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1. The Gastroscopy RAte of Cleanliness Evaluation (GRACE) Scale: time to establish a Grading Scale for Upper Gastrointestinal Endoscopy

Author

Esposito, G., additional, Ligato, I., additional, Dilaghi, E., additional, Libanio, D., additional, Chaves, J., additional, Arantes, V. N., additional, Moresi, R., additional, Weusten, B., additional, Bac, S., additional, Elvas, L., additional, Viegas, M. I., additional, Bergman, J., additional, Boonstra, K., additional, Bisschops, R., additional, Sinonquel, P., additional, Andrisani, G., additional, Di Matteo, F. M., additional, Citterio, N., additional, Ebigbo, A., additional, Ayoub, M., additional, Ferlitsch, M., additional, Frick, A., additional, Giljaca, V., additional, Tahir, I., additional, Hassan, C., additional, Capogreco, A., additional, Dal Buono, A., additional, Hucl, T., additional, Macinga, P., additional, De Jonge, P. J., additional, Van De Ven, S. E., additional, Kuvaev, R., additional, Filimendikova, K., additional, Leclercq, P., additional, Plomteux, O., additional, Angeletti, S., additional, Dell'unto, E., additional, Le Rhun, M., additional, Prouvost, V., additional, Yuichi, M., additional, Halvorsen, N., additional, Moss, A., additional, Nicolaides, S., additional, Perez-Cuadrado-Robles, E., additional, Gonzalez, E. Tenorio, additional, Pouw, R., additional, Meijer, B., additional, Rex, D. K., additional, Guardiola, J., additional, De Santiago, E. Rodriguez, additional, Chivato, I., additional, Siersema, P. D., additional, Borren, N., additional, Tham, T. C., additional, Tang, K., additional, Triantafyllou, K., additional, Samarentzis, N., additional, Voiosu, A. M., additional, Dragan, V., additional, Dinis-Ribeiro, M., additional, and Areia, M., additional

Published
2024
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6. The Role of Statins on Helicobacter pylori Eradication: Results from the European Registry on the Management of H. pylori (Hp-EuReg)

Author

Caldas M., Perez-Aisa A., Tepes B., Keco-Huerga A., Bujanda L., Lucendo A. J., Rodrigo L., Vaira D., Fernandez-Salazar L., Huguet J. M., Perez-Lasala J., Jurecic N. B., Fadeenko G., Barrio J., Areia M., Ortuno J., Pellicano R., Leja M., Molina-Infante J., Bogomolov P., Alekseenko S., Dominguez-Cajal M., Gomez-Camarero J., Ntouli V., Martinez-Dominguez S. J., Ruiz-Zorrilla R., Nunez O., Silkanovna Sarsenbaeva A., Almela P., Phull P., Espada M., Puig I., Nyssen O. P., Megraud F., O'Morain C., Gisbert J. P., the HP-EuReg Investigators, Gravina AG, Romano M., Caldas M., Perez-Aisa A., Tepes B., Keco-Huerga A., Bujanda L., Lucendo A.J., Rodrigo L., Vaira D., Fernandez-Salazar L., Huguet J.M., Perez-Lasala J., Jurecic N.B., Fadeenko G., Barrio J., Areia M., Ortuno J., Pellicano R., Leja M., Molina-Infante J., Bogomolov P., Alekseenko S., Dominguez-Cajal M., Gomez-Camarero J., Ntouli V., Martinez-Dominguez S.J., Ruiz-Zorrilla R., Nunez O., Silkanovna Sarsenbaeva A., Almela P., Phull P., Espada M., Puig I., Nyssen O.P., Megraud F., O'Morain C., Gisbert J.P., Caldas, M., Perez-Aisa, A., Tepes, B., Keco-Huerga, A., Bujanda, L., Lucendo, A. J., Rodrigo, L., Vaira, D., Fernandez-Salazar, L., Huguet, J. M., Perez-Lasala, J., Jurecic, N. B., Fadeenko, G., Barrio, J., Areia, M., Ortuno, J., Pellicano, R., Leja, M., Molina-Infante, J., Bogomolov, P., Alekseenko, S., Dominguez-Cajal, M., Gomez-Camarero, J., Ntouli, V., Martinez-Dominguez, S. J., Ruiz-Zorrilla, R., Nunez, O., Silkanovna Sarsenbaeva, A., Almela, P., Phull, P., Espada, M., Puig, I., Nyssen, O. P., Megraud, F., O'Morain, C., Gisbert, J. P., the HP-EuReg, Investigator, Gravina, Ag, and Romano, M.

