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https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#1
REVIEW
Michael E Nelson
The reimbursement for procedures utilizing moderate (conscious) sedation has changed significantly as of January 1(st), 2017. Due to the increasing use of anesthesia services to provide moderate sedation during endoscopy, CMS made the decision to remove work relative value units (wRVUs) from many of the services requiring moderate sedation, including the bronchoscopy codes. If a bronchoscopist provides the moderate sedation to a patient without using anesthesia services or another qualified provider, that work (and revenue) can be reclaimed using the relevant codes...
July 4, 2017: Chest
https://www.readbyqxmd.com/read/28676593/the-relationship-between-food-insecurity-and-esophageal-and-gastric-cancers-a-case-control-study
#2
Milad Daneshi-Maskooni, Mahtab Badri-Fariman, Nahal Habibi, Ahmadreza Dorosty-Motlagh, Hashem Yavari, Arvin Kashani, Mostafa Hosseini
BACKGROUND: Food insecurity is defined as the limited or uncertain availability of enough food for permanent active and healthy life. Upper gastrointestinal (GI) cancers (esophagus and stomach) are one of five most common cancers in Iran. This study aimed to determine the association of food insecurity and upper GI cancers in newly diagnosed patients. STUDY DESIGN: Case-control study. METHODS: Overall, 120 patients with upper GI cancers as cases and 120 patients with orthopedic, ear-nose-throat (ENT), and neurologic diseases as controls were recruited from Imam Khomeini Hospital, Tehran, Iran in 2013...
June 14, 2017: Journal of Research in Health Sciences
https://www.readbyqxmd.com/read/28676207/effects-of-allergen-sensitization-on-response-to-therapy-in-children-with-eosinophilic-esophagitis
#3
Robert D Pesek, Mallikarjuna Rettiganti, Erin O'Brien, Sarah Beckwith, Caroline Daniel, Chunqiao Luo, Amy M Scurlock, Peggy Chandler, Rebecca A Levy, Tamara T Perry, Joshua L Kennedy, Sheva Chervinskiy, Maryelle Vonlanthen, Helen Casteel, Stephen C Fiedorek, Troy Gibbons, Stacie M Jones
BACKGROUND: In children with eosinophilic esophagitis (EoE) foods are the most common disease triggers, but environmental allergens are also suspected culprits. OBJECTIVE: To determine the effects of environmental allergen sensitization on response to treatment in children with EoE in the southeastern United States. METHODS: Patients 2 to 18 years old who were referred to the Arkansas Children's Hospital Eosinophilic Gastrointestinal Disorders Clinic from January 2012 to January 2016 were enrolled in a prospective, longitudinal cohort study with collection of demographics, clinical symptoms, medical history, allergy sensitization profiles, and response to treatment over time...
July 1, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28675080/radiodensity-of-the-ostiomeatal-complex-in-recurrent-acute-rhinosinusitis
#4
Sean M Johnson, Adam L Honeybrook, Vaibhav H Ramprasad, Ralph Abi Hachem, David W Jang
Objective Recurrent acute rhinosinusitis (RARS) can be an elusive diagnosis due to the lack of clinical and radiographic findings in between acute episodes. This study aims to identify objective computed tomography (CT) characteristics in RARS. Study Design Case series with chart review. Setting Tertiary academic medical center. Subjects and Methods Patients meeting diagnostic criteria for RARS were identified retrospectively from the senior author's practice. Patients were diagnosed with RARS if they experienced 3 or more episodes of acute sinusitis within the past year with complete resolution of symptoms in between episodes...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28674950/confocal-laser-endomicroscopy-in-ulcerative-colitis-beyond-endoscopic-assessment-of-disease-activity
#5
F Maione, M C Giglio, G Luglio, A Rispo, M D'Armiento, B Manzo, G Cassese, P Schettino, N Gennarelli, S Siciliano, F P D'Armiento, G D De Palma
BACKGROUND: The aim of this study was to investigate the role of confocal laser endomicroscopy (CLE) in the assessment of disease activity in ulcerative colitis (UC). METHODS: Consecutive patients with UC referred to our inflammatory bowel disease unit for colonoscopy were enrolled. Patients without UC were used as controls. UC activity was evaluated by white light endoscopy and classified according to the Mayo Ulcerative Colitis Endoscopic Score of Severity. Endoscopic biopsies were also taken for histological assessment of disease activity and then assessed with CLE...
