M. Navas - Academia.edu (original) (raw)
Papers by M. Navas
Revista Española de Enfermedades Digestivas, 2012
Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected cli... more Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever. Its occurrence may be due to reactivation of a previous infection or less often a primary infection. Herpes simplex type 1 is the most common cause. Upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. It also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis. The severity of symptoms is related to the degree of oesophageal involvement. In immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications. We present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and nonspecific onset of flu-like symptoms. Endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa.
Revista Española de Enfermedades Digestivas, 2013
Background and objectives: recently, Olympus developed a new prototype (XCF-Q180AY2L) with respon... more Background and objectives: recently, Olympus developed a new prototype (XCF-Q180AY2L) with responsive insertion technology (RIT), which besides the still known variable stiffness technology, included a passive bending section and a new high force insertion tube. Our objective was to investigate whether the use of this prototype could ease colonoscope insertion, increasing the cecal intubation rate, and/or shortening the cecal intubation time. Material and methods: the study was designed as a prospective observational study in 305 consecutive patients from a colo-rectal cancer screening program. We compared colonoscopies performed with conventional colonoscopes (CFH180AL/CFQ160L) with those performed with the prototype XCF-Q180AY2L. End points were mean cecal and terminal ileal intubation times, cecum intubation rate, and need for specific maneuvers. All colonoscopies were performed under sedation with intravenous propofol. Finally, 288 patients were included. Results: no complications were observed. Complete cecal intubation rate was 100 % in both groups. The ileum could be reached in 98.95 % of cases. Mean time required to reach the cecum was shorter in the prototype endoscope group (4.31 min, SD 2.63 min) than in the conventional endoscope group (4.66 min, SD 2.52 min) (p < 0.05). Compared with the standard colonoscope group, we observed in the prototype group less subjective sensation of difficulty in the passage of the sigma (p < 0.01), fewer maneuvers when it proved necessary to straighten the scope (p < 0.01), and less frequent need to modify the stiffness of the endoscope (p < 0.05). Conclusion: we concluded that the prototype endoscope (XCF-Q180AY2L) facilitated colonoscope insertion, requiring slightly less time to reach the cecum than a standard colonoscope.
New England Journal of Medicine, 2009
Background An ingestible capsule consisting of an endoscope equipped with a video camera at both ... more Background An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer. Methods
Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva, 2000
We report the case of a 12-year-old boy, diagnosed of Klippel Trenaunay Weber syndrome, with hema... more We report the case of a 12-year-old boy, diagnosed of Klippel Trenaunay Weber syndrome, with hemangiomas and venous varicosities in the right leg, who complaint about incidental hematochezia. In the colonoscopy some violet and plain angiodysplastic lesions like in the skin, were observed in rectum and distal sigmoid colon. We think this case is interesting, because of the unusual affectation of the gut in this disease and the importance of considering the endoscopic procedures in the evaluation of these patients.
Gastroenterología y Hepatología, 2011
Endoscopy, 2006
Background: Thiazolidinedione ligands (TZDs) for the gamma subtype of peroxisome proliferator-act... more Background: Thiazolidinedione ligands (TZDs) for the gamma subtype of peroxisome proliferator-activated receptors (PPAR␥), widely used to treat type 2 diabetes mellitus, have been proposed to have anti-inflammatory properties in the colon. However, their efficacy in humans with active ulcerative colitis is uncertain. Methods: This multicenter, randomized, double-blind, placebocontrolled clinical trial compared the efficacy of rosiglitazone (Avandia) 4 mg orally twice daily with placebo twice daily for 12 weeks in 105 patients with mild to moderately active ulcerative colitis refractory to or intolerant of 5-aminosalicylic acid. Disease activity was measured with the Disease Activity Index (DAI), with mild to moderate activity defined as a score of 4-10, inclusively. The primary end point was clinical response (reduction in the DAI by 2 points or more) at week 12. Secondary outcomes included clinical response defined as reduction in the DAI by 3 points or more, clinical remission (DAI Յ 2), endoscopic remission (DAI Ͻ 2 and mucosal appearance ϭ 0), and quality of life (increase in Inflammatory Bowel Disease Questionnaire score by 16 points or more). Patients who did not complete 12 weeks of follow-up were defined as treatment failures for all outcomes. Analyses were performed according to the principle of intention to treat. Results: After 12 weeks of therapy, 23 patients (44%) treated with rosiglitazone and 12 patients (23%) treated with placebo had achieved clinical response (P ϭ .03). Patients treated with rosiglitazone had higher rates of the secondary definition of response (reduction in the DAI by 3 points or more) and clinical remission but not endoscopic remission (Table 1). Improvement in endoscopic appearance (P ϭ .01), stool frequency (P ϭ .04),
Endoscopy, 2006
Either your web browser doesn't support Javascript or it is currently turned off. In the lat... more Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. ... PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a ...
