目的:以儿童癫痫为研究病种,调研该院门诊儿科患者面临的超说明书用药情况,建立门诊儿科超说明书用药风险获益评估体系。方法:对2021—2022年该院儿科诊断为癫痫的1400例患者的门诊处方进行分析,运用Logistic回归分析推测影响儿童癫痫...目的:以儿童癫痫为研究病种,调研该院门诊儿科患者面临的超说明书用药情况,建立门诊儿科超说明书用药风险获益评估体系。方法:对2021—2022年该院儿科诊断为癫痫的1400例患者的门诊处方进行分析,运用Logistic回归分析推测影响儿童癫痫患者超说明书用药的独立因素,并使用“Benefit and Risk Assessment for Off-label Use”(BRAvO)评估表对托吡酯超说明书用药进行分析。结果:1400例门急诊癫痫患儿中,共有112例超说明书用药。多因素Logistic回归分析结果显示,年龄和用药品种数是癫痫患儿超说明书用药的独立影响因素。运用BRAvO评估表确定了托吡酯在2岁以下儿童使用的有效性,但是未确定具体给药剂量。结论:超说明书用药仍然是门诊儿科患者面临的主要问题,BRAvO评估表可为门诊儿科超说明书用药提供决策,规范儿科超说明书用药,降低超说明书用药风险。展开更多
目的 探讨MRI 3D Bravo序列在脑转移瘤诊断中的应用价值。方法 选取2020年12月至2024年12月医院收治的80例脑转移瘤患者作为研究对象,所有患者均分别行常规MRI平扫、MRI增强扫描以及MRI 3D Bravo序列扫描。采用双盲法对不同序列扫描所...目的 探讨MRI 3D Bravo序列在脑转移瘤诊断中的应用价值。方法 选取2020年12月至2024年12月医院收治的80例脑转移瘤患者作为研究对象,所有患者均分别行常规MRI平扫、MRI增强扫描以及MRI 3D Bravo序列扫描。采用双盲法对不同序列扫描所获取的图像进行观察,记录并比较不同序列转移病灶[微小(<5 mm)、小(5~10 mm)、较大(>10 mm)及隐匿性转移病灶]数目、转移病灶大小(微小转移病灶、小转移病灶、较大转移病灶最大径)及图像质量评估指标(图像信噪比、病灶大小测量误差、肿瘤与周围组织关系显示清晰度评分)。结果 MRI 3D Bravo序列检出的微小转移病灶、隐匿性转移病灶数量均高于常规MRI平扫和MRI增强扫描(P<0.05)。MRI 3D Bravo序列测量的微小转移病灶、小转移病灶最大径明显小于常规MRI平扫和MRI增强扫描(P<0.05)。MRI 3D Bravo序列图像的信噪比、肿瘤与周围组织关系显示清晰度评分明显高于常规MRI平扫及MRI增强扫描,病灶大小测量误差小于常规MRI平扫及MRI增强扫描(P<0.05)。结论 MRI 3D Bravo序列在脑转移瘤诊断中具有较高的临床价值,可提高脑转移瘤检出率。展开更多
AIM： To investigate if differences exist for patients＇ gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.METHODS： A retrospective study of 27 consecutive adult pat...AIM： To investigate if differences exist for patients＇ gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.METHODS： A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under Ⅳ conscious sedation prior to Bravo placement. Acid reflux variables and symptom scores for d 1 were compared to d 2.RESULTS： The mean doses of fentanyl and midazolam were 90.4 μg and 7.2 mg, respectively. D 1 results were significantly more elevated than d 2 with respect to total time pH 〈 4, upright position reflux, and mean number of long refluxes. No statistical difference was noted between the two days for supine position reflux, number of refluxes, duration of longest reflux, episodes of heartburn, and symptom score.CONCLUSION： Patients undergoing Bravo esophageal pH monitoring in association with EGD and moderate conscious sedation experience significantly more acid reflux on d i compared to d 2. The Ⅳ sedation may be responsible for the increased reflux on d 1. Performed this way, 48-h Bravo results may not be entirely representative of the patients＇ true GE reflux profile.展开更多
AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive ...AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent failures were due to poor data reception (4.5%), early dislodgement (4.5%) and capsule removal (6.1%). CONCLUSION: The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.展开更多
AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutiv...AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutive days.For comparison,a gastric fistula model was used.Effects of ghrelin and esomeprazole,with or without pentagastrin,on gastric pH were studied.In addition,effects of esomeprazole on plasma ghrelin,gastrin and somatostatin were analyzed.RESULTS: All rats recovered after surgery.The average 24-h pH during free feeding was 2.3 ± 0.1 (n = 20) with a variation of 18% ± 6% over 5 d.Ghrelin,2400 pmol/kg,t.i.d.increased pH from 1.7 ± 0.1 to 3.1 ± 0.3 (P < 0.01) as recorded with the Bravo system.After esomeprazole (1 mg/kg,3 mg/kg and 5 mg/kg) there was a dose-dependent pH increase of maximally 3.4 ± 0.1,with day-to-day variation over the entire period of 8% ± 3%.The fistula and pH studies generated similar results.Acid inhibition with esomeprazole increased plasma ghrelin from 10 ± 2 pmol/L to 65 ± 26 pmol/L (P < 0.001),and somatostatin from 10 ± 2 pmol/L to 67 ± 18 pmol/L (P < 0.001).CONCLUSION: pH measurements with the Bravo capsule are reliable,and comparable to those of the gastric fistula model.The Bravo system optimizes accurate intragastric pH monitoring over prolonged periods and allows both short-and long-term evaluation of effects of drugs and hormones.展开更多
We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visua...We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo p H test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but nontrivial, risk of complications.展开更多
