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Quality colonoscopy

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https://www.readbyqxmd.com/read/28328936/polyp-detection-rate-in-transverse-and-sigmoid-colon-significantly-increases-with-longer-withdrawal-time-during-screening-colonoscopy
#1
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/28319429/current-standards-and-new-developments-of-colorectal-polyp-management-and-resection-techniques
#2
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
#3
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/28303842/improvement-of-quality-of-nonanesthetic-colonoscopy-by-preoperative-administration-of-pinaverium-bromide
#4
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
https://www.readbyqxmd.com/read/28296927/harms-benefits-and-costs-of-fecal-immunochemical-testing-versus-guaiac-fecal-occult-blood-testing-for-colorectal-cancer-screening
#5
S Lucas Goede, Linda Rabeneck, Marjolein van Ballegooijen, Ann G Zauber, Lawrence F Paszat, Jeffrey S Hoch, Jean H E Yong, Sonja Kroep, Jill Tinmouth, Iris Lansdorp-Vogelaar
BACKGROUND: The ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms. METHODS: We used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants...
2017: PloS One
https://www.readbyqxmd.com/read/28293023/advances-in-image-enhancement-in-colonoscopy-for-detection-of-adenomas
#6
REVIEW
Takahisa Matsuda, Akiko Ono, Masau Sekiguchi, Takahiro Fujii, Yutaka Saito
High-quality colonoscopy is mandatory to prevent adenoma recurrence and colorectal cancer. In the past few years, technical advances have been developed with the purpose of improving adenoma detection rate (ADR), one of the most important validated colonoscopy quality benchmarks. Several techniques or devices are used to optimize visualization: observation techniques; add-on devices; auxiliary imaging devices; colonoscopes with increased field of view; and colonoscopes with an integrated inflatable reusable balloon...
March 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28262219/does-urgent-colonoscopy-improve-outcomes-in-the-management-of-lower-gastrointestinal-bleeding
#7
REVIEW
Ankur Seth, Muhammad Ali Khan, Richard Nollan, Deepansh Gupta, Sehrish Kamal, Utkarsh Singh, Faisal Kamal, Colin W Howden
Colonoscopy continues to be an essential diagnostic and therapeutic tool in the management of lower gastrointestinal bleeding (LGIB). Studies that have evaluated the role of urgent colonoscopy for treating LGIB have reached conflicting conclusions. We conducted a systematic review and meta-analysis to evaluate the role of urgent colonoscopy in several outcomes in patients with LGIB. We searched Medline, Embase, Scopus and Cochrane databases from inception to July 10, 2016 for comparative studies evaluating the role of urgent versus elective colonoscopy in the management of LGIB...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28260941/is-there-evidence-that-we-should-screen-the-general-population-for-lynch-syndrome-with-genetic-testing-a-systematic-review
#8
REVIEW
Anya E R Prince, R Jean Cadigan, Gail E Henderson, James P Evans, Michael Adams, Emmanuel Coker-Schwimmer, Dolly C Penn, Marcia Van Riper, Giselle Corbie-Smith, Daniel E Jonas
BACKGROUND: The emerging dual imperatives of personalized medicine and technologic advances make population screening for preventable conditions resulting from genetic alterations a realistic possibility. Lynch syndrome is a potential screening target due to its prevalence, penetrance, and the availability of well-established, preventive interventions. However, while population screening may lower incidence of preventable conditions, implementation without evidence may lead to unintentional harms...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28257546/commentary-on-effects-of-starting-a-gastroenterology-fellowship-training-program-on-quality-measures-of-colonoscopy
#9
David Friedel
No abstract text is available yet for this article.
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257545/effects-of-starting-a-gastroenterology-fellowship-training-program-on-quality-measures-of-colonoscopy
#10
Sherif Elhanafi, Rahul Chhana, Indika Mallawaarachchi, Wynee Lou, Gabriela Rangel, Hongfei Fang, Rinkal Patel, Alok Kumar Dwivedi, Marc J Zuckerman, Mohamed O Othman
OBJECTIVES: Adenoma detection rate (ADR) is the most established indicator of the quality of screening colonoscopy. The effect of gastroenterology (GI) fellows on the quality of screening colonoscopies has been evaluated previously; however, the effect of starting a new GI fellowship program on the quality of screening colonoscopies has not been studied. The aim of our study was to assess the effects of starting a GI fellowship program and the participation of fellows in screening colonoscopies on ADR and other measures of quality...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28256484/cecal-intubation-rate-during-colonoscopy-at-a-tertiary-hospital-in-south-west-nigeria-how-frequent-and-what-affects-completion-rate
#11
A Akere, K O Akande
BACKGROUND: Colonoscopy is useful in the diagnosis, treatment of colorectal diseases, and for colorectal cancer screening program. Complete colonoscopy is therefore crucial for the success of any screening program. One important measure of the quality of colonoscopy is the cecal intubation rate (CIR). AIM: This was to assess the CIR at our endoscopy unit and evaluate the factors responsible for uncompleted cases. PATIENTS AND METHODS: This was a prospective study at the endoscopy unit of the University College Hospital, Ibadan...
