Category Archives: Online

Inter-observer variability on the value of endoscopic images for the documentation of upper gastrointestinal endoscopy – our center experience

DOI: 10.2478/amma-2023-0015

Objective: Endoscopy is an essential and invaluable diagnostic tool in the arsenal of every gastroenterologist. ESGE presented additional guidelines for standardized image documentation in upper and lower gastrointestinal endoscopy. Clinical disagreement is a common challenge in most, if not all, fields of medicine. Settling disagreements is important so as to find ways to minimize it. Clinical disagreement in gastroscopy may be demonstrated by studying the observer variability.
Methods: We retrospectively recruited 120 random patients that underwent conventional upper gastrointestinal endoscopy between 2021-2022 in our Department of Gastroenterology, all of them performed by one endoscopist. As part of the study, all video-endoscopic recordings were stored using one internal server. In order to study interobserver variability, four physicians (endoscopists and gastroenterologist specialists) were invited to complete the questionnaire.
Results: The interobserver variability in our study ranged from moderate to very good in the assessment of the esophagus, with the highest degree of agreement in response to questions concerning characteristic findings such as normal mucosa, esophagitis Class A Los Angeles, hiatal hernia for the esophagus endoscopic evaluation, benign ulcer niche in gastric antrum, normal gastric corpus mucosa, intestinal metaplasia and angiodysplasia in gastric corpus. The question on atrophic mucosa in the first and second part of the duodenum was the most difficult to agree upon.
Conclusion: The present study found that the variability between observers in the assessment of images obtained from patients that underwent conventional upper gastrointestinal endoscopy in our center was acceptably good.

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Should we screen for sarcopenia in Romanian patients with osteoporosis? An overview of the current knowledge on osteosarcopenia

DOI: 10.2478/amma-2023-0014

The combination of osteoporosis and sarcopenia is wider known as “osteosarcopenia”, and it is considered to be a “hazardous duet” for the patient. The clinical consequences of this geriatric syndrome include a higher risk of fractures and mortality compared to osteoporosis or sarcopenia alone. Fractures are considered to be a burden for the patient but also for the health care system from an economic point of view, therefore it is important to prevent them. Emerging evidence shows that osteosarcopenia is an increasingly prevalent disease. The Fracture Risk Assessment Tool (FRAX) is of major importance for the management of a patient, however, muscle weakness is not part of this instrument. It has been suggested to go “beyond the FRAX” and to evaluate muscle mass/strength besides bone mineral density when it comes to the management of a patient with a sustained fragility fracture. In this review we try to answer whether this is feasible or not when it comes to Romanian patients.

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Prevalence of human Papillomavirus associated oropharyngeal and oral squamous cell carcinoma in Asian countries: A systematic review and large-scale meta-analysis

DOI: 10.2478/amma-2023-0005

Human Papillomavirus (HPV) associated with oropharyngeal and oral squamous cell carcinoma (OPSCC and OSCC) is escalating over the years. Hence, the present review aims to determine the prevalence of HPV-OSCC and HPV-OPSCC in Asian countries over the last decades. An electronic search was conducted using nine online databases to identify English-language articles on the prevalence of HPV-OPSCC and HPV-OSCC in Asian countries from January 2011 to June 2022. The risk of bias was assessed using the JBI critical appraisal checklist and the level of evidence was determined based on the OCEBM guideline. Single-arm meta-analysis was used to estimate the weighted mean prevalence of HPV-OPSCC and HPV-OSCC among patients in Asia. Subgroup analysis meta-regression and Egger’s tests were also conducted. 59 eligible studies were included with a higher prevalence of HPV-OPSCC (32.6%-37.4%) as compared to HPV-OSCC (10.9%-23.5%). Subgroup analysis revealed that the weighted mean prevalence of HPV-OPSCC was significantly higher (P<0.001) among East Asians, while the weighted mean prevalence of HPV-OSCC was significantly higher (P<0.001) among South Asians. All studies showed a low to moderate risk of bias with the level of evidence ranked between 2 and 3. The diagnostic tools utilised and geographical locations significantly affect the findings.

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