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Quality colonoscopy

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https://www.readbyqxmd.com/read/28188978/split-dose-bowel-preparation-with-polyethylene-glycol-for-colonoscopy-performed-under-propofol-sedation-is-there-an-optimal-timing
#1
Alaa Alghamry, Sureshkumar K Ponnuswamy, Aditya Agarwal, Hadi Moattar, Stephanie T Yerkovich, Ann E Vandeleur, James Thomas, John Croese, Tony Rahman, Ruth Hodgson
AIM: Aspiration risk, especially with propofol sedation, remains a concern with split-dose bowel preparation using polyethylene glycol, which involves up to one liter of preparation intake close to the procedure time. We aim to identify the ideal timing of bowel preparation that achieves optimal colon cleansing with no increased risk of aspiration in all patients undergoing combined esophagogastroduodenoscopy (EGD) and colonoscopy with propofol sedation. METHODS: We prospectively recruited 892 consecutive patients undergoing simultaneous EGD and colonoscopy...
February 11, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28153571/providing-data-for-serrated-polyp-detection-rate-benchmarks-an-analysis-of-the-new-hampshire-colonoscopy-registry
#2
Joseph C Anderson, Lynn F Butterly, Julia E Weiss, Christina M Robinson
BACKGROUND AND AIMS: Similar to achieving adenoma detection rate (ADR) benchmarks to prevent colorectal cancer (CRC), achieving adequate serrated polyp detection rates (SDR) may be essential to the prevention of CRC associated with the serrated pathway. Previous studies have been based on data from high-volume endoscopists at single academic centers. Based on a hypothesis that ADR is correlated with SDR, we stratified a large, diverse group of endoscopists (n=77 practicing at 28 centers) into high and low performers based on ADR, to provide data for corresponding target SDR benchmarks...
January 30, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28142309/interval-cancers-in-a-guaiac-based-colorectal-cancer-screening-programme-consequences-on-sensitivity
#3
Johannes Blom, Sven Törnberg
Objective To evaluate interval cancers in the population-based colorectal cancer screening programme of Stockholm/Gotland, Sweden. Methods From 2008, individuals aged 60-69 were invited to colorectal cancer screening using biennial guaiac-based faecal occult blood test (Hemoccult®). Interval cancers, defined as colorectal cancer among participants not diagnosed by the screening programme but registered in the Swedish cancer register, were evaluated by cross-checking the screening histories for all cancers in the region 2008-2012...
January 1, 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28138858/strategies-to-increase-adenoma-detection-rates
#4
REVIEW
Eelco C Brand, Michael B Wallace
The adenoma detection rate (ADR), i.e., the proportion of average risk patients with at least one adenoma detected during screening colonoscopy, is inversely associated with the development of interval colorectal cancer. Increasing the ADR is therefore an important proxy for increase in quality and efficacy of (screening) colonoscopy. Several potentially modifiable factors, such as, procedural and technological factors, and quality improvement programs, and their effect on the ADR will be reviewed. Procedural factors, such as, bowel preparation, withdrawal time, and position changes of the patient are associated with the ADR...
January 30, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28115863/correlation-between-obesity-and-metabolic-syndrome-related-factors-and-cecal-intubation-time-during-colonoscopy
#5
Ryo Kawasato, Shinichi Hashimoto, Tomohiro Shirasawa, Atsushi Goto, Takeshi Okamoto, Jun Nishikawa, Isao Sakaida
PURPOSE: To investigate which colonoscopy (CS) cases should be presided over by endoscopists in training, using factors including obesity and metabolic syndrome. PATIENTS AND METHODS: Items investigated were sex, age, body mass index (BMI), waist circumference, hypertension, diabetes, hyperlipidemia, history of abdominal surgery (excluding colectomy), colon diverticulosis, prescription of antithrombotic agents, and quality of bowel preparation. Expert physicians were defined as those with at least 9 years of endoscopy experience; all other physicians were defined as being in training...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28108788/outpatient-application-of-formalin-for-chronic-rectal-bleeding-after-prostate-irradiation-a-quasi-experimental-study
#6
Gustavo Arruda Viani, Aline Sakamoto
PURPOSE: The aim of this quasi-experimental study is to evaluate a novel technique for an outpatient application of formalin for chronic rectal bleeding after prostate irradiation. METHODS: This is a quasi- experimental clinical trial developed between January 2010 and July 2015, including 35 patients with chronic radiation rectitis (CRP) due to a previous prostate radiation course. The study's eligibility was (1) completed external beam radiation therapy for prostate carcinoma >6 months previously, (2) rectal bleeding, defined as a frequency of >1× per week and/or needing of blood transfusions, and (3) diagnosis of chronic proctitis at colonoscopy...
