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https://www.readbyqxmd.com/read/28906425/impact-of-changeover-to-newer-endoscopic-systems-on-quality-and-efficiency-of-screening-and-surveillance-colonoscopy-equipment-or-endoscopist
#1
Manpreet Singh, Melody Sacatos, Loren Laine
GOALS: The goal of this study is to assess whether changeover to newer endoscopic systems impacts quality or efficiency, and quantify the relation between increased withdrawal time and detection rates of sessile serrated polyps (SSPDR) and adenomas (ADR) in real-world practice. STUDY: Beginning 2 months after new endoscopic systems were implemented at 2 endoscopy units, we included all outpatients undergoing screening/surveillance colonoscopy for 4 months. Outpatients during the same 4-month period 1 year earlier comprised the control group...
September 12, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28866457/randomized-trial-of-cholangioscopy-guided-laser-lithotripsy%C3%A2-versus-conventional-therapy-for-large-bile-duct%C3%A2-stones-with-videos
#2
James Buxbaum, Ara Sahakian, Christopher Ko, Preeth Jayaram, Christianne Lane, Chung Yao Yu, Ravi Kankotia, Loren Laine
BACKGROUND AND AIMS: Bile duct stones >1 cm have a decreased incidence of successful endoscopic extraction and often require lithotripsy. Although previous guidelines suggested mechanical lithotripsy for large common bile duct stones, current guidelines suggest cholangioscopy-guided lithotripsy as an adjunct with or without balloon dilation or mechanical lithotripsy. However, no randomized trials have assessed the usefulness of this practice. METHODS: Patients with bile duct stones >1 cm in diameter were randomized in a 2:1 ratio to cholangioscopy-guided laser lithotripsy versus conventional therapy only...
September 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28841650/transparency-ethics-in-practice-revisiting-financial-conflicts-of-interest-disclosure-forms-in-clinical-practice-guidelines
#3
Yidan Lu, Derek J Jones, Nour Sharara, Tonya Kaltenbach, Loren Laine, Kenneth McQuaid, Roy Soetikno, Venkataraman Subramanian, Alan Barkun
BACKGROUND: Authors of clinical practice guidelines (CPGs) disclose financial conflicts of interest (FCOIs) to promote transparency ethics. Typically, they do so on standard declaration forms containing generic open-ended questions on FCOIs. Yet, the literature is scant on the format and effect of alternative disclosure forms. Does supplementing a standard form with subsequent detailed disclosure forms tailored to the context of the CPG improve the yield or accuracy of FCOIs declarations? METHODS: For an international CPG in gastroenterology on the endoscopic surveillance for colorectal neoplasia in inflammatory bowel disease, we compared the use of a standard FCOIs disclosure form with a contextual FCOIs disclosure form that detailed commercial relations related to the CPG topic...
2017: PloS One
https://www.readbyqxmd.com/read/28818507/optimizing-quality-of-endoscopy-in-inflammatory-bowel-disease-focus-on-surveillance-and-management-of-colorectal-dysplasia-using-interactive-image-and-video-based-teaching
#4
Tonya R Kaltenbach, Roy M Soetikno, Rebecca DeVivo, Loren A Laine, Alan Barkun, Kenneth R McQuaid
BACKGROUND & AIMS: Varying recommendations regarding the detection and management of dysplasia can lead to uncertainty and may have impeded the uptake of strategies that could improve surveillance in patients with inflammatory bowel disease (IBD). As such, an educational event was held to assist in disseminating the recently published Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in Inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC)...
August 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28728669/is-there-a-role-for-combined-sclerotherapy-and-ligation-in-the-endoscopic-treatment-of-gastroesophageal-varices
#5
EDITORIAL
Loren Laine
No abstract text is available yet for this article.
August 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28666949/bleeding-with-direct-oral-anticoagulants-the-gastrointestinal-tract-and-beyond
#6
EDITORIAL
Loren Laine
No abstract text is available yet for this article.
November 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28657377/predictors-and-outcomes-of-delayed-plastic-biliary-stent-removal-following-endoscopic-retrograde-cholangiopancreatography
#7
Shawn J Kim, Edmond Ohanian, Frances Lee, Bryan Nam, Kendrick Che, Loren Laine, Sarah E Kim, John J Kim
OBJECTIVE: Plastic biliary stents are commonly placed during endoscopic retrograde cholangiopancreatography (ERCP) and should be removed or replaced within 3 months to reduce the risk of stent obstruction. The aim of the study was to identify predictors and outcomes of patients who had delayed plastic biliary stent removal following ERCP. MATERIALS AND METHODS: Consecutive patients who received ERCP with plastic biliary stent placement at Loma Linda University Medical Center (10/2004-6/2013) were identified...