July 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28664437/a-modified-endoscopic-method-for-resection-of-gastric-submucosal-tumor
#6
Qiang Zhang, Yue Li, Zhou-Yang Lian, Zhen Wang, Li-Hui Wang, Yang Bai, Si-de Liu
BACKGROUND AND OBJECTIVE: Endoscopic mucosa-sparing lateral dissection (EMSLD) was developed by our group, and is used to remove gastric submucosal tumor (SMT). This study aims to evaluate the feasibility and safety of this method. METHODS: This retrospective study included 25 patients who underwent EMSLDs at an endoscopy center as a national key unit in china from October 2015 to July 2016. The main data collected were the size of the gastric SMT, its location and origin, en bloc resection rate, operating time, intraoperative and postoperative complications, hospitalization expense, hospital days, and follow-up after hospital discharge...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28663599/palate-perforation-differentiates-cocaine-induced-midline-destructive-lesions-from-granulomatosis-with-polyangiitis
#7
M Trimarchi, S Bondi, E Della Torre, M R Terreni, M Bussi
Cocaine abuse occasionally causes extensive destruction of the osteocartilaginous structures of the nose, sinuses and palate, which mimics the clinical picture of other diseases associated with necrotising midfacial lesions. The differentiation of cocaine-induced midline destructive lesions (CIMDL) and limited granulomatosis with polyangiitis (GPA) may be difficult, particularly if patients do not readily admit substance abuse. We studied 10 patients with CIMDL and palate perforation referred to our Unit between 2002 and 2015...
June 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28660168/spontaneous-intraventricular-rupture-of-a-craniopharyngioma-cyst-a-case-report
#8
Kunal Vakharia, Ioannis Dimitrios Siasios, Alexander B Dorsch, Jody Leonardo
Intraventricular rupture of craniopharyngioma cysts is an unusual event which is associated with a high risk of loculated or communicating hydrocephalus. A 75-year-old woman presented at the Emergency Department of our hospital with mental status deterioration due to chemical ventriculitis and acute hydrocephalus following the intraventricular rupture of a craniopharyngioma cyst. The patient was treated with stress-dose steroid therapy. In addition, she underwent placement of an external ventricular drain and endoscopy-assisted intra-cystic placement of an Ommaya reservoir for the aspiration of the cystic fluid...
April 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28644360/quality-improvement-in-pediatric-endoscopy-a-clinical-report-from-the-naspghan-endoscopy-committee
#9
Robert E Kramer, Catharine M Walsh, Diana G Lerner, Douglas S Fishman
The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units...
July 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28644313/unique-clinical-features-of-los-angeles-grade-d-esophagitis-suggest-that-factors-other-than-gastroesophageal-reflux-contribute-to-its-pathogenesis
#10
Anh D Nguyen, Stuart J Spechler, Monique N Shuler, Rhonda F Souza, Kerry B Dunbar
BACKGROUND: The Los Angeles (LA) grade of reflux esophagitis (A to D) is assumed to reflect severity of the underlying gastroesophageal reflux disease (GERD). Thus, LA-D esophagitis patients might be expected to have the most conditions predisposing to GERD (eg, obesity, hiatal hernia), and the highest frequency of GERD symptoms. GOALS: The main goal of this study is to compare clinical features of patients with the most severe (LA-D) and mildest (LA-A) grades of esophagitis...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#11
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28634135/outcomes-and-role-of-urgent-endoscopy-in-high-risk-patients-with-acute-nonvariceal-gastrointestinal-bleeding
#12
Soo-Han Cho, Yoon-Seon Lee, Youn-Jung Kim, Chang Hwan Sohn, Shin Ahn, Dong-Woo Seo, Won Young Kim, Jae Ho Lee, Kyoung Soo Lim
BACKGROUND & AIMS: We investigated clinical outcomes in high-risk patients with acute nonvariceal upper gastrointestinal bleeding (UGIB), and determined if urgent endoscopy is effective. METHODS: Consecutive patients with a Glasgow-Blatchford score greater than 7 who underwent endoscopy for acute nonvariceal UGIB at the emergency department from January 1, 2005, to December 31, 2014, were included. Urgent (<6 h) and elective (6-48 h) endoscopies were defined according to the time to endoscopy after the initial presentation...
