Double-balloon enteroscopy (DBE) in patients presenting with obscure gastrointestinal bleeding (OGIB)

Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study

Background and Aim: Double-balloon enteroscopy (DBE) is a well-established procedure for direct visualisation of the entire small bowel mucosa, and, in contrast with other imaging techniques, allows to perform biopsies and therapeutic interventions. The aim of this study was to evaluate the indications, diagnostic yield, therapeutic yield, and complications of DBE in a cohort of consecutive patients according to patients’ age. Methods: We conducted a retrospective study of consecutive patients who underwent DBE in our endoscopy unit between January 2006 and December 2021. Results: A total of 387 consecutive patients who underwent 460 DBE procedures were included. Mean age of the patients was 63 years. The overall diagnostic yield was 67.6%; vascular lesions were the predominant endoscopic findings (31.5%), followed by polyps or neoplastic masses (17.6%). Older patients (≥65 years) showed statistically higher rates of clinically relevant findings than adult patients (18–65 years) (p = 0.001). Crohn’s disease and polyps or neoplastic masses were more frequent in the younger group (p = 0.009 and p = 0.066, respectively), while vascular lesions and non-specific inflammation were the most common findings in the older group (p < 0.001 and p < 0.001, respectively). The therapeutic intervention rate was 31.7%. Rates of endoscopic treatment were significantly higher in the older group (p < 0.001). Total complications occurred in five procedures (1.1%). Conclusion: In clinical practice, DBE is an efficient diagnostic and therapeutic tool with a high safety profile, particularly in the elderly population.

An intelligent intestinal bleeding diagnosis and treatment capsule system based on color recognition

To our best knowledge, there are no non-invasive and painless means for the diagnosis and treatment of intestinal bleeding as of now, especially the segment of intestine that cannot be reached by endoscopy. We proposed an intelligent intestinal bleeding diagnosis and treatment capsule (IBDTC) system for the first time to diagnose and treat intestinal bleeding with low power consumption, estimated to be about 2.16mW. A hue-saturation-light (HSL) color space method was applied to diagnose bleeding according to H (hue) values of the film dyed by blood. A MEMS-based micro-igniter works as the critical component of the micro-thruster that houses the propellant (74.6% potassium nitrate, 11.9% sulfur, 13.5% charcoal) and the detonating agent (dinitrodiazophenol), to help release drug. Bleeding detection and ignition tests were performed to justify its feasibility and reliability. Results demonstrated that the bleeding diagnosis module of the IBDTC can effectively detect bleeding and the micro-igniter can successfully ignite the propellant. Owing to its simplicity and intelligence, the IBDTC system will pave a way for future accurate treatment of small intestinal bleeding with no injury, no pain, no complicated supporting equipment, no need for in vitro operation and positioning.

[Influence of preparation height and cement space on the fit and retention of computer aided design/computer aided manufacturing zirconia crown]

OBJECTIVE

To investigate the effects of preparation height and cement space on the fit and retention of computer aided design (CAD)/computer aided manufacturing (CAM) zirconia crown, and to provide reference for the clinical design and fabrication of CAD/CAM crowns.

METHODS

3D printing system was used to fabricate resin abutment teeth with convergence angle of 2° and height of 1-3 mm. The models' optical impressions were collected by the three-shape scanner. Then, the cement spaces were set by Cradle CAD/CAM system at 10-50 μm to create an all-ceramic zirconia crown. The fit of the crowns was measured by using silicone rubber interstitial impression method. The retention of the crowns was measured by pull-off test with uniaxial tensile force after the crown was bonded. The data were analyzed by SPSS 22.0 soft-ware.

RESULTS

When the preparation height was fixed, the fitness values of different cement space groups have statistical difference (P<
0.05), whereas the retention values of different cement space groups have no statistical difference (P>0.05). The fitness values of different preparation height groups have no statistical difference (P>0.05), and the retention values of different preparation height groups have statistical difference (P<0.05) when the cement space was fixed. No interaction was observed between the cement space and the preparation height (P>0.05).

CONCLUSIONS

When cradle CAD/CAM system is used to create a full crown in the clinic, the preparation height should be set to more than 3 mm, and the cement space should be set at 30 μm.