Search

Introduction and Objectives: in view of the advances made over the past few years, digestive endoscopy units must adapt to an increased demand and the development of novel techniques. However, the actual status of these units is virtually unknown and is limited to few surveys from over a decade ago. Thus, a new survey was performed of the current situation of endoscopy units in the Valencian Community., Material and Methods: a specific survey was designed to assess the status of endoscopy units within public hospitals and privately managed public hospitals in the Valencian Community. The survey included the following items: hospital data, unit architectural structure, equipment, human resources, functional structure, sedation, procedures performed, advanced therapies and ongoing care., Results: twenty-four of the 25 public hospitals or privately funded public hospitals in the Valencian Community responded to the survey, corresponding to a 96% participation. The number of physicians in gastroenterology services or sections ranged from 2 to 21. Endoscopist-controlled propofol sedation was used in 13 hospitals (54.2%). Most centers performed 1,000 to 3,000 gastroscopies per year. Fourteen units (58.3%) performed 2,000 to 3,000 colonoscopies and endoscopic retrograde cholangiopancreatography (ERCP) was performed in 22 hospitals (91.7%)., Conclusions: the results of the survey revealed large differences in infrastructure and organization among public hospital endoscopy units in the Valencian Community. Organization is highly heterogeneous and independent of hospital size.

Aims: To assess the expression of cathepsins in pancreatic samples obtained by endoscopic ultrasonography and fine needle aspiration (EUS-FNA) and to investigate their relationship with the staging of the pancreatic ductal adenocarcinoma (PDAC)., Methods: We prospectively included patients with solid pancreatic masses, in which EUS-FNA were performed. Cathepsins B, L, S and H expression was determined in FNA samples., Results: Seventeen FNA were performed. All cytological material was from PDAC. Expression of cathepsins was predominantly low (B 65%, L 23%, S 76%, and H 41%). We found no correlation between the expression levels and the extension of the neoplasm., Conclusion: Expression of cathepsins in the cytological material of PDAC is diverse but still poor to be useful in the pre-operative diagnosis. There is no correlation between the expression levels of cathepsins and the extension of the PDAC.

Background and Aims: To assess the expression levels of cathepsins in malignant and premalignant lesions., Methods: We retrospectively included patients who underwent pancreatic surgery on pancreatic solid or cystic masses. The expression of cathepsin H, L, B and S was determined in both types of samples. Lesions were divided into three categories: malignant (pancreatic adenocarcinoma and malignant mucinous neoplasms), premalignant (mucinous neoplasms) and benign (other lesions)., Results: Thirty-one surgical resection samples were studied. The expression of cathepsins was significantly higher in malignant lesions than in premalignant and benign lesions (H 75%, 27%, 37% p = 0.05; L 92%, 36%, 37% p = 0.011; B 83%, 36%, 62% p = 0.069; S 92%, 36%, 25% p = 0.004, respectively)., Conclusions: Cathepsins are overexpressed in histological samples of malignant lesions compared to premalignant and benign lesions. However, the expression of cathepsins is similar in both premalignant and benign lesions.

Objective: to evaluate safety of continuous propofol sedation in elderly patients who undergo endoscopic procedures and investigate risk factors to develop complications in the geriatric population., Material and Methods: patients who received endoscopist-directed propofol sedation were classified into two groups according to age. Group I: > 80 years; Group II: < 80 years. Propofol was administered by continuous intravenous infusion to achieve deep sedation. Arterial oxygen saturation, heart rate, blood pressure, and electrocardiographic records were monitored during the procedure. Therapy and complications secondary to sedation were recorded., Results: one thousand two-hundred and ninety-five endoscopic procedures (gastroscopies, colonoscopies and endoscopic ultrasonographies) were included. The dose of propofol was lower and therapy was more frequently performed in Group I. There were no differences between sedation-related complications in both groups (Group I: 15.4%, Group II: 14%; p:n.s.). Patients in Group I showed greater tendency to develop severe oxygen desaturation in the colonoscopy and endoscopic ultrasonography procedures. In the univariate analysis, a higher dose of propofol was associated with the appearance of complications (157.4 ± 84.4 vs 121.3 ± 89.6 mg) in elderly patients but it was not associated with severe oxygen desaturation., Conclusions: continuous propofol sedation during endoscopic procedures in elderly patients > 80 years is as safe as in younger patients.