Subjects
Microbiology (medical), medicine.medical_specialty, Multivariate analysis, Helicobacter pylori, statins, treatment, RM1-950, Biochemistry, Microbiology, Article, statins, Rescue therapy, Internal medicine, In real life, Medicine, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Helicobacter pylori, treatment, biology, business.industry, Statin, Statin treatment, biology.organism_classification, Treatment, Infectious Diseases, Therapeutics. Pharmacology, business
Abstract

Statins could increase the effectiveness of Helicobacter pylori eradication therapies due to their anti-inflammatory effect. The aim of this study was to analyze the impact of this therapeutic association in real life. This is a multicenter, prospective, non-interventional study aimed at evaluating the management of H. pylori by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap from 2013 to 2020. The association between statin use and H. pylori eradication effectiveness was evaluated through multivariate analysis. Overall, 9988 and 705 patients received empirical and culture-guided treatment, respectively. Overall, statin use was associated with higher effectiveness in the empirical group (OR = 1.3, 95%CI = 1.1–1.5), but no association was found with first-line treatment effectiveness (N = 7738), as an exception, statin use was specifically associated with lower effectiveness of standard triple therapy (OR = 0.76, 95%CI = 0.59–0.99). In the rescue therapy empirical group (N = 2228), statins were associated with higher overall effectiveness (OR = 1.9, 95%CI = 1.4–2.6). However, sub-analyses by treatment schemes only confirmed this association for the single-capsule bismuth quadruple therapy (OR = 2.8, 95%CI = 1.3–5.7). No consistent association was found between statin use and H. pylori therapy effectiveness. Therefore, the addition of statins to the usual H. pylori treatment cannot be currently recommended to improve cure rates.

Published
2021

7. The Colon Endoscopic Bubble Scale (CEBuS): A two-phase evaluation study

Author

Taveira, F., Hassan, Cesare, Kaminski, M. F., Ponchon, T., Benamouzig, R., Bugajski, M., De Castelbajac, F., Cesaro, Paola, Chergui, H., Goran, L., Minelli Grazioli, L., Janicko, M., Januszewicz, W., Lamonaca, L., Lenz, J., Negreanu, L., Repici, A., Spada, Cristiano, Spadaccini, M., State, M., Szlak, J., Veseliny, E., Dinis-Ribeiro, M., Areia, M., Hassan C., Cesaro P., Spada C. (ORCID:0000-0002-5692-0960), Taveira, F., Hassan, Cesare, Kaminski, M. F., Ponchon, T., Benamouzig, R., Bugajski, M., De Castelbajac, F., Cesaro, Paola, Chergui, H., Goran, L., Minelli Grazioli, L., Janicko, M., Januszewicz, W., Lamonaca, L., Lenz, J., Negreanu, L., Repici, A., Spada, Cristiano, Spadaccini, M., State, M., Szlak, J., Veseliny, E., Dinis-Ribeiro, M., Areia, M., Hassan C., Cesaro P., and Spada C. (ORCID:0000-0002-5692-0960)

