Muñoz-Navas, M. (Miguel)
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- Recognition and management of hereditary colorectal cancer syndromes(The Spanish Society of Digestive Pathology, 2009) Herraiz-Bayod, M.J. (Maite J.); Muñoz-Navas, M. (Miguel)Over 1,900 colorectal tumors will arise in association with a hereditary colorectal cancer syndrome in Spain in 2009. The genetic defects responsible for the most common syndromes have been discovered in recent years. Genetic testing helps diagnose affected individuals and allows identification of individuals at-risk. Colonoscopy and prophylactic colectomy decrease colorectal cancer incidence and overall mortality in patients with hereditary colon cancer. Extracolonic tumors are frequent in these syndromes, so specific surveillance strategies should be offered
- Capsule endoscopy(Baishideng, 2008) Muñoz-Navas, M. (Miguel)Capsule endoscopy (CE) is a simple, safe, non-invasive, reliable technique, well accepted and tolerated by the patients, which allows complete exploration of the small intestine. The advent of CE in 2000 has dramatically changed the diagnosis and management of many diseases of the small intestine, such as obscure gastrointestinal bleeding, Crohn’s disease, small bowel tumors, polyposis syndromes, etc . CE has become the gold standard for the diagnosis of most diseases of the small bowel. Lately this technique has also been used for esophageal and colonic diseases.
- Commercially available endoscopy facemasks to prevent aerosolizing spread of droplets during COVID-19 outbreak(Georg Thieme Verlag KG, 2020) Zozaya-Larequi, F.J. (Francisco Javier); Muñoz-Navas, M. (Miguel); Bojórquez, A. (Alejandro); Subtil, J.C. (José Carlos); Betes, M.T. (María Teresa)We read with great interest the ESGE and ESGENA Position Statement [1] on gastrointestinal endoscopy and the COVID-19 pandemic. We share the concerns listed in the suggested research agenda, particularly about enhancing procedural protection in the endoscopy unit to reduce risk of COVID-19 dissemination. We would like to bring attention to commercially available endoscopy masks that can be used to avoid aerosolizing spread of droplets during upper endoscopic procedures. These products seem to improve intra-procedure risk management and can serve as an alternative to a modified ventilation mask reported for this purpose by Marchese et al [2].
- Endoscopic diagnosis of gastric peptic ulcer penetrating into the liver(Georg Thieme Verlag, 1991) Jimenez-Perez, F.J. (F. J.); Muñoz-Navas, M. (Miguel)A 61-year-old man was admitted with upper gastrointestinal bleeding. Endoscopy showed a large gastric peptic ulcer with a pseudotumoral mass protruding from the ulcer bed. Histological examination of biopsies taken from the mass revealed distorted hepatic tissue and inflammatory changes. Hepatic penetration was diagnosed as the cause of bleeding. Surgery findings confirmed the endoscopic diagnosis.
- Capsule endoscopy interpretation: the role of physician extenders(The Spanish Society of Digestive Pathology, 2008) Carretero, C. (Cristina); Espinet, E. (E.); Herraiz-Bayod, M.J. (Maite J.); Muñoz-Navas, M. (Miguel); Fernandez-Urien, I. (Ignacio); Perez, N. (N.); Betes, M.T. (María Teresa)Background and aims: capsule endoscopy (CE) allows for a new era in small-bowel examination. Nevertheless, physicians’ time for CE-interpretation remains longer than desirable. Alternative strategies to physicians have not been widely investigated. The aim of this study was to evaluate the accuracy of physician extenders in CE-interpretation. Material and methods: one CE-experienced gastroenterologist and two physician extenders reviewed independently 20 CEprocedures. Each reader was blinded to the findings of their colleagues. A consensus formed by the readers and a second CE-experienced gastroenterologist was used as gold standard. Number, type and location of images selected, character of CEexams and their relationship with indications were recorded. Gastric emptying time (GEt), small-bowel transit time (SBTt) and time spent by readers were also noted. Results: sensitivity and specificity for “overall” lesions was 79 and 99% for the gastroenterologist; 86 and 43% for the nurse; and 80 and 57% for the resident. All 34 “major” lesions considered by consensus were found by the readers. Agreement between consensus and readers for images classification and procedures interpretation was good to excellent (κ from 0.55 to 1). No significant differences were found in the GEt and SBTt obtained by consensus and readers. The gastroenterologist was faster than physician extenders (mean time spent was 51.9 ± 13.5 minutes versus 62.2 ± 19 and 60.9 ± 17.1 for nurse and resident, respectively; p < 0.05). Conclusions: physician extenders could be the perfect complement to gastroenterologists for CE-interpretation but gastroenterologists should supervise their findings. Future cost-efficacy analyses are required to assess the benefits of this alternative.
