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https://www.readbyqxmd.com/read/28333822/committee-opinion-no-694-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#1
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333816/committee-opinion-no-696-nonobstetric-surgery-during-pregnancy
#2
(no author information available yet)
The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice acknowledges that the issue of nonobstetric surgery during pregnancy is an important concern for physicians who care for women. It is important for a physician to obtain an obstetric consultation before performing nonobstetric surgery and some invasive procedures (eg, cardiac catheterization or colonoscopy) because obstetricians are uniquely qualified to discuss aspects of maternal physiology and anatomy that may affect intraoperative maternal-fetal well-being...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333814/committee-opinion-no-694-summary-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#3
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28328936/polyp-detection-rate-in-transverse-and-sigmoid-colon-significantly-increases-with-longer-withdrawal-time-during-screening-colonoscopy
#4
Kazuhiro Kashiwagi, Nagamu Inoue, Toshifumi Yoshida, Rieko Bessyo, Kazuaki Yoneno, Hiroyuki Imaeda, Haruhiko Ogata, Takanori Kanai, Yoshinori Sugino, Yasushi Iwao
BACKGROUND: The guidelines for colonoscopy present withdrawal time (WT) and adenoma detection rate (ADR) as the quality indicator. The purpose of this retrospective study is to analyze the predicting factors with polyp detection rate (PDR) as a surrogate for ADR by using comprehensive health checkup data, and assess the correlation between PDR per each colonic segment and WT, and factors influencing WT. METHODS: One thousand and thirty six consecutive health checkup cases from April 2015 to March 2016 were enrolled in this study, and 880 subjects who undertook colonoscopy without polyp removal or biopsy were divided into the two groups (polyp not detected group vs polyp detected group)...
2017: PloS One
https://www.readbyqxmd.com/read/28328623/a-novel-user-friendly-model-to-predict-corticosteroid-utilization-in-newly-diagnosed-patients-with-ulcerative-colitis
#5
Nabeel Khan, Dhruvan Patel, Yash Shah, Gary Lichtenstein, Yu-Xiao Yang
BACKGROUND: Corticosteroid (CS) use is an important marker of poor prognosis in ulcerative colitis (UC). Our aim was to develop and validate a model to predict the risk of CS utilization over the course of disease in newly diagnosed patients with UC. METHODS: Newly diagnosed patients with UC from a nationwide VA cohort were followed over time to evaluate factors predictive of CS use. Multivariate logistic regression was performed. Model development was performed in a random 2/3 of the total cohort and then validated in the remaining 1/3...
March 21, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28325827/sessile-serrated-polyps-and-colon-cancer-prevention
#6
Shahrooz Rashtak, Rafaela Rego, Seth R Sweetser, Frank A Sinicrope
Evidence suggests that up to one fifth of colorectal carcinomas (CRC) develop from serrated polyps, named for their pattern of colonic crypts, and include the sessile serrated adenoma/polyp (SSA/P) that has malignant potential. SSA/Ps are typically located in the proximal colon and have molecular features of hypermethylation of CpG islands in gene promoters and activating point mutations (V600E) in the BRAF oncogene. Both of these features are seen in sporadic CRCs with microsatellite instability (MSI) which is potentially consistent with an origin of these cancers from precursor SSA/Ps...
