o VO2máx, ou seja, o limite inferior da zona de intensidades severas. Objetivo: obter e comparar valores de VC obtidos por meio de nove modelos de diferentes números e combinações de distâncias, utilizando o mesmo grupo de nadadores. Método: Onze nadadores juvenis (idade: 14,4 ± 0,5 anos, massa corporal: 60,6 ± 7,0 kg, estatura: 175,5 ± 5,2 cm, envergadura: 182,2 ± 4,9 cm), com índice de participação em Campeonatos Brasileiros participaram deste estudo. Para a determinação dos diferentes modelos de VC, os atletas realizaram, em nado crawl, testes de 50 m, 100 m, 200 m, 400 m, 800 m e 1500 m sob máxima intensidade. Para a determinação da VC1 foram utilizadas as distâncias de 50 e 200 m; VC2, 100 e 400 m; VC3, 200 e 800 m, VC4, 400 e 1500 m, VC5, 50, 100 e 200 m; VC6, 100, 200 e 400 m; VC7, 200, 400 e 800 m; VC8, 400, 800 e 1500 m; e para a VC9, 50, 100, 200 e 400 m. Resultados: VC1 (1,28 ± 0,07 m/s), VC5 (1,27 ± 0,07 m/s) e VC9 (1,26 ± 0,07 m/s) apresentaram maiores valores que VC4 (1,19 ± 0,09 m/s) e VC8 (1,19 ± 0,10 m/s). VC4 e VC8 foram semelhantes aos modelos VC2 (1,25 ± 0,07 m/s), VC3 (1,21 ± 0,07 m/s), VC6 (1,25 ± 0,07 m/s) e VC7 (1,20 ± 0,07 m/s). VC6 foi similar a todos os modelos de VC. Conclusão: distâncias percorridas em aproximadamente 60 segundos ou menos parecem induzir a valores mais altos de VC comparados a outras combinações, sugerindo assim a exclusão da distância de50 m e, se necessário, também a distância de100 m na confecção de modelos para determinação da mesma. Por outro lado, a exclusão das distâncias mais longas (800 m e1500 m) parece não alterar o valor da VC em relação aos modelos de VC confeccionados com inclusão de distâncias percorridas em tempos superiores a 60 s.Palavras-chave: natação, desempenho, potência crítica.
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Alatoom, Adnan A., Ricardo Aburto, Abdul N. Hamood, and Jane A. Colmer-Hamood. "VceR negatively regulates the vceCAB MDR efflux operon and positively regulates its own synthesis in Vibrio cholerae 569B." Canadian Journal of Microbiology 53, no. 7 (July 2007): 888–900. http://dx.doi.org/10.1139/w07-054.
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The vceCAB (vce) operon encodes the multidrug resistance pump VceCAB (VCE), which contributes to resistance of Vibrio cholerae to carbonyl cyanide m-chlorophenylhydrazine (CCCP), deoxycholate, and pentachlorophenol by several-fold. vceR, which encodes the TetR-type repressor VceR and is divergently transcribed from vce, has been characterized in Escherichia coli . Detailed characterization of vceR in V. cholerae 569B confirmed the repressive effect of VceR on VCE function and indicated several novel features of VceR. Deletion of vceR increased resistance of strain 569B to CCCP and deoxycholate modestly, but did not affect resistance to pentachlorophenol. Transcriptional analysis revealed that vce expression was not only increased in strain 569BΔvceR::Ω by 2-fold but continued to rise throughout the growth cycle. Using a vceR–lux transcriptional fusion plasmid, we examined whether vceR is autoregulated in strain 569B. Expression of vceR from the vceR–lux fusion was significantly lower in strain 569BΔvceR::Ω than in strain 569B. In addition, exposure to CCCP reduced vceR expression from the vceR–lux fusion in strain 569B but not in strain 569BΔvceR::Ω. Despite differences in the VceR binding site in strain 569B from the previously recognized 28 bp sequence in V. cholerae CVD101, purified recombinant VceR bound to the 24 bp sequence from strain 569B. We propose that VceR modulates vce expression by binding in vivo to the 24 bp sequence within the vceR–vce intergenic region; unlike many TetR repressors that are negatively autoregulated, VceR positively regulates vceR expression in trans.
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Patty, Litta Marlin, Jodelin Muninggar, and Nur Aji Wibowo. "PROFILE OF LUNGS VOLUME IN THE DIABETES MELITUS AND NON DIABETES MELITUS." EDU SCIENCES JOURNAL 1, no. 1 (February 18, 2020): 25–36. http://dx.doi.org/10.30598/edusciencesvol1iss1pp25-36.
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International Diabetes Federation states that in 2007 there were 246 million people in the world suffering from diabetes and it is expected to increase to 380 million by 2025. DM can cause susceptibility to infections in the human lung organs due to hyperglycemia. The purpose of this study was to determine the lung volume profile in the form of VT, VCI, VCE and VKP in the DM group and non DM group. This study uses a quantitative descriptive survey design with a sample of 60 people, consisting of 30 people from the DM group and 30 people from the Non DM group. The statistical test used in this study is the Independent statistical sample t-test, the Mann-Whitney test and the Pearson correlation. The results showed: (1) There was a significant difference in the DM of the DM group and the Non DM group with p = 0.021 (p <0.05); (2) There were significant differences in VT, VCI, VCE of the DM group and Non DM group with significant values of VT (p = 0,000 <0.05), VCI (p = 0.003 <0.05) and VCE (p = 0.001 <0.05); (3) There was no significant difference in the VKP of the DM group and the Non DM group with p = 0.805 (p <0.05); (4) Relationship between GD and VT (r = 0.220), GD with VCI (r = 0.308), GD with VCE (r = -0.110), GD with VKP (r = 0.219). So it was concluded that there was a positive relationship between GD and VT, VCI, VKP and also there was a negative relationship between GD and VCE. Suggestion: DM sufferers need to conduct routine checks so that health remains well controlled
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Krahn, T., M. I. Suliman, B. Halloran, S. Wasilenko, and S. Zepeda-Gomez. "A31 OUTCOMES OF PATIENTS UNDERGOING REPEAT VIDEOCAPSULE ENDOSCOPY (VCE) PRESENTING WITH OBSCURE GASTROINTESTINAL BLEEDING (OGIB)." Journal of the Canadian Association of Gastroenterology 5, Supplement_1 (February 21, 2022): 35–36. http://dx.doi.org/10.1093/jcag/gwab049.030.
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Abstract Background Videocapsule Endoscopy (VCE) as well as balloon-assisted enteroscopy (BAE) are useful tools in the diagnosis and management of obscure gastrointestinal bleeding (OGIB). There is limited data assessing the diagnostic yield of VCE in subjects with OGIB according to different subtypes: 1) obscure overt 2) inactive overt and 3) active overt. Aims We evaluated the diagnostic yield and outcomes of patients undergoing a second VCE in OGIB. Methods This is a retrospective analysis of all patients who underwent more than one VCE completed at the University of Alberta from January 1, 2015 to August 31, 2021. Demographic and background information was collected including previous endoscopy results, cross-sectional imaging, and subsequent interventions. Patient data was analyzed according to subtype of OGIB at presentation. Results During the study period, there were 59 subjects who met inclusion criteria. The indication for VCE was recurrent iron deficiency anemia (IDA), active OGIB, and/or inactive OGIB in 38 subjects. The median time to VCE after initial endoscopic evaluation was 61 days. Median age of cases was 61.5 years and 49% were female. Initial VCE had clinically significant positive findings in 68% of cases (Table 1). The diagnostic yield was 75%, 56% and 74% in active OGIB, inactive OGIB, and IDA, respectively. Active bleeding or fresh blood was present in 33% of VCEs for active OGIB compared to 11% of inactive OGIB and 13% of subjects with IDA. At second VCE investigation, there were positive findings in 42% of cases. Findings on second VCE differed from initial VCE in 17 of 38 cases. Findings that changed clinical management were found in 76% of patients after first and second VCE. BAEs were performed in 20 subjects after VCE, with therapeutics applied in 75%. The most common findings were arteriovenous malformations (AVMs) (65%) and erosions/ulcers (15%). Conclusions The diagnostic yield of VCE is high in appropriately selected patients and did not significantly differ in patients with IDA, active, and inactive OGIB. Serial VCE is appropriate for the investigation of suspected recurrent small bowel bleeding when initial workup is nondiagnostic. Funding Agencies None
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Shimamura, Y., C. M. Walsh, S. Cohen, M. Aronson, U. Tabori, P. P. Kortan, and C. A. Durno. "Role of video capsule endoscopy in patients with constitutional mismatch repair deficiency (CMMRD) syndrome: report from the International CMMRD Consortium." Endoscopy International Open 06, no. 08 (August 2018): E1037—E1043. http://dx.doi.org/10.1055/a-0591-9054.
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Abstract Background and study aims Constitutional mismatch repair deficiency (CMMRD) syndrome, also known as biallelic mismatch repair deficiency (BMMRD) syndrome is a rare autosomal-recessive genetic disorder that has a high mortality due to malignancy in childhood and early adulthood. The small bowel phenotype in CMMRD is not well described and surveillance protocols for small bowel cancer have not been well established. This study was conducted to evaluate the usefulness and clinical impact of video capsule endoscopy (VCE) for small bowel surveillance. Patients and methods We retrospectively reviewed the prospectively maintained International CMMRD Consortium database. Treating physicians were contacted and VCE report data were extracted using a standardized template. Results Among 58 patients included in the database, 38 VCE reports were collected from 17 patients. Polypoid lesions were first detected on VCE at a median age of 14 years (range: 4 – 17). Of these, 39 % in 7 patients (15/38) showed large polypoid lesions (> 10 mm) or multiple polyps that prompted further investigations. Consequently, three patients were diagnosed with small bowel neoplasia including one patient with adenocarcinoma. Small bowel neoplasia and/or cancer were confirmed histologically in 35 % of the patients (6/17) who had capsule surveillance and the lesions in half of these patients were initially visualized on VCE. Multiple polyps were identified on eight VCEs that were completed on three patients. Ten VCEs (28 %) were incomplete due to slow bowel transit; none required capsule removal. Conclusions Small bowel surveillance in patients with CMMRD should be initiated early in life. VCE has the potential to detect polyps; however, small bowel neoplasias are often proximal and can be missed, emphasizing the importance of concurrent surveillance with other modalities. Meeting presentations Digestive Disease Week 2017 and World Congress of Pediatric Gastroenterology, Hepatology and Nutrition 2016.
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Dorn, Sheri, and Paula Diane Relf. "Assessing the Virginia Cooperative Extension Master Gardener Coordinator Manual." HortTechnology 11, no. 3 (January 2001): 472–76. http://dx.doi.org/10.21273/horttech.11.3.472.
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The Virginia Cooperative Extension (VCE) Master Gardener (MG) Coordinator Manual, a 14-chapter resource book, was developed cooperatively with teams of VCE MGs, coordinators, and agents to enhance coordinators' skills. It includes chapters on risk management, volunteer management, the educational process, current policies, and the volunteer section of the VCE Master Gardener's Handbook. The VCE MG Coordinator Manual was the basis of four local VCE MG coordinator-training sessions in 1998. This evaluation showed that coordinators are using the manual and adapting the suggestions and samples to fit their local programs, despite the fact that more planning time is often required. Those using the manual increased their understanding of VCE goals and the role of the VCE MG and slightly increased their leadership skills. Reading the manual showed a need for information on training VCE MGs to work with agents to design and implement strong horticulture education programs for Virginia communities. Areas for improvement were identified before final publication.
