{"id":2838,"date":"2021-09-12T14:45:02","date_gmt":"2021-09-12T14:45:02","guid":{"rendered":"https:\/\/www.q-bital.com\/?p=2838"},"modified":"2021-09-12T14:45:02","modified_gmt":"2021-09-12T14:45:02","slug":"endoscopy-demand-is-up-and-not-just-for-detecting-cancer","status":"publish","type":"post","link":"https:\/\/www.q-bital.com\/bs_ba\/endoscopy-demand-is-up-and-not-just-for-detecting-cancer\/","title":{"rendered":"Potra\u017enja za endoskopijom raste - i to ne samo za otkrivanje raka"},"content":{"rendered":"

Gastroskopija je, na primjer, 'zlatni standard' za dijagnosticiranje celijakije, sve \u010de\u0161\u0107eg stanja u svijetu. Iako su simptomi manje zabrinjavaju\u0107i od sumnjivih karcinoma, medicinska dijagnoza je i dalje va\u017ena, a pacijenti se suo\u010davaju sa du\u017eim \u010dekanjima nego ikad.\n\n Sve \u010de\u0161\u0107e stanje\n<\/strong>\nCelijakija je stanje u kojem imunolo\u0161ki sistem osobe nenormalno reagira na gluten, protein koji se nalazi u p\u0161enici i drugim \u017eitaricama, i uzrokuje o\u0161te\u0107enje tankog crijeva. Ako se stanje ne dijagnosticira ili ne lije\u010di pravilno, to mo\u017ee dovesti do ozbiljnih zdravstvenih posljedica.<\/p>\n

Procjenjuje se da celijakija poga\u0111a u prosjeku oko\n\n 1 od 100 ljudi\n<\/a>\n\u0161irom svijeta, iako se stope razlikuju od zemlje do zemlje. Me\u0111utim, ve\u0107ina ljudi s ovim stanjem nema medicinsku dijagnozu \u2013 smatra se da \u010dak 80% onih koji \u017eive s celijakijom ostaje nedijagnostikovan.<\/p>\n

Pobolj\u0161anja u tehnologiji testiranja celijakije tokom posljednje decenije otkrila su da je celijakija ra\u0161irenija nego \u0161to se mislilo. Prvobitno se smatralo da poga\u0111a prvenstveno belu populaciju belaca, istra\u017eivanje je otkrilo da je ovo stanje prisutno globalno i da\n\n najve\u0107a prevalencija\n<\/a>\ncelijakije bilo gdje u svijetu je zapravo prona\u0111ena u sjevernoj Africi.<\/p>\n

Sada se dijagnosticira vi\u0161e ljudi u odnosu na prije 10 godina. Nedavno\n\n globalna studija\n<\/a>\notkrili su da je nova dijagnoza celijakije porasla za vi\u0161e od 7,51 TP3T svake godine, i otkrili da je obrazac pove\u0107anja incidencije tokom vremena konzistentan u svim geografskim podru\u010djima, spolu i dobi, iako je porast bio ne\u0161to ve\u0107i kod \u017eena i djece.<\/p>\n

Iako se pove\u0107anje broja ljudi s dijagnozom posljednjih godina mo\u017ee djelomi\u010dno pripisati pobolj\u0161anoj svijesti o stanju i ve\u0107em pristupu testiranju, istinski porast incidencije celijakije na globalnom nivou je \u0161iroko priznat. Ovo doprinosi sve ve\u0107em optere\u0107enju zdravstvenih sistema, uklju\u010duju\u0107i i ve\u0107u potra\u017enju za endoskopijom.\n\n Dijagnoza putem gastroskopije\n<\/strong>\nJedan od razloga za\u0161to je samo 20% pacijenata sa ovim stanjem medicinski dijagnosticirano je taj \u0161to se smatra da je do 50% pacijenata sa celijakijom asimptomatski. Stanje se ne pregleda rutinski; otkriva se tek kada se simptomi prijave i istra\u017ee. A \u010dak i tada dijagnoza mo\u017ee potrajati nekoliko godina, jer su simptomi tako raznoliki.<\/p>\n

\u010cak 99% oboljelih od ove bolesti ima genetsku predispoziciju, ali \u010dak polovina populacije mo\u017eda nosi gene, tako da to nije samo po sebi marker celijakije. Me\u0111utim, testiranje genotipa se mo\u017ee koristiti za isklju\u010divanje celijakije kada je dijagnoza upitna.<\/p>\n

Imunolo\u0161ki odgovor na celijakiju proizvodi antitijela koja se mogu izmjeriti. Ali iako testiranje na antitijela ima visoku osjetljivost i specifi\u010dnost, la\u017eno negativni i la\u017eno pozitivni testovi se javljaju u\n\n pribli\u017eno 5% testova\n<\/a>\n. Stoga, jedini na\u010din da se dobije kona\u010dna dijagnoza zahtijeva gastroskopiju i biopsiju duodenuma, tokom koje se istra\u017euje potencijalno o\u0161te\u0107enje sluznice tankog crijeva.<\/p>\n

