The DJBL, when used for a period of 6 months, is effective in the control of diabetes, weight loss, improvement of insulin resistance, and decrease of cardiovascular risk among morbidly obese patients with type 2 diabetes mellitus.
BackgroundIn patients with chronic diarrhea, colonoscopy may identify inflammatory causes or
some occult disease, and also can show a normal mucosa. Serial biopsies of
intestinal mucosa can be useful for a differential diagnosis, and to modify the
treatment.AimTo evaluate whether the biopsies performed in patients with chronic diarrhea and a
normal colonoscopy contribute to the differential diagnosis and alter the
therapeutic approach.MethodsA descriptive, retrospective and cross-sectional study using a computerized
database was done. Patients with chronic diarrhea and a normal
colonoscopy underwent serial biopsies of the terminal ileum, ascending colon and
rectum.ResultsFrom 398 records, 214 were excluded. Of the 184 patients enrolled, 91 showed
histological changes: 40% nonspecific inflammation; 5.18% lymphocytic
inflammation, 10.37% eosinophilic inflammation; 39.26% lymphoid hyperplasia; 2.22%
collagenous colitis; 2.22% melanosis; and 0.74% pseudomelanose. The sites with the
largest number of changes were the terminal ileum and right colon.ConclusionsSerial biopsies in patients with chronic diarrhea and normal colonoscopy
identified changes in almost 50% of cases and 22% of these cases may had modified
the treatment after identification of collagenous, lymphocytic and eosinophilic
colitis.
BackgroundGastroesophageal reflux disease is an increasingly common condition worldwide
causing a considerable economic impact. More than half the patients with clinical
symptoms of reflux disease display no mucosal erosions on
esophagogastroduodenoscopy, making it impossible to confirm the diagnosis without
further investigations.AimTo evaluate the correlation between minimal endoscopic changes on white-light
esophagogastroduodenoscopy (carditis, mucosal thickening and invisibility of
vessels) and histologic changes observed in distal esophageal biopsies in a sample
of patients with symptoms suggestive of reflux disease, and to verify the
specificity of these symptoms for non-erosive reflux disease.MethodsRetrospective, cross-sectional study based on information retrieved from a digital
database at a Brazilian hospital for the period March-October, 2012. The sample
consisted of previously untreated, non-smoking subjects aged >18 years with
symptoms suggestive of reflux disease but no esophageal erosions, submitted to
esophagogastroduodenoscopy and distal esophageal biopsy.ResultsThe final sample included 23 subjects. The most frequently observed change was
invisibility of vessels (n=21; 91.3%), followed by mucosal thickening (n=15;
65.2%) and carditis (n=5; 21.7%). The correlation coefficient between each
variable and the anatomopathological diagnosis was 0.386 for body mass index,
0.479 for mucosal thickening, -0.116 for invisibility of vessels, 0.306 for
carditis and 0.462 for hiatal hernia.ConclusionAll patients displayed minimal endoscopic changes on esophagogastroduodenoscopy,
but only mucosal thickening revealed a moderately significant correlation with
severity of esophagitis, although increased body mass index values and the
presence of hiatal hernia were also associated.
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