Abstract

Background To date, no scale has been validated to assess bubbles associated with bowel preparation. This study aimed to develop and assess the reliability of a novel scale - the Colon Endoscopic Bubble Scale (CEBuS). Methods This was a multicenter, prospective, observational study with two online evaluation phases of 45 randomly distributed still colonoscopy images (15 per scale grade). Observers assessed images twice, 2 weeks apart, using CEBuS (CEBuS-0 - no or minimal bubbles, covering<5% of the surface; CEBuS-1 - bubbles covering 5%-50%; CEBuS-2 - bubbles covering >50%) and reporting the clinical action (do nothing; wash with water; wash with simethicone). Results CEBuS provided high levels of agreement both in evaluation Phase 1 (4 experts) and Phase 2 (6 experts and 13 non-experts), with almost perfect intraobserver reliability: kappa 0.82 (95% confidence interval 0.75-0.88) and 0.86 (0.85-0.88); interobserver agreement - intraclass correlation coefficient (ICC) 0.83 (0.73-0.89) and 0.90 (0.86-0.94). Previous endoscopic experience had no influence on agreement among experts vs. non-experts: kappa 0.86 (0.80-0.91) vs. 0.87 (0.84-0.89) and ICC 0.91 (0.87-0.94) vs. 0.90 (0.86-0.94), respectively. Interobserver agreement on clinical action was ICC 0.63 (0.43-0.78) in Phase 1 and 0.77 (0.68-0.84) in Phase 2.Absolute agreement on clinical action per scale grade was 85% (82-88) for CEBuS-0, 21% (16-26) for CEBuS-1, and 74% (70-78) for CEBuS-2. Conclusion CEBuS proved to be a reliable instrument to standardize the evaluation of colonic bubbles during colonoscopy. Assessment in daily practice is warranted.

Published
2022

12. Empirical Second-Line Therapy in 5,000 Patients of the European Registry on Helicobacter pylori Management (Hp-EuReg)

Author

Nyssen OP, Vaira D, Pérez Aísa Á, Rodrigo L, Castro-Fernandez M, Jonaitis L, Tepes B, Vologzhanina L, Caldas M, Lanas A, Lucendo AJ, Bujanda L, Ortuño J, Barrio J, Huguet JM, Voynovan I, Lasala JP, Sarsenbaeva AS, Fernandez-Salazar L, Molina-Infante J, Jurecic NB, Areia M, Gasbarrini A, Kupcinskas J, Bordin D, Marcos-Pinto R, Lerand F, Leja M, Buzas GM, Niv Y, Rokkas T, Phull P, Smith S, Shvets O, Venerito M, Milivojevic V, Simsek I, Lamy V, Bytzer P, Boyanova L, Kunovský L, Beglinger C, Doulberis M, Marlicz W, Goldis A, Tonkic A, Capelle L, Puig I, Megraud F, Morain CO, Gisbert JP, and European Registry on Helicobacter pylori Management Hp-EuReg Investigators

Subjects
Helicobacter pylori, Clarithromycin, Rescue, Levofloxacin, Bismuth
Abstract

BACKGROUND & AIMS: After a first Helicobacter pylori eradication attempt, approximately 20% of patients will remain infected. The aim of the current study was to assess the effectiveness and safety of second-line empiric treatment in Europe. METHODS: This international, multicenter, prospective, noninterventional registry aimed to evaluate the decisions and outcomes of H pylori management by European gastroenterologists. All infected adult cases with a previous eradication treatment attempt were registered with the Spanish Association of Gastroenterology-Research Electronic Data Capture until February 2021. Patients allergic to penicillin and those who received susceptibility-guided therapy were excluded. Data monitoring was performed to ensure data quality. RESULTS: Overall, 5055 patients received empiric second-line treatment. Triple therapy with amoxicillin and levofloxacin was prescribed most commonly (33%). The overall effectiveness was 82% by modified intention-to-treat analysis and 83% in the per-protocol population. After failure of first-line clarithromycin-containing treatment, optimal eradication (>90%) was obtained with moxifloxacin-containing triple therapy or levofloxacin-containing quadruple therapy (with bismuth). In patients receiving triple therapy containing levofloxacin or moxifloxacin, and levofloxacin-bismuth quadruple treatment, cure rates were optimized with 14-day regimens using high doses of proton pump inhibitors. However, 3-in-1 single capsule or levofloxacin-bismuth quadruple therapy produced reliable eradication rates regardless of proton pump inhibitor dose, duration of therapy, or previous first-line treatment. The overall incidence of adverse events was 28%, and most (85%) were mild. Three patients developed serious adverse events (0.3%) requiring hospitalization. CONCLUSIONS: Empiric second-line regimens including 14-day quinolone triple therapies, 14-day levofloxacin-bismuth quadruple therapy, 14-day tetracycline-bismuth classic quadruple therapy, and 10-day bismuth quadruple therapy (as a single capsule) provided optimal effectiveness. However, many other second-line treatments evaluated reported low eradication rates. ClincialTrials.gov number: NCT02328131.