January 20, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28104808/training-mid-career-internists-to-perform-high-quality-colonoscopy-a-pilot-training-programme-to-meet-increasing-demands-for-colonoscopy
#7
Nicole K Shah-Ghassemzadeh, Christian S Jackson, David Juma, Richard M Strong
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this need. OBJECTIVE: To determine if a mid-career general internist (GIN) could be trained to perform high-quality colonoscopes via an intensive training programme. DESIGN: A GIN trained 2-3 days/week, 4-5 hours/day, for 7 months with an experienced gastroenterologist...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28103289/cost-effectiveness-analysis-of-five-competing-strategies-for-the-management-of-multiple-recurrent-community-onset-clostridium-difficile-infection-in-france
#8
Emilie Baro, Tatiana Galperine, Fanette Denies, Damien Lannoy, Xavier Lenne, Pascal Odou, Benoit Guery, Benoit Dervaux
BACKGROUND: Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. METHODS: We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema...
2017: PloS One
https://www.readbyqxmd.com/read/28093425/unexpected-complication-of-colonoscopy
#9
Ramesh Nadarajah, Leon Pee
The authors present a rare case of a 71-year-old man presenting with large bowel obstruction after attempted colonoscopy. The procedure was impossible to complete due to a tight sigmoid stricture and the patient presented with an acute abdomen the following day. He was managed conservatively and discharged before returning for an elective laparoscopic sigmoid colectomy. The potential differentials of an acute abdomen post-colonoscopy are discussed and the literature reviewed on this rare complication. Finally, the authors review whether there is pressure on endoscopists to 'complete' colonoscopies (by achieving caecal intubation) based on regulatory indices in quality, and how this might have to be disregarded in unfavourable circumstances...
January 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28088179/chronic-constipation-diagnosis-and-treatment-evaluation-the-chro-co-di-t-e-study
#10
Massimo Bellini, Paolo Usai-Satta, Antonio Bove, Renato Bocchini, Francesca Galeazzi, Edda Battaglia, Pietro Alduini, Elisabetta Buscarini, Gabrio Bassotti
BACKGROUND: According to Rome criteria, chronic constipation (CC) includes functional constipation (FC) and irritable bowel syndrome with constipation (IBS-C). Some patients do not meet these criteria (No Rome Constipation, NRC). The aim of the study was is to evaluate the various clinical presentation and management of FC, IBS-C and NRC in Italy. METHODS: During a 2-month period, 52 Italian gastroenterologists recorded clinical data of FC, IBS-C and NRC patients, using Bristol scale, PAC-SYM and PAC-QoL questionnaires...
January 14, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28070476/evaluating-screening-colonoscopy-quality-in-an-uninsured-urban-population-following-patient-navigation
#11
Keith Naylor, Cassandra Fritz, Blase Polite, Karen Kim
Patient navigation (PN) increases screening colonoscopy completion in minority and uninsured populations. However, colonoscopy quality is under-reported in the setting of PN and quality indicators have often failed to meet benchmark standards. This study investigated screening colonoscopy quality indicators after year-one of a PN initiative targeting the medically uninsured. This was a retrospective analysis of 296 outpatient screening colonoscopies. Patients were 45 to 75 years of age with no history of bowel cancer, inflammatory bowel disease, or colorectal surgery...
March 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28067463/enhanced-education-for-bowel-preparation-before-colonoscopy-a-state-of-the-art-review
#12
Zhu Liu, Ming Ming Zhang, Yue Yue Li, Li Xiang Li, Yan Qing Li
Colonoscopy remains the mainstay in the diagnosis and monitoring for colorectal cancer and other colorectal lesions. The diagnostic efficiency of colonoscopy highly depends on the quality of bowel preparation, which is closely associated with patient's compliance to preparation instructions. In addition, the procedural requirements of bowel preparation are often complex and difficult to be comprehended and memorized by patients, especially those with lower health literacy and motivation. Therefore, in recent years, many educational methods have been constantly developed, such as educational booklets, cartoon visual aids, educational videos, the short message service, the telephone, social media applications and smart phone applications...
January 9, 2017: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/28063287/clinical-practice-guidelines-for-the-use-of-video-capsule%C3%A2-endoscopy
#13
Robert A Enns, Lawrence Hookey, David Armstrong, Charles N Bernstein, Steven J Heitman, Christopher Teshima, Grigorios I Leontiadis, Frances Tse, Daniel Sadowski
BACKGROUND & AIMS: Video capsule endoscopy (CE) provides a noninvasive option to assess the small intestine, but its use with respect to endoscopic procedures and cross-sectional imaging varies widely. The aim of this consensus was to provide guidance on the appropriate use of CE in clinical practice. METHODS: A systematic literature search identified studies on the use of CE in patients with Crohn's disease, celiac disease, gastrointestinal bleeding, and anemia...