文摘目的:以儿童癫痫为研究病种,调研该院门诊儿科患者面临的超说明书用药情况,建立门诊儿科超说明书用药风险获益评估体系。方法:对2021—2022年该院儿科诊断为癫痫的1400例患者的门诊处方进行分析,运用Logistic回归分析推测影响儿童癫痫患者超说明书用药的独立因素,并使用“Benefit and Risk Assessment for Off-label Use”(BRAvO)评估表对托吡酯超说明书用药进行分析。结果:1400例门急诊癫痫患儿中,共有112例超说明书用药。多因素Logistic回归分析结果显示,年龄和用药品种数是癫痫患儿超说明书用药的独立影响因素。运用BRAvO评估表确定了托吡酯在2岁以下儿童使用的有效性,但是未确定具体给药剂量。结论:超说明书用药仍然是门诊儿科患者面临的主要问题,BRAvO评估表可为门诊儿科超说明书用药提供决策,规范儿科超说明书用药,降低超说明书用药风险。
文摘目的 探讨MRI 3D Bravo序列在脑转移瘤诊断中的应用价值。方法 选取2020年12月至2024年12月医院收治的80例脑转移瘤患者作为研究对象,所有患者均分别行常规MRI平扫、MRI增强扫描以及MRI 3D Bravo序列扫描。采用双盲法对不同序列扫描所获取的图像进行观察,记录并比较不同序列转移病灶[微小(<5 mm)、小(5~10 mm)、较大(>10 mm)及隐匿性转移病灶]数目、转移病灶大小(微小转移病灶、小转移病灶、较大转移病灶最大径)及图像质量评估指标(图像信噪比、病灶大小测量误差、肿瘤与周围组织关系显示清晰度评分)。结果 MRI 3D Bravo序列检出的微小转移病灶、隐匿性转移病灶数量均高于常规MRI平扫和MRI增强扫描(P<0.05)。MRI 3D Bravo序列测量的微小转移病灶、小转移病灶最大径明显小于常规MRI平扫和MRI增强扫描(P<0.05)。MRI 3D Bravo序列图像的信噪比、肿瘤与周围组织关系显示清晰度评分明显高于常规MRI平扫及MRI增强扫描,病灶大小测量误差小于常规MRI平扫及MRI增强扫描(P<0.05)。结论 MRI 3D Bravo序列在脑转移瘤诊断中具有较高的临床价值,可提高脑转移瘤检出率。
文摘AIM： To investigate if differences exist for patients＇ gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.METHODS： A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under Ⅳ conscious sedation prior to Bravo placement. Acid reflux variables and symptom scores for d 1 were compared to d 2.RESULTS： The mean doses of fentanyl and midazolam were 90.4 μg and 7.2 mg, respectively. D 1 results were significantly more elevated than d 2 with respect to total time pH 〈 4, upright position reflux, and mean number of long refluxes. No statistical difference was noted between the two days for supine position reflux, number of refluxes, duration of longest reflux, episodes of heartburn, and symptom score.CONCLUSION： Patients undergoing Bravo esophageal pH monitoring in association with EGD and moderate conscious sedation experience significantly more acid reflux on d i compared to d 2. The Ⅳ sedation may be responsible for the increased reflux on d 1. Performed this way, 48-h Bravo results may not be entirely representative of the patients＇ true GE reflux profile.
文摘AIM: To evaluate the technical failures of the Bravo pH test in a population with nonerosive gastroesophageal reflux disease. METHODS: Over the course of a year, we prospectively studied a population of 66 nonerosive reflux disease patients who received a Bravo pH test. The number and frequency of all technical failures were documented, quantified and analyzed. RESULTS: A total of 66 patients, with a mean age of 41.7 years, were studied. Technical failures occurred in 15.15% of the sample. The most frequent failures were due to poor data reception (4.5%), early dislodgement (4.5%) and capsule removal (6.1%). CONCLUSION: The Bravo capsule pH test involves a low but non-negligible rate of technical problems, a fact that must always be considered by physicians.
文摘AIM: To evaluate measurements of intragastric pH with the Bravo capsule system over a prolonged time.METHODS: A Bravo capsule was placed inside the rat gastric body and pH was studied for periods up to five consecutive days.For comparison,a gastric fistula model was used.Effects of ghrelin and esomeprazole,with or without pentagastrin,on gastric pH were studied.In addition,effects of esomeprazole on plasma ghrelin,gastrin and somatostatin were analyzed.RESULTS: All rats recovered after surgery.The average 24-h pH during free feeding was 2.3 ± 0.1 (n = 20) with a variation of 18% ± 6% over 5 d.Ghrelin,2400 pmol/kg,t.i.d.increased pH from 1.7 ± 0.1 to 3.1 ± 0.3 (P < 0.01) as recorded with the Bravo system.After esomeprazole (1 mg/kg,3 mg/kg and 5 mg/kg) there was a dose-dependent pH increase of maximally 3.4 ± 0.1,with day-to-day variation over the entire period of 8% ± 3%.The fistula and pH studies generated similar results.Acid inhibition with esomeprazole increased plasma ghrelin from 10 ± 2 pmol/L to 65 ± 26 pmol/L (P < 0.001),and somatostatin from 10 ± 2 pmol/L to 67 ± 18 pmol/L (P < 0.001).CONCLUSION: pH measurements with the Bravo capsule are reliable,and comparable to those of the gastric fistula model.The Bravo system optimizes accurate intragastric pH monitoring over prolonged periods and allows both short-and long-term evaluation of effects of drugs and hormones.
文摘We report an unexpected, previously unreported complication of Bravo p H capsule dislodgement. During Bravo p H testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo p H test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but nontrivial, risk of complications.
