tbuckley/cabot-search huggingface dataset:
FRI0430 Phenotype of patients and impact of the disease in early spondyloarthritis are similar regardless the arm of the asas criteria (“imaging” or “clinical”) fulfilled by the patients. data from the desir cohort.
Authors: A. Moltó, S. Paternotte, D. van der Heijde, P. Claudepierre, M. Rudwaleit, M. Dougados
Journal: Annals of the Rheumatic Diseases (2013)

Background Patients can fulfil the ASAS (Assessment of SpondyloArthritis (SpA) international Society) axial SpA (axSpA) criteria with either objective evidence of sacroiliac joint damage (X-Ray) or inflammation (MRI): (“imaging” arm) or without imaging abnormalities in HLA-B27 positive (or +) patients (“clinical” arm). The clinical arm is not well recognized by the medical community and the health care systems. Objectives to compare the phenotype but also the impact of the disease on the daily life of the patients with regard to the “imaging” versus the “clinical” arm of early spondyloarthritis patients. Methods Prospective, multi-centre, observational study. 708 patients with early inflammatory back pain suggestive of spondyloarthritis have been included in the DESIR cohort. Demographics, items of the ASAS AxSpA criteria, disease activity, severity, quality of life, were collected. Statistical analysis: The patients fulfilling the ASAS criteria were splitted in two groups regarding the presence of imaging (X-ray or MRI) abnormalities of the sacroiliac joints (e.g. imaging arm), and within the clinical arm, with regard to the presence of CRP abnormality (e.g. >6mg/L). Results 682 patients had complete data to permit classification according to the ASAS AxSpA criteria; 476 (69.8%) patients fulfilled them: 296 (60.1%) and 190 (39.9%) the imaging and clinical arm respectively. When comparing both arms (“imaging vs “clinical”) of the ASAS AxSpA criteria, no differences were found in patient characteristics (age, gender, HLAB27+), disease presentation, activity or severity, except for: patients in the ‘imaging arm’ are younger, more frequently male and showed higher CRP values. Multiple logistic regression analysis confirmed the positive association of male gender (OR 1.70 [1.12 – 2.58]) and ASDAS-CRP (2.6[±1.1] vs. 2.3[±1.0], OR 2.44 [1.73 – 3.44]) with the “imaging” arm. The [table][1] resumes the description of the different subgroups within the “imaging” and “clinical” arms with regard to the imaging and CRP abnormality. ![Figure][2]</img> Conclusions This study suggests that despite some differences (e.g. gender, inflammation) the impact of the disease on daily activities was similar in the imaging and clinical arm and therefore therapeutical strategies and access to care in disabled patients should be identical regardless the arm of the ASAS criteria they are fulfilling. Acknowledgements This study was finantially supported by a Pfizer grant. Disclosure of Interest None Declared [1]: #F1 [2]: pending:yes
QL-23 * AN ADJUSTED CUMULATIVE SCORING SYSTEM FOR MALIGNANT BRAIN TUMORS
Authors: S. Singel, A. Dawson, K. Sharifi, J. Huang, E. Fonkem, B. Chopko
Journal: Neuro-Oncology (2014)

BACKGROUND: In malignant brain tumors, quality of life and length of survival are the major parameters of outcome. To integrate these two parameters, we propose a new scale utilizing cumulative monthly performance analysis. METHODS: Performance scores were assessed once a month in a cohort of 74 patients with malignant brain tumors. The Karnofsky scoring system was chosen for ease of use and familiarity. To facilitate computation and interpretation of data, values were expressed as Karnofsky/100. RESULTS: Score values of up to 3.0 at three months and 6.0 at six months were observed. With disease progression beyond six months, lower incremental increases in score values were gained. The scoring methodology and computation of values was well adapted by the practitioners. CONCLUSIONS: Cumulative outcome scores can be easily calculated from monthly Karnofsky values. Integration of this data enables simultaneous assessment of both function and survival in high grade gliomas.
Ganciclovir-Induced Psychosis
Authors: Barbara A. Hansen, Kenneth S. Greenberg, Jason A. Richter
Journal: New England Journal of Medicine (1996)

