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https://www.readbyqxmd.com/read/29142513/sedation-for-routine-gastrointestinal-endoscopic-procedures-a-review-on-efficacy-safety-efficiency-cost-and-satisfaction
#1
REVIEW
Otto S Lin
Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation...
October 2017: Intestinal Research
https://www.readbyqxmd.com/read/29133257/comparative-efficacy-of-colonoscope-distal-attachment-devices-in-increasing-rates-of-adenoma-detection-a-network-meta-analysis
#2
REVIEW
Antonio Facciorusso, Valentina Del Prete, Rosario Vincenzo Buccino, Nicola Della Valle, Maurizio Cosimo Nacchiero, Fabio Monica, Renato Cannizzaro, Nicola Muscatiello
BACKGROUND & AIMS: Several add-on devices have been developed to increase rates of colon adenoma detection (ADR). We assessed their overall and comparative efficacy, and estimated absolute magnitude of benefit through a network meta-analysis. METHODS: We searched the PubMed/Medline and Embase database through March 2017 and identified 25 randomized controlled trials (comprising 16,103 patients) that compared the efficacy of add-on devices (cap, Endocuff, and Endorings) with each other or with standard colonoscopy...
November 10, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29129158/practical-gastrointestinal-investigation-of-iron-deficiency-anaemia
#3
Anjan K Banerjee, Valerio Celentano, Jim Khan, Gaius Longcroft-Wheaton, Amanda Quine, Pradeep Bhandari
About 10% of oesophagogastroduodenoscopies (OGDs) and colonoscopies are done for investigation of iron deficiency anemia (IDA) . Much of the existing guidance on investigation of IDA predates CRC screening, which has driven significant improvements in colonoscopy quality and completion rates, as well as a reduction in Helicobacter pylori prevalence and increase in PPI usage, and therefore probably needs re-consideration. New investigations, e.g. CT colonography, enteroscopy and capsule endoscopy have also been introduced...
November 13, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29112048/results-of-a-community-based-randomized-study-comparing-a-clear-liquid-diet-with-a-low-residue-diet-using-a-magnesium-citrate-preparation-for-screening-and-surveillance-colonoscopies
#4
Chandrashekhar Thukral, Sumeet K Tewani, Adam J Lake, Aaron J Shiels, Kathy Geissler, Sara Popejoy, Megan Stafford, Joseph J Vicari
BACKGROUND: Current bowel preparations for colonoscopy include a clear liquid diet (CLD) along with consumption of a laxative. This dietary restriction along with large volume bowel preparations are barriers to compliance and willingness among patients in scheduling screening examinations. The aim of our study was to compare the efficacy and tolerability of a low-volume split dose magnesium citrate bowel preparation in patients on a low-residue diet (LRD) with those on a CLD. METHODS: In this single center, single blinded, randomized controlled trial, patients scheduled for outpatient colonoscopies were assigned to either a CLD or a LRD 1 day before the examination...
November 3, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29108983/a-novel-device-for-improving-visualization-in-an-inadequately-prepared-colon
#5
Seth Gross, Lauren Gerson, Blair Lewis, Robert Ganz
BACKGROUND AND AIMS: Adequate bowel preparation is essential for a quality colonoscopy. Poor bowel preparation can result in longer procedural times, missed adenomas, earlier repeat procedures, increase costs, and decreased patient satisfaction [1-5]. Pure-Vu (MOTUS GI, Tirat Carmel, Israel) is a system that facilitates intra-procedural cleaning of a poorly prepared colon during a colonoscopy by irrigating the colon and evacuating the fluid and feces. The study aims were to evaluate Pure-Vu's cleansing capabilities and its usability and safety, in a live animal colon METHODS: The Pure-Vu system was used by four experienced gastroenterologists in 35 Yorkshire cross swine (66% female) that received a reduced bowel preparation to ensure an inadequate bowel preparation at baseline...
November 3, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29107471/quality-of-care-indicators-in-inflammatory-bowel-disease-in-a-tertiary-referral-center-with-open-access-and-objective-assessment-policies
#6
Lorant Gonczi, Zsuzsanna Kurti, Petra Anna Golovics, Barbara Dorottya Lovasz, Orsolya Menyhart, Anna Seres, Liza Dalma Sumegi, Alexander Gal, Akos Ilias, Papp Janos, Krisztina Barbara Gecse, Talat Bessisow, Waqqas Afif, Alain Bitton, Zsuzsanna Vegh, Peter Laszlo Lakatos
BACKGROUND: In the management of inflammatory bowel diseases, there is considerable variation in quality of care. AIMS: The aim of this study was to evaluate structural, access/process components and outcome quality indicators in our tertiary referral IBD center. METHODS: In the first phase, structural/process components were assessed, followed by the second phase of formal evaluation of access and management on a set of consecutive IBD patients with and without active disease (248CD/125UC patients, median age 35/39 years)...