June 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28633677/surveillance-of-endoscopes-comparison-of-different-sampling-techniques
#13
Lien Cattoir, Thomas Vanzieleghem, Lisa Florin, Tania Helleputte, Martine De Vos, Bruno Verhasselt, Jerina Boelens, Isabel Leroux-Roels
OBJECTIVE To compare different techniques of endoscope sampling to assess residual bacterial contamination. DESIGN Diagnostic study. SETTING The endoscopy unit of an 1,100-bed university hospital performing ~13,000 endoscopic procedures annually. METHODS In total, 4 sampling techniques, combining flushing fluid with or without a commercial endoscope brush, were compared in an endoscope model. Based on these results, sterile physiological saline flushing with or without PULL THRU brush was selected for evaluation on 40 flexible endoscopes by adenosine triphosphate (ATP) measurement and bacterial culture...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28624578/accuracy-in-diagnosis-of-celiac-disease-without-biopsies-in-clinical-practice
#14
K J Werkstetter, I R Korponay-Szabó, A Popp, V Villanacci, M Salemme, G Heilig, S T Lillevang, M L Mearin, C Ribes-Koninckx, A Thomas, R Troncone, B Filipiak, M Mäki, J Gyimesi, M Najafi, J Dolinšek, S Dydensborg Sander, R Auricchio, A Papadopoulou, A Vécsei, P Szitanyi, E Donat, R Nenna, Ph Alliet, F Penagini, H Garnier-Lengliné, G Castillejo, K Kurppa, R Shamir, A C Hauer, F Smets, S Corujeira, M van Winckel, S Buderus, S Chong, S Husby, S Koletzko, Piotr Socha, Bozena Cukrowska, Hania Szajewska, Jan Wyhowski, Nailah Brown, Gauri Batra, Zrinjka Misak, Sven Seiwerth, Yulia Dmitrieva, Dmitry Abramov, Yvan Vandenplas, Annieta Goossens, Maaike W Schaart, V T H B M Smit, Nicolas Kalach, Pierre Gosset, Judit B Kovács, Anikó Nagy, Ilona Lellei, Rita Kőbányai, Katayoun Khatami, Maryam Monajemzadeh, Konstantina Dimakou, Amalia Patereli, Tine Plato Hansen, Rajko Kavalar, Miguel Bolonio, Hubert Kogler, Gabriele Amann, Roberta Kosova, Mariantonia Maglio, Elke Janssens, Ruth Achten, Pavel Frűhauf, Helena Skálová, Thomas Kirchner, Laura Petrarca, Fabio Massimo Magliocca, Francesc Martínez, Vanesa Morente, Sonja Thanner-Lechner, Manfred Ratschek, Marco Gasparetto, Liz Hook, Danielle Canioni, Catherine Wanty, Anne Mourin, Kaija Laurila, Martine Vornane, Vered Nachmias Friedler, Sara L Morgenstern, Jorge Amil Dias, Fátima Carneiro, Stephanie Van Biervliet, Saskia Vande Velde, Hany Banoub, Steve Sampson, Annette M Müller, Adina Ene, Mandana Rafeey, Iran Amir Taher Eftekhar Sadat
BACKGROUND & AIMS: The guidelines of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition allow for diagnosis of celiac disease without biopsies in children with symptoms and levels of immunoglobulin A against tissue-transglutaminase (TGA-IgA) 10-fold or more the upper limit of normal (ULN), confirmed by detection of endomysium antibodies (EMA) and positivity for HLA-DQ2/DQ8. We performed a large, international prospective study to validate this approach. METHODS: We collected data from consecutive pediatric patients (18 years or younger) on a gluten-containing diet who tested positive for TGA-IgA from November 2011 through May 2014, seen at 33 pediatric gastroenterology units in 21 countries...