March 21, 2017: Cancer Prevention Research
https://www.readbyqxmd.com/read/28325724/air-everywhere-colon-perforation-after-colonoscopy
#7
Ana Virgínia Araújo, Cláudia Santos, Helena Contente, Cláudia Branco
Colonoscopy is being widely used since the 1980s and is the leading diagnostic procedure for colorectal cancer. For many colorectal diseases, it is also a therapeutic tool. Like many other procedures in Medicine, it has its drawbacks and complications, some of which if not readily diagnosed can represent a serious risk to the patient's health and well-being. We describe a case of colon perforation during diagnostic colonoscopy in a patient, resulting in exuberant pneumoretroperitoneum, pneumoperitoneum, pneumomediastinum and subcutaneous emphysema, who successfully underwent laparoscopic colonic resection with primary anastomosis...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28321345/a-patency-capsule-remained-intact-in-the-colon-over-210-hours
#8
Yu Hihara, Satoru Joshita, Toshiharu Takahashi, Shinji Okaniwa, Yoshiki Mizukami, Yoshiyuki Nakamura
We present an unusual case of a 35-year-old male patient whom a patency capsule stayed in his gut without breaking. He has a history of Peutz-Jeghers syndrome and multiple abdominal surgeries. Prestudy was performed for abdominal searching, but a patency capsule remained in the colon over 9 days. He displayed neither abdominal nor obstructive symptoms in that period. We collected the patency capsule using colonoscopy after dilating a postoperative stricture at an anastomotic site of the rectum. Clinicians should bear in mind that patency capsules may become retained as distally as the colon in patients with a surgical history of the large intestine...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28321304/gastric-heterotopia-in-rectum-a-literature-review-and-its-diagnostic-pitfall
#9
Peyman Dinarvand, Ashley A Vareedayah, Nancy J Phillips, Christine Hachem, Jinping Lai
OBJECTIVES: The term heterotopia, in pathology, refers to the presence of normal tissues at foreign sites. Gastric heterotopia has been reported anywhere in the gastrointestinal tract. However, the presence of gastric heterotopia in the rectum is very rare. METHODS: We, here, report a rare case of a localized 2-cm area of cratered mucosa with heaped-up borders in the rectum of a 51-year-old, asymptomatic woman who underwent screening colonoscopy. RESULTS: Histologic examination of the biopsy from the lesional tissue in rectum demonstrated fragments of rectal mucosa co-mingling with oxyntic- and antral-type gastric mucosa...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28320200/clinical-and-biological-features-of-interval-colorectal-cancer
#10
Yu Mi Lee, Kyu Chan Huh
Interval colorectal cancer (I-CRC) is defined as a CRC diagnosed within 60 months after a negative colonoscopy, taking into account that 5 years is the "mean sojourn time." It is important to prevent the development of interval cancer. The development of interval colon cancer is associated with female sex, old age, family history of CRC, comorbidities, diverticulosis, and the skill of the endoscopist. During carcinogenesis, sessile serrated adenomas/polyps (SSA/Ps) share many genomic and colonic site characteristics with I-CRCs...
March 21, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28319511/the-first-us-clinical-experience-with-computer-assisted-propofol-sedation-a-retrospective-observational-comparative-study-on-efficacy-safety-efficiency-and-endoscopist-and-patient-satisfaction
#11
Otto S Lin, Richard A Kozarek, Deborah Tombs, Danielle La Selva, Wade Weigel, Ryan Beecher, Ana Jensen, Michael Gluck, Andrew Ross
BACKGROUND: Computer-assisted propofol sedation (CAPS) is now approved for moderate sedation of American Society of Anesthesiologists (ASA) class I and II patients undergoing routine endoscopy. As the first US medical center to adopt CAPS for routine clinical use, we compared patient and endoscopist satisfaction with CAPS versus midazolam and fentanyl (MF) sedation. METHODS: Patients who underwent elective outpatient upper endoscopy and colonoscopy with CAPS were compared with concurrent patients sedated with MF...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319429/current-standards-and-new-developments-of-colorectal-polyp-management-and-resection-techniques
#12
Daniel von Renteln, Mickael Bouin, Alan N Barkun
Colonoscopy and endoscopic removal of precancerous polyps play an important role in colorectal cancer (CRC) prevention. Improved endoscopes and quality standards have led to an increasing polyp and adenoma detection rate. Optimal polyp resection techniques and management strategies are key for an effective colonoscopy practice. Areas covered: Strategies for how to improve diminutive polyp (polyps up to 5mm in size) management are discussed because of their high prevalence. Systematic removal of diminutive polyps leads to increasing costs of colonoscopy practice, while the effect on colorectal cancer prevention might be negligible...
March 20, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28319242/quality-of-cancer-surveillance-clinical-practice-guidelines-specificity-and-consistency-of-recommendations
#13
Ryan P Merkow, Deborah Korenstein, Rubaya Yeahia, Peter B Bach, Shrujal S Baxi
Importance: Primary care clinicians, who are increasingly responsible for caring for the growing population of cancer survivors, may be unfamiliar with appropriate cancer surveillance strategies. Clinical practice guidelines can inform cancer follow-up care and surveillance testing. Vague recommendations and inconsistencies among guidelines can lead to overuse and underuse of health care resources and have a negative impact on cost and quality of survivorship care. Objective: To examine the specificity and consistency of recommendations for surveillance after active treatment across cancer guidelines...
