The diagnostic value of video capsule endoscopy

Background and aimsVideo capsule endoscopy (VCE) offers the best means of studying small bowel, but is expensive. We investigated how physicians appraise the value of VCE.MethodsA questionnaire was sent to remitting physicians comprising questions on the value of VCE in altogether 189 adults. The follow-up time was at least one year. The patient history was also scrutinized in case records.ResultsThe most common indications for VCE were anaemia (n = 100) or gastrointestinal bleeding (n = 21) (60%), suspicion of Crohn's disease (21%), abdominal pain (9%) and coeliac disease (6%). The diagnostic value of VCE was rated best in patients suffering from anaemia or bleeding, being decisive or beneficial in 33% (OR 2.3, CI = 1.1–4.8 compared to all series) and helpful in exclusion in an additional 36%. In Crohn's disease, VCE was helpful in the exclusion of intestinal lesions in 50% of cases; in coeliac disease the corresponding percentage was 42%. When abdominal pain was the only indication for VCE, the examination was beneficial in one patient only.ConclusionsThe diagnostic value of VCE was evident in patients with anaemia or gastrointestinal bleeding. The procedure was deemed to be helpful in exclusion also in Crohn's disease and in coeliac disease. Abdominal pain was a rare indication, and the diagnostic yield limited.     

Language differences in qualitative research: is meaning lost in translation?

This article discusses challenges of language differences in qualitative research, when participants and the main researcher have the same non-English native language and the non-English data lead to an English publication. Challenges of translation are discussed from the perspective that interpretation of meaning is the core of qualitative research. As translation is also an interpretive act, meaning may get lost in the translation process. Recommendations are suggested, aiming to contribute to the best possible representation and understanding of the interpreted experiences of the participants and thereby to the validity of qualitative research.     

VENOUS NEEDLE DISLODGEMENT: THE PITFALLS OF VENOUS PRESSURE MEASUREMENT AND POSSIBLE ALTERNATIVES,A REVIEW

The historical development of the use of pressure sensors as protective system against blood loss to the environment is reviewed. In spite of early warnings about the deficiency of such sensors, the venous pressure sensor is still formally accepted as protective system against blood loss to the environment in case of leaks or needle dislodgement. The early warnings were corroborated by publications and accident reports. Several alternative methods have been developed or described in the literature recently. These methods are critically reviewed. The conclusion is that external monitors are currently the only available alternatives, although long‐time clinical experience is missing. Methods employing sensors integrated into dialysis machines have been described but it is unlikely that any of these methods will become available in the immediate future.     

A potential role for muscle in glucose homeostasis: in vivo kinetic studies in glycogen storage disease type 1a and fructose-1,6-bisphosphatase deficiency

Background  

A potential role for muscle in glucose homeostasis was recently suggested based on characterization of extrahepatic and extrarenal glucose-6-phosphatase (glucose-6-phosphatase-β). To study the role of extrahepatic tissue in glucose homeostasis during fasting glucose kinetics were studied in two patients with a deficient hepatic and renal glycogenolysis and/or gluconeogenesis.