Endoskopie Heute, 2012
PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsu... more PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and workup of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.
Revista Española de Enfermedades Digestivas, 2012
A 72-year-old male was admitted because of dysphagia for solids and liquids. He had undergone a l... more A 72-year-old male was admitted because of dysphagia for solids and liquids. He had undergone a laparoscopic Nissen fundoplication due to erosive esophagitis and hiatal hernia. Three years later, due to symptomatic recurrence of the hernia, surgery with placement of a polypropylene mesh was indicated. After four years he developed epigastric pain and dysphagia for liquids. Gastroduodenoscopy showed a polypropylene mesh occluding almost all the esophageal lumen (Fig. 1). The symptoms worsened, with dysphagia for solids and liquids, with weight loss. First of all, we decided to remove the mesh endoscopically. A first attempt was done by exerting strong traction on the mesh with biopsy forceps without any result. At this point we looked for each one of the blue Prolene 3/0 (Fig. 2A) sutures and cut them with endoscopic scissors FS-3L1 and FS-5U-1 (Fig. 2B) (Olympus, Tokyo, Japan). The mesh was extracted successfully in two
New England Journal of Medicine, 2009
An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was de... more An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer.
Revista Española de Enfermedades Digestivas, 2012
Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected cli... more Herpetic esophagitis in immunocompetent individuals is a rare entity that should be suspected clinically by an acute onset of symptoms, and without apparent cause of a symptomatic triad consisting on odynophagia, heartburn and fever. Its occurrence may be due to reactivation of a previous infection or less often a primary infection. Herpes simplex type 1 is the most common cause. Upper endoscopy establishes the diagnosis of suspicion of herpetic esophagitis. It also allows to take multiple biopsy samples and viral culture, leading to a definitive diagnosis. The severity of symptoms is related to the degree of oesophageal involvement. In immunocompromised patients treatment is indicated with acyclovir, but the indication in immunocompetent patients is controversial because the process is time, limited with a low probability of complications. We present a case of acute herpetic esophagitis in an immunocompetent host that debuted acutely with severe upper gastrointestinal tract symptoms, associated with an insidious and nonspecific onset of flu-like symptoms. Endoscopic findings showed a severe involvement in the lower third of the oesophageal mucosa.
Revista Española de Enfermedades Digestivas, 2013
Background and objectives: recently, Olympus developed a new prototype (XCF-Q180AY2L) with respon... more Background and objectives: recently, Olympus developed a new prototype (XCF-Q180AY2L) with responsive insertion technology (RIT), which besides the still known variable stiffness technology, included a passive bending section and a new high force insertion tube. Our objective was to investigate whether the use of this prototype could ease colonoscope insertion, increasing the cecal intubation rate, and/or shortening the cecal intubation time. Material and methods: the study was designed as a prospective observational study in 305 consecutive patients from a colo-rectal cancer screening program. We compared colonoscopies performed with conventional colonoscopes (CFH180AL/CFQ160L) with those performed with the prototype XCF-Q180AY2L. End points were mean cecal and terminal ileal intubation times, cecum intubation rate, and need for specific maneuvers. All colonoscopies were performed under sedation with intravenous propofol. Finally, 288 patients were included. Results: no complications were observed. Complete cecal intubation rate was 100 % in both groups. The ileum could be reached in 98.95 % of cases. Mean time required to reach the cecum was shorter in the prototype endoscope group (4.31 min, SD 2.63 min) than in the conventional endoscope group (4.66 min, SD 2.52 min) (p < 0.05). Compared with the standard colonoscope group, we observed in the prototype group less subjective sensation of difficulty in the passage of the sigma (p < 0.01), fewer maneuvers when it proved necessary to straighten the scope (p < 0.01), and less frequent need to modify the stiffness of the endoscope (p < 0.05). Conclusion: we concluded that the prototype endoscope (XCF-Q180AY2L) facilitated colonoscope insertion, requiring slightly less time to reach the cecum than a standard colonoscope.