To the Editor: Several reports of ganciclovir-induced psychiatric disturbances have been reported in the medical literature.1–3 Two cases involved patients with mild renal insufficiency1,2 and one a patient who was undergoing hemodialysis.3 Since ganciclovir is primarily eliminated through the kidney as the parent compound (91 percent),4 renal failure probably contributed to these cases. We describe a case of ganciclovir-induced psychosis that was not associated with renal insufficiency. A 43-year-old man with advanced human immunodeficiency virus disease (CD4 lymphocyte count, 17 per cubic millimeter in October 1995) was admitted because of acute changes in mental status. He was incontinent . . .
944 PHENOTYPIC AND FUNCTIONAL PLASTICITY OF CD4posCD25highCD127pos AND CD4posCD25highCD127neg T CELLS IN AUTOIMMUNE HEPATITIS
Authors: R. Liberal, C.R. Grant, B.S. Holder, Y. Ma, G. Mieli-Vergani, D. Vergani, M.S. Longhi
Journal: Journal of Hepatology (2013)
COMPARACION DE DOS SISTEMAS DE CAPSULA ENDOSCOPICA: PILLCAM Y MIROCAM
Authors: A Castellot Martín, C Sánchez Vilar, M Lorente Arencibia, A Monescillo Francia, L Betancor Hernandez, A Cruz Bonilla, E Jiménez Mutiloa, JM Marrero Monroy, V Sosa De La Nuez, A Sierra Hernández
Journal: Endoscopy (2013)

Introducción: La cápsula endoscópica (CE) ha cambiado el diagnóstico y manejo de la patología del intestino delgado. Hay distintos modelos de cápsulas en el mercado. Objetivo: Valorar si existen diferencias entre dos tipos distintos de CE. Material y Método: Estudio retrospectivo de CE realizada en nuestro centro desde mayo de 2006 a mayo de 2013. Se administraron dos tipos de cápsula: Pillcam y Mirocam, de forma aleatoria no controlada, con preparación igual (dieta líquida el día previo, ayunas previo a la ingesta y en las 6 horas siguientes). Los datos se recogieron en una base de datos diseñada para tal fin. La lectura de la cápsula se realizó por una única endoscopista. Resultados:
AB0014 Implication of VEGFR2 in systemic lupus erythematosus: A combined genetic and structural biological approach
Authors: M.I. Zervou, E. Eliopoulos, V. Vazgiourakis, S. Sharma, P. Sidiropoulos, B.S. Franek, E. Myrthianou, M. Melissourgaki, T.B. Niewold, D.T. Boumpas, G.N. Goulielmos
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> The vascular endothelial growth factor receptor 2 (<i>VEGFR2</i>) gene polymorphisms have already been correlated with vascular diseases such as Coronary Heart Disease (CHD). In view of the premature atherosclerosis observed in systemic lupus erythematosus (SLE), we hypothesized that variation of <i>VEGFR2</i> gene may influence endothelial function in patients with SLE. <h3>Objectives</h3> a) To construct a three-dimensional (3D) model of the VEGFR2 regions harboring the polymorphisms rs2305948 and rs1870377, localize them on this model and explore their putative role on the VEGFR2 function in SLE; and b) To determine whether these polymorphisms are associated with risk of SLE by influencing endothelial cells. <h3>Methods</h3> Three-dimensional (3D) homology modeling of the mutation V297I was based on the 3D structure of domains D2 and D3 of VEGFR2 in complex with VEGF-C, while mutation Q472H was investigated by homology modeling on the KIT ectodomain structure. The V297I (rs2305948) and Q472H (rs1870377) SNPs in VEGFR2 were genotyped with Taqman technology in 250 SLE patients and 241 healthy controls from a Greek population (Cretan). The replication sample set for the rs1870377 SNP consisted of 253, 184 and 77 patients with SLE of African-, European- and Hispanic-American origin, respectively, as well as geographically/ethnically-matched controls <h3>Results</h3> Modeling revealed that polymorphism V297I affects the efficiency of trans-autophosphorylation and cell signaling while Q472H affects homotypic contacts of membrane proximal Ig-like domains. These findings prompted us to examine whether these polymorphisms contribute to SLE risk or vascular damage. No significant difference was observed in the frequency of the minor allele <i>A</i> of rs1870377 when SLE patients were compared with controls either in the Greek population or in the 3 replication groups analyzed. The <i>TT</i> genotype was found to be associated with a higher number of circulating endothelial cells (CECs) in SLE patients. Half of the Greek SLE patients enrolled in the study, with clinical data, analyzed further but no association between genotype and clinical CVD was detected. Furthermore, no association was found between rs2305948 SNP and SLE when tested in the Greek population. <h3>Conclusions</h3> Although structural data suggest that both VEGFR2 SNPs may contribute to SLE pathogenesis by impairing cell signaling, none of the SNPs analyzed was associated with increased susceptibility to SLE. However, they still may be relevant to the vascular damage/atherosclerosis in SLE and other genetic variations in or near the <i>VEGFR2</i> locus may play a role in the disease. <h3>Disclosure of Interest</h3> None Declared
Effect of toxaphene on pyruvic and lactic acid levels in the rat.
Authors: D B Peakall
Journal: Environmental Health Perspectives (1979)