Sl. - Dijagnoza celijakije\n\"\"\n\n Izvor:\n<\/em>\n\n \n Testiranje na celijakiju\n <\/em>\n<\/a>\nIstorijski gledano, mnogi pacijenti sa sumnjom na celijakiju nikada nisu bili upu\u0107eni ili medicinski dijagnosticirani, ve\u0107 im je savjetovano da umjesto toga usvoje dijetu bez glutena kako bi vidjeli da li se simptomi pobolj\u0161aju. Iako je to i danas slu\u010daj, sve ve\u0107i broj pacijenata sada prelazi na kona\u010dnu dijagnozu putem gastroskopije.\n\n Medicinska dijagnoza je va\u017ena\n<\/strong>\nSimptomi bolesti su uglavnom gastrointestinalni, kao \u0161to su mu\u010dnina, bol u trbuhu i \u010direvi u ustima, ali tako\u0111er uklju\u010duju gubitak te\u017eine, umor, abnormalne testove funkcije jetre i manjak vitamina i minerala.<\/p>\n

Dugoro\u010dne posljedice nelije\u010dene celijakije uklju\u010duju op\u0107enito lo\u0161e zdravlje, sistemsku upalu, lo\u0161u ishranu ili malapsorpciju nutrijenata, a povezana je s ranom pojavom osteoporoze, neplodnosti, poba\u010daja, depresije i o\u0161te\u0107enja zubne cakline. Pravovremena dijagnoza i do\u017eivotna, stroga dijeta bez glutena mogu sprije\u010diti ili preokrenuti mnoga povezana zdravstvena stanja.<\/p>\n

Uklanjanjem uzroka bolesti, sluznici tankog crijeva se dozvoljava da zacijeli i simptomima se dozvoljava da se povuku, iako \u0107e se recidiv dogoditi ako se gluten ponovo uvede u ishranu. Me\u0111utim, po\u010detak stroge do\u017eivotne dijete bez glutena bez jasne dijagnoze celijakije moglo bi imati svoje posljedice, a budu\u0107i da krvni testovi imaju visoku stopu la\u017eno pozitivnih, biopsija se sve \u010de\u0161\u0107e\n\n preporu\u010duje se svim pacijentima\n<\/a>\nza potvrdu dijagnoze.\n\n Drugi izvori endoskopije zahtijevaju\n<\/strong>\nNije samo celijakija u porastu. Iako gastroezofagealna refluksna bolest op\u0107enito nije opasno stanje, ipak\n\n prevalencija se pove\u0107ava\n<\/a>\nkako stanovni\u0161tvo stari i nivoi gojaznosti rastu, a gastroskopija se mo\u017ee uraditi kako bi se isklju\u010dilo ozbiljnije stanje.<\/p>\n

Helicobacter (pylori), koji mo\u017ee uzrokovati bol i \u010dir na \u017eelucu, te mo\u017ee pove\u0107ati rizik od dobijanja raka \u017eeluca, tako\u0111er se otkriva pomo\u0107u\n\n gastroskop\n<\/a>\n. Iako su rak \u017eeluca i rak jednjaka re\u0111i, osobama sa simptomima mo\u017eda \u0107e biti potrebna gastroskopija kako bi se isklju\u010dili.<\/p>\n

Na sli\u010dan na\u010din, promjene uzrokovane Barrettovim jednjakom, stanjem u kojem se mijenja sluznica donjeg dijela jednjaka, a tokom gastroskopije mogu se uo\u010diti znaci bolesti jetre. Ulcerozni kolitis i Crohnova bolest su neka od stanja koja se mogu otkriti kolonoskopijom.<\/p>\n

Rano otkrivanje, prevencija i lije\u010denje karcinoma crijeva jedan je od glavnih razloga zbog kojih se rade kolonoskopije, a skrining na rane znakove je sve \u010de\u0161\u0107i.\n\n Potra\u017enja za endoskopijom je u porastu\n<\/strong>\nBroj izvr\u0161enih endoskopija nastavlja da raste iz godine u godinu. Zvani\u010dni podaci iz\n\n Australijski institut za zdravlje i dobrobit\n<\/a>\npokazuje da se samo izme\u0111u 2016\/17. i 2018\/19. godine broj endoskopskih procedura pove\u0107ao za \u010dak 12%, dok su podaci iz\n\n NHS England\n<\/a>\no dijagnosti\u010dkom vremenu \u010dekanja i aktivnosti pokazuje da se u Engleskoj broj izvr\u0161enih endoskopija pove\u0107ao za 47% u posljednjih 10 godina. \u010cini se da potra\u017enja raste jo\u0161 br\u017ee.<\/p>\n