Published
2022

13. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

Author

Dinis-Ribeiro, M., Areia, M., de Vries, A. C., Marcos-Pinto, R., Monteiro-Soares, M., O’Connor, A., Pereira, C., Pimentel-Nunes, P., Correia, R., Ensari, A., Dumonceau, J. M., Machado, J. C., Macedo, G., Malfertheiner, P., Matysiak-Budnik, T., Megraud, F., Miki, K., O’Morain, C., Peek, R. M., Ponchon, T., Ristimaki, A., Rembacken, B., Carneiro, F., Kuipers, E. J., and on behalf of MAPS Participants

Published
2012
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14. Overcoming the barriers to dissemination and implementation of quality measures for gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) position statement

Author

Bisschops, R., Rutter, M. D., Areia, M., Spada, Cristiano, Domagk, D., Kaminski, M. F., Veitch, A., Khannoussi, W., Gralnek, I. M., Hassan, Cesare, Messmann, H., Ponchon, T., Fockens, P., Dignass, A., Dinis-Ribeiro, M., Spada C. (ORCID:0000-0002-5692-0960), Hassan C., Bisschops, R., Rutter, M. D., Areia, M., Spada, Cristiano, Domagk, D., Kaminski, M. F., Veitch, A., Khannoussi, W., Gralnek, I. M., Hassan, Cesare, Messmann, H., Ponchon, T., Fockens, P., Dignass, A., Dinis-Ribeiro, M., Spada C. (ORCID:0000-0002-5692-0960), and Hassan C.

Abstract

The European Society of Gastrointestinal Endoscopy (ESGE) has developed performance measures and established a framework for quality assessment for gastrointestinal endoscopy in Europe. Most national societies actively undertake initiatives to implement and explicitly endorse these quality indicators. Given this, ESGE proposes that, at a national level, strong leadership should exist to disseminate and implement quality parameters. Thus, understanding the potential barriers that may vary locally is of paramount importance. ESGE suggests that each national society should prioritize quality and standards of care in gastrointestinal endoscopy in their activities and should survey/understand which measures are a local priority to their members and make measuring quality intrinsic to daily endoscopy practice.

Published
2021

15. European Registry on Helicobacter pylori management: Single-capsule bismuth quadruple therapy is effective in real-world clinical practice

Author

Nyssen, O. P., Perez-Aisa, A., Castro-Fernandez, M., Pellicano, R., Huguet, J. M., Rodrigo, L., Ortun, J., O, Gomez-Rodriguez, B. J., Pinto, R. M., Areia, M., Perona, M., Nunez, O., Romano, M., Gravina, A. G., Pozzati, L., Fernandez-Bermejo, M., Venerito, M., Malfertheiner, P., Fernanadez-Salazar, L., Gasbarrini, Antonio, Vaira, D., Puig, I., Megraud, F., O'Morain, C., Gisbert, J. P., Gasbarrini A. (ORCID:0000-0002-7278-4823), Nyssen, O. P., Perez-Aisa, A., Castro-Fernandez, M., Pellicano, R., Huguet, J. M., Rodrigo, L., Ortun, J., O, Gomez-Rodriguez, B. J., Pinto, R. M., Areia, M., Perona, M., Nunez, O., Romano, M., Gravina, A. G., Pozzati, L., Fernandez-Bermejo, M., Venerito, M., Malfertheiner, P., Fernanadez-Salazar, L., Gasbarrini, Antonio, Vaira, D., Puig, I., Megraud, F., O'Morain, C., Gisbert, J. P., and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