- Gallbladder drainage guided by endoscopic ultrasound(Baishideng, 2010) Muñoz-Navas, M. (Miguel); Subtil, J.C. (José Carlos); Betes, M.T. (María Teresa)The gold-standard management of acute cholecystitis is cholecystectomy. Surgical intervention may be contraindicated due to permanent causes. To date, the classical approach is percutaneous cholecystostomy in patients unresponsive to medical therapy. However, with this treatment some patients may experience discomfort, complications and a decrease in their quality of life. In these cases, endoscopic ultrasound (EUS)-guided gallbladder drainage may represent an effective minimally invasive alternative. Our objective is to describe in detail this new and not well-known technique: EUS-guided cholecystenterostomy. We will describe how the patient should be prepared, what accessories are needed and how the technique is performed. We will also discuss the possible indications for this technique and will provide a brief review based on published reports and our own experience.
- Sucralfato(Universidad de Navarra, 1982) Sanchez, L. (L.); Conchillo, F. (F.); Muñoz-Navas, M. (Miguel); Zozaya, J.M. (José Manuel)
- Caustic colitis due to formalin enema(Elsevier, 1992) Muñoz-Navas, M. (Miguel); Garcia-Villarreal, L. (Luis)
- Sarcomatoid carcinoma of the pancreas and congenital choledochal cyst(Elsevier, 2006) Carretero, C. (Cristina); Riva, S. (Susana) de la; Muñoz-Navas, M. (Miguel); Subtil, J.C. (José Carlos); Betes, M.T. (María Teresa)
- Colitis colágena y colitis linfocítica: aspectos clínicos y endoscópicos(The Spanish Society of Digestive Pathology, 2000) Riva, S. (Susana) de la; Angós, R. (Ramón); Muñoz-Navas, M. (Miguel); Duque, J.M. (José M.); Betes, M.T. (María Teresa)INTRODUCCIÓN: la Colitis Colágena (CC) y la Colitis Linfocítica (CL) son dos entidades de etiología desconocida caracterizadas por diarrea crónica acuosa, mucosa de colon macroscópicamente normal y alteraciones histopatológicas de las biopsias de la mucosa de colon. Las características clínicas de esta enfermedad están fundamentalmente basadas en casos publicados o pequeñas series no controladas. Aunque una mucosa de colon macroscópicamente normal, clásicamente, forma parte del diagnóstico de CC, han sido publicados varios casos de colitis macroscópica asociada con CC, pero el espectro de los cambios endoscópicos de la mucosa no han sido descritos en series importantes. MÉTODOS: presentamos un estudio retrospectivo de todos los pacientes estudiados en nuestra Unidad de Endoscopia mediante colonoscopia completa y biopsias de mucosa entre 1991 y 1997. En los pacientes diagnosticados de CC y CL se revisaron los datos clínicos y endoscópicos. RESULTADOS: de 676 pacientes estudiados, 398 presentaban diarrea crónica. Se diagnosticó CC en 22 casos y CL en diez. Un 11% de las CC (2/22) y un 20% de las CL (2/10) no presentaban diarrea. Se observó colitis macroscópica en seis de los 22 casos con CC (27%) y en cuatro de los diez casos con CL (40%). Las lesiones macroscópicas incluyen edema, eritema, pérdida del patrón vascular subcutáneo, erosiones o ulceraciones superficiales y sufusión hemorrágica. En nuestra serie, las CC y las CL representan el 7,03% de los pacientes con diarrea crónica. CONCLUSIÓN: la CC y la CL son entidades a tener en cuenta en el diagnóstico diferencial de la diarrea crónica, que requieren la realización de colonoscopia completa y toma de biopsias múltiples incluyendo colon derecho. La existencia de lesiones macroscópicas durante la endoscopia no excluye su diagnóstico. Existen casos de CC y CL que cumplen criterios histológicos pero no presentan diarrea.