Rats were given a single dose of toxaphene (120 mg/kg equilavent to 1/2 LD50) and sacrificed at 1, 5, and 15 days. No alterations of levels of pyruvic or lactic acid in blood plasma were observed. In a second experiment, rats were given 2.4 mg/kg daily and sacrificed at 1, 3, and 6 months, and again no alterations of pyruvic or lactic acid levels were found. It is concluded that observed alterations of the activity of lactic acid dehydrogenase induced by toxaphene do not give rise to physiological changes in unstressed rats.
P413 ROLE OF KINASES EGFR AND SRC IN ESTRADIOL 17β-GLUCURONIDE (E17G) INDUCED CHOLESTASIS IN ISOLATED RAT HEPATOCYTES COUPLETS (IRHC)
Authors: I.R. Barosso, A.E. Zucchetti, G.S. Miszczuk, M.G. Roma, F.A. Crocenzi, E.J. Sánchez Pozzi
Journal: Journal of Hepatology (2014)
Abstract 4127: <i>EGFR and K-Ras</i> mutations and resistance of lung cancer to the IGF-1R tyrosine kinase inhibitors
Authors: Woo-Young Kim, Quanri Jin, Ludmilla Prudkin, Jin-Soo Kim, Floriana Morgillo, Lei Feng, Edward S. Kim, Bryan Hennessy, Ju-Seog Lee, Gordon Mills, J. J. Lee, Bonnie Glisson, Scott M. Lippman, Ignacio I. Wistuba, Ho-Young Lee
Journal: Cancer Research (2010)

Abstract Background: The majority of patients with non-small cell lung cancer (NSCLC) has responded poorly to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). We investigated (1) the involvement of insulin-like growth factor 1 receptor (IGF-1R) signaling in primary resistance to EGFR TKIs and (2) the molecular determinants of resistance to IGF-1R TKIs. Methods: Phosphorylated IGF-1R/insulin receptor (pIGF-1R/IR) was immunohistochemically evaluated in NSCLC tissue microarrays. The antitumor effects of IGF-1R TKIs (PQIP, OSI906), either alone or in combination with small-molecular inhibitors or siRNA targeting K-Ras or MAPK/extracellular signal-regulated kinase kinase (MEK) were analyzed in vitro and in vivo in 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)-transformed human bronchial epithelial (HBE) cells and in NSCLC cells with variable histologic features and mutations in EGFR or K-Ras. Results: pIGF-1R/IR expression in NSCLC specimens was positively correlated with presence of a history of tobacco smoking, squamous cell carcinoma, mutant (mut) K-Ras, and wild-type (wt) EGFR, all of which have been strongly associated with poor response to EGFR TKIs. IGF-1R TKIs exhibited significant antitumor activity in NNK-transformed HBE cells and in NSCLC cells harboring wt EGFR and wt K-Ras, but not those with mutations in these genes. Introduction of mut K-Ras attenuated the effects of IGF-1R TKIs on wt K-Ras-expressing NSCLC cells. Conversely, inactivation of MEK restored sensitivity to IGFR-TKI in cells carrying mut K-Ras. Conclusions: The mutation status of both EGFR and K-Ras could be a predictive marker for response to IGF-1R TKIs. Also, MEK antagonism can abrogate primary resistance of NSCLC to IGF-1R TKIs. This work was supported by NIH grants R01 CA-109520-01 and CA-100816 (all to H-YL.) and in part by DOD grant W81XWH-04-1-0142 VITAL and W8XWH-06-1-0303 BATTLE (W-K H.) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4127.
MIP-1α/CCL3-expressing basophil-lineage cells drive the leukemic hematopoiesis of chronic myeloid leukemia in mice
Authors: Tomohisa Baba, Yamato Tanabe, Soichiro Yoshikawa, Yoshinori Yamanishi, Soji Morishita, Norio Komatsu, Hajime Karasuyama, Atsushi Hirao, Naofumi Mukaida
Journal: Blood (2016)
Bone Scintigraphy of Caudal Regression Syndrome
Authors: &NA; D. NGUYEN, A. CAHID CIVELEK
Journal: Clinical Nuclear Medicine (1996)

