Rosa, B. (Bruno)

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    Role of capsule endoscopy in suspected celiac disease: A European multi-centre study
    (2017) Carretero, C. (Cristina); Valle-Muñoz, J. (Julio); Herrerías-Gutiérrez, J. M. (Juan Manuel); Sanjuan-Acosta, M. (Mileidis); Gonzalez-Suarez, B. (Begoña); Juanmartiñena-Fernández, J.F. (José Francisco); Luján-Sanchís, M. (Marisol); Rosa, B. (Bruno); González-Vázquez, S. (Santiago); Jiménez-García, V. A. (Victoria Alejandra); Argüelles-Arias, F. (Federico); Borque-Barrera, P. (Pilar); Elli, L. (Luca); Fernandez-Urien, I. (Ignacio); Sempere-García-Argüelles, J. (Javier); Alonso-Lázaro, N. (Noelia); Xavier, S. (Sofía); Egea-Valenzuela, J. (Juan); Ruano-Díaz, L. (Lucía); Pérez-Cuadrado-Martínez, E. (Enrique); Pons-Beltran, V. (Vicente); García-Lledó, J. (Javier); Sánchez-Ceballos, F. (Francisco); Prieto-Frías, C. (Cesár); Branchi, F. (Federica); Pérez-Cuadrado-Robles, E. (Enrique); López-Higueras, A. (Antonio)
    METHODS This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed. RESULTS The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P < 0.001) and 81.9% of the patients responded to diet. There was one case of capsule retention (0.6%). Agreement between CE findings and subsequent histology was 100% for diagnosing normal/other conditions, 70% for suspected CD and 50% for complicated CD. CONCLUSION CE has a high DY in cases of suspicion of CD and it leads to changes in the clinical course of the disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD.
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    Small bowel enteroscopy - A joint clinical guideline from the spanish and portuguese small bowel study groups
    (Karger, 2020) Nogales, Ó. (Óscar); Carretero, C. (Cristina); Cardoso, H. (Hélder); Delgado, P.E. (Pilar Esteban); Alonso, P. (Pedro); Valdivieso-Cortazar, E. (Eduardo); Gómez-Rodríguez, B.J. (Blas José); Gonzalez, B. (Begoña); Almeida, N. (Nuno); Juanmartiñena-Fernández, J.F. (José Francisco); Rosa, B. (Bruno); Ponte, A. (Ana); Argüelles-Arias, F. (Federico); San-Juan-Acosta, M. (Mileidis); Borque-Barrera, P. (Pilar); Andrade, P. (Patricia); Bernardes, C. (Carlos); Mascarenhas-Saraiva, M. (Miguel); Lopes, S. (Sandra); Egea-Valenzuela, J. (Juan); Pérez-Cuadrado-Martínez, E. (Enrique); Pinho, R. (Rolando); Caballero, N. (Noemí); García-Lledó, J. (Javier); Chagas, C. (Crisitina); Sánchez-Ceballos, F. (Francisco); Prieto-Frías, C. (Cesár); Figueiredo, P. (Pedro); Gálvez, C. (Consuelo); Mão-de-Ferro, S. (Susana); Pérez-Cuadrado-Robles, E. (Enrique)
    The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.