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Nemeth, Artur, Daniel Agardh, Gabriele Wurm Johansson, Henrik Thorlacius, and Ervin Toth. "Video capsule endoscopy in pediatric patients with Crohn’s disease: a single-center experience of 180 procedures." Therapeutic Advances in Gastroenterology 11 (January 1, 2018): 175628481875892. http://dx.doi.org/10.1177/1756284818758929.
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Background Video capsule endoscopy (VCE) is a noninvasive method enabling excellent visualization of the small bowel (SB) mucosa. The aim of this study was to examine the impact and safety of VCE performed in children and adolescents with suspected or established Crohn’s disease (CD). Methods A total of 180 VCE examinations in 169 consecutive patients conducted in 2003–14 in a single center were retrospectively analyzed. The median age was 13 years (range 3–17 years) and indications for VCE were suspected (125 cases, 69%) and established (55 cases, 31%) CD. VCE was performed with a PillCam SB (Given Imaging, Yokneam, Israel) VCE system with 8–12 h of registration without bowel preparation. Results A total of 154 of 180 (86%) patients swallowed the capsule and 26 (14%) had the capsule endoscopically placed in the duodenum. Patency capsule examination was performed in 71 cases prior to VCE to exclude SB obstruction. VCE detected findings consistent with SB CD in 71 (40%) examinations and 17 (9%) procedures showed minor changes not diagnostic for CD. A total of 92 (51%) examinations displayed normal SB mucosa. The capsule did not reach the colon within the recording time in 30 (17%) procedures and were defined as incomplete examinations. A change in diagnosis or therapy was recommended in 56 (31%) patients based on VCE results. Capsule retention occurred in one patient. Conclusions VCE is a safe method in children with suspected or established CD. VCE often leads to a definitive diagnosis and has a significant impact on the clinical management of pediatric patients with CD.
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Fan, Cynthia, and Bernadette Hood. "Brief Research Report - An Analysis of the Relationship Between Secondary and Tertiary Psychology Performance." Australian Educational and Developmental Psychologist 12, no. 1 (May 1995): 25–29. http://dx.doi.org/10.1017/s0816512200027140.
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ABSTRACTThis study aimed to evaluate the effectiveness of the Victorian Certificate of Education (VCE) secondary psychology course in preparing students for studying psychology at a tertiary level. First semester results of 228 first year psychology students at Victoria University of Technology were analysed. Of these students 60 had completed VCE Psychology in 1992. No significant differences were observed in overall semester one psychology performance between students who had completed VCE Psychology and those who had not. Regression analysis suggested that VCE aggregate score was a better predictor than the VCE Psychology score of overall performance in the first year psychology course. Subsequent correlation analyses demonstrated that VCE Psychology scores correlated significantly with tertiary psychology examination results but not with coursework requirements. VCE aggregate scores correlated with both examination and coursework requirements. These results suggest that completion of VCE Psychology does not advantage students entering tertiary psychology courses and educators need to analyse both the content and process of both secondary and tertiary psychology courses to facilitate more effective articulations for students.
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Dorn, Sheri T., and Paula Diane Relf. "Volunteer Management Reference for Local VCE Master Gardener Coordinators." HortScience 33, no. 3 (June 1998): 503a—503. http://dx.doi.org/10.21273/hortsci.33.3.503a.
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Virginia Cooperative Extension's (VCE) Master Gardener volunteer program is available in 72 unit offices. The unit programs are managed by MG coordinators who currently include 10 locally funded agents, eight locally funded technicians, and 28 volunteers. The VCE Master Gardener Coordinator Manual, a 12-unit resource book, was developed cooperatively with teams of MGs, coordinators, and agents to enhance coordinators' skills for managing the local VCE MG program. The manual includes chapters on VCE MG components such as risk management; job descriptions; recruitment and screening; and volunteer review, recognition, and retention. Additional resources within the manual include a synopsis of educational program planning, implementation, and evaluation, as well as a copy of the current VCE Master Gardener Program Policies and the volunteer section of the Virginia Master Gardener Handbook, which serves as program orientation for new or prospective trainees. The VCE Master Gardener Coordinator Manual is the basis of three local MG coordinator training sessions in 1998. Additional resources available to coordinators for enhancing the local MG program include a MG newsletter focused on the role of Master Gardeners as community leaders and educators; program policies and guidelines for the management of MG training and operation; VCE publication 426-699 Welcome to Virginia Master Gardenering! Guide to Educational Programming and Resource and Reference Guide; and the VCE Master Gardener Internet website at http://www.ext.vt.edu/vce/specialty/envirohort/mastergard/master.html.
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Yoo, Jae-Myung, Kwang Il Park, and Jin Yeul Ma. "Anticolitic Effect of Viscum coloratum through Suppression of Mast Cell Activation." American Journal of Chinese Medicine 47, no. 01 (January 2019): 203–21. http://dx.doi.org/10.1142/s0192415x19500101.
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Viscum coloratum has been used as a component for traditional medicine for therapy of inflammatory diseases. Nonetheless, effect of Viscum coloratum on inflammatory bowel disease is unknown. Therefore, we investigated whether the ethanol extract of Viscum coloratum (VCE) could suppress inflammatory responses in dextran sodium sulfate (DSS)-treated mice and mast cell-derived inflammatory mediator (MDIM)-activated Caco-2 cells. VCE significantly attenuated body weight loss, shortened colon length, enteric epithelium disruption, enterorrhagia and colonic edema in DSS-treated mice. Additionally, VCE decreased the levels of immunoglobulin E, interleukin-6 and tumor necrosis factor-[Formula: see text] in serum and the activity of myeloperoxidase in colonic tissue. Moreover, VCE inhibited the infiltration of immune cells as well as the activity and expression of both matrix metalloprotease-2 and matrix metalloprotease-9. Furthermore, VCE restored zonula occludens-1 expression. Consistent with in vivo studies, VCE suppressed the activity and expression of matrix metalloprotease-2 and matrix metalloprotease-9 in MDIM-activated Caco-2 cells. In addition, VCE reinstated the expression of zonula occludens-1 through inhibiting activation of janus kinase 2/signal transducer and activator of transcription 3 in the cells. In conclusion, VCE exerts anticolitic action through inhibiting the activation of mast cells. Therefore, VCE may be useful as a phytomedicine or functional food for inflammatory bowel disease.
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Guarini, Alessandra, Francesca De Marinis, Cesare Hassan, Raffaele Manta, Vincenzo De Francesco, Bruno Annibale, and Angelo Zullo. "High Concordance between Trained Nurses and Gastroenterologists in Evaluating Recordings of Small Bowel Video Capsule Endoscopy (VCE)." Journal of Gastrointestinal and Liver Diseases 27, no. 2 (June 30, 2018): 127–31. http://dx.doi.org/10.15403/jgld.2014.1121.272.vce.
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Background & Aims: The video capsule endoscopy (VCE) is an accurate and validated tool to investigate the entire small bowel mucosa, but VCE recordings interpretation by the gastroenterologist is time-consuming.A pre-reading of VCE recordings by an expert nurse could be accurate and cost saving. We assessed the concordance between nurses and gastroenterologists in detecting lesions on VCE examinations.Methods: This was a prospective study enrolling consecutive patients who had undergone VCE in clinical practice. Two trained nurses and two expert gastroenterologists participated in the study. At VCE pre-reading the nurses selected any abnormalities, saved them as “thumbnails” and classified the detected lesions as a vascular abnormality, ulcerative lesion, polyp, tumor mass, and unclassified lesion. Then, the gastroenterologist evaluated and interpreted the selected lesions and, successively, reviewed the entire video for potential missed lesions. The time for VCE evaluation was recorded.Results: A total of 95 VCE procedures performed on consecutive patients (M/F: 47/48; mean age: 63 ± 12years, range: 27−86 years) were evaluated. Overall, the nurses detected at least one lesion in 54 (56.8%) patients.There was total agreement between nurses and gastroenterologists, no missing lesions being discovered at a second look of the entire VCE recording by the physician. The pre-reading procedure by nurse allowed a time reduction of medical evaluation from 49 (33-69) to 10 (8-16) minutes (difference: -79.6%).Conclusions: Our data suggest that trained nurses can accurately identify and select relevant lesions in thumbnails that subsequently were faster reviewed by the gastroenterologist for a final diagnosis. This could significantly reduce the cost of VCE procedure.
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Kono, Yoshiyasu, Seiji Kawano, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Hiroyuki Sakae, Makoto Abe, et al. "Clinical outcome of patients with obscure gastrointestinal bleeding during antithrombotic drug therapy." Therapeutic Advances in Gastroenterology 11 (January 1, 2018): 1756283X1774693. http://dx.doi.org/10.1177/1756283x17746930.
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Background: The clinical outcome of patients with obscure gastrointestinal bleeding (OGIB) during antithrombotic drug therapy has not been fully investigated. Methods: Patients who underwent video capsule endoscopy (VCE) for the investigation of OGIB at Okayama University Hospital from January 2009 to March 2016 were enrolled. We evaluated the VCE findings, the patterns of OGIB, and the rate of rebleeding within 1 year in antithrombotic drug users and antithrombotic drug nonusers. Results: A total of 181 patients were enrolled. Among the antithrombotic drug users, the rate of VCE positivity in the patients with overt OGIB was significantly higher in comparison with patients with occult OGIB (45% versus 16%, p = 0.014), whereas there was no significant difference among the antithrombotic drug nonusers (27% versus 26%, p = 1.0). Among the antithrombotic drug users, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (50% versus 5.9%, p = 0.011). Moreover, among antithrombotic drug users who did not receive therapeutic intervention, the rate of rebleeding among the VCE-positive patients was significantly higher in comparison with the VCE-negative patients (75% versus 6.3%, p = 0.001). However, among the antithrombotic drug nonusers who did not receive therapeutic intervention, the rebleeding rate of the VCE-positive patients was not significantly different from that of the VCE-negative patients (20% versus 9.4%, p = 0.43). Conclusion: Therapeutic intervention should be considered for patients with overt OGIB who are VCE positive and who use antithrombotic drugs due to the high risk of rebleeding.
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Liu, Qing, Michael Schmidt, Roland Pail, and Martin Willberg. "Determination of the Regularization Parameter to Combine Heterogeneous Observations in Regional Gravity Field Modeling." Remote Sensing 12, no. 10 (May 19, 2020): 1617. http://dx.doi.org/10.3390/rs12101617.
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Various types of heterogeneous observations can be combined within a parameter estimation process using spherical radial basis functions (SRBFs) for regional gravity field refinement. In this process, regularization is in most cases inevitable, and choosing an appropriate value for the regularization parameter is a crucial issue. This study discusses the drawbacks of two frequently used methods for choosing the regularization parameter, which are the L-curve method and the variance component estimation (VCE). To overcome their drawbacks, two approaches for the regularization parameter determination are proposed, which combine the L-curve method and VCE. The first approach, denoted as “VCE-Lc”, starts with the calculation of the relative weights between the observation techniques by means of VCE. Based on these weights, the L-curve method is applied to determine the regularization parameter. In the second approach, called “Lc-VCE”, the L-curve method determines first the regularization parameter, and it is set to be fixed during the calculation of the relative weights between the observation techniques from VCE. To evaluate and compare the performance of the two proposed methods with the L-curve method and VCE, all these four methods are applied in six study cases using four types of simulated observations in Europe, and their modeling results are compared with the validation data. The RMS errors (w.r.t the validation data) obtained by VCE-Lc and Lc-VCE are smaller than those obtained from the L-curve method and VCE in all the six cases. VCE-Lc performs the best among these four tested methods, no matter if using SRBFs with smoothing or non-smoothing features. These results prove the benefits of the two proposed methods for regularization parameter determination when different data sets are to be combined.