October 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28528939/aga-white-paper-training-and-implementation-of-endoscopic-image-enhancement-technologies
#8
Neil Gupta, Joel V Brill, Marcia Canto, Daniel DeMarco, Brian M Fennerty, Loren Laine, David Lieberman, Charles Lightdale, Elizabeth Montgomery, Robert Odze, Douglas Rex, Prateek Sharma, Jeffrey L Tokar, Michael L Kochman
Endoscopic image-enhancement technologies provide opportunities to visualize normal and abnormal tissues within the gastrointestinal (GI) tract in a manner that complements conventional white light endoscopic imaging. The additional information that is obtained enables the endoscopist to better identify, delineate, and characterize lesions and can facilitate targeted biopsies or, in some cases, eliminate the need to send samples for histologic analysis. Some of these technologies have been available for more than a decade, but despite this fact, there is limited use of these technologies by endoscopists...
June 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28396275/relationship-of-time-to-presentation-after-onset-of-upper-gi-bleeding-with-patient-characteristics-and-outcomes-a-prospective-study
#9
Loren Laine, Stig B Laursen, Harry R Dalton, Jing H Ngu, Michael Schultz, Adrian J Stanley
BACKGROUND & AIMS: We performed a prospective multi-national study of patients presenting to the emergency department with upper gastrointestinal bleeding (UGIB) and assessed the relationship of time to presentation after onset of UGIB symptoms with patient characteristics and outcomes. METHODS: Consecutive patients presenting with overt UGIB (red-blood emesis, coffee-ground emesis and/or melena) from March 2014 to March 2015 at 6 hospitals were included. Multiple pre-defined patient characteristics and outcomes were collected...
April 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28366441/narrow-band-imaging-versus-white-light-versus-mapping-biopsy-for-gastric-intestinal-metaplasia-a-prospective-blinded-trial
#10
James L Buxbaum, David Hormozdi, Mario Dinis-Ribeiro, Christianne Lane, Diogo Dias-Silva, Ara Sahakian, Preeth Jayaram, Pedro Pimentel-Nunes, Daniel Shue, Michael Pepper, Daniel Cho, Loren Laine
BACKGROUND AND AIMS: Gastric intestinal metaplasia (GIM) is a gastric cancer precursor. Narrow-band imaging (NBI) may improve detection of GIM. We compared detection of GIM with high-definition white-light (HD-WL) endoscopy, NBI, and mapping biopsies in a population with increased gastric cancer risk. METHODS: Patients undergoing upper endoscopy had HD-WL examination by 1 endoscopist, followed by an NBI examination by a second endoscopist blinded to HD-WL findings...
March 30, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28266591/early-aggressive-hydration-hastens-clinical-improvement-in-mild-acute-pancreatitis
#11
RANDOMIZED CONTROLLED TRIAL
James L Buxbaum, Michael Quezada, Ben Da, Niraj Jani, Christianne Lane, Didi Mwengela, Thomas Kelly, Paul Jhun, Kiran Dhanireddy, Loren Laine
OBJECTIVES: Early aggressive intravenous hydration is recommended for acute pancreatitis treatment although randomized trials have not documented benefit. We performed a randomized trial of aggressive vs. standard hydration in the initial management of mild acute pancreatitis. METHODS: Sixty patients with acute pancreatitis without systemic inflammatory response syndrome (SIRS) or organ failure were randomized within 4 h of diagnosis to aggressive (20 ml/kg bolus followed by 3 ml/kg/h) vs...
May 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28174126/accuracy-of-asge-high-risk-criteria-in-evaluation-of-patients-with-suspected-common-bile-duct-stones
#12
Huiqin He, Chenfei Tan, Jiaguo Wu, Ning Dai, Weiling Hu, Yawen Zhang, Loren Laine, James Scheiman, John J Kim
BACKGROUND AND AIMS: ERCP is recommended for patients considered high risk for choledocholithiasis after biochemical testing and abdominal US. Our aim was to determine whether the American Society for Gastrointestinal Endoscopy (ASGE) guidelines accurately select patients for whom the risk of ERCP is justified. METHODS: Consecutive patients hospitalized with suspected choledocholithiasis at Sir Run Run Shaw Hospital who received biochemical testing, abdominal US, and definitive testing for choledocholithiasis (MRCP, EUS, ERCP, intraoperative cholangiogram, and/or common bile duct [CBD] exploration) were identified...
September 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28159539/continued-midazolam-versus-diphenhydramine-in-difficult-to-sedate-patients-a-randomized-double-blind-trial
#13
Hamita Sachar, Nipaporn Pichetshote, Kavitha Nandigam, Keta Vaidya, Loren Laine
BACKGROUND AND AIMS: Current guidelines recommend diphenhydramine in patients undergoing endoscopy who are not adequately sedated with a benzodiazepine and opioid combination. Because this practice has not been adequately assessed, we performed a randomized, double-blind trial comparing diphenhydramine with continued midazolam in such patients. METHODS: Patients undergoing elective colonoscopy with moderate sedation were eligible. Sedation was measured with the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) score with adequate sedation defined as 3 on a 0- to 5-point scale...