A case is presented of caudal regression syndrome, which is assessed by Tc-99m MDP bone scintigraphy. The finding of sacral agenesis correlates well with other scintigraphic findings: solitary right kidney and ileocecal continent urinary reservoir. Ileocecal continent urinary reservoir is secondary to neurogenic bladder dysfunction.
QUANTITATIVE ATHEROSCLEROTIC PLAQUE CHARACTERIZATION BY NOVEL SELECTIVE CATHETER-DIRECTED CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY: COMPARISON WITH CONVENTIONAL INTRAVENOUS CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY
Authors: Hyung Bok Park, Youngtaek Hong, Ran Heo, Sanghoon Shin, Hyuk-Jae Chang
Journal: Journal of the American College of Cardiology (2016)
Abstract P1-11-06: Tumor-Associated Lymphocytes and Hormone Receptor Status Predict Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer
Authors: L Hee Jin, A Jin-Hee, S Jin Young, A Sei-hyun, G. Gyungyub
Journal: Cancer Research (2010)

Abstract Background: Neoadjuvant chemotherapy has been used for patients with locally advanced breast cancer and is increasingly given to patients with operable breast cancer which is not suitable for breast conserving surgery or proven lymph node metastases. Recently, tumor-associated lymphocytes in breast cancer have been suggested as a new independent predictor of neoadjuvant chemotherapy. To evaluate the predictive value of tumor-associated lymphocytes in the neoadjuvant chemotherapy of breast cancer patients, we performed this study. Materials and Methods: Two hundred and sixty five patients received surgery after neoadjuvant chemotherapy between 2000 and 2009. We investigated the proportion of intratumoral and stromal tumor-associated lymphocytes in 212 patients with available pretreatment biopsy specimens and following three groups of chemotherapy regimens: anthracycline-based (50 patients, 23.6%), anthracycline/taxane-based (130 patients, 61.3%), and herceptin-based (32 patients, 15.1%) regimens. Combined tumor-associated lymphocyte infiltrate was obtained from the greater value of intratumoral or stromal lymphocytes. We evaluated the relationship between pathological complete response (pCR) and clinicopathological factors including combined tumor-associated lymphocyte infiltrate. The definition of pCR was the absence of residual invasive or noninvasive carcinoma in breast and lymph nodes. Results: pCR was achieved in 17 (8.0%) patients. In the multivariate logistic regression analysis, the degree of combined tumor-associated lymphocyte infiltrate is correlated with the higher rate of pCR (p=0.024, odds ratio 1.24, 95% confidential interval 1.03-1.49). ER-and PR-negativity was also a significant independent factor of pCR (p=0.047, odds ratio 3.09, 95% confidential interval 1.01-9.42). However, cT stage, cN stage, age, chemotherapy regimen, tumor grade, HER2 positivity, and triple negativity were not significantly correlated with pCR. Conclusion: The percentage of tumor-associated lymphocytes and negative hormone receptor expression are significantly linked to pCR. Tumor-associated lymphocytes could be considered as a new important pathologic factor to predict the response of neoadjuvant chemotherapy in heterogeneous breast cancer other than conventional biomakers. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-11-06.
EFICACIA, COMPLICACIONES Y MORTALIDAD DE LA CPRE EN PACIENTES MAYORES DE 85 AÑOS
Authors: M López-López, M Navajas-Laboa, B Sampedro-Andrada, L Bridet, JA Arévalo-Serna, M Durán-Rigueira, A Orive-Calzada, A Bernal-Martínez, JL Cabriada-Nuño
Journal: Endoscopy (2011)