Uticaj Covid-19 bio je zna\u010dajan u zemljama koje su se suo\u010davale s dugim periodima otkazivanja. U Engleskoj je endoskopska aktivnost pala za vi\u0161e od 80% u ranim fazama po\u010detnog vala Covid-19, i uprkos tome \u0161to su se nivoi donekle oporavili od tada, na nacionalnom nivou jo\u0161 uvijek ima preko 40% vi\u0161e ljudi koji \u010dekaju na endoskopiju nego prije pandemije.<\/p>\n

U Australiji, koja je bila manje pogo\u0111ena po\u010detnom epidemijom, skrining kolonoskopija je uglavnom nastavljena kao dio nacionalnog programa skrininga raka crijeva. Ali \u010dak i tako, i tamo je do\u0161lo do zna\u010dajnog smanjenja endoskopske aktivnosti. A\n\n nova studija\n<\/a>\notkrio je da je tokom Covid-19 obavljeno 66% manje procedura, pri \u010demu je kolonoskopija smanjena na 46% nivoa prije Covida, a gastroskopija na 25%.<\/p>\n

Iako su se termini vezani za rak nastavili kroz pandemiju i mnoge dr\u017eave su po\u010dele sustizati zaostatak, ostaju pitanja o pravom utjecaju na endoskopske usluge. Broj posjeta primarnoj zdravstvenoj za\u0161titi zbog gastrointestinalnih simptoma \u0107e se morati procijeniti, ali je opao u protekloj godini, posebno za manje ozbiljna stanja, i vjerovatno se time krije zna\u010dajniji zaostatak nego \u0161to je sada jasno vidljivo.\n\n Dugoro\u010dno je potreban zna\u010dajan kapacitet\n<\/strong>\nOsim oporavka od Covid-19, dodatni teret \u010de\u0161\u0107ih upu\u0107ivanja gastroenterolozima zbog celijakije i drugih manje ozbiljnih stanja, potaknut pobolj\u0161anjem krvnih pretraga, ve\u0107om svijesti i sve ve\u0107im skriningom ovih stanja, zna\u010di nastavak obavljanja dijagnosti\u010dkih endoskopskih procedura gore navedenih. minimalni prag mo\u017ee biti kriti\u010dan kako bi se sprije\u010dilo da liste \u010dekanja eskaliraju iznad prihvatljivih nivoa u bliskoj budu\u0107nosti.<\/p>\n

Za to \u0107e biti potreban dodatni kapacitet. Ovo mo\u017ee do\u0107i u obliku ve\u0107ih dijagnosti\u010dkih \u010dvori\u0161ta, ili super-centra, koji mogu napraviti ve\u0107u razliku za ve\u0107i broj ljudi, ili kao vi\u0161e lokalizirane usluge, ovisno o potrebama svake zemlje. Ono \u0161to je, me\u0111utim, jasno je da su potrebna zna\u010dajna ulaganja i vrijeme da se ova infrastruktura uspostavi. Ali sa dodatnim kapacitetom koji je hitno potreban sada, koje druge opcije postoje?<\/p>\n

Jedan od na\u010dina za zna\u010dajno pove\u0107anje kapaciteta u vrlo kratkom vremenskom periodu je pu\u0161tanje u rad mobilnog ili modularnog ure\u0111aja\n\n endoskopski paket\n<\/a>\n. Takvo postrojenje mo\u017ee biti pu\u0161teno u rad za nekoliko sedmica i mo\u017ee imati ugra\u0111ene dekontaminacijske ure\u0111aje kako bi se podr\u017ealo pove\u0107anje brzine u aktivnostima.<\/p>","protected":false},"excerpt":{"rendered":"

Endoskopija je \u010desto povezana s dijagnozom raka, ali i druga stanja se dijagnosticiraju kori\u0161tenjem razli\u010ditih vrsta endoskopije - a mnoge od ovih bolesti se otkrivaju u sve ve\u0107oj mjeri.<\/p>","protected":false},"author":1,"featured_media":1301,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,123],"tags":[134,130],"class_list":["post-2838","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-procedures","tag-endoscope-decontamination","tag-endoscopy-suite"],"acf":[],"yoast_head":"\nEndoscopy demand is up - and not just for detecting cancer - Q-bital Healthcare Solutions<\/title>\n<meta name=\"description\" content=\"Endoscopy demand is up and not just for detecting cancer, other conditions are also diagnosed using different types of endoscopy\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.q-bital.com\/bs_ba\/endoscopy-demand-is-up-and-not-just-for-detecting-cancer\/\" \/>\n<meta property=\"og:locale\" content=\"bs_BA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Endoscopy demand is up - 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