January 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28061339/how-to-perform-high-quality-endoscopic-mucosal-resection-during-colonoscopy
#14
Amir Klein, Michael J Bourke
No abstract text is available yet for this article.
January 3, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28059941/adenoma-detection-rates-for-screening-colonoscopies-in-smokers-and-obese-adults-data-from-the-new-hampshire-colonoscopy-registry
#15
Joseph C Anderson, Julia E Weiss, Christina M Robinson, Lynn F Butterly
GOAL: To examine screening adenoma detection rates (ADR) and serrated detection rates (SDR) among smokers and obese adults in the New Hampshire Colonoscopy Registry. BACKGROUND: ADR, a quality measure for screening colonoscopies, is associated with protection from interval colorectal cancer. Currently, only sex-specific ADR benchmarks are reported. However, obesity and smoking ≥20 pack-years are strong predictors for colorectal neoplasia, as highlighted by the 2009 American College of Gastroenterology CRC Screening Guidelines...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28055031/a-customized-mobile-application-in-colonoscopy-preparation-a-randomized-controlled-trial
#16
Ala I Sharara, Jean M Chalhoub, Maya Beydoun, Rani H Shayto, Hamed Chehab, Ali H Harb, Fadi H Mourad, Fayez S Sarkis
OBJECTIVES: Adherence with diet and prescribed purgative is essential for proper cleansing with low-volume bowel preparations. The aim of this work was to assess the effect of a customized mobile application (App) on adherence and quality of bowel preparation. METHODS: One hundred and sixty (160) eligible patients scheduled for elective colonoscopy were randomly assigned to paper (control) or App-based instructions. The preparation consisted of low-fiber diet for 2 days, clear fluids for one day and split-dose sodium picosulfate/magnesium citrate (SPS)...
January 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28045200/quality-of-colonoscopy-performed-in-rural-practice-experience-from-the-clinical-outcomes-research-initiative-and-the-oregon-rural-practice-based-research-network
#17
Jennifer L Holub, Cynthia Morris, Lyle J Fagnan, Judith R Logan, LeAnn C Michaels, David A Lieberman
PURPOSE: Colon cancer screening is effective. To complete screening in 80% of individuals over age 50 years by 2018 will require adequate colonoscopy capacity throughout the country, including rural areas, where colonoscopy providers may have less specialized training. Our aim was to study the quality of colonoscopy in rural settings. METHODS: The Clinical Outcomes Research Initiative (CORI) and the Oregon Rural Practice-based Research Network (ORPRN) collaborated to recruit Oregon rural practices to submit colonoscopy reports to CORI's National Endoscopic Database (NED)...
January 3, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28042391/identification-of-factors-associated-with-sedation-tolerance-in-5000-patients-undergoing-outpatient-colonoscopy-canadian-tertiary-center-experience
#18
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
AIM: To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. METHODS: A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed...
December 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28035547/diabetics-on-narcotics-are-less-likely-to-achieve-excellent-bowel-preparation-than-are-patients-with-either-condition
#19
Mohammad F Madhoun, Hussein Bitar, Owais Bhatti, Hassaan Zia, Pratyusha Parava, Muhammad H Bashir
BACKGROUND: Diabetes and chronic narcotic use negatively affect the quality of bowel preparation before colonoscopy. AIM: To investigate whether narcotic use and diabetes have an additive negative impact on bowel preparation. PATIENTS AND METHODS: We performed a retrospective study of 2841 patients (mean age 61 ± 10.2; 94% male) who received outpatient colonoscopies at our Veterans Affairs Medical Center between June 2012 and December 2014...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28035253/colon-adenoma-features-and-their-impact-on-risk-of-future-advanced-adenomas-and-colorectal-cancer
#20
Audrey H Calderwood, Karen E Lasser, Hemant K Roy
AIM: To review the evidence on the association between specific colon adenoma features and the risk of future colonic neoplasia [adenomas and colorectal cancer (CRC)]. METHODS: We performed a literature search using the National Library of Medicine through PubMed from 1/1/2003 to 5/30/2015. Specific Medical Subject Headings terms (colon, colon polyps, adenomatous polyps, epidemiology, natural history, growth, cancer screening, colonoscopy, CRC) were used in conjunction with subject headings/key words (surveillance, adenoma surveillance, polypectomy surveillance, and serrated adenoma)...
December 15, 2016: World Journal of Gastrointestinal Oncology
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