Introducción: La colangiopancreatografía retrógrada endoscópica (CPRE) es una técnica importante para el dco y tratamiento de patología bilio-pancreática, pero no exenta de riesgos. La prevalencia de patología biliar aumenta con la edad, lo cual lleva apareado un aumento de la demanda de CPRE.
443 KILLER-CELL IMMUNOGLOBULIN-LIKE RECEPTOR 2DL3 AND ITS HLA-C LIGANDS DO NOT PREDICT SPONTANEOUS RESOLUTION IN PATIENTS WITH ACUTE HEPATITIS C
Authors: S. Beinhardt, B.A. Payer, C. Datz, M. Strasser, A. Maieron, L. Dorn, F. Huber, E. Dulic-Lakovic, R. Stauber, H. Laferl, J.H. Aberle, H. Holzmann, W. Vogel, G. Fischer, P. Ferenci, H. Hofer
Journal: Journal of Hepatology (2013)
AB0820 Early Changes in Bone Markers Predict Response to Teriparatide in an Osteoporotic Portuguese Population
Authors: R. Fonseca, D. Gonçalves, J. Abelha-Aleixo, F. Aguiar, P. Madureira, R. Vieira, G. Terroso, M. Bernardes, L. Costa
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Short-term changes in biochemical markers of bone turnover have been suggested as predictors of long-term response in bone mass density (BMD) during teriparatide treatment. However, few data are available, particularly regarding increases in hip BMD. <h3>Objectives</h3> The aim of this study was to examine whether early changes in biochemical markers of bone turnover predict long-term changes of BMD in patients treated with teriparatide. <h3>Methods</h3> BMD values at baseline and 18 months were obtained with a LUNAR Expert 1320 R. β-C-telopeptide of collagen 1 crosslinks (β-CTX1), osteocalcin (OC), alkaline phosphatase and 25 (OH) vitamin D3 were measured at baseline, 3 and at 18 months. The association between baseline and 3 months markers levels and BMD changes at the end of treatment was evaluated using Spearman correlation analysis (SPSS 21.0). <h3>Results</h3> Sixty three patients were evaluated. 92,1% (58) were female and the mean age was 67,65±8,8 years. 60,3% (38) had glucocorticoid-induced osteoporosis and/or secondary to chronic inflammatory diseases. After treatment median DMD changes were: 0,088 g/cm<sup>2</sup> in lumbar spine (gain of 10,65%), 0,024 g/cm<sup>2</sup> in femoral neck (gain of 4,16%), 0,03g/cm<sup>2</sup> in wards triangle (gain of 7,7%) and 0,011g/cm<sup>2</sup> in total hip (gain of 1,1%). At baseline, β-CTX1 and OC levels correlated positively with the variation of BMD in lumbar spine at 18 months (r =0,452; p=0,01 and r=0,305; p=0,04, respectively). Baseline OC levels also correlated significantly with BMD variation in femoral neck (r=0,524; p&lt;0,01), wards triangle (r=0,442; p=0,02) and total hip (r=0,364; p=0,01). Statistically significant correlation was found between β-CTX1 level at 3 months and BMD variation in femoral neck (r=0,389; p=0,01) and wards triangle (r=0,402; p=0,03). 3 months OC levels correlated significantly with femoral neck DMO variation (r=0,517; p&lt;0,01) and wards triangle DMO variation (r=0,501; p&lt;0,01). No association was found between alkaline phosphatase and 25 (OH) vitamin D3 values at baseline and 3 months and BMD changes. <h3>Conclusions</h3> In our study, we found an association between bone turnover markers levels at baseline and 3 months and final changes in BMD at the lumbar spine and total hip. The early measurement of bone turnover markers may be a useful tool to predict BMD response to this anabolic therapy. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.4623
PWE-078 Mean Corpuscular Volume But Not Lymphocyte Count Is A Predictor Of Thiopurine Dose Adequacy And Toxicity
Authors: A Kneebone, SS Poon, R Asher, R Jackson, B Gregg, S Kerr, P Collins, C Probert, S Subramanian, M Dibb
Journal: Gut (2014)