Background: There has been resurgence in the use of bismuth quadruple therapy (proton pump inhibitor, bismuth, tetracycline and metronidazole) for treating Helicobacter pylori infection thanks to a three-in-one single-capsule formulation. Objective: To evaluate the effectiveness and safety of the single-capsule bismuth quadruple therapy. Methods: Data were collected in a multicentre, prospective registry of the clinical practice of gastroenterologists on the management of H. pylori infection, where patients were registered at the Asociación Española de Gastroenterologia REDCap database on an electronic case report form until January 2020. Effectiveness by modified intention-to-treat and per-protocol as well as multivariable analysis were performed. Independent factors evaluated were: age, gender, indication, compliance, proton pump inhibitor dose and treatment line. Results: Finally, 2100 patients were prescribed single-capsule bismuth quadruple therapy following the technical sheet (i.e., three capsules every 6 h for 10 days). The majority of these patients were naive (64%), with an average age of 50 years, 64% women and 16% with peptic ulcer. An overall modified intention-to-treat effectiveness of 92% was achieved. Eradication was over 90% in first-line treatment (95% modified intention-to-treat, n = 1166), and this was maintained as a rescue therapy, both in second (89% modified intention-to-treat, n = 375) and subsequent lines of therapy (third to sixth line: 92% modified intention-to-treat, n = 236). Compliance was the factor most closely associated with treatment effectiveness. Adverse events were generally mild to moderate, and 3% of patients reported a severe adverse event, leading to discontinuation of treatment in 1.7% of cases. Conclusions: Single-capsule bismuth quadruple therapy achieved H. pylori eradication in approximately 90% of patients in real-world clinical practice, both as a first-line and rescue treatment, with good compliance and a favourab

Published
2021

20. Endoscopic Submucosal Dissection: A Country Implementation Experience and Results

Author

Rodriguez-Carrasco, M, additional, Libânio, D, additional, Pimentel-Nunes, P, additional, Barreiro, P, additional, Ferreira, A, additional, Küttner-Magalhães, R, additional, Pinho, R, additional, Boal Carvalho, P, additional, Areia, M, additional, Lage, J, additional, Serrano, M, additional, Silva, J, additional, Dias-Pereira, A, additional, Carvalho, L, additional, Cadime, AT, additional, Cotter, J, additional, Carvalho, J, additional, Pedroto, I, additional, Gonçalves, R, additional, Chagas, C, additional, and Dinis-Ribeiro, M, additional

Published
2021
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29. European Registry on Helicobacter pylori Management: single-capsule bismuth quadruple therapy is effective in real-world clinical practice

Author

Nyssen OP, Perez-Aisa A, Castro-Fernandez M, Pellicano R, Huguet JM, Rodrigo L, Ortuño J, Gomez-Rodriguez BJ, Pinto RM, Areia M, Perona M, Nuñez O, Romano M, Gerarda Gravina A, Pozzati L, Fernandez-Bermejo M, Venerito M, Malfertheiner P, Fernanadez-Salazar L, Gasbarrini A, Vaira D, Puig I, Megraud F, O'Morain C, and Gisbert JP

Subjects
inorganic chemicals, Helicobacter pylori, Pylera, Helicobacter pylori, Pylera, bismuth, eradication, quadruple, quadruple, equipment and supplies, bacterial infections and mycoses, digestive system, digestive system diseases, bismuth, eradication
Abstract

BACKGROUND: There has been resurgence in the use of bismuth quadruple therapy (proton pump inhibitor, bismuth, tetracycline and metronidazole) for treating Helicobacter pylori infection thanks to a three-in-one single-capsule formulation. OBJECTIVE: To evaluate the effectiveness and safety of the single-capsule bismuth quadruple therapy. METHODS: Data were collected in a multicentre, prospective registry of the clinical practice of gastroenterologists on the management of H. pylori infection, where patients were registered at the Asociacion Espanola de Gastroenterologia REDCap database on an electronic case report form until January 2020. Effectiveness by modified intention-to-treat and per-protocol as well as multivariable analysis were performed. Independent factors evaluated were: age, gender, indication, compliance, proton pump inhibitor dose and treatment line. RESULTS: Finally, 2100 patients were prescribed single-capsule bismuth quadruple therapy following the technical sheet (i.e. three capsules every 6 hours for 10 days). The majority of these patients were naive (64%), with an average age of 50 years, 64% women and 16% with peptic ulcer. An overall modified intention-to-treat effectiveness of 92% was achieved. Eradication was over 90% in first-line treatment (95% modified intention-to-treat, n=1166), and this was maintained as a rescue therapy, both in second (89% modified intention-to-treat, n=375) and subsequent lines of therapy (third to sixth line: 92% modified intention-to-treat, n=236). Compliance was the factor most closely associated with treatment effectiveness. Adverse events were generally mild to moderate, and 3% of patients reported a severe adverse event, leading to discontinuation of treatment in 1.7% of cases. CONCLUSIONS: Single-capsule bismuth quadruple therapy achieved H. pylori eradication in approximately 90% of patients in real-world clinical practice, both as a first-line and rescue treatment, with good compliance and a favourable safety profile.

