Browsing by Author "Soares, JB"
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- Colorectal cancer polyp screening in treated acromegalic patientsPublication . Lopes, S; Soares, JB; Marques, O; Almeida, R; Macedo, G
- Endoscopic resection of a large colonic lipoma by unroofing techniquePublication . Soares, JB; Gonçalves, R; Rolanda, C
- Hepatic abscess and colonic stenosis: two complications of an unlikely causePublication . Soares, JB; Ferreira, A; Gonçalves, R
- Ménétrier disease with antrum polyposis and gastritis cystica profundaPublication . Soares, JB; Bastos, P; Gonçalves, R
- A multicenter validation of an endoscopic classification with narrow band imaging for gastric precancerous and cancerous lesionsPublication . Pimentel-Nunes, P; Dinis-Ribeiro, M; Soares, JB; Marcos-Pinto, R; Santos, C; Rolanda, C; Bastos, RP; Areia, M; Afonso, L; Bergman, J; Sharma, P; Gotoda, T; Henrique, R; Moreira-Dias, LBACKGROUND AND STUDY AIM: The reliability and external validity of narrow band imaging (NBI) in the stomach have not been described consistently. The aim of the current study was to describe and estimate the accuracy and reliability of a simplified classification system for NBI in the diagnosis of gastric lesions. METHODS: Consecutive patients undergoing NBI endoscopy at two reference centers (n=85, 33% with dysplasia) were included in two studies. In total, 224 different areas were biopsied and recorded onto video. In the derivation study, previously described NBI features were analyzed in order to develop a simplified classification. In the validation study the accuracy and reliability of this classification were estimated among three groups of endoscopists with different levels of expertise in NBI. RESULTS: The reliability/accuracy results from the derivation study allowed the creation of a simplified NBI classification. In the validation study, "regular vessels with circular mucosa" (pattern A) was associated with normal histology (accuracy 83%; 95% confidence interval [CI] 75 %-90%); "tubulo-villous mucosa" (pattern B) was associated with intestinal metaplasia (accuracy 84%; 95CI 77%-91%; positive likelihood ratio [LR+]=4.75); and "irregular vessels and mucosa" (pattern C) was associated with dysplasia (accuracy 95%; 95CI 90%-99%; LR+=44.33). The reproducibility of these patterns was high (k=0.62). "Light-blue crest" was moderately reliable (k=0.49) but specific (87%) for intestinal metaplasia. A variable vascular density (additional pattern+) was the best feature for Helicobacter pylori gastritis (accuracy 70%; 95CI 59%-80%) but showed only fair reliability (k=0.38). Non-experienced endoscopists presented lower agreement (k=0.6 vs. k=0.75) and accuracy (74% vs. 86%) than international experts/experienced endoscopists. CONCLUSION: A simplified NBI classification is accurate and reliable for the diagnosis of intestinal metaplasia and dysplasia. The classification should be further assessed and validated on a per-patient assessment of NBI, and by comparing NBI with other imaging technologies.
- The management of ingested foreign bodies in an Ear Nose and Throat emergency unit: Prospective study of 204 casesPublication . Marçal, N; Soares, JB; Pereira, G; Guimarães, J; Godinho, TAIMS: To determine how often ingested foreign bodies are found and what parameters may predict their retrieval. METHODS: During 1 year, we prospectively studied all patients referred to our Ear Nose and Throat Emergency Unit because of foreign body ingestion. RESULTS: During the study, 204 (median age-42 years [10 months-84 years]) patients were admitted because of ingested foreign body. The most common was fish bone (88%). Most patients were admitted <24-hour after ingestion (72%) and complained of symptoms above the cricoid cartilage (79%). A foreign body was removed by Ear Nose and Throat team in 108 (53%) patients. Twenty-three (11%) patients were referred to Gastroenterology. In 9 (39%) of these patients, a foreign body was identified by esophagogastroscopy, always from the esophagus. Predictive variables for retrieval of foreign body by Ear Nose and Throat team were ingested fish bone (P=.000; odds ratio [OR]=17.3), short duration (<6hours) of symptoms (P=.001; OR=2.3) and symptoms above or at the level of cricoid cartilage (P=.000; OR=8.9). In patients with symptoms below the cricoid cartilage the rate of retrieval of foreign body by Ear Nose and Throat team (11%) was significantly increased by Gastroenterology (41%; P=.03). CONCLUSIONS: Patients with ingestion of foreign body who ingest fish bone, present within the first 6hours or complain of symptoms at or above cricoid cartilage deserve greater investment in terms of time and resources for retrieval of ingested foreign body by Ear Nose and Throat team.