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Li Fraine, S., C. Langevin, N. Mahdi, and M. Bouin. "A130 VIDEOCAPSULE ENDOSCOPY VERSUS DOUBLE-BALLOON ENTEROSCOPY: WHICH ONE WINS?" Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 113–14. http://dx.doi.org/10.1093/jcag/gwab002.128.
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Abstract Background Videocapsule endoscopy (VCE) and double-balloon enteroscopy (DBE) are two endoscopic exams that permit the investigation of the small intestinal mucosa. There exists few studies that compare the diagnostic performance and results between these two diagnostic modalities. Aims To compare the diagnostic performance between VCE and DBE. Methods Retrospective study between 2016 and 2019. All patients at a tertiary care centre undergoing both VCE and DBE were recruited. Clinical and endoscopic information was compiled from patients’ medical charts as well as the indications and results of the two endoscopic exams. The patients with an incomplete endoscopy report or who were unable to complete both VCE and DBE were excluded. The results of both VCE and DBE were compared using univariate analysis. Results In total, 126 patients underwent VCE. Of those patients, 15 further underwent DBE (average age: 69±17, 53% female). In total, 11 patients underwent upper DBE, 3 patients underwent lower DBE, and one patient underwent both upper and lower DBE. The indications for endoscopy were: gastrointestinal bleeding (47%), iron deficient anemia (40%), and other (13%). The VCE findings were: angiodysplasia (35%), inflammation (35%), polyp/neoplasia (20%), and other (10%). The DBE findings were: angiodysplasia (41%), normal (35%), polyp/neoplasia (12%), stenosis (6%) and other (6%). In 53% of cases there was at least one finding concordant between VCE and DBE. In only 20% of cases, DBE found a new lesion that was not seen by VCE. In comparison, 33% of DBE exams were normal despite a positive findings by VCE. The discordance between exams was possibly due to the delay between both exams (average 125 days). Conclusions In over half of cases, there is at least one lesion consistent between both endoscopic modalities. DBE finds a new lesion that was not seen by VCE in only 20% of cases. Therefore, VCE should be the first choice in the investigation of the small intestine mucosa even though both exams seem to be complementary. Funding Agencies None
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Graessler, Iris, and Patrick Taplick. "Supporting Creativity with Virtual Reality Technology." Proceedings of the Design Society: International Conference on Engineering Design 1, no. 1 (July 2019): 2011–20. http://dx.doi.org/10.1017/dsi.2019.207.
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AbstractThis contribution includes the development and validation of a Virtual Reality (VR) supported creativity technique: “Sensory Stimulus Environment Technique”. Key elements of this technique are the creativity process, a VR tool and the support of the tool (Virtual Creative Environments). The creativity process consists of phases for individual and group-based work. The VR tool “Virtual Creativity” includes functions to support the preparation of Virtual Creative Environments (VCE), the generation and evaluation of new ideas. For the generation of VCE, the tool possesses an environment configurator. Users of this function are supported by Design Rules for VCE.For the validation of the creativity technique, it was used in a product engineering project. The project members procedure two phases of the creativity process (Preparation and Individual Idea Generation) and used “Virtual Creativity” to generate VCEs and ideas to solve their tasks. By questionnaires, functions of “Virtual Creativity” were assessed for generating VCEs and ideas.
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Pioche, Mathieu, Christell Ganne, Rodica Gincul, Antoine De Leusse, Julien Marsot, Julien Balique, Alain Fond, et al. "Colon capsule versus computed tomography colonography for colorectal cancer screening in patients with positive fecal occult blood test who refuse colonoscopy: a randomized trial." Endoscopy 50, no. 08 (February 27, 2018): 761–69. http://dx.doi.org/10.1055/s-0044-100721.
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Abstract Objective Some patients (10 % – 32 %) with a positive guaiac fecal occult blood test (gFOBT) do not undergo the recommended colonoscopy. The aim of this study was to compare video capsule endoscopy (VCE) and computed tomography colonography (CTC) in terms of participation rate and detection outcomes when offered to patients with a positive gFOBT who did not undergo the recommended colonoscopy. Methods An invitation letter offering CTC or VCE was sent to selected patients after randomization. Acceptance of the proposed (or alternative) procedure and procedure results were recorded. Sample size was evaluated according to the hypothesis of a 13 % increase of participation with VCE. Results A total of 756 patients were targeted. Following the invitation letter, 5.0 % (19/378) of patients underwent the proposed VCE and 7.4 % (28/378) underwent CTC, (P = 0.18). Following the letter, 9.8 % (37/378) of patients in the VCE group underwent a diagnostic procedure (19 VCE, 1 CTC, 17 colonoscopy) vs. 10.8 % in the CTC group (41/378: 28 CTC, 13 colonoscopy; P = 0.55). There were more potentially neoplastic lesions diagnosed in the VCE group than in the CTC group (12/20 [60.0 %] vs. 8/28 [28.6 %]; P = 0.04). Thus, 15/20 noninvasive procedures in the VCE group (19 VCE, 1 CTC; 75.0 %) vs. 10/28 in the CTC group (35.7 %; P = 0.01) resulted in a recommendation of further colonoscopy, but only 10/25 patients actually underwent this proposed colonoscopy. Conclusion Patients with a positive gFOBT result who do not undergo the recommended colonoscopy are difficult to recruit to the screening program and simply proposing an additional, less-invasive procedure, such as VCE or CTC, is not an effective strategy.
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Stanich, Peter, Joshua Peck, Christopher Murphy, Kyle Porter, and Marty Meyer. "Physical activity during video capsule endoscopy correlates with shorter bowel transit time." Endoscopy International Open 05, no. 09 (September 2017): E856—E860. http://dx.doi.org/10.1055/s-0043-115385.
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Abstract Background and study aim Video capsule endoscopy (VCE) is limited by reliance on bowel motility for propulsion, and lack of physical activity has been proposed as a cause of incomplete studies. Our aim was to prospectively investigate the association between physical activity and VCE bowel transit. Patients and methods Ambulatory outpatients receiving VCE were eligible for the study. A pedometer was attached at the time of VCE ingestion and step count was recorded at the end of the procedure. VCE completion was assessed by logistic regression models, which included step count (500 steps as one unit). Total transit time was analyzed by Cox proportional hazards models. The hazard ratios (HR) with 95 % confidence interval (CI) indicated the “hazard” of completion, such that HRs > 1 indicated a reduced transit time. Results A total of 100 patients were included. VCE was completed in 93 patients (93 %). The median step count was 2782 steps. Step count was not significantly associated with VCE completion (odds ratio 1.45, 95 %CI 0.84, 2.49). Pedometer step count was significantly associated with shorter total, gastric, and small-bowel transit times (HR 1.09, 95 %CI 1.03, 1.16; HR 1.05, 95 %CI 1.00, 1.11; HR 1.07, 95 %CI 1.01, 1.14, respectively). Higher body mass index (BMI) was significantly associated with VCE completion (HR 1.87, 95 %CI 1.18, 2.97) and shorter bowel transit times (HR 1.05, 95 %CI 1.02, 1.08). Conclusions Increased physical activity during outpatient VCE was associated with shorter bowel transit times but not with study completion. In addition, BMI was a previously unreported clinical characteristic associated with VCE completion and should be included as a variable of interest in future studies.
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Patel, Vijaykumar G., Olufemi A. Babalola, David M. Martin, James K. Fortson, and William L. Weaver. "Video Capsule Endoscopy: Clinical Relevance of Capsule Endoscopy Findings." American Surgeon 72, no. 6 (June 2006): 546–51. http://dx.doi.org/10.1177/000313480607200618.
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Video capsule endoscopy (VCE) is a novel diagnostic tool for noninvasively visualizing the lumen of the entire small intestine. It is especially useful in identifying the source of obscure small intestinal bleeding. However, VCE is not always optimal for localizing small bowel lesions. Several studies show VCE to be markedly superior to standard diagnostic techniques although the true clinical relevance of many of the capsule endoscopic findings remain unknown. We present two case reports of VCE findings that resulted in surgical intervention but were found to be benign lesions on definitive pathological examination. The actual clinical relevance of many of the lesions found on VCE thus remains to be demonstrated.
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Zhang, Jian Hui, Jian Wu, Petre Alexandrov, Terry Burke, Kuang Sheng, and Jian Hui Zhao. "1836 V, 4.7 mΩ•cm2 High Power 4H-SiC Bipolar Junction Transistor." Materials Science Forum 527-529 (October 2006): 1417–20. http://dx.doi.org/10.4028/www.scientific.net/msf.527-529.1417.
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This paper reports recent progress in the development of high power 4H-SiC BJTs based on an improved device design and fabrication scheme. Near theoretical limit high blocking voltage of VCEO=1,836 V has been achieved for 4H-SiC BJTs based on a drift layer of only 12 μm, doped to 6.7x1015 cm-3. The collector current measured for a single cell BJT with an active area of 0.61 mm2 is up to IC=9.87 A (JC=1618 A/cm2). The collector current is 7.64 A (JC=1252 A/cm2) at VCE=5.9 V in the saturation region, corresponding to an absolute specific on-resistance (RSP_ON) of 4.7 m9·cm2. From VCE=2.4 V to VCE= 5.8 V, the BJT has a differential RSP_ON of only 3.9 m9·cm2. The current gain is about 8.8 at Ic=5.3 A (869 A/cm2). This 4H-SiC BJT shows a V2/RSP_ON of 717 MW/cm2, which is the highest value reported to date for high-voltage and high-current 4H-SiC BJTs. A verylarge area 4H-SiC BJT with an active area of 11.3 mm2 is also demonstrated.
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Akopova, A. O., O. M. Mikcheeva, P. L. Shcherbakov, and A. I. Parfenov. "Helminths detection with video capsule endoscopy." Terapevticheskii arkhiv 91, no. 11 (November 15, 2019): 72–74. http://dx.doi.org/10.26442/00403660.2019.11.000420.
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The article describes clinical observations of helminthiasis detection in 18 of 208 patients during video capsule endoscopy (VCE). Indications for the appointment of VCE were complex clinical situations associated with the search for inflammatory diseases of the small intestine and sources of small intestine bleeding. Because of the high cost of VCE the diagnosis of parasitic diseases should be based on laboratory techniques in clinical practice. Only in case of anemia of unknown etiology VCE demonstrates high efficiency.
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Morera, Hunter, Roshan Warman, Azubuogu Anudu, Chukwudumebi Uche, Ivana Radosavljevic, Nikhil Reddy, Ahan Kayastha, et al. "Reduction of Video Capsule Endoscopy Reading Times Using Deep Learning with Small Data." Algorithms 15, no. 10 (September 21, 2022): 339. http://dx.doi.org/10.3390/a15100339.
