SLE patients continue to be at risk for extrarenal activity after RRT. The most common flare was haematologic, which correlated with the history of haematologic activity and anti-cardiolipin positivity as independent risk factors. Lower C4 levels and younger age at the beginning of RRT were also associated. Patients with these characteristics should have a closer follow-up in order to detect and treat SLE flares in a timely manner.
Artículo de revisión resumenUna adecuada selección del paciente, la estratificación del riesgo preprocedimiento, modificaciones a la técnica de la colangiopancreatografía retrógrada endoscópica (CPRE) y la profilaxis farmacológica son estrategias que han demostrado ser costo-efectivas en la prevención de pancreatitis post-CPRE. Esta revisión se centrará en los factores de riesgo asociados a pancreatitis post-CPRE y en las intervenciones que han demostrado mayor beneficio para disminuir esta complicación.
6cm above GEJ) and preservation of the longitudinal muscles was reported by 91.5%, 41.46% and 75.6%, respectively. We found that 64.6% performed a 2cm myotomy extension into the cardia and 97.6% prescribe prophylactic antibiotics peri-procedure. The most common diathermy settings used for myotomy were "endocut" (53.8%) and "spray coagulation" (28.8%). Post-POEM, 53.8% and 40.0% of respondents admit patients to hospital for one or two nights, respectively. Only 55.0% routinely perform a barium/gastrograffin study and 16.0% do not prescribe PPI. Conclusion: POEM has rapidly gained worldwide popularity. However, our survey of POEM experts identified significant variation in POEM practices. An international study group is needed to better define and provide guidance on best practices in POEM.
Background: During the COVID-19 pandemic, several questions have arisen about which endoscopic procedures (EPs) must be performed and which ones can be postponed. The aim of this study was to conduct a nationwide survey regarding the appropriate timing of EPs during the COVID-19 pandemic. Methods: This prospective study was performed through a nationwide electronic survey. The survey consisted of 15 questions divided into three sections. The first evaluated the agreement for EPs classified as “time sensitive” and “not time sensitive”. Two other sections assessed “high-priority” and “low-priority” scenarios. Agreement was considered when >75% of respondents answered a question in the same direction. Results: The response rate was 27.2% (214/784). Among the respondents, agreement for the need to perform EP in <72 hours was only reached for variceal bleeding (93.4%). Dysphagia with alarm symptoms was the scenario in which the highest percentage of physicians (95.9%) agreed that an EP needed to be performed within a month. Less than 30% of endoscopists would perform an EP within the first 72 hours for patients with mild cholangitis, non-variceal upper gastrointestinal bleeding without hemodynamic instability, or severe anaemia without overt bleeding. In time-sensitive clinical scenarios suggestive of benign disease, none of the scenarios reached agreement in any sense. Among the time-sensitive clinical scenarios suggestive of malignancy, >90% of the surveyed respondents considered that EP could not be postponed for >8 weeks. Conclusions: There was no consensus among endoscopists about the timing of EPs in patients with pathologies considered time sensitive or in those with high-priority pathologies. Agreement was only reached in five (17%) of the evaluated clinical scenarios.
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