New England Journal of Medicine, 2009
Background An ingestible capsule consisting of an endoscope equipped with a video camera at both ... more Background An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer. Methods
Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva, 2000
We report the case of a 12-year-old boy, diagnosed of Klippel Trenaunay Weber syndrome, with hema... more We report the case of a 12-year-old boy, diagnosed of Klippel Trenaunay Weber syndrome, with hemangiomas and venous varicosities in the right leg, who complaint about incidental hematochezia. In the colonoscopy some violet and plain angiodysplastic lesions like in the skin, were observed in rectum and distal sigmoid colon. We think this case is interesting, because of the unusual affectation of the gut in this disease and the importance of considering the endoscopic procedures in the evaluation of these patients.
Gastroenterología y Hepatología, 2011
Endoscopy, 2006
Background: Thiazolidinedione ligands (TZDs) for the gamma subtype of peroxisome proliferator-act... more Background: Thiazolidinedione ligands (TZDs) for the gamma subtype of peroxisome proliferator-activated receptors (PPAR␥), widely used to treat type 2 diabetes mellitus, have been proposed to have anti-inflammatory properties in the colon. However, their efficacy in humans with active ulcerative colitis is uncertain. Methods: This multicenter, randomized, double-blind, placebocontrolled clinical trial compared the efficacy of rosiglitazone (Avandia) 4 mg orally twice daily with placebo twice daily for 12 weeks in 105 patients with mild to moderately active ulcerative colitis refractory to or intolerant of 5-aminosalicylic acid. Disease activity was measured with the Disease Activity Index (DAI), with mild to moderate activity defined as a score of 4-10, inclusively. The primary end point was clinical response (reduction in the DAI by 2 points or more) at week 12. Secondary outcomes included clinical response defined as reduction in the DAI by 3 points or more, clinical remission (DAI Յ 2), endoscopic remission (DAI Ͻ 2 and mucosal appearance ϭ 0), and quality of life (increase in Inflammatory Bowel Disease Questionnaire score by 16 points or more). Patients who did not complete 12 weeks of follow-up were defined as treatment failures for all outcomes. Analyses were performed according to the principle of intention to treat. Results: After 12 weeks of therapy, 23 patients (44%) treated with rosiglitazone and 12 patients (23%) treated with placebo had achieved clinical response (P ϭ .03). Patients treated with rosiglitazone had higher rates of the secondary definition of response (reduction in the DAI by 3 points or more) and clinical remission but not endoscopic remission (Table 1). Improvement in endoscopic appearance (P ϭ .01), stool frequency (P ϭ .04),
Endoscopy, 2006
Either your web browser doesn't support Javascript or it is currently turned off. In the lat... more Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page. ... PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a ...
Endoskopie Heute, 2012
PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsu... more PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and workup of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.
Revista Española de Enfermedades Digestivas, 2012
A 72-year-old male was admitted because of dysphagia for solids and liquids. He had undergone a l... more A 72-year-old male was admitted because of dysphagia for solids and liquids. He had undergone a laparoscopic Nissen fundoplication due to erosive esophagitis and hiatal hernia. Three years later, due to symptomatic recurrence of the hernia, surgery with placement of a polypropylene mesh was indicated. After four years he developed epigastric pain and dysphagia for liquids. Gastroduodenoscopy showed a polypropylene mesh occluding almost all the esophageal lumen (Fig. 1). The symptoms worsened, with dysphagia for solids and liquids, with weight loss. First of all, we decided to remove the mesh endoscopically. A first attempt was done by exerting strong traction on the mesh with biopsy forceps without any result. At this point we looked for each one of the blue Prolene 3/0 (Fig. 2A) sutures and cut them with endoscopic scissors FS-3L1 and FS-5U-1 (Fig. 2B) (Olympus, Tokyo, Japan). The mesh was extracted successfully in two
New England Journal of Medicine, 2009
An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was de... more An ingestible capsule consisting of an endoscope equipped with a video camera at both ends was designed to explore the colon. This study compared capsule endoscopy with optical colonoscopy for the detection of colorectal polyps and cancer.