Published
2020

30. Helicobacter pylori first-line and rescue treatments in patients allergic to penicillin: Experience from the European Registry on H pylori management (Hp-EuReg)

Author

Nyssen, O. P., Perez-Aisa, A., Tepes, B., Rodrigo-Saez, L., Romero, P. M., Lucendo, A., Castro-Fernandez, M., Phull, P., Barrio, J., Bujanda, L., Ortuno, J., Areia, M., Brglez Jurecic, N., Huguet, J. M., Alcaide, N., Voynovan, I., Maria Botargues Bote, J., Modolell, I., Perez Lasala, J., Arino, I., Jonaitis, L., Dominguez-Cajal, M., Buzas, G., Lerang, F., Perona, M., Bordin, D., Axon, T., Gasbarrini, Antonio, Marcos Pinto, R., Niv, Y., Kupcinskas, L., Tonkic, A., Leja, M., Rokkas, T., Boyanova, L., Shvets, O., Venerito, M., Bytzer, P., Goldis, A., Simsek, I., Lamy, V., Przytulski, K., Kunovsky, L., Capelle, L., Milosavljevic, T., Caldas, M., Garre, A., Megraud, F., O'Morain, C., Gisbert, J. P., Hinojosa, J., Fernandez, N., Molina Infante, J., Alonso Galan, H., Di Maira, T., Alves, S. I., Saraiva, S., Elvas, L., Brito, D., Teresa Cadime, A., Lampic, P., Gruncic, A., Leban, V., Ferrer, L., Fernandez Salazar, L., Lanas, A., Kristensen, V., Brackmann, S., Delchier, J. C., Anton, C., Gomez Rodriguez, B. J., Pellicano, R., Boltin, D., and Gastroenterology & Hepatology

Subjects
medicine.medical_specialty, Allergy, Settore MED/12 - GASTROENTEROLOGIA, allergic, Penicillins, Gastroenterology, Helicobacter Infections, Drug Hypersensitivity, 03 medical and health sciences, 0302 clinical medicine, Levofloxacin, Metronidazole, Clarithromycin, Internal medicine, bismuth, medicine, Humans, Prospective Studies, Registries, Adverse effect, levofloxacin, biology, Helicobacter pylori, business.industry, Settore MED/09 - MEDICINA INTERNA, allergy, clarithromycin, penicillin, Proton Pump Inhibitors, General Medicine, Tetracycline, biology.organism_classification, medicine.disease, Anti-Bacterial Agents, 3. Good health, Penicillin, Regimen, Infectious Diseases, 030220 oncology & carcinogenesis, Drug Therapy, Combination, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract

Background Experience in Helicobacter pylori eradication treatment of patients allergic to penicillin is very scarce. A triple combination with a PPI, clarithromycin (C), and metronidazole (M) is often prescribed as the first option, although more recently the use of a quadruple therapy with PPI, bismuth (B), tetracycline (T), and M has been recommended. Aim To evaluate the efficacy and safety of first-line and rescue treatments in patients allergic to penicillin in the "European Registry of H pylori management" (Hp-EuReg). Methods A systematic prospective registry of the clinical practice of European gastroenterologists (27 countries, 300 investigators) on the management of H pylori infection. An e-CRF was created on AEG-REDCap. Patients with penicillin allergy were analyzed until June 2019. Results One-thousand eighty-four patients allergic to penicillin were analyzed. The most frequently prescribed first-line treatments were as follows: PPI + C + M (n = 285) and PPI + B + T + M (classic or Pylera(R); n = 250). In first line, the efficacy of PPI + C + M was 69%, while PPI + B + T + M reached 91% (P < .001). In second line, after the failure of PPI + C + M, two rescue options showed similar efficacy: PPI + B + T + M (78%) and PPI + C + levofloxacin (L) (71%) (P > .05). In third line, after the failure of PPI + C + M and PPI + C + L, PPI + B + T + M was successful in 75% of cases. Conclusion In patients allergic to penicillin, a triple combination with PPI + C + M should not be generally recommended as a first-line treatment, while a quadruple regimen with PPI + B + T + M seems to be a better option. As a rescue treatment, this quadruple regimen (if not previously prescribed) or a triple regimen with PPI + C + L could be used but achieved suboptimal (