March 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28317624/cap-assisted-colonoscopy-increases-detection-of-advanced-adenomas-and-polyps
#14
Mohamed O Othman, Daniel Zhang, Sherif Elhanafi, Mohamed Eloliby, Brian Davis, Richard Guererro, Luis Alvarado, Linda Sanchez, Alok Dwivedi, Marc J Zuckerman
BACKGROUND: Cap-assisted colonoscopy (CAC) has been reported to increase the adenoma detection rate (ADR) in Asian population. However, CAC trials in non-Asian population have had conflicting results. Studies in North America have shown an improvement in ADRs with the use of CAC, but it mainly included white and African American patients. Given the lack of prospective studies of CAC in Hispanics, we conducted this randomized controlled trial. MATERIALS AND METHODS: This is a randomized controlled trial comparing CAC with standard colonoscopy (SC) in patients undergoing screening or surveillance colonoscopy...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28317231/prospective-evaluation-of-same-day-versus-next-day-colon-manometry-results-in-children-with-medical-refractory-constipation
#15
R A Arbizu, S Nurko, N Heinz, M Amicangelo, L Rodriguez
BACKGROUND: We evaluated the change in colon manometry (CM) parameters and interpretation comparing results when the study is performed the same day after the motility catheter is placed under anesthesia or the following day. METHODS: CM catheter was placed with colonoscopy under anesthesia and recorded on day 1 and repeated on day 2. Study parameters including motility index during fasting, post-prandial and post-Bisacodyl challenge phase; gastrocolonic response; number, presence and propagation of high amplitude propagating contractions (HAPCs); and, study interpretation were compared between both the days...
March 20, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28316766/colonic-laterally-spreading-tumor-diagnosed-as-an-early-cancer-and-treated-with-endoscopic-mucosal-resection-a-case-report-and-review-of-literature
#16
Mohamad Abdelaziz, Motaz Sayed
Laterally spreading tumors (LSTs) are generally defined as superficial lesions ≥10 mm in diameter that typically extend laterally rather than vertically along the colonic wall. Such lesions are now increasingly reported because of increased awareness and the introduction of chromo and magnifying colonoscopy. Although the clinicopathological characteristics and the efficacy of endoscopic management of LSTs have been defined in Japanese cohorts, reports from the Middle East are lacking where surgical resection is the mainstay of treatment...
January 2017: Middle East Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28315280/beyond-white-light-optical-enhancement-in-conjunction-with-magnification-colonoscopy-for-the-assessment-of-mucosal-healing-in-ulcerative-colitis
#17
Marietta Iacucci, Ralf Kiesslich, Xianyong Gui, Remo Panaccione, Joan Heatherington, Oluseyi Akinola, Subrata Ghosh
Background and study aim The I-SCAN optical enhancement (OE) system with magnification is a recently introduced combination of optical and digital electronic virtual chromoendoscopy, which enhances mucosal and vascular details. The aim of this pilot study was to investigate the use of I-SCAN OE in the assessment of inflammatory changes in ulcerative colitis (UC). Patients and methods A total of 41 consecutive patients with UC and 9 control patients were examined by I-SCAN OE (Pentax Medical, Tokyo, Japan)...
March 17, 2017: Endoscopy
https://www.readbyqxmd.com/read/28315031/feasibility-of-large-scale-identification-of-sessile-serrated-polyp-patients-using-electronic-records-a-utah-study
#18
Kajsa Affolter, Keith Gligorich, Niloy Jewel Samadder, Wade S Samowitz, Karen Curtin
BACKGROUND/AIMS: The serrated pathway accounts for 15-25% of sporadic colorectal cancer (CRC). In our study, we sought to accurately characterize sessile serrated polyps (SSP) in a population by electronically interrogating colonoscopy patients' endoscopy and pathology reports using a rules-based text search of pre-defined SSP-related terms. To this aim, we compared a sample of putative SSP and hyperplastic polyps (HP) using our algorithm to a determination of SSP or HP by pathologist and molecular examination to determine the feasibility of large-scale identification of SSP in electronic medical records...
March 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28314604/a-prospective-randomised-study-comparing-double-balloon-colonoscopy-and-conventional-colonoscopy-in-pre-defined-technically-difficult-cases
#19
Edward J Despott, Alberto Murino, Masanao Nakamura, Leonidas Bourikas, Chris Fraser
BACKGROUNDS AND AIM: Technically 'difficult' (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon. METHODS: We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC...
February 14, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28303842/improvement-of-quality-of-nonanesthetic-colonoscopy-by-preoperative-administration-of-pinaverium-bromide
#20
Xiao-Lin Wang, Jian-Ning Zhou, Li Ren, Xiao-Li Pan, Hong-Yu Ren, Jun Liu
BACKGROUND: Nonanesthetic colonoscopy is popular in clinical practice in China. However, intestinal spasms often result in a prolonged examination time, increased operating difficulties, decreased polyp detection rate, and failure to complete the procedure clinically. Therefore, exploring alternative approaches that can reduce the pain in patients during colonoscopy is of utmost importance, and finding the optimal preoperative administration to improve the quality of nonanesthetic colonoscopy is also necessary...
March 20, 2017: Chinese Medical Journal
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