June 15, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28619257/withdrawn-the-role-of-capsule-endoscopy-and-device-assisted-enteroscopy-for-small-bowel-lesions-in-hereditary-hemorrhagic-telangiectasia
#15
Rossella Cianci, Riccardo Urgesi, Annalisa Tortora, Arianna Amato, Estelle E Newton, Guido Costamagna, Maria Elena Riccioni
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
May 25, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28594696/quality-measures-in-gastrointestinal-endoscopy-the-current-state
#16
Megan A Adams, Sameer D Saini, John I Allen
PURPOSE OF REVIEW: The purpose of this review is to summarize the current state of endoscopic quality measurement and use of measures in enhancing the value of endoscopic services. RECENT FINDINGS: Initially, quality measurement of endoscopic procedures was claims based or included small unit or practice-specific efforts. Now we have a mature national registry and large electronic medical or procedural records that are designed to yield valuable data relevant to quality measurement...
June 7, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28591245/agreement-between-different-pathologists-in-histopathologic-diagnosis-of-128-gastric-polyps
#17
Sérgio Henrique Brito Barbosa, Geraldo Cezário de Lázaro, Luciano Monteiro Franco, José Telmo Valença, Miguel Ângelo Nobre E Souza, Marcellus Henrique Loiola Ponte Souza
BACKGROUND: - Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps. OBJECTIVE: - To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012...
May 25, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28576517/retrieval-of-tracheobronchial-foreign-bodies-by-short-flexible-endoscopy-in-children
#18
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Flexible endoscopy (FE) is frequently used to diagnose tracheobronchial foreign bodies (TBFB). However, it is still controversial for retrieval of TBFB in pediatric field. This study aims at reporting and evaluating our experiences of using short-length FE with a non-invasive ventilation (NIV) technique and intensive care unit (ICU) support in retrieving pediatric TBFB. METHODS: A retrospective review of the hospital database and FE videos of pediatric patients aged less than 18 year-old who were diagnosed of TBFB and managed in our hospital over a 17-year period (1999-2015)...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28573171/topical-lidocaine-inhibits-spasm-during-colonoscopy-a-double-blind-randomized-controlled-trial-with-video
#19
Daiki Nemoto, Kenichi Utano, Noriyuki Isohata, Shungo Endo, Kensuke Kumamoto, Taka-Aki Koshimizu, Alan Lefor, Kazutomo Togashi
BACKGROUND AND STUDY AIMS:  Topical peppermint oil prevents intestinal spasm, but can cause rebound spasm. Lidocaine hydrochloride, a local anesthetic, may work as an antispasmodic by blocking Na + channels. The aim of this study was to investigate the effect of topical lidocaine on the inhibition of colonic spasm during colonoscopy, compared with peppermint oil. PATIENTS AND METHODS:  A randomized, controlled double-blind trial was conducted in an academic endoscopy unit...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28562538/quick-outpatient-diagnosis-in-small-district-or-general-tertiary-hospitals-a-comparative-observational-study
#20
COMPARATIVE STUDY
Elisabet Montori-Palacín, Sergio Prieto-González, Ignasi Carrasco-Miserachs, Jordi Altes-Capella, Yaroslau Compta, Alfons López-Soto, Xavier Bosch
While quick diagnosis units (QDUs) have expanded as an innovative cost-effective alternative to admission for workup, studies investigating how QDUs compare are lacking. This study aimed to comparatively describe the diagnostic performance of the QDU of an urban district hospital and the QDU of its reference general hospital.This was an observational descriptive study of 336 consecutive outpatients aged ≥18 years referred to the QDU of a urban district hospital in Barcelona (QDU1) during 2009 to 2016 for evaluation of suspected severe conditions whose physical performance allowed them to travel from home to hospital and back for visits and examinations...
June 2017: Medicine (Baltimore)
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