Published
2020

31. Role of gastrointestinal endoscopy in the screening of digestive tract cancers in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Author

Săftoiu, A., Hassan, C., Areia, M., Bhutani, M.S., Bisschops, R., Bories, E., Cazacu, I.M., Dekker, E., Deprez, P.H., Pereira, S.P., Senore, C., Capocaccia, R., Antonelli, G., Hooft, J. van 't, Messmann, H., Siersema, P.D., Dinis-Ribeiro, M., Ponchon, T., Săftoiu, A., Hassan, C., Areia, M., Bhutani, M.S., Bisschops, R., Bories, E., Cazacu, I.M., Dekker, E., Deprez, P.H., Pereira, S.P., Senore, C., Capocaccia, R., Antonelli, G., Hooft, J. van 't, Messmann, H., Siersema, P.D., Dinis-Ribeiro, M., and Ponchon, T.

Abstract

Contains fulltext : 220005.pdf (Publisher’s version ) (Closed access), In Europe at present, but also in 2040, 1 in 3 cancer-related deaths are expected to be caused by digestive cancers. Endoscopic technologies enable diagnosis, with relatively low invasiveness, of precancerous conditions and early cancers, thereby improving patient survival. Overall, endoscopy capacity must be adjusted to facilitate both effective screening programs and rigorous control of the quality assurance and surveillance systems required. 1 : For average-risk populations, ESGE recommends the implementation of organized population-based screening programs FOR COLORECTAL CANCER: , based on fecal immunochemical testing (FIT), targeting individuals, irrespective of gender, aged between 50 and 75 years. Depending on local factors, namely the adherence of the target population and availability of endoscopy services, primary screening by colonoscopy or sigmoidoscopy may also be recommendable. 2 : In high-risk populations, endoscopic screening FOR GASTRIC CANCER: should be considered for individuals aged more than 40 years. Its use in countries/regions with intermediate risk may be considered on the basis of local settings and availability of endoscopic resources. 3 : For esophageal and pancreatic cancer, endoscopic screening may be considered only in high-risk individuals:- FOR SQUAMOUS CELL CARCINOMA: , in those with a personal history of head/neck cancer, achalasia, or previous caustic injury; - FOR BARRETT'S ESOPHAGUS (BE)-ASSOCIATED ADENOCARCINOMA: , in those with long-standing gastroesophageal reflux disease symptoms (i. e., > 5 years) and multiple risk factors (age ≥ 50 years, white race, male sex, obesity, first-degree relative with BE or esophageal adenocarcinoma [EAC]). - FOR PANCREATIC CANCER SCREENING: , endoscopic ultrasound may be used in selected high-risk patients such as those with a strong family history and/or genetic susceptibility.

Published
2020

40. Performance measures for upper gastrointestinal endoscopy: a single centre evolution in 7 years.

Author

Viegas, M. I., Areia, M., Elvas, L., Alves, S., Saraiva, S., Brito, D., and Cadime, A. T.

