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loren laine

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
James Buxbaum, David Hormozdi, Mário Dinis-Ribeiro, Christianne Lane, Diogo Dias da Silva, Ara Sahakian, Preeth Jayaram, Pedro Pimentel Nunes, Daniel Shue, Michael Pepper, Daniel Cho, Loren Laine
BACKGROUND & 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 one endoscopist, followed by NBI examination by a second endoscopist blinded to HD-WL findings...
March 30, 2017: Gastrointestinal Endoscopy
James L Buxbaum, Michael Quezada, Ben Da, Niraj Jani, Christianne Lane, Didi Mwengela, Thomas Kelley, 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...
March 7, 2017: American Journal of Gastroenterology
Huiqin He, Chenfei Tan, Jiaguo Wu, Ning Dai, Weiling Hu, Yawen Zhang, Loren Laine, James Scheiman, John J Kim
BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is recommended for patients considered high-risk for choledocholithiasis after biochemical testing and abdominal ultrasound. Our aim was to determine whether American Society for Gastrointestinal Endoscopy (ASGE) guidelines accurately select patients where the risk of ERCP is justified. METHODS: Consecutive patients hospitalized with suspected choledocholithiasis at Sir Run Run Shaw Hospital who received biochemical testing, abdominal ultrasound, and definitive testing for choledocholithiasis (magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), ERCP, intraoperative cholangiogram (IOC), common bile duct (CBD) exploration) were identified...
February 4, 2017: Gastrointestinal Endoscopy
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
Colleen R Kelly, Alison M Kim, Loren Laine, Gary D Wu
No abstract text is available yet for this article.
March 2017: Gastroenterology
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
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...
November 21, 2016: Journal of Clinical Gastroenterology
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
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
Loren Laine
No abstract text is available yet for this article.
November 2016: Clinical Gastroenterology and Hepatology
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
James Buxbaum, Paul Leonor, Jonathan Tung, Christianne Lane, Ara Sahakian, Loren Laine
OBJECTIVES: Biliary cannulation is frequently the most difficult component of endoscopic retrograde cholangiopancreatography (ERCP). Techniques employed to improve safety and efficacy include wire-guided access and the use of sphincterotomes. However, a variety of options for these techniques are available and optimum strategies are not defined. We assessed whether the use of endoscopist- vs. assistant-controlled wire guidance and small vs. standard-diameter sphincterotomes improves safety and/or efficacy of bile duct cannulation...
December 2016: American Journal of Gastroenterology
Loren Laine
No abstract text is available yet for this article.
June 16, 2016: New England Journal of Medicine
Neil D Parikh, Louis Chaptini, Basile Njei, Loren Laine
BACKGROUND AND STUDY AIMS: Distinguishing sessile