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Video capsule endoscopy (VCE) is an innovation that has revolutionized care within the field of gastroenterology, but the time needed to read the studies generated has often been cited as an area for improvement. With the aid of artificial intelligence, various fields have been able to improve the efficiency of their core processes by reducing the burden of irrelevant stimuli on their human elements. In this study, we have created and trained a convolutional neural network (CNN) capable of significantly reducing capsule endoscopy reading times by eliminating normal parts of the video while retaining abnormal ones. Our model, a variation of ResNet50, was able to reduce VCE video length by 47% on average and capture abnormal segments on VCE with 100% accuracy on three VCE videos as confirmed by the reading physician. The ability to successfully pre-process VCE footage as we have demonstrated will greatly increase the practicality of VCE technology without the expense of hundreds of hours of physician annotated videos.
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Song, Joo Hye, Ji Eun Kim, Hwe Hoon Chung, Sung Noh Hong, Heejung Kim, Eun Ran Kim, Dong Kyung Chang, and Young-Ho Kim. "Video Capsule Endoscopy Optimal Timing in Overt Obscure Gastrointestinal Bleeding." Diagnostics 12, no. 1 (January 9, 2022): 154. http://dx.doi.org/10.3390/diagnostics12010154.
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Video capsule endoscopy (VCE) has become the noninvasive diagnostic standard in the investigation of overt obscure gastrointestinal bleeding (OGIB), with a high positive and negative predictive value. However, the diagnostic yield of the VCE is thought to depend on when it was performed. We evaluate the optimal timing performing VCE relative to overt OGIB to improve the diagnostic yield. A total 271 patients had admitted and underwent VCE for overt OGIB between 2007 and 2016 in Samsung Medical Center, Seoul, Korea. To evaluate the diagnostic yield of VCE for overt OGIB with respect to timing of the intervention, diagnostic yield was analyzed according to the times after latest bleeding. The finding of VCE was classified into P0 or P1 (no potential for bleeding or uncertain hemorrhagic potential) and P2 (high potential for bleeding, such as active bleeding, typical angiodysplasia, large ulcerations or tumors). The P2 lesion was found in 106 patients and diagnostic yield of was 39.1% for overt OGIB. Diagnostic yield of VCE to detect P2 lesion was higher when it is performed closer to the time of latest bleeding (timing of VCE between the VCE and latest bleeding: <24 h, 43/63 (68.3%); 1 days, 16/43 (34.9%); 2 days, 18/52 (34.6%); 3 days, 13/43 (30.2%); 4 days, 7/28 (25.0%); 5–7 days, 6/24 (25.0%), and ≥8 days, 4/18 (22.2%); ptrend < 0.001). The interval between the VCE and latest bleeding were categorized into <24 h (n = 63), 1–2 days (n = 95), 3–7 days (n = 95) and ≥8 days (n = 18). Multivariable analyses showed the odds ratio for P2 lesion detection was 4.99 (95% confidence interval, 1.47–16.89) in <24 h group, compared with ≥8 days group (p < 0.010). The overall re-bleeding rate for those with P2 lesion was higher than for those with P0 or P1 lesion at the end of mean follow up of 2.5 years. The proportion of patients who underwent therapeutic intervention including surgery, endoscopic intervention and embolization was higher when VCE is performed closer to the time of latest bleeding (p = 0.010). Early deployment of VCE within 24 h of the latest GI bleeding results in a higher diagnostic yield for patients with overt OGIB and consequently resulted in a higher therapeutic intervention rate
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Li Fraine, S., C. Langevin, N. Mahdi, and M. Bouin. "A129 VIDEOCAPSULE ENDOSCOPY RETENTION: WHAT ARE THE RISK FACTORS?" Journal of the Canadian Association of Gastroenterology 4, Supplement_1 (March 1, 2021): 112–13. http://dx.doi.org/10.1093/jcag/gwab002.127.
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Abstract Background The most feared complication of videocapsule endoscopy (VCE) is retention in the intestine. It is estimated to occur in 1.4% of cases but the risk factors are not well known. Aims To determine the prevalence of VCE retention at a tertiary care centre as well the associated risk factors. Methods Retrospective study between 2016 and 2019. All patients at a tertiary care centre undergoing VCE were recruited. The patients with an incomplete endoscopy report or who were unable to complete VCE were excluded. Clinical and endoscopic information was compiled from patients’ medical charts as well as the indications and results of the endoscopic procedure. VCE retention, evaluated by radiography or CT scan, was defined as persistence of the videocapsule in the gastrointestinal tract for ≥14 days or the need for an intervention for removal. Results In total, 126 patients underwent VCE (average age: 66±16, 52% female). There was 6% of patients with Crohn’s disease, and 40% of patients had a previous abdominal surgery. The indications for endoscopy were: iron deficient anemia (48%), gastrointestinal bleeding (32%), suspicion/follow up of IBD (10%), and other (11%). The VCE findings (n=146) were: angiodysplasia (30%), inflammation (30%), normal (20%), polyp (5%), and other (15%). 77% of results were not previously found by conventional endoscopy or imaging. The prevalence of VCE retention was 1.6%. The patient risk factors for retention were Crohn’s disease (OR 19.67; 95CI 1.09–354.11; p<0.05) and corticosteroid use in the previous 2 weeks (OR 19.67; 95CI 1.09–354.11; p<0.05). There was no risk of retention associated with ulcerative colitis, sex, abdominal surgery, or opioid use. The finding of stenosis on VCE was associated with an increased risk of retention (OR 123; 95% CI 4.11-3683.43; p<0.01). Conclusions VCE retention remains a rare complication. There is increased risk of retention in patients with known Crohn’s disease or recent use of corticosteroids. Funding Agencies None
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Alsahafi, Majid, Paula Cramer, Nazira Chatur, and Fergal Donnellan. "The Effect of Prucalopride on Small Bowel Transit Time in Hospitalized Patients Undergoing Capsule Endoscopy." Canadian Journal of Gastroenterology and Hepatology 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/2696947.
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Background. The inpatient status is a well-known risk factor for incomplete video capsule endoscopy (VCE) examinations due to prolonged transit time. We aimed to evaluate the effect of prucalopride on small bowel transit time for hospitalized patients undergoing VCE. Methods. We included all hospitalized patients who underwent VCE at a tertiary academic center from October 2011 through September 2016. A single 2 mg dose of prucalopride was given exclusively for all patients who underwent VCE between March 2014 and December 2015. VCE studies were excluded if the capsule was retained or endoscopically placed, if other prokinetic agents were given, in cases with technical failure, or if patients had prior gastric or small bowel resection. Results. 442 VCE were identified, of which 68 were performed in hospitalized patients. 54 inpatients were included, of which 29 consecutive patients received prucalopride. The prucalopride group had a significantly shorter small bowel transit time compared to the control group (92 versus 275.5, p<0.001). There was a trend for a higher completion rate in the prucalopride group (93.1% versus 76%, p=0.12). Conclusions. Our results suggest that the administration of prucalopride prior to VCE is a simple and effective intervention to decrease small bowel transit time.
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Yoshida, Shoichi. "Massive Fire Incidents of Multiple Aboveground Storage Tanks due to Vapor Cloud Explosion." EPI International Journal of Engineering 2, no. 2 (August 31, 2019): 102–8. http://dx.doi.org/10.25042/epi-ije.082019.03.
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The vapor cloud explosion (VCE) begins with a release of a large quantity of flammable vaporing liquid from a storage tank, transportation vessel or pipeline. If VCE occurs in an oil storage facility, multiple tanks burn simultaneously. There is no effective firefighting method for multiple tanks fire. It will be extinguished when oil burned out spending several days. Many incidents of multiple tanks fire due to VCE have occurred all over the world in recent 50 years. This paper reviews the past 6 incidents of multiple tanks fire due to VCE.
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Correia, J., A. Ponte, L. Proença, A. Rodrigues, R. Pinho, S. Leite, C. Fernandes, et al. "P206 Comparison of dye-spraying chromoendoscopy and virtual chromoendoscopy for colonic dysplasia detection in longstanding Inflammatory Bowel Disease." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i265. http://dx.doi.org/10.1093/ecco-jcc/jjab232.333.
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Abstract Background Dye-spraying chromoendoscopy (DCE) is the technique of choice for colonic surveillance in patients with long-standing extensive Inflammatory Bowel Disease (IBD). Conversely, the use of virtual chromoendoscopy (VCE) is still controversial. This study aimed to compare lesion and dysplasia detection and accuracy of margins delineation between VCE and DCE. Methods Eleven gastroenterologists were given a survey with 20 pairs of pictures of IBD surveillance colonoscopies (10 with nondysplastic lesions, 5 with dysplastic lesions and 5 with no lesions). Each pair contained the same image captured during colonoscopy using VCE and DCE. The 40 pictures were randomly ordered to avoid any classification bias. For each picture, the gastroenterologist assessed the presence/absence of lesion and, when a lesion was identified, assessed the presence/absence of dysplasia and delineated its margins. To compare lesion and dysplasia detections between techniques, the sensitivity, specificity and inter-observer agreement (using fleiss’ kappa (K) test) were calculated. The chi-square test was used to assess the accuracy of margins delineation. Results When assessing lesion detection using VCE, sensitivity (S) and specificity (E) were 0.93 and 0.49 and in, DCE, 0.97 and 0.38, respectively. When assessing dysplasia detection using VCE, S and E were 0.74 and 0.60 and, in DCE, 0.67 and 0.62, respectively. Interobserver agreement analysis revealed that VCE and DCE had a moderate agreement in lesion detection - 0.57 and 0.58, respectively; however, for dysplasia detection, VCE had a fair agreement (k=0.30) and DCE a slight agreement (k=0.11). The rate of accurately defined margins was similar for both techniques (p=0.22). Conclusion Similar lesion and dysplasia detection and margins delineation were achieved with both techniques. However, concerning dysplasia detection, interobserver agreement was slightly better using VCE. Therefore, VCE may constitute a valid alternative to DCE for dysplasia screening in IBD. Further studies are needed to validate these findings.
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Micol, Jean-Baptiste, Valerie Coiteux, Laurent Pascal, Louis Terriou, Christophe Willekens, Jean-Pierre Jouet, Vincent Maunoury, and Ibrahim Yakoub-Agha. "Wireless Video-Capsule Endoscopy Is a More Sensitive Investigative Method Than Gastro-Intestinal Endoscopy and Biopsies for the Diagnosis of Acute GI-Gvhd." Blood 112, no. 11 (November 16, 2008): 1123. http://dx.doi.org/10.1182/blood.v112.11.1123.1123.