<h3>Introduction</h3> The thiopurines, azathioprine (AZA) and mercaptopurine (MP), commonly used in the treatment of inflammatory bowel diseases (IBD), are typically dosed according to patient’s body weight. A previous meta-analysis showed higher remission rates in patients with “therapeutic” levels of 6-thioguanine (6-TGN), but weight based dosing correlates poorly with 6-TGN levels (1). 6-TGN testing is not universally available, results are not available immediately and repeated measurements are necessary to ensure dose adequacy and adherence to therapy. Proxy measures such as mean corpuscular volume (MCV) and lymphocyte count (LC) have been advocated as markers of dose adequacy. We aimed to analyse the relationship between 6-TGN levels, MCV, LC and other putative surrogate markers of therapeutic 6-TGN levels. <h3>Methods</h3> This retrospective study was conducted at the Royal Liverpool University Hospital. All patients who had concurrent measurements of 6-TGN and full blood count were included in the analysis. 6-TGN levels were classed as sub-therapeutic (&lt;230), therapeutic (230–450) or supra-therapeutic (&gt;450). The association between 6-TGN, patient demographics, MCV, LC and other putative surrogate markers was estimated using a multivariable linear regression model for continuous 6-TGN and a proportional odds logistic regression model for the ordered 6TGN levels. All results were declared statistically significant if p &lt; 0.05. <h3>Results</h3> A total of 106 patients (48 male, 58 female) were included and contributed 133 measurements. Of these patients 58 (55%) had Crohn’s disease and 47 (44%) had ulcerative colitis. The mean azathioprine dose was 123.5 mg (SD 73.8) or 1.70 mg/kg (SD 0.67). After adjusting for other variables, a one unit increase in MCV, was associated with a 10.88 unit increase in 6TGN levels, Figure 1 (95% CI: 7.63 and 14.014, p &lt; 0.0001) and a one unit increase in ALT was associated with a 2.67 unit decrease in 6TGN levels (95% CI: 0.36 to 4.97 p = 0.0237). There was no correlation between LC, NC, WCC or ALKPHOS and 6-TGN levels. <h3>Conclusion</h3> MCV and 6-TGN nucleotide levels increase together. If 6-TGN levels are not available, MCV can be used as a crude but imperfect surrogate marker of dose adequacy and toxicity. <h3>Reference</h3> Osterman MT, Kundu R, Lichtenstein GR, Lewis JD. Association of 6-thioguanine nucleotide levels and inflammatory bowel disease activity: a meta-analysis.<i> Gastroenterology</i> 2006;130:1047–53 <h3>Disclosure of Interest</h3> None Declared.
TIEMPO DE INSERCIÓN EN COLONOSCOPIA. ESTUDIO COMPARATIVO Y ALEATORIZADO UTILIZANDO UN APARATO CON SECCIÓN DE FLEXIÓN PASIVA ENTRE LA CAÑA Y LA SECCIÓN DE FLEXIÓN Y CURVADO Y UN COLONOSCOPIO ESTÁNDAR
Authors: JM Bordas, DC Balderramo, J Llach, À Ginès, G Fernández-Esparrach, M Pellisé, O Sendino, A Cárdenas, B González, H Córdova, J Panés, A Castells
Journal: Endoscopy (2010)

Introducción: El cribaje del cáncer colorectal (CCR) ha aumentado el número de colonoscopias. La colonoscopia es un procedimiento complejo que consume tiempo Mejorar tiempo para acceder a ciego es uno de los objetivos más importantes. La inserción de los colonoscopios precisan presión de introducción para superar las asas del colon lo que produce dolor y riesgo. Las mejoras técnicas en el diseño de los colonoscopios pretenden facilitar la colonoscopia. La inclusión de una zona corta de flexión pasiva entre la caña y la sección de flexión y curvado del colonoscopio puede facilitar la inserción y posiblemente disminuir la presión necesaria para superar las flexuras y ángulos.