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https://www.readbyqxmd.com/read/28644360/quality-improvement-in-pediatric-endoscopy-a-clinical-report-from-the-naspghan-endoscopy-committee
#1
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
#2
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
#3
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
#4
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 Glasgow-Blatchford score >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 17, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28633677/surveillance-of-endoscopes-comparison-of-different-sampling-techniques
#5
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/temporary-removal-accuracy-of-tests-for-antibodies-against-tissue-transglutaminase-in-diagnosis-of-celiac-disease-without-biopsy
#6
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
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
June 15, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28619257/the-role-of-capsule-endoscopy-and-device-assisted-enteroscopy-for-small-bowel-lesions-in-hereditary-hemorrhagic-telangiectasia
#7
Rossella Cianci, Riccardo Urgesi, Annalisa Tortora, Arianna Amato, Estelle E Newton, Guido Costamagna, Maria Elena Riccioni
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal-dominant disorder leading to telangiectases and arteriovenous malformations of the skin, mucosa, and viscera. Telangiectases in the upper gastrointestinal tract are known, but data regarding possible small-bowel involvement are poor. AIMS: To evaluate the role of capsule endoscopy (CE) to determine the prevalence of small-bowel telangiectases in HHT patients, and the role of endoscopic treatment of these patients with particular reference to the incidence of re-bleeding after treatment...
May 25, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28594696/quality-measures-in-gastrointestinal-endoscopy-the-current-state
#8
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
#9
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
#10
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
#11
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
#12
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)
https://www.readbyqxmd.com/read/28555631/the-conversion-of-planned-colonoscopy-to-sigmoidoscopy-and-the-effect-of-this-practice-on-the-measurement-of-quality-indicators
#13
Sabina Beg, Stefano Sansone, Francesco Manguso, John Schembri, Jay Patel, Mo Thoufeeq, Gareth Corbett, Krish Ragunath
OBJECTIVES: A cecal intubation rate (CIR) of >90% is a well-accepted quality indicator of colonoscopy and is consequently monitored within endoscopy units. Endoscopists' desire to meet this target may mean that incomplete colonoscopies are recorded as flexible sigmoidoscopies. The aim of this study was to examine whether the conversion of requested colonoscopies is a clinically significant phenomenon and whether this impacts upon the measurement of quality indicators. METHODS: A retrospective review of all flexible sigmoidoscopies performed between 1 January 2015 and 31 December 2015 at Nottingham University Hospitals, Sheffield Teaching Hospitals, and Cambridge University Hospitals was performed...
May 30, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28553719/quality-indicators-in-digestive-endoscopy-introduction-to-structure-process-and-outcome-common-indicators
#14
Julio López-Picazo, Fernando Alberca de Las Parras, Antonio Sánchez Del Río, Shirley Pérez Romero, Joaquín León Molina, Francisco Javier Júdez
The general goal of the project wherein this paper is framed is the proposal of useful quality and safety procedures and indicators to facilitate quality improvement in digestive endoscopy units. This initial offspring sets forth procedures and indicators common to all digestive endoscopy procedures. First, a diagram of pre- and post-digestive endoscopy steps was developed. A group of health care quality and/or endoscopy experts under the auspices of the Sociedad Española de Patología Digestiva (Spanish Society of Digestive Diseases) carried out a qualitative review of the literature regarding the search for quality indicators in endoscopic procedures...
May 29, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28550489/impedance-ph-monitoring-for-diagnosis-of-reflux-disease-new-perspectives
#15
REVIEW
Marzio Frazzoni, Nicola de Bortoli, Leonardo Frazzoni, Salvatore Tolone, Vincenzo Savarino, Edoardo Savarino
Heartburn is the most specific symptom of gastroesophageal reflux disease (GERD). In clinical practice, heartburn relief by a proton pump inhibitor (PPI) trial does suffice to confirm GERD. However, an objective diagnosis of GERD is required before anti-reflux endoscopic or surgical interventions, independently from PPI response. Thus, since normal findings at upper endoscopy are detected in the majority of patients with heartburn, reflux monitoring is often required. When traditional catheter-based or wireless pH tests are used, reflux episodes are conventionally identified by pH drops below 4...
May 26, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28547532/prehospital-blood-transfusions-in-pediatric-trauma-and-nontrauma-patients-a-single-center-review-of-safety-and-outcomes
#16
Aodhnait S Fahy, Cornelius A Thiels, Stephanie F Polites, Maile Parker, Michael B Ishitani, Christopher R Moir, Kathleen Berns, James R Stubbs, Donald H Jenkins, Scott P Zietlow, Martin D Zielinski
PURPOSE: Prehospital transfusions are a novel yet increasingly accepted intervention in the adult population as part of remote damage control resuscitation, but prehospital transfusions remain controversial in children. Our purpose was to review our pediatric prehospital transfusion experience over 12 years to describe the safety of prehospital transfusion in appropriately triaged trauma and nontrauma patients. METHODS: Children (<18 years) transfused with packed red blood cells (pRBC) or plasma during transport to a single regional academic medical center between 2002 and 2014 were identified...
May 25, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28516968/preliminary-experience-with-4k-ultra-high-definition-endoscope-analysis-of-pros-and-cons-in-skull-base-surgery
#17
M Rigante, G La Rocca, L Lauretti, G Q D'Alessandris, A Mangiola, C Anile, A Olivi, G Paludetti
During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 - VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan)...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28516058/comparison-of-amoxicillin-and-metronidazole-effect-on-three-drug-regimen-for-the-treatment-of-helicobacter-pylori-infection-in-children
#18
Karam-Ali Kasiri, Abolfazl Khoshdel, Afshin Karimi, Morteza Sedehi, Niloufar Kasiri
Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1-15-year-old children. This clinical trial was conducted on 82 patients aged 1-15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord...
April 2017: Journal of Advanced Pharmaceutical Technology & Research
https://www.readbyqxmd.com/read/28510243/koloskopier-m%C3%A3-ste-kvalitetss%C3%A3-kras-verksamheterna-b%C3%A3-r-registrera-och-f%C3%A3-lja-upp-specifika-indikatorer-f%C3%A3-r-h%C3%A3-gkvalitetskoloskopi
#19
Henrik Thorlacius, Gabriele Wurm Johansson, Artur Nemeth, Ervin Toth
High quality colonoscopy must be secured Colonoscopy plays a key role in the work-up of digestive diseases and constitutes the cornerstone in colorectal cancer diagnosis and prevention. Data suggest that the quality of colonoscopy varies widely between different endoscopists. This article summarizes current evidence and expert consensus on quality indicators, along with the evidence supporting their use in benchmarking, quality reporting, and continuous quality improvement in order to secure high quality colonoscopy...
May 15, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28509811/implementation-of-a-new-method-to-track-propofol-in-an-endoscopy-unit
#20
Catherine Horvath
AIM: Propofol is a widely used anesthesia induction agent and is easily accessible in most healthcare facilities. Unlike regulated or schedule drugs, propofol is inconsistently tracked, leading to inaccurate inventories, incorrect billing, and unrecognized diversion. The goal of this project was to implement a new method of tracking propofol in a single setting, with the aim of accounting for 100% of the drug. METHODS: For two, 2-week observation periods, data were extracted from an automated medication management system or pharmacy inventory system, anesthesia records, and pharmacy billing sheets for cases in a Gastrointestinal (GI) Endoscopy Unit, and compared pre-implementation and post-implementation of a new tracking and accounting protocol...
April 29, 2017: International Journal of Evidence-based Healthcare
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