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Abstract Acute gastro-intestinal graft-versus-host disease (GI-GVHD) is a major complication following allogeneic stem cell transplantation (allo-SCT) and results in high morbidity and mortality. Diagnosis of GI-GVHD is problematic due a lack of specific symptoms and confounding variables in allo-SCT patients. Although diarrhea is the most common (but non-specific) presenting symptom in acute GI-GVHD, diagnosis is especially difficult when the diarrheal disorder is atypical (i.e. when there is no or limited skin involvement). In a previous study, we reported the positive impact of wireless video-capsule endoscopy (VCE) in the diagnosis of post-transplant diarrhea. Here, we report our experience over the last 5 years with an overall diagnostic approach (including VCE) to the management of allo-SCT patients with suspected acute GI-GVHD. In addition to wireless VCE, patients with atypical post-transplant diarrhea underwent bacterial and viral investigations and upper and/or lower GI-tract endoscopy (plus biopsies, as appropriate). VCE images were scored according to standard endoscopic classification. The final diagnosis took account of the results of the investigation as a whole and the response to therapy. Between August 2002 and October 2007, 240 patients underwent allo-SCT. Thirty patients underwent 37 extensive investigations, with VCE being performed in the following situations: febrile and/or hemorrhagic diarrhea (n=17), isolated diarrhea (n=15), persistent diarrhea or relapse despite appropriate adjustment of immunosuppressive (IS) treatment (n=5). Median time between allo-SCT and VCE was 50 days (range: 19–197). The final diagnosis was acute GVHD (n=19), viral infection (n=6, with 5 CMVs and 1 HHV6s) and a combination of both in 3 cases. The result of our approach was negative in 9 cases (with a normal GI tract by VCE in 8 of them) who were ultimately diagnosed as having functional diarrhea and recovered without any specific treatment. We observed 5 (14%) VCE failures, either due to an absence of intestinal passage (n=3) or major GI hemorrhage (n=2). In the other cases, VCE results were concordant with the final diagnosis. It was noteworthy that VCE was superior to biopsies in some cases. Thus, while VCE demonstrated typical GI-GVHD lesions in 8 patients with histological proven GI-GVHD, VCE showed a normal GI tract (n=4) or GI-GVHD features in 8 other cases where the biopsies were uncertain (n=7) or non-contributive (n=1). The response to appropriate treatment was favorable in 20 cases but was unfavorable and required further therapeutic adjustment in 8 cases (7 GVHDs, 1 CMV). Five patients died of GVHD (n=3), HHV6 infection (n=1) or both (n=1). This study confirms that VCE is a more sensitive investigative method than GI-endoscopy and biopsies. This approach enhanced our ability to modulate IS treatments in patients suffering from atypical post-transplant diarrhea. With its apparently high predictive value, routine use of VCE could be of great interest, particularly with a view to avoiding unnecessary digestive biopsies.
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Hakimian, Shahrad, Salmaan Jawaid, Yurima Guilarte-Walker, Jomol Mathew, and David Cave. "Video capsule endoscopy as a tool for evaluation of obscure overt gastrointestinal bleeding in the intensive care unit." Endoscopy International Open 06, no. 08 (August 2018): E989—E993. http://dx.doi.org/10.1055/a-0590-3940.
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Abstract Background and study aims Video capsule endoscopy (VCE) is a minimally invasive tool that helps visualize the gastrointestinal tract from the esophagus to the right colon without the need for sedation or preparation. VCE is safe with very few contraindications. However, its role and safety profile in the intensive care unit (ICU) population have not been reported. The aim of this study is to evaluate the safety, efficacy, and feasibility of VCE use in ICU patients. Patients and methods We conducted a single-center retrospective observational study of patients who underwent VCE for evaluation of obscure overt gastrointestinal bleeding in the ICU between 2008 and 2016. Results This study included 48 patients who were admitted to the UMass Memorial Medical Center ICUs for gastrointestinal bleeding. VCE was successfully completed in 43/48 (90 %) patients. The entire length of small bowel could be evaluated in 75 % and the source of bleeding was identified in 44 % of the patients. The most commonly identified source of bleeding included small bowel angioectasias, duodenal erosions/ulcers, and small bowel polyps. No major complications could be attributed to the VCE. Only 1 capsule was retained after 2 wk; however, there was no incidence of bowel obstruction, perforation, or capsule aspiration. Conclusions This observational retrospective study demonstrates that VCE may be a safe, feasible, and effective diagnostic tool in evaluation of gastrointestinal bleeding in the ICU population with few complications. VCE may be a safe diagnostic prelude and be a guide to the correct therapeutic procedure if needed, in the context of patients who are seriously ill.
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Kurteva, E., G. Rendo, T. Ahmad, T. Watson, K. Jones, E. Gaynor, and F. Kiparissi. "P158 Diagnostic yield of different imaging modalities (VCE, MRE and SBUS) in paediatric Inflammatory Bowel Disease patients." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S238. http://dx.doi.org/10.1093/ecco-jcc/jjab076.285.
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Abstract Background Wireless Video Capsule Endoscopy (VCE), Magnetic resonance enterography (MRE) and Small Bowel ultrasound (SBUS) are well-established diagnostic tools, used in the evaluation of small bowel disease in paediatric inflammatory bowel disease (IBD) patients.The aim of this study was to compare VCE findings with those of MRE and SBUS and evaluate discrepancies between them. Methods VCE examinations were conducted in histologically confirmed paediatric IBD patients in a period of 19 months (March 2018 – November 2019) in a tertiary center. The VCE findings were retrospectively compared to relevant findings on MRE and SBUS, collected from electronic data records. Results 34 patients were included in the study (16 males,18 females) with an age range at the moment of diagnostic assessment between 4–17 years (median 12 years). 21 patients were diagnosed with Crohn disease (CD), 9 patients with Ulcerative Colitis (UC) and 4 patients with IBD Unclassified (IBD-U). 8/34 (23.5%) patients were found to have all three diagnostic investigations, 21/34 (61.8%) had MRE and 21/34 (61.8%) had SBUS. Concordance between the three modalities were seen in 5/8 (62.5%) patients. Of these, 3/5 (60%) had no small bowel disease identified on VCE, MRE and SBUS, while in 2/5 patients (40%) the same distribution of small bowel disease was identified using all three diagnostic modalities. When comparing VCE to MRE, differing distributions of disease were seen in 10/21 patients (47.6%). 6/10 (60%) had terminal ileitis, 2/10 (20%) had ceacal disease and 3/10 (30%) jejunal disease noted on MRE, but with no disease identified on VCE. 1/10 patient (10%) had a normal MRE but duodenal and proximal jejunal ulceration was reported on VCE. VCE and SBUS had a higher concordance (71.4%) in identifying disease distribution. In 6/21 patients (28.5%) there was a discrepancy in the findings reported on SBUS when compared to VCE.Of these, 4/6 (66.7%) had a normal SBUS but small bowel disease (jejunal and ileal disease) on VCE.1/6 patient (16.7%) had caecal inflammation and 1/6 (16.7%) had active terminal ileitis on SBUS, which was not reported on their VCE. Conclusion The identification of small bowel disease is essential in the diagnosis and subsequent management of paediatric IBD. VCE, MRE and SBUS are established modalities to detect intestinal disease. This study demonstrates that performing all three diagnostic modalities may have important practical significance and increase diagnostic yield in detecting small bowel inflammatory bowel disease.
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Song, Hyun Joo, Jeong Seop Moon, and Ki-Nam Shim. "Optimal Bowel Preparation for Video Capsule Endoscopy." Gastroenterology Research and Practice 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/6802810.
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During video capsule endoscopy (VCE), several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG-) based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE.
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Tahiri, Houda, M. Salihoun, I. Serraj, M. Acharki, and N. Kabbaj. "Performance of PILLCAMSB3 Video-Capsule Endoscopy in the Diagnosis of the Non-Small Bowel Hemorrhagic Lesions Undetected by Upper and Lower Digestive Endoscopy." Saudi Journal of Medical and Pharmaceutical Sciences 9, no. 1 (January 5, 2023): 6–10. http://dx.doi.org/10.36348/sjmps.2023.v09i01.002.
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Introduction: Videocapsule endoscopy (VCE) is a minimally invasive approach to visualize the mucosal surface of the gastrointestinal tract. It was initially used in the evaluation of small-bowel lesions, however many studies showed that it has a potential role in evaluating other digestive segments as the stomach and large bowel. Our study aim to assess the diagnostic performance of VCE after a non-conclusive upper and lower digestive endoscopy and to highlight the comfort and the diagnostic efficiency of this tool. Materials and Methods: In this monocentric and descriptive study, we include all patients who underwent a Pillcam SB3 VCE (59 patients), from July 2018 to Semptember 2022, after a normal gastroscopy and ileocoloscopy. All the patients received a preparation by PEG (2l the day before ingestion of the capsule) with clear broth the day before the examination, and a 10 days off oral iron if previously prescribed. Results: 59 patients were included and 15 VCE (25%) allowed the diagnosis of non-small haemorrhagic lesions, unnoticed by usual endoscopy. The main indication for VCE was an unxplained digestive bleeding (73%) with an average hemoglobin level of 5,4g/dL. The mean age was 59 years (23-90 years) with a femal predominance (sex-ratio:0,6). 40% of the patients had a chronic renal failure, 13% had a portal hypertension, 13% had a history of heart disease, 6% had a Rendu-Osler disease. 13% of patients were on antiplatelet agent, 6% on anticoagulants therapy and 6% on non-steroidal anti-inflammatory drugs. The mean time between the onset of symptoms and the VCE was 26,3months. The lesions noticed by VCE were: angiodysplasia (80%), with different localizations: gastric (46%), duodenal (21%), cecal (21%), bulbar (12%) and Forrest III gastric ulcerations (20%). The diagnostic yield of VCE in non-small bowel hemorrhagic lesions was 25%. Conclusion: The VCE represents the most patient-friendly alternative method of examination. It is a first-line approach in the evaluation of small-bowel lesions, but it can also detect upper and lower digestive lesions. However, we believe that the slightest doubt concerning the quality of the first upper and lower digestive endoscopies in patients with digestive bleeding and/or anemia should lead to the repetition of the conventional endoscopies before performing VCE.
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Kim, Wonshik, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, and Jong-Jae Park. "Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis." Diagnostics 11, no. 11 (November 16, 2021): 2123. http://dx.doi.org/10.3390/diagnostics11112123.
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Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture (n = 14, 60.9%) and erosion (n = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02–1.1, p = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81–70.60; p = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92–227.33; p = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP.
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González-Bernardo, O., S. Vivas, R. de Francisco, I. Pérez-Martínez, A. Castaño-García, V. Jiménez-Beltrán, P. Flórez-Díez, et al. "P299 A prospective randomised trial comparing dye-based chromoendoscopy with electronic virtual chromoendoscopy for detection of colonic neoplastic lesions during IBD surveillance colonoscopy." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S302—S303. http://dx.doi.org/10.1093/ecco-jcc/jjz203.428.
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Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. Dye-based chromoendoscopy (CE) is the currently recommended method for the detection of dysplasia in IBD surveillance colonoscopy; the role of virtual chromoendoscopy (VCE) is not yet well defined. To compare CE with VCE using iSCAN1 digital image enhanced colonoscopy in the detection of colonic neoplastic lesions in IBD patients. Methods Randomised, single-centre trial to assess the detection rate of colonic neoplastic lesions in patients with long-standing IBD. Patients were randomised in two arms: dye-spraying CE using indigo carmine and electronic VCE using iSCAN1 digital image. Detection rates of dysplasia or any neoplastic lesion were compared by the two endoscopic techniques. Results A total of 129 patients were studied (67 by CE and 62 by VCE). Demographic and clinical characteristics were homogeneous in the two groups; 26 Crohn′s disease and 103 ulcerative colitis, 52% women, mean age 50 years, median duration of IBD 204 months, family history of colorectal cancer in 10 (8%), associated primary sclerosing cholangitis in 8 (6%), personal history of colorectal dysplastic lesions in 12 (9%), and more than 50% colonic involvement in 72 (56%). In total, 27 lesions (9 hyperplastic, 8 adenomatous and 10 low-grade dysplasia) were detected in 23 patients, without differences between CE and VCE arms (15 [22%] and 12 [19%] lesions, respectively; p = 0.98); on the other hand, neoplastic lesion (dysplasia or adenoma) detection rates was similar (12 [18%] in CE and 6 [10%] in VCE arms, p = 0.2). The duration of the withdrawal time of colonoscopy in minutes for patients in the CE group was median 14 min and in the VCE group was median 10 min (p < 0.001). Conclusion There is no statistical difference between CE and VCE using iSCAN1 in the detection rate of colonic neoplastic lesions in IBD patients. Surveillance colonoscopy with VCE (iSCAN1) spends less time than conventional CE.