Subjects
*ENDOSCOPY, *ESOPHAGEAL cancer
Abstract

This article discusses a study conducted at a single center to assess the quality standards of upper gastrointestinal endoscopies over a period of seven years. The study used performance measures defined by the European Society of Gastrointestinal Endoscopy (ESGE) and compared the results from different years. The study found improvements in certain areas, such as documentation of procedure duration and use of standardized terminology, but also identified areas of worsening performance, such as appropriate photodocumentation and inspection time in the stomach. The authors emphasize the importance of regular evaluation and auditing of performance measures to maintain and enhance the quality of upper gastrointestinal endoscopy. [Extracted from the article]

Published
2024
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44. Performance measures for upper gastrointestinal endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Author

Bisschops, R., Areia, M., Coron, E., Dobru, D., Kaskas, B., Kuvaev, R., Pech, O., Ragunath, K., Weusten, B., Familiari, Pietro, Domagk, D., Valori, R., Kaminski, M. F., Spada, Cristiano, Bretthauer, M., Bennett, C., Senore, C., Dinis-Ribeiro, M., Rutter, M. D., Familiari P. (ORCID:0000-0002-5181-2928), Spada C. (ORCID:0000-0002-5692-0960), Bisschops, R., Areia, M., Coron, E., Dobru, D., Kaskas, B., Kuvaev, R., Pech, O., Ragunath, K., Weusten, B., Familiari, Pietro, Domagk, D., Valori, R., Kaminski, M. F., Spada, Cristiano, Bretthauer, M., Bennett, C., Senore, C., Dinis-Ribeiro, M., Rutter, M. D., Familiari P. (ORCID:0000-0002-5181-2928), and Spada C. (ORCID:0000-0002-5692-0960)

Abstract

N/A

Published
2016

45. Cancro Gástrico: Uma Oportunidade para Prevenção

Author

Areia, M, Pimentel-Nunes, P., Marcos-Pinto, R., and Dinis-Ribeiro, M.

Subjects
Gastrointestinal, Metaplasia, Endoscopy, Stomach Neoplasms/prevention & control, Helicobacter Pylori, Helicobacter Infections
Published
2013

48. 'Downhill' varices: A rare cause of esophageal hemorrhage

Author

Areia, M., Romãozinho, J. M., Ferreira, M., Amaro, P., and Freitas, D.

Subjects
Esophageal and gastric varices, Gastrointestinal hemorrhage, Pulmonary hypertension
Abstract

"Downhill" varices or upper esophageal varices are a rare cause of proximal digestive tract hemorrhage with only 16 cases described in the literature. In our series, hemorrhage due to "Downhill" varices represents 0.1% of all acute esophageal variceal bleeding. Their etiology differs from that of the usual "uphill' varices secondary to portal hypertension, and the clinical management should be directed to vascular obstruction if present. We report a case of an 89-year-old male with hemorrhagic "Downhill" varices not associated, as usually, with superior vena cava obstruction or compression, but with severe pulmonary hypertension and drug-related hemorrhagic risk factors, whose removal proved sufficient to prevent rebleeding.

Published
2006

49. Heterotopia gástrica sob a forma de pólipo esofágico

Author

Areia,M., Figueiredo,P., Gouveia,H., and Freitas,D.

Subjects
digestive system diseases
Abstract

A Heterotopia Gástrica no esófago é uma entidade frequente, normalmente assintomática. Na maioria das situações representa a presença de pequenas áreas de mucosa plana com glândulas fúndicas situadas no esófago superior. Os autores apresentam um caso de heterotopia gástrica revelando-se sob a forma de um pólipo esofágico composto por epitélio do tipo antral. A remoção endoscópica da lesão permitiu a resolução clínica e sintomática no caso descrito. Heterotopic Gastric Mucosa in the esophagus is a frequent, though usually asymptomatic condition. Most of the cases present as a flat area of the fundic-type gastric mucosa in the upper esophagus. We present a case of a polypoid heterotopic gastric mucosa with an antral pattern. Endoscopic removal of the lesion provided clinical relief and cure.

Published
2006

50. A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesions

Author

Pimentel-Nunes, P., additional, Dinis-Ribeiro, M., additional, Soares, J., additional, Marcos-Pinto, R., additional, Santos, C., additional, Rolanda, C., additional, Bastos, R., additional, Areia, M., additional, Afonso, L., additional, Bergman, J., additional, Sharma, P., additional, Gotoda, T., additional, Henrique, R., additional, and Moreira-Dias, L., additional

Published
2012
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