January 31, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28143773/the-aga-s-fecal-microbiota-transplantation-national-registry-an-important-step-toward-understanding-risks-and-benefits-of-microbiota-therapeutics
#14
EDITORIAL
Colleen R Kelly, Alison M Kim, Loren Laine, Gary D Wu
No abstract text is available yet for this article.
March 2017: Gastroenterology
https://www.readbyqxmd.com/read/28053181/comparison-of-risk-scoring-systems-for-patients-presenting-with-upper-gastrointestinal-bleeding-international-multicentre-prospective-study
#15
MULTICENTER STUDY
Adrian J Stanley, Loren Laine, Harry R Dalton, Jing H Ngu, Michael Schultz, Roseta Abazi, Liam Zakko, Susan Thornton, Kelly Wilkinson, Cristopher J L Khor, Iain A Murray, Stig B Laursen
OBJECTIVE:  To compare the predictive accuracy and clinical utility of five risk scoring systems in the assessment of patients with upper gastrointestinal bleeding. DESIGN:  International multicentre prospective study. SETTING:  Six large hospitals in Europe, North America, Asia, and Oceania. PARTICIPANTS:  3012 consecutive patients presenting over 12 months with upper gastrointestinal bleeding. MAIN OUTCOME MEASURES:  Comparison of pre-endoscopy scores (admission Rockall, AIMS65, and Glasgow Blatchford) and post-endoscopy scores (full Rockall and PNED) for their ability to predict predefined clinical endpoints: a composite endpoint (transfusion, endoscopic treatment, interventional radiology, surgery, or 30 day mortality), endoscopic treatment, 30 day mortality, rebleeding, and length of hospital stay...
January 4, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27875357/optimal-timing-of-endoscopic-retrograde-cholangiopancreatography-in-acute-cholangitis
#16
Linda A Hou, Loren Laine, Nima Motamedi, Ara Sahakian, Christianne Lane, James Buxbaum
OBJECTIVES: Acute cholangitis mandates resuscitation, antibiotic therapy, and biliary decompression. Our aim was to define the optimal timing of endoscopic retrograde cholangiopancreatography (ERCP) for patients with acute cholangitis. METHODS: Clinical data on all cases of cholangitis managed by ERCP were prospectively collected from September 2010 to July 2013. The clinical impact of the time to ERCP, defined as the time from presentation in the emergency department to the commencement of the ERCP, was determined...
July 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27725645/histological-disease-activity-as-a-predictor-of-clinical-relapse-among-patients-with-ulcerative-colitis-systematic-review-and-meta-analysis
#17
REVIEW
Sunhee Park, Tsion Abdi, Mark Gentry, Loren Laine
OBJECTIVES: Endoscopic remission in ulcerative colitis (UC) is associated with improved clinical outcomes. We assessed whether histological remission predicts clinical outcomes, estimated the magnitude of effect, and determined whether histological remission provides additional prognostic utility beyond clinical or endoscopic remission. METHODS: Bibliographic databases were searched for studies in inflammatory bowel disease providing baseline histological status and relation to an outcome of clinical relapse or exacerbation...
December 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27624167/early-transjugular-intrahepatic-portosystemic-shunt-in-us-patients-hospitalized-with-acute-esophageal-variceal-bleeding
#18
Basile Njei, Thomas R McCarty, Loren Laine
BACKGROUND AND AIM: Early transjugular intrahepatic portosystemic shunt (TIPS) used as preventive therapy prior to recurrent bleeding has been recommended in patients presenting with acute esophageal variceal bleeding (EVB) who are at high risk of further bleeding and death. We investigated the impact of early TIPS on outcomes of US patients hospitalized with EVB from 2000 to 2010. METHODS: The Nationwide Inpatient Sample database was queried to identify patients with EVB and decompensated cirrhosis (because early TIPS is recommended only in high-risk patients)...
April 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27521511/risk-assessment-tools-for-gastrointestinal-bleeding
#19
EDITORIAL
Loren Laine
No abstract text is available yet for this article.
November 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27464591/no-benefit-from-platelet-transfusion-for-gastrointestinal-bleeding-in-patients-taking-antiplatelet-agents
#20
Liam Zakko, Tarun Rustagi, Maura Douglas, Loren Laine
BACKGROUND & AIMS: Antiplatelet agents decrease cardiovascular events but increase gastrointestinal bleeding (GIB). Guidelines propose platelet transfusion for patients who take antiplatelet agents and have serious GIB. We investigated whether such patients are at decreased risk for rebleeding or increased risk for cardiovascular events after platelet transfusion. METHODS: We performed a retrospective cohort study of patients with GIB admitted to Yale-New Haven Hospital from 2008 to 2013 who were taking antiplatelet agents and had platelet counts higher than 100 × 10(9)/L...
January 2017: Clinical Gastroenterology and Hepatology
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