October 9, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29104910/implementation-of-real-time-probe-based-confocal-laser-endomicroscopy-pcle-for-differentiation-of-colorectal-polyps-during-routine-colonoscopy
#7
Tim D G Belderbos, Martijn G H van Oijen, Leon M G Moons, Peter D Siersema
Background and aims:  Probe-based confocal laser endomicroscopy (pCLE) is used to differentiate between neoplastic and non-neoplastic colorectal polyps during colonoscopy. We aimed to assess the accuracy of two endoscopists starting to use real-time pCLE for differentiation of colorectal polyps and to determine the negative predictive value (NPV) for neoplasia in polyps ≤ 5 mm. Methods:  Patients undergoing colonoscopy in a tertiary hospital were included in this prospective trial...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29102524/the-optimal-bowel-preparation-intervals-before-colonoscopy-a-randomized-study-comparing-polyethylene-glycol-and-low-volume-solutions
#8
Vladimir Kojecky, Jan Matous, Radan Keil, Milan Dastych, Zdena Zadorova, Michal Varga, Radek Kroupa, Jiri Dolina, Miroslav Misurec, Ales Hep, Martin Griva
BACKGROUND & AIMS: The optimal duration of bowel preparation has only been assessed for polyethylene glycol (PEG). The aim of the study was to determine the intervals for achieving a satisfactory quality/tolerability of the preparation using PEG/ascorbic acid (PEGA) and sodium picosulphate/magnesium citrate (SPMC), and to compare them with 4L of PEG. METHODS: A randomized, endoscopist-blinded, multicentre study. The 612 outpatients referred to a colonoscopy, were prepared using PEG, SPMC, PEGA...
November 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29089272/post-polypectomy-bleeding-after-colonoscopy-on-uninterrupted-aspirin-non-steroideal-antiflammatory-drugs-systematic-review-and-meta-analysis
#9
REVIEW
Flavia Pigò, Helga Bertani, Giuseppe Grande, Abate Federica, Sara Vavassori, Rita Luisa Conigliaro
BACKGROUND AND AIM: The aim of this systematic review and meta-analysis was to assess the risk of post-polypectomy bleeding (PPB) in patients that underwent colorectal polypectomy and exposed to ASA/NSAIDs. METHODS: Relevant publications were identified in MEDLINE/EMBASE for the period 1950-2016. Studies with specified ASA/NSAIDs exposure and bleeding rate were included. Study quality was ascertained according to Newcastle-Ottawa Scale. Forest plot was based on fixed or random effect models in relation to the heterogeneity...
October 18, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29079605/cost-effectiveness-of-the-faecal-immunochemical-test-at-a-range-of-positivity-thresholds-compared-with-the-guaiac-faecal-occult-blood-test-in-the-nhs-bowel-cancer-screening-programme-in-england
#10
Jacqueline Murphy, Stephen Halloran, Alastair Gray
OBJECTIVES: Through the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP), men and women in England aged between 60 and 74 years are invited for colorectal cancer (CRC) screening every 2 years using the guaiac faecal occult blood test (gFOBT). The aim of this analysis was to estimate the cost-utility of the faecal immunochemical test for haemoglobin (FIT) compared with gFOBT for a cohort beginning screening aged 60 years at a range of FIT positivity thresholds. DESIGN: We constructed a cohort-based Markov state transition model of CRC disease progression and screening...
October 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/29070970/polyp-resection-and-removal-procedures-insights-from-the-2017-digestive-disease-week
#11
Carol Burke, Vivek Kaul, Heiko Pohl
Colorectal cancer (CRC) is an important public health issue not only because of its high incidence but also for its high mortality rate. When CRC is diagnosed at an early stage, the 5-year relative survival rate reaches 89.9%. However, only 39% of patients with CRC are diagnosed at this stage. Screening decreases both the incidence of CRC and the number of CRC-related deaths. There are several options available for screening, and colonoscopy is one of the most common methods utilized in the United States. Screening colonoscopy is associated with durable protection from CRC...
September 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29065438/surveillance-colonoscopy-in-austria-are-we-following-the-guidelines
#12
Irina Gessl, Elisabeth Waldmann, Martha Britto-Arias, Daniela Penz, Eleonore Pablik, Michael Trauner, Monika Ferlitsch
Background and study aim The European guidelines for quality assurance in colorectal cancer screening and diagnosis contain postpolypectomy surveillance recommendations. They recommend follow-up intervals depending on the findings at index colonoscopy, and divide patients into a low-, intermediate- or high-risk group. The aim of this study was to assess the adherence of Austrian endoscopists to the European guidelines and to determine whether sending a reminder letter resulted in better adherence. Methods A single reminder letter containing the guidelines was sent to all endoscopists who participated in the Certificate of Quality for Screening Colonoscopy program in Austria...
October 24, 2017: Endoscopy
https://www.readbyqxmd.com/read/29060996/-screening-for-precursors-of-colorectal-cancer
#13
L W Huang, S J Wang, M Y Liang, D X Feng, G C Wu, S N Xu, Y Fang, Z S Huang
Screening has been proven to be effective for the control of colorectal cancer (CRC). The target of CRC screening is shifting from CRC to colorectal neoplasia (CN), the precursors of CRC. Based on the the latest national guideline, the Consensus of Screening for CRC and CN, and the recent research of precursors both at home and abroad. This paper summarizes the progress in the research of risk factors, risk prediction model, screening strategy optimization, colonoscopy quality control, sessile serrated adenoma identification and follow up as well as the recognition of precursors...