March 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28252461/the-effect-of-a-health-education-intervention-on-jordanian-participants-colorectal-cancer-knowledge-health-perceptions-and-screening-practices
#12
Fuad H Abuadas, Wasileh J Petro-Nustas, Mohammad H Abuadas
BACKGROUND: Globally, colorectal cancer (CRC) is the second and third most commonly diagnosed cancer in women and men, respectively. OBJECTIVES: The aim of this study is to test the effectiveness of a health education intervention on the current level of Jordanians' CRC knowledge, health perceptions, and screening practices. METHODS: A convenience sampling method was used to recruit a sample of 197 average-risk Jordanian adults aged 50 to 75 years...
March 1, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28246494/proposed-score-for-the-self-assessment-of-an-endoscopy-department-performance-in-colonoscopy-screening
#13
Ioan Sporea, Alina Popescu, Roxana Sirli, Oliviu Pascu, Cristina Cijevschi Prelipcean, Daniela Dobru, Simona Bota, Diana Gherhardt, Oana Gradinaru, Madalina Popescu
The aim of the paper was to propose a score for performance evaluation in colonoscopy units. METHOD: We proposed a score (CDCD score - Cecal intubation, polyp Detection rate, Cleansing and Documentation of cecal intubation) based on the following parameters that assess the quality of colonoscopy units: total colonoscopies rate, polyp detection rate, rate of cecal intubation photo record, rate of recorded Boston bowel preparation scale (BBPS) (rated 1 to 5 stars). The mean score obtained based on the above mentioned criteria was used as a quality parameter of the endoscopy unit...
2017: Clujul Medical (1957)
https://www.readbyqxmd.com/read/28244948/safety-of-large-volume-same-day-oral-bowel-preparations-during-deep-sedation-a-prospective-observational-study
#14
Kanwarpreet Tandon, Charl Khalil, Fernando Castro, Alison Schneider, Mosaab Mohameden, Seifeldin Hakim, Kinchit Shah, Chau To, Colin O'Rourke, Jeffrey Jacobs
BACKGROUND: Colonoscopy quality is directly related to the bowel preparation. It is well established that bowel preparations are improved when at least part of the laxative is ingested on the day of the procedure. However, there is concern that this can result in higher gastric residual volumes (GRV) and increase the risk of pulmonary aspiration. The aim of this study is to evaluate GRV and gastric pH in patients who received day-before bowel preparation versus those ingesting their laxative on the day of colonoscopy under anesthesiologist-directed propofol deep sedation...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28241037/randomized-controlled-trial-standard-versus-supplemental-bowel-preparation-in-patients-with-bristol-stool-form-1-and-2
#15
Yueyue Li, Xinyong Jia, Baozhen Liu, Yanmei Qi, Xiubin Zhang, Rui Ji, Yanbo Yu, Xiuli Zuo, Yanqing Li
BACKGROUND: Bristol stool form 1 and 2 is an important predictor of inadequate bowel preparation. AIM: To evaluate the efficacy of supplemental preparation in bowel cleansing quality among patients with Bristol stool form 1 and 2, as well as the feasibility of tailored bowel preparation guided by Bristol stool form scale. METHODS: Patients with Bristol stool form 1 and 2 from 3 Chinese tertiary hospitals randomly received either 2 L PEG-ELP (group A) or 10 mg bisacodyl plus 2 L PEG-ELP (group B); patients with Bristol stool form 3 to 7 received 2 L PEG-ELP (group C) for bowel preparation...
2017: PloS One
https://www.readbyqxmd.com/read/28231692/risk-and-characteristics-of-postcolonoscopy-interval-colorectal-cancer-after-a-positive-fecal-test-a-nationwide-population-based-study-in-korea
#16
Chang Kyun Lee, Kui Son Choi, Chang Soo Eun, Dong-Il Park, Dong Soo Han, Minjoo Yoon, Mina Suh, Jae Kwan Jun
Purpose: Fecal tests remain a mainstay of population-based colorectal cancer (CRC) screening programs worldwide. However, data on interval CRC (iCRC) arising after follow-up colonoscopy of a positive fecal test are scarce. We conducted a nationwide population-based study to reveal the risk and characteristics of iCRC in this setting. Materials and Methods: We searched the National Cancer Screening Program for CRC database in Korea (2005-2010). Incidence of iCRC within the program was estimated, then Cox proportional-hazards regression analysis was performed to determine the independent predictors of iCRC...
February 24, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#17
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28219690/factors-associated-with-shorter-colonoscopy-surveillance-intervals-for-patients-with-low-risk-colorectal-adenomas-and-effects-on-outcome
#18
Joseph C Anderson, John A Baron, Dennis J Ahnen, Elizabeth L Barry, Roberd M Bostick, Carol A Burke, Robert S Bresalier, Timothy R Church, Bernard F Cole, Marcia Cruz-Correa, Adam S Kim, Leila A Mott, Robert S Sandler, Douglas J Robertson
BACKGROUND & AIMS: Endoscopists do not routinely follow guidelines to survey individuals with low-risk adenomas (LRAs, 1-2 small tubular adenomas, less than 1 cm) every 5-10 years for colorectal cancer (CRC)-many endoscopists recommend shorter surveillance intervals for these individuals. We aimed to identify reasons that endoscopists recommend shorter surveillance intervals for some individuals with LRAs and determine whether timing affects outcomes at follow-up examinations. METHODS: We collected data from 1560 individuals (45-75 years old) who participated in a prospective chemoprevention trial (of vitamin D and calcium) from 2004 through 2008...
February 17, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28188978/split-dose-bowel-preparation-with-polyethylene-glycol-for-colonoscopy-performed-under-propofol-sedation-is-there-an-optimal-timing
#19
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
#20
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
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