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Rondonotti, Emanuele, and Silvia Paggi. "Videocapsule Endoscopy in Celiac Disease: Indications and Timing." Digestive Diseases 33, no. 2 (2015): 244–51. http://dx.doi.org/10.1159/000369510.
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Background: Because of its technical characteristics (i.e. 8-fold magnification, capability to inspect the entire small bowel) and minimal invasiveness, videocapsule endoscopy (VCE) has been proposed as a useful tool for managing patients with celiac disease (CD). Key Messages: Although VCE has been found to be highly sensitive and specific in identifying CD endoscopic markers, it is still inadequate to replace esophagogastroduodenoscopy (EGD) with biopsies in the diagnosis of CD. Nevertheless, it represents a reliable alternative in patients unable or unwilling to undergo EGD. Up to now, available studies have failed to identify any correlation between the length of small bowel involvement and the severity of symptoms. The available evidence on the use of VCE in diagnosing CD in equivocal cases (patients with positive serology and negative or nonspecific histology or those with negative serology and histologically proven villous atrophy) is limited, and its role is still under discussion. In CD patients not improving on gluten-free diet, a complete workup is necessary. In patients with nonresponsive (NRCD) or refractory CD (RCD), VCE has been shown to be able not only to detect significant findings, driving further management, but also to rule out major complications. Nevertheless, in this setting, the inability of VCE to take tissue samples and the risk of capsule retention can represent major limitations. Conclusions: At the present time, for diagnostic purposes, VCE can be proposed only in patients unable or unwilling to undergo EGD, whereas it could be useful in some equivocal cases. Conversely, there is no room for VCE either to estimate the length of the small bowel affected by villous atrophy or to follow up patients improving on gluten-free diet. In patients with NRCD or RCD, VCE can play a role, but it should be combined with other diagnostic techniques.
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Nwaezeigwe, Mary, John O’Grady, Lorraine Nolan, Julie O’Neill, Aidan Kaar, Lucy Quinlivan, and Martin Buckley. "Upper Gastrointestinal Tract Video Capsule as an Alternative to Oesophago-Gastro-Duodenoscopy in Clinical Practice." GastroHep 2022 (December 31, 2022): 1–6. http://dx.doi.org/10.1155/2022/4652730.
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Introduction. Upper gastrointestinal (UGI) video capsule endoscopy (VCE) provides a possible alternative to conventional oesophago-gastro-duodenoscopy (OGD). In Ireland, the COVID-19 pandemic led to unprecedented change in endoscopy services, accelerating the need for UGI VCE to help reduce patient exposure but allow the continuation of endoscopy services. We report on using UGI VCE as an alternative to OGD throughout all phases of COVID-related endoscopy adjustments. Aims/Background. Prospective observational study to assess identification of relevant UGI anatomical landmarks on UGI VCE as defined in the British Society of Gastroenterology. Method. Inclusion criteria were: patients with dyspepsia under 40 years of age with no alarm symptoms; known cirrhosis for variceal screening; UGI bleeds with the Blatchford score ≤ 2 . A protocol for preparation and a series of positional movements were adapted for the procedure. Landmarks and pathology detection were evaluated by two independent endoscopists. Results. 127 UGI VCE was performed from June 2020 to December 2021, of which 22 required further evaluation with OGD. The most common indications were dyspepsia and abdominal pain, 71% and 19%, respectively. With the use of the dual-facing camera, clear views of the OGJ in 100% of cases, cardia 100%, fundus 97%, greater curve 99%, lesser curve 98%, incisura angularis 95%, antrum 95%, pylorus 94%, D1/bulb 83%, and D2 82% were obtained. The main findings at UGI VCE were reflux oesophagitis and gastritis, with normal mucosa observed in 48% of cases. Findings suggesting a neoplastic lesion at the OG junction were detected in 1 case. Conclusion. Since June 2020, 81% ( N = 103 ) of a selected cohort of patients referred for UGI endoscopy avoided invasive traditional endoscopy and were successfully managed by VCE, thus reducing endoscopy waiting lists. UGI VCE may serve as a clinical diagnostic tool, used alongside OGD in appropriate cases, to help improve patient services and care delivery.
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Parfenov, A. I., A. O. Akopova, P. L. Shcherbakov, and O. M. Mikcheeva. "Role of video capsulе endoscopy in the diagnostic algorithm of small bowel Crohn's disease." Terapevticheskii arkhiv 91, no. 4 (April 15, 2019): 37–42. http://dx.doi.org/10.26442/00403660.2019.04.000079.
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Aim. To evaluate the possibilities of video capsule endoscopy (VCE) for diagnosing small bowel Crohn's disease (SBCD). Materials and methods. The study included 25 patients (12 men, 13 women) diagnosed with Crohn's disease. The mean age of the patients was 31.84±10.5 years. The VCE was performed using the GivenImaging system (Yokneam, Israel), OMOM (China). After the end of each test, the data was analyzed at a rate of 8 to 10 frames per second using Rapid® Reader (version 7.0). Results and discussion. The examination of patients in accordance with the diagnostic algorithm showed that for 11 patients (44%) the clinical assumption of SBCD was confirmed only with the help of VCE (1st group). Consequently, the use of VCE in these patients was crucial in the diagnosis of SBCD, since standard methods of analisys were insufficient to establish this diagnosis. For 14 patients (2nd group), the diagnosis of SBCD was established with the help of colonoscopy and/or diagnostic imaging modalities. The use of VCE allowed to confirm the diagnosis, to clarify the localization and extent of inflammation of the small intestine. Conclusion. VCE can be recommended for the diagnosis of SBCD during the period of early inflammatory manifestations in the small intestine mucosa.
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Yang, Dong-Hoon, Bora Keum, and Yoon Tae Jeen. "Capsule Endoscopy for Crohn’s Disease: Current Status of Diagnosis and Management." Gastroenterology Research and Practice 2016 (2016): 1–12. http://dx.doi.org/10.1155/2016/8236367.
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Crohn’s disease (CD) is an idiopathic inflammatory bowel disease involving the small and/or large intestine. More than 50% of Western CD patients and up to 88% of Asian CD patients may have small intestinal involvement. Video capsule endoscopy (VCE) has a higher diagnostic yield than small bowel barium radiography and computed tomography enterography for the detection of small intestinal involvement of CD. VCE also provides diagnostic yields comparable to magnetic resonance- (MR-) based enterography or enteroclysis and may have several advantages over MR-based tests for the detection of early small intestinal lesions. Several studies have suggested the use of VCE-based disease activity scoring systems to evaluate small intestinal mucosal disease activity, although their clinical relevance needs to be further studied. A possible indication for VCE is recurrence monitoring after complete surgical excision of CD-involved segments but its usefulness and efficacy compared with conventional endoscopy should be evaluated. The capsule retention rate ranges from 0 to 5.4% in suspected CD patients and from 0 to 13.2% in established CD patients. If VCE is necessary, significant small bowel stricture should be ruled out before VCE by performing a patency capsule study and/or small bowel radiological study in suspected or established CD patients.
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Chao, Che-Yung, Carl Frederic Duchatellier, and Ernest G. Seidman. "Unsuspected Small-Bowel Crohn’s Disease in Elderly Patients Diagnosed by Video Capsule Endoscopy." Diagnostic and Therapeutic Endoscopy 2018 (January 29, 2018): 1–7. http://dx.doi.org/10.1155/2018/9416483.
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Background. Video capsule endoscopy (VCE) is increasingly performed among the elderly for obscure bleeding. Our aim was to report on the utility of VCE to uncover unsuspected Crohn’s disease (CD) in elderly patients. Methods. Retrospective review of VCE performed in elderly patients (≥70 y) at a tertiary hospital (2010–2015). All underwent prior negative bidirectional endoscopies. CD diagnosis was based on consistent endoscopic findings, exclusion of other causes, and a Lewis endoscopic score (LS) > 790 (moderate-to-severe inflammation). Those with lower LS (350–790) required histological confirmation. Known IBD cases were excluded. Results. 197 VCE were performed (mean age 78; range 70–93). Main indications were iron deficiency anemia (IDA), occult GI bleeding (OGIB), chronic abdominal pain, or diarrhea. Eight (4.1%) were diagnosed as CD based on the aforementioned criteria. Fecal calprotectin (FCP) was elevated in 7/8 (mean 580 μg/g). Mean LS was 1824. Small-bowel CD detected by VCE led to a change in management in 4/8. One patient had capsule retention secondary to NSAID induced stricture, requiring surgical retrieval. Conclusions. VCE can be safely performed in the elderly. A proportion of cases may have unsuspected small-bowel CD despite negative endoscopies. FCP was the best screening test. Diagnosis frequently changed management.
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El-Dallal, Mohammed, Ye Chen, Qianyun Lin, Shana Rakowsky, Lindsey Sattler, Joshua Foromera, Laurie Grossberg, Adam S. Cheifetz, and Joseph D. Feuerstein. "Meta-analysis of Virtual-based Chromoendoscopy Compared With Dye-spraying Chromoendoscopy Standard and High-definition White Light Endoscopy in Patients With Inflammatory Bowel Disease at Increased Risk of Colon Cancer." Inflammatory Bowel Diseases 26, no. 9 (February 8, 2020): 1319–29. http://dx.doi.org/10.1093/ibd/izaa011.
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Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. We sought to assess the comparative efficacy of virtual chromoendoscopy (VCE) vs high definition white light endoscopy (HDWLE) or dye-spraying chromoendoscopy (DCE) through a meta-analysis and rating the quality of evidence. Methods A systematic review of the literature was performed through February 15, 2019. Primary outcomes were number of patients in whom dysplasia was identified and number of dysplastic lesions identified in these patients. We included only randomized control trials (RCTs) and performed meta-analysis using RevMan5.3. Results Of the 3205 studies identified, 11 RCTs were included, with a total of 1328 patients. Per patient analysis, VCE was not statistically different compared with DCE (risk ratio [RR] 0.77; 95% CI, 0.55–1.08) or HDWLE (RR 0.72; 95% CI, 0.45–1.15). However, per dysplasia analysis, VCE was not statistically different compared with DCE (RR 0.72; 95% CI, 0.47–1.11) and inferior compared with HDWLE (RR 0.62; 95% CI, 0.44–0.88). The quality of evidence was moderate in the HDWLE and low to moderate in the DCE studies. Conclusion Based on this meta-analysis, VCE was as good as HDWLE and DCE in identifying dysplasia per patient analysis. However, per dysplasia analysis, VCE was inferior compared with HDWLE and no different from DCE. Further studies need to examine the efficacy of each individual VCE technique.