October 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/29049756/interventions-to-improve-follow-up-of-positive-results-on-fecal-blood-tests-a-systematic-review
#14
REVIEW
Kevin Selby, Christine Baumgartner, Theodore R Levin, Chyke A Doubeni, Ann G Zauber, Joanne Schottinger, Christopher D Jensen, Jeffrey K Lee, Douglas A Corley
Background: Fecal immunochemical testing is the most commonly used method for colorectal cancer screening worldwide. However, its effectiveness is frequently undermined by failure to obtain follow-up colonoscopy after positive test results. Purpose: To evaluate interventions to improve rates of follow-up colonoscopy for adults after a positive result on a fecal test (guaiac or immunochemical). Data Sources: English-language studies from the Cochrane Central Register of Controlled Trials, PubMed, and Embase from database inception through June 2017...
October 17, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29048918/cost-effectiveness-of-screening-colonoscopy-in-iranian-high-risk-population
#15
Hamideh Javadinasab, Rajabali Daroudi, Hamideh Salimzadeh, Alireza Delavari, Payam Vezvaie, Reza Malekzadeh
BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer among men and the second among women in Iran. First-Degree Relatives (FDRs) of patients with CRC are known to be at higher risk of CRC. The aim of this study was to identify the most cost-effective strategy for CRC screening in Iranian high risk individuals. METHODS: A Markov model was developed to assess the cost-effectiveness of six colonoscopy screening strategies for individuals at increased risk of CRC because of positive history of the disease in at least one first-degree relative in their family...
September 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29043592/factors-associated-with-surveillance-adenoma-and-sessile-serrated-polyp-detection-rates
#16
Jennifer K Maratt, Joseph Dickens, Philip S Schoenfeld, Grace H Elta, Kenya Jackson, Daniel Rizk, Christine Erickson, Stacy B Menees
BACKGROUND: Adenoma detection rate (ADR) and sessile serrated polyp detection rate (SSPDR) data in surveillance colonoscopy are limited. AIMS: Our aim was to determine surveillance ADR and SSPDR and identify associated predictors. METHODS: A retrospective review of subjects who underwent surveillance colonoscopy for adenoma and/or SSP at an academic center was performed. The following exclusion criteria were applied: prior colonoscopy ≤ 3 years, incomplete examination, or another indication for colonoscopy...
October 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29019424/endoscopy-for-patients-affected-by-inflammatory-bowel-disease-bowel-preparation-and-sedation
#17
Cristina Bezzio, Paolo Andreozzi, Valentina Casini, Gianpiero Manes, Simone Saibeni
Endoscopy has a key role in the management of inflammatory bowel disease (IBD). It is helpful in the diagnosis, in case of relapse, refractoriness, before therapeutic changes, after surgery as well as in the assessment of mucosal healing and in the surveillance of colo-rectal cancer. IBD patients are intended to undergo several times the examination during their lifespan. Bowel preparation and sedation highly contribute to high-quality colonoscopy. Areas covered: Few studies addressed preparation and sedation in the field of IBD...
October 17, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29017291/can-patient-education-with-a-smartphone-application-improve-the-quality-of-bowel-preparation-for-colonoscopy
#18
Yoo Jin Lee, Kyung Sik Park
No abstract text is available yet for this article.
September 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/29016825/nlpreviz-an-interactive-tool-for-natural-language-processing-on-clinical-text
#19
Gaurav Trivedi, Phuong Pham, Wendy W Chapman, Rebecca Hwa, Janyce Wiebe, Harry Hochheiser
The gap between domain experts and natural language processing expertise is a barrier to extracting understanding from clinical text. We describe a prototype tool for interactive review and revision of natural language processing models of binary concepts extracted from clinical notes. We evaluated our prototype in a user study involving 9 physicians, who used our tool to build and revise models for 2 colonoscopy quality variables. We report changes in performance relative to the quantity of feedback. Using initial training sets as small as 10 documents, expert review led to final F1 scores for the "appendiceal-orifice" variable between 0...
July 22, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28988890/current-status-and-future-challenge-of-population-based-organized-colorectal-cancer-screening-lesson-from-the-first-decade-of-taiwanese-program
#20
REVIEW
Ying-Wei Wang, Hsiu-Hsi Chen, Ming-Shiang Wu, Han-Mo Chiu
Colorectal cancer (CRC) is the most common cancer in Taiwan, and is the third leading cause of cancer-related death. Screening has been proven the most effective way to reduce CRC mortality, and stool-based screening is currently the most popular method of screening worldwide. In 2004, Taiwanese government launched a nationwide screening program and fecal immunochemical test (FIT) is offered biennially to individuals aged 50 to 75. The results from the program have demonstrated that FIT screening could effectively reduce the mortality from CRC...
October 5, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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