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https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#1
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28802556/randomized-sham-controlled-trials-in-endoscopy-a-systematic-review-and-meta-analysis-of-adverse-events
#2
REVIEW
Allison R Schulman, Violeta Popov, Christopher C Thompson
BACKGROUND AND AIMS: Sham procedures in endoscopy are used with the intention of controlling for placebo response, potentially allowing more precise evaluation of treatment effect. Nevertheless, this type of study may impose significant risk without potential benefit for those in the sham group. The aim of the current study is to systematically review and analyze the endoscopic literature to assess the safety of sham controls. METHODS: MEDLINE and Embase databases were searched for endoscopic sham procedures for all dates through July 2017...
August 9, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28797911/a-prospective-evaluation-of-radiation-free-direct-solitary-cholangioscopy-for-the-management-of-choledocholithiasis
#3
Monique T Barakat, Mohit Girotra, Abhishek Choudhary, Robert J Huang, Saurabh Sethi, Subhas Banerjee
BACKGROUND AND AIMS: Endoscopy has replaced many radiological studies for the GI tract. However, ERCP remains a hybrid endoscopic-fluoroscopic procedure, which limits its portable delivery, creates delays due to fluoroscopy room unavailability and exposes patients/providers to radiation. We evaluated fluoroscopy/radiation-free management of patients with non-complex choledocholithiasis using direct solitary cholangioscopy (DSC). METHODS: Patients underwent fluoroscopy-free biliary cannulation, sphincterotomy then cholangioscopy to establish location, number/size of stones and document distance from ampulla to bifurcation to guide balloon advancement...
August 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28797247/is-histologic-esophagitis-associated-with-dental-erosion-a-cross-sectional-observational-study
#4
Lynn Roosa Friesen, Brenda Bohaty, Robin Onikul, Mary P Walker, Caren Abraham, Karen B Williams, Jose T Cocjin, Eileen L Cocjin, Craig A Friesen
BACKGROUND: Gastroesophageal reflux disease (GERD) affects 15-25% of children and adolescents in the United States. The diagnosis of GERD in children is complex as reported symptoms or symptom profiles have been found to be unreliable. Frequently, the diagnosis must be confirmed by objective tests such as pH monitoring or histological evidence of esophagitis on an esophageal biopsy. Dental erosion has been shown to be associated with GERD as an atypical complication and has the potential to be a marker of GERD...
August 10, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28791330/computer-assisted-instruction-before-colonoscopy-is-as-effective-as-nurse-counselling-a-clinical-pilot-trial
#5
Govert Veldhuijzen, Michael Klemt-Kropp, Casper Noomen, Aura A Van Esch, Eric T Tjwa, Joost Drenth
BACKGROUND AND STUDY AIMS:  Better patient education prior to colonoscopy improves adherence to instructions for bowel preparation and leads to cleaner colons. We reasoned that computer assisted instruction (CAI) using video and 3 D animations followed by nurse contact maximizes the effectiveness of nurse counselling, increases proportion of clean colons and improves patient experience. PATIENTS AND METHODS:  Adults referred for colonoscopy in a high-volume endoscopy unit in the Netherlands were included...
August 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28768440/contribution-of-intraoperative-colonoscopy-in-a-colorectal-surgery-unit
#6
Carlos Cerdán Santacruz, José Miguel Esteban López-Jamar, Esther Sánchez López, Javier Cerdán Miguel
OBJECTIVES: Intraoperative colonoscopy (IC) is routinely used in colorectal surgery procedures, both oncologic and benign ones. Despite its extensive use there is a lack of literature addressing this important issue. The aims of this paper are to determine the contributions of this tool, especially considering changes in attitude from preoperative designed intervention. MATERIALS AND METHODS: This study is a retrospective analysis of a prospective maintained database...
August 2, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28743561/increased-prevalence-of-colonic-adenomas-in-patients-with-cystic-fibrosis
#7
Mehdi Hegagi, Shawn D Aaron, Paul James, Rakesh Goel, Avijit Chatterjee
BACKGROUND: Cystic fibrosis (CF) is the most common lethal genetic illness in the Caucasian population. Studies have shown that CF patients are at an elevated risk of developing colon cancer. Colonic adenomas are the precursors of colon cancer. This study aims to determine the prevalence of adenomas in patients with cystic fibrosis. METHODS: All patients were recruited prospectively at The Ottawa Hospital Cystic Fibrosis Clinic from 2010 through 2015. Baseline demographic and cystic fibrosis disease characteristics were collected from the clinic's CF patient database...
July 22, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/28735835/effect-of-scheduled-second-look-endoscopy-on-peptic-ulcer-bleeding-a-prospective-randomized-multicenter-trial
#8
Soo Jung Park, Hyojin Park, Yong Chan Lee, Chang Hwan Choi, Tae Joo Jeon, Jun Chul Park, Jie-Hyun Kim, Young Hoon Youn, Yu Jin Kim, Jae Hak Kim, Kwang Jae Lee, Sun Gyo Lim, Hyung Gil Kim, Byoung Wook Bang
BACKGROUND AND AIM: This study aimed to investigate the effectiveness of scheduled second-look EGD with endoscopic hemostasis on peptic ulcer rebleeding and sought to identify the risk factors related to the need for second-look EGD. METHODS: We prospectively randomized patients who had endoscopically confirmed bleeding peptic ulcer with stigmata of active bleeding, visible vessel, or adherent clot into 2 groups between August 2010 and January 2013. Hemoclip application or thermal coagulation, and/or epinephrine injection were allowed for initial endoscopic therapy...
July 20, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28730132/investigation-of-efficacy-of-lidocaine-spray-for-sedated-esophagogastroduodenoscopy-in-children
#9
Ahmet Basturk, Reha Artan, Aygen Yılmaz
PURPOSE: Our aim in this study is to investigate efficacy of topical lidocaine spray for sedated esophagogastroduodenoscopy (EGD) in children. METHODS: The endoscopy of children aged between 3-18 years who underwent EGD in our endoscopy unit. Intravenous (IV) midazolam and ketamine were used for sedation. Prior to sedation, endoscopy nurse applied topical lidocaine 10% with pump spray at 1 mg/kg dose in group 1, and distilled water via identically scaled pump spray in group 2, in a double blinded fashion...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28687379/moderate-sedation-changes-for-bronchoscopy-in-2017
#10
REVIEW
Michael E Nelson
The reimbursement for procedures using moderate (conscious) sedation has changed significantly as of January 1, 2017. Due to the increasing use of anesthesia services to provide moderate sedation during endoscopy, the Centers for Medicare & Medicaid Services made the decision to remove work relative value units from many of the services requiring moderate sedation, including the bronchoscopy codes. If a bronchoscopist provides moderate sedation to a patient without using anesthesia services or another qualified provider, that work (and revenue) can be reclaimed by 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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