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Nolan, Timiya S., Alicia McKoy, Darrell M. Gray, Faith Metlock, Sarah Addison, Stephanie S. Ogonuwe, John Gregory, Dana Lavender, Luiza Reopell, and Joshua J. Joseph. "Virtual Community Engagement for Retention of Black Men in Clinical Research." American Journal of Men's Health 17, no. 1 (January 2023): 155798832211477. http://dx.doi.org/10.1177/15579883221147767.
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Black American men have worse cardiovascular health compared with their White counterparts, yet are highly underrepresented in clinical trials. In 2020, Black men were recruited to participate in Black Impact, a community-based lifestyle intervention to increase cardiovascular health. Due to the research pause during the Coronavirus Disease (COVID-19) pandemic, a virtual community engagement (VCE) process was co-designed with community stakeholders and evaluated for its effect on retention for the clinical trial. VCE via weekly virtual video conference sessions occurred for 9 weeks as a run-in phase prior to in-person research activities. Data collected during sessions included attendance, anecdotes on acceptability, and topical requests for subsequent weeks. Content analysis was performed on scribe notes from sessions to ascertain themes describing the implementation and participant perceptions of the VCE. Descriptive statistics were used to analyze quantitative data. The VCE provided opportunities to co-create a safe atmosphere in small groups, discuss mental health, foster trust, capitalize on the power of spirituality, and establish a brotherhood. Following the VCE run-in phase, 74 of 100 participants remained engaged for participation in the Black Impact study. The VCE described provides a framework that can be used to retain Black men during study delays or disruptions through fostering engagement and building community among participants and researchers.
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Segarajasingam, Dev S., Stephen C. Hanley, Alan N. Barkun, Kevin A. Waschke, Pascal Burtin, Josée Parent, Serge Mayrand, et al. "Randomized Controlled Trial Comparing Outcomes of Video Capsule Endoscopy with Push Enteroscopy in Obscure Gastrointestinal Bleeding." Canadian Journal of Gastroenterology and Hepatology 29, no. 2 (2015): 85–90. http://dx.doi.org/10.1155/2015/897567.
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BACKGROUND: Optimal management of obscure gastrointestinal bleeding (OGIB) remains unclear.OBJECTIVE: To evaluate diagnostic yields and downstream clinical outcomes comparing video capsule endoscopy (VCE) with push enteroscopy (PE).METHODS: Patients with OGIB and negative esophagogastroduodenoscopies and colonoscopies were randomly assigned to VCE or PE and followed for 12 months. End points included diagnostic yield, acute or chronic bleeding, health resource utilization and crossovers.RESULTS: Data from 79 patients were analyzed (VCE n=40; PE n=39; 82.3% overt OGIB). VCE had greater diagnostic yield (72.5% versus 48.7%; P<0.05), especially in the distal small bowel (58% versus 13%; P<0.01). More VCE-identified lesions were rated possible or certain causes of bleeding (79.3% versus 35.0%; P<0.05). During follow-up, there were no differences in the rates of ongoing bleeding (acute [40.0% versus 38.5%; P not significant], chronic [32.5% versus 45.6%; P not significant]), nor in health resource utilization. Fewer VCE-first patients crossed over due to ongoing bleeding (22.5% versus 48.7%; P<0.05).CONCLUSIONS: A VCE-first approach had a significant diagnostic advantage over PE-first in patients with OGIB, especially with regard to detecting small bowel lesions, affecting clinical certainty and subsequent further small bowel investigations, with no subsequent differences in bleeding or resource utilization outcomes in follow-up. These findings question the clinical relevance of many of the discovered endoscopic lesions or the ability to treat most of these effectively over time. Improved prognostication of both patient characteristics and endoscopic lesion appearance with regard to bleeding behaviour, coupled with the impact of therapeutic deep enteroscopy, is now required using adapted, high-quality study methodologies.
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Dodson, Daniel S., Christine MacBrayne, Manon Williams, and Sarah Parker. "634. Incidence of vanC-Mediated Vancomycin-Resistant Enterococcus Bloodstream Infections at Children’s Hospital of Colorado and Implications for Empiric Enterococcal Therapy." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S294. http://dx.doi.org/10.1093/ofid/ofz360.702.
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Abstract Background The most well-known Enterococcal species, E. faecium and E. faecalis, can harbor high-level vancomycin resistance mediated by acquired vanA and vanB operons. However, other Enterococcal species such as E. gallinarum and E. casseliflavus (VCE), harbor intrinsic low-level vancomycin resistance mediated by an intrinsic vanC operon, and the incidence of these pathogens among pediatric patients is not clear. As the antibiotic resistance pattern of VCE is different than E. faecium and E. faecalis, a high prevalence of VCE may have implications for antibiotic therapy. We describe the incidence and susceptibility of VCE bloodstream infections at a large children’s hospital and compare to E. faecalis and E. faecium. Methods Positive blood culture results from 2013 to 2018 were obtained from the Children’s Hospital of Colorado data warehouse. All first-time positive cultures for Enterococcus were analyzed for species, susceptibility, and hospital unit location. First-time positive was defined as being at least 2 weeks after any previous positive Enterococcus blood culture. Susceptibilities were categorized by clinical laboratories standards institute (CLSI) guidelines. Results Of 240 positive isolates, 7% were ampicillin susceptible and vancomycin nonsusceptible (resistant or intermediate), vs. 6% that were ampicillin resistant and vancomycin susceptible. An additional 3% of isolates were not susceptible to either antibiotic; all of these were E. faecium. VCE accounted for 12% of our isolates while E. faecalis and E. faecium accounted for 66% and 16%, respectively. All VCE were susceptible to ampicillin, but 52% were nonsusceptible to vancomycin. VCE incidence, ampicillin resistance, and vancomycin nonsusceptibility were most prevalent in our hematology, oncology, and bone marrow transplant (BMT) units. Conclusion At our institution, an as yet unspeciated Enterococcus is equally likely to be ampicillin susceptible and vancomycin nonsusceptible as ampicillin resistant and vancomycin susceptible. This is driven by a significant incidence of VCE, especially on our hematology, oncology, and BMT units. Therefore, vancomycin may not provide adequate empiric Enterococcal coverage on these units, and the addition of ampicillin will be recommended. Disclosures All authors: No reported disclosures.
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Burgaz, Sonia, Concepción García, Maria Gómez-Cañas, Eduardo Muñoz, and Javier Fernández-Ruiz. "Development of An Oral Treatment with the PPAR-γ-Acting Cannabinoid VCE-003.2 Against the Inflammation-Driven Neuronal Deterioration in Experimental Parkinson’s Disease." Molecules 24, no. 15 (July 25, 2019): 2702. http://dx.doi.org/10.3390/molecules24152702.
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In a recent study, we described the neuroprotective properties of VCE-003.2—an aminoquinone derivative of the non-psychotropic phytocannabinoid cannabigerol (CBG)—administered intraperitoneally (i.p.) in an inflammatory model of Parkinson’s disease (PD). We also demonstrated that these properties derive from its activity on the peroxisome proliferator-activated receptor-γ, in particular at a regulatory site within this receptor type. In the present study, we wanted to further confirm this neuroprotective potential using an oral lipid formulation of VCE-003.2, developed to facilitate the clinical development of this phytocannabinoid derivative. To this end, we evaluated VCE-003.2, administered orally at two doses (10 and 20 mg/kg), to mice subjected to unilateral intrastriatal injections of lipopolysaccharide (LPS), a classic model of inflammation-driven neuronal deterioration that recapitulates characteristics of PD. The administration of VCE-003.2 to these mice showed, as expected, poor activity in the different motor tests (rotarod, computer-aided actimeter) used in experimental parkinsonism, in general due to the lack of evident changes in these behaviors by LPS lesion. However, VCE-003.2, at 20 mg/kg, was highly active in improving the changes detected in LPS-lesioned mice in the cylinder rearing test. In addition, the histopathological analysis of the basal ganglia revealed a trend towards recovery at 20 mg/kg VCE-003.2 in the loss of tyrosine hydroxylase-containing nigrostriatal neurons, as well as a complete reduction in the elevated LAMP-1 immunolabeling (reflecting autophagy impairment) caused by LPS lesion. These effects were not seen at 10 mg/kg. This was associated with a partial reduction in the intense glial reactivity provoked by LPS in the substantia nigra, in particular the astroglial reactivity labeled with glial fibrillary acidic protein. The analysis using qPCR in the striatum of proinflammatory mediators, such as tumor necrosis factor-α, interleukin-1β, inducible nitric oxide synthase, and cyclooxygenase-2, showed that the marked elevations provoked by the LPS lesion tended to be, in general, attenuated by VCE-003.2 treatment, with the greatest effects normally found with the highest dose of 20 mg/kg. In summary, our data confirm the neuroprotective potential of an oral formulation of VCE-003.2 against neuronal injury in an in vivo model of PD based on neuroinflammation, and this study opens the possibility to further the development of oral VCE-003.2 in the clinic.
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Haanstra, Jasmijn, Abdul Al-Toma, Evelien Dekker, Steven Vanhoutvin, Fokko Nagengast, Elisabeth Mathus-Vliegen, Monique van Leerdam, et al. "Incidence of small bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy." Endoscopy International Open 05, no. 07 (July 2017): E622—E626. http://dx.doi.org/10.1055/s-0043-111723.
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Abstract Background and study aims Lynch syndrome (LS) patients have an increased risk of small bowel cancer. The question is whether surveillance will lead to early detection of (pre)malignant lesions. We recently reported on prevalence of small bowel neoplasia (SBN) in LS patients as assessed by video capsule endoscopy (VCE). The aim of this prospective study was to determine the incidence of SBN. Patients and methods Asymptomatic LS patients who underwent a VCE were invited to undergo a second VCE procedure 2 years later. If abnormalities or polypoid lesions larger than 1 cm were detected, subsequent endoscopic procedures were performed. Results A total of 155 (78 %) of the initial 200 patients underwent a second VCE procedure after a mean of 2.2 (range 1 – 6) years. In 17 of the 155 (11 %) patients possibly significant lesions were detected, which required further investigation by means of gastroduodenoscopy (n = 8) or balloon-assisted endoscopy (n = 9). These procedures revealed no SBN. Conclusion No SBN was found after 2 years. Surveillance of the small bowel by VCE does not seem to be warranted in asymptomatic LS patients. This study was registered in the Clinical Trials.gov registry with identifier NCT00898768.
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Al-Azzawi, Yasir, Lidia Spaho, Mohammed Mahmoud, Joan Kheder, Anne Foley, and David Cave. "Video Capsule Endoscopy in the Assessment of Portal Hypertensive Enteropathy." International Journal of Hepatology 2018 (November 1, 2018): 1–5. http://dx.doi.org/10.1155/2018/5109689.
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Background. The features of the portal hypertension enteropathy (PHE) vary from mild mucosal changes to varices with or without bleeding. The prevalence and the development are not fully understood. Aim. Our aim is to examine the prevalence and the different manifestations of PHE using video capsule endoscopy (VCE). Methods. It is a single center retrospective study of patients with cirrhosis, who had VCE. Based on the published literature, we divided the PHE lesions into vascular lesions and mucosal lesions. Results. Of the 100 patients with cirrhosis that had a VCE study, the mean age was 62.82 years. Male gender was predominant (64%), while Caucasians represented 82% of the cohort. The most common etiology of cirrhosis was chronic alcohol abuse followed by chronic hepatitis C virus and nonalcoholic steatohepatitis. VCE detected small bowel lesions in 71% of the patients while the features of PHE were found in 65% from the total cohort. AVMs and inflammatory changes were the most common findings, followed by bleeding. More than 50% of the lesions were vascular in nature. The risk of finding PHE in decompensated cirrhosis is twice that in compensated cirrhosis. Forty-five patients had negative EGD exam for any active bleeding, esophageal varices, portal hypertensive gastropathy, or gastric varices. Of these, 69% had features of PHE in their VCE. Conclusions. VCE detected small bowel lesions in 71% of our cohort. There is a high prevalence of PHE in decompensated cirrhosis. Vascular lesions are the most common finding in the small bowel of this population.
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Tabet, Rabih, Najib Nassani, Boutros Karam, Youssef Shammaa, Philippe Akhrass, and Liliane Deeb. "Pooled Analysis of the Efficacy and Safety of Video Capsule Endoscopy in Patients with Implantable Cardiac Devices." Canadian Journal of Gastroenterology and Hepatology 2019 (May 19, 2019): 1–6. http://dx.doi.org/10.1155/2019/3953807.
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Background. To date, video capsule endoscopy (VCE) is still contraindicated by the FDA and the main manufacturers of Cardiac Implantable Electronic Devices (CIED) in patients with CIED, given a theoretical electromagnetic interference and possible device malfunction. Objectives. The objective of this study was to assess the safety profile and efficacy of VCE in patients with implantable cardiac devices through analyzing the risk of mutual interference. Methods. A systematic review of PubMed, Web of Science, and Embase databases was conducted. Peer-reviewed original articles, published in the English language and containing “capsule endoscopy” AND “pacemaker”, “defibrillator” OR “left ventricular assist device” as keywords, were selected. Studies performed in vitro, isolated case reports, and abstracts/posters were excluded. Results. A total of 735 VCE procedures were performed in patients with cardiac devices in various clinical settings. Cardiac events were not seen in any case. Interference on capsule images transmission was noted in 5 cases (left ventricular assist device (LVAD)) where few images were lost when the capsule was closest to the device. Finally, interference between capsule and telemetry leads was noted in 6 cases (4 Permanent Pacemakers (PPM), 2 Implantable Cardioverter-Defibrillator (ICD)) leading to image artifacts. Discussion. Adverse cardiac events were not seen in any study. Loss of images occurred when the VCE was in proximity to the device (only with LVAD) or after telemetry leads installation without affecting the completion rate and diagnostic yield of VCE. Conclusion. VCE is safe and remains efficient in patients with cardiac devices. If cardiac monitoring is required, wired systems are preferable.
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Iacucci, M., R. Cannatelli, T. L. Parigi, A. Buda, N. Labarile, O. M. Nardone, G. E. Tontini, et al. "OP16 The first virtual chromoendoscopy artificial intelligence system to detect endoscopic and histologic remission in Ulcerative Colitis." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i017—i018. http://dx.doi.org/10.1093/ecco-jcc/jjab232.015.
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Abstract Background Endoscopic and histologic activity are important therapeutic targets in ulcerative colitis (UC). The Paddington International Virtual ChromoendoScopy ScOre (VCE-PICaSSO)1 demonstrated that enhanced visualisation of subtle mucosal and vascular inflammatory changes correlated strongly with histology. However, without adequate training, the subjective evaluation of white light (WL) and VCE endoscopic scores varies between observers. We aimed to develop an artificial intelligence (AI) system for objective assessment of endoscopic disease activity and predict histology related to both white light and VCE videos. Methods 469 endoscopy videos (48512 frames) from 235 patients representative of all grades of inflammation, from our prospective PICaSSO multicentre study1 were used to develop a convolutional neural network (CNN). 316 videos were divided into training (254) and validation (62) sets. 153 additional videos (78 patients) were used as test cohort. The videos were edited to separate clips with WL and with VCE, and assessed using Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and PICaSSO, respectively. The classification stage of a pre-trained ResNet50 CNN classifier was trained to predict the healing or active inflammation on video frames. One network was trained to predict endoscopic remission (ER) as UCEIS≤1 from WL frames, and a second network was trained to predict PICaSSO≤3 from VCE. Histological remission (HR) was defined as Robarts Histological Index (RHI) ≤3 with no neutrophils in lamina propria or epithelium. Results In the validation cohort, our system predicted ER (UCEIS ≤1) in WL videos with 82% sensitivity (Se), 94% specificity (Sp) and an area under the ROC curve (AUROC) of 0.92. For the detection of remission in VCE videos (PICaSSO ≤3) Se was 74%, Sp 95%, and AUROC 0.95. In the testing cohort of independent videos, the diagnostic performance for both cut offs of ER remained similar. Our system also had an excellent diagnostic performance for the prediction of HR in the validation set, with Se, Sp, and Accuracy of 92%, 83%, and 85% respectively, using VCE, and 83%, 87%, and 86% respectively, with WL. In the testing set performance declined modestly while remaining good. Of note, the algorithm’s prediction of histology was similar with VCE and WL videos. Table 1 Table 2 Conclusion Our AI system accurately recognize endoscopic remission in videos and predict histological remission equally well. This is the first AI model developed to analyse inflammation and endoscopic remission in VCE through the PICaSSO score, and the first multi-domain system providing a complete endoscopic and histologic assessment. Reference 1. Iacucci et al. Gastroenterology 2021
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Baty, F., J. P. Flandrois, and M. L. Delignette-Muller. "Modeling the Lag Time of Listeria monocytogenes from Viable Count Enumeration and Optical Density Data." Applied and Environmental Microbiology 68, no. 12 (December 2002): 5816–25. http://dx.doi.org/10.1128/aem.68.12.5816-5825.2002.
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ABSTRACT The following two factors significantly influence estimates of the maximum specific growth rate (μmax) and the lag-phase duration (λ): (i) the technique used to monitor bacterial growth and (ii) the model fitted to estimate parameters. In this study, nine strains of Listeria monocytogenes were monitored simultaneously by optical density (OD) analysis and by viable count enumeration (VCE) analysis. Four usual growth models were fitted to our data, and estimates of growth parameters were compared from one model to another and from one monitoring technique to another. Our results show that growth parameter estimates depended on the model used to fit data, whereas there were no systematic variations in the estimates of μmax and λ when the estimates were based on OD data instead of VCE data. By studying the evolution of OD and VCE simultaneously, we found that while log OD/VCE remained constant for some of our experiments, a visible linear increase occurred during the lag phase for other experiments. We developed a global model that fits both OD and VCE data. This model enabled us to detect for some of our strains an increase in OD during the lag phase. If not taken into account, this phenomenon may lead to an underestimate of λ.
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Burgaz, Sonia, Concepción García, María Gómez-Cañas, Alain Rolland, Eduardo Muñoz, and Javier Fernández-Ruiz. "Neuroprotection with the Cannabidiol Quinone Derivative VCE-004.8 (EHP-101) against 6-Hydroxydopamine in Cell and Murine Models of Parkinson’s Disease." Molecules 26, no. 11 (May 28, 2021): 3245. http://dx.doi.org/10.3390/molecules26113245.
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The 3-hydroxyquinone derivative of the non-psychotrophic phytocannabinoid cannabigerol, so-called VCE-003.2, and some other derivatives have been recently investigated for neuroprotective properties in experimental models of Parkinson’s disease (PD) in mice. The pharmacological effects in those models were related to the activity on the peroxisome proliferator-activated receptor-γ (PPAR-γ) and possibly other pathways. In the present study, we investigated VCE-004.8 (formulated as EHP-101 for oral administration), the 3-hydroxyquinone derivative of cannabidiol (CBD), with agonist activity at the cannabinoid receptor type-2 (CB2) receptor in addition to its activity at the PPAR-γ receptor. Studies were conducted in both in vivo (lesioned-mice) and in vitro (SH-SY5Y cells) models using the classic parkinsonian neurotoxin 6-hydroxydopamine (6-OHDA). Our data confirmed that the treatment with VCE-004.8 partially reduced the loss of tyrosine hydroxylase (TH)-positive neurons measured in the substantia nigra of 6-OHDA-lesioned mice, in parallel with an almost complete reversal of the astroglial (GFAP) and microglial (CD68) reactivity occurring in this structure. Such neuroprotective effects attenuated the motor deficiencies shown by 6-OHDA-lesioned mice in the cylinder rearing test, but not in the pole test. Next, we explored the mechanism involved in the beneficial effect of VCE-004.8 in vivo, by analyzing cell survival in cultured SH-SY5Y cells exposed to 6-OHDA. We found an important cytoprotective effect of VCE-004.8 at a concentration of 10 µM, which was completely reversed by the addition of antagonists, T0070907 and SR144528, aimed at blocking PPAR-γ and CB2 receptors, respectively. The treatment with T0070907 alone only caused a partial reversal, whereas SR144528 alone had no effect, indicating a major contribution of PPAR-γ receptors in the cytoprotective effect of VCE-004.8 at 10 µM. In summary, our data confirmed the neuroprotective potential of VCE-004.8 in 6-OHDA-lesioned mice, and in vitro studies confirmed a greater relevance for PPAR-γ receptors rather than CB2 receptors in these effects.
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Banerjee, Rupa, and Partha Pal. "Endoscopic Evaluation and Therapeutic Considerations of Small Bowel Crohn’s Disease." Gastroenterology Insights 12, no. 2 (May 12, 2021): 238–58. http://dx.doi.org/10.3390/gastroent12020021.
Full textAbstract:
Small bowel evaluation is warranted in all newly diagnosed cases of Crohn’s disease (CD) as small bowel is involved in two-thirds of CD patients at diagnosis and the involvement can be discontinuous. Endoscopic evaluation of the small bowel in suspected or established CD can be done by video capsule endoscopy (VCE), device assisted enteroscopy (DAE) (which includes single and double balloon enteroscopy, novel motorized spiral enteroscopy (NMSE) and balloon guided endoscopy (BGE)) and intra-operative enteroscopy (IOE). In suspected CD with a negative ileo-colonoscopy, VCE is the preferred initial diagnostic modality in the absence of obstructive symptoms or known stenosis. VCE should be preceded by cross-sectional imaging or patency capsule testing if obstruction is suspected given with high retention risk. In established cases, small bowel cross-sectional imaging (magnetic resonance or computed tomography enterography) is preferred over VCE as it can assess transmural and extra-luminal involvement. VCE is indicated subsequently if necessary to assess disease extent, unexplained symptoms (e.g., anemia, malnutrition) or mucosal healing. Pan-enteric capsule endoscopy (PCE) and the use of artificial intelligence are the recent developments with VCE. DAE with small bowel biopsy can provide definitive evidence of CD including the extent and severity. A final diagnosis of CD is based on the constellation of clinical, radiologic, histologic and endoscopic features. Newer technologies like NMSE and BGE can help with deeper and faster small bowel evaluation. DAE has also allowed endoscopic treatment of small bowel strictures, small bowel bleeding and retrieval of retained capsule or foreign bodies. Endoscopic balloon dilation (EBD), endoscopic electro-incision, strictureplasty and stenting have shown promising results in CD related small bowel strictures. In conclusion, endoscopic evaluation of the small bowel is rapidly evolving field that has a major role in diagnosis and management of small bowel CD and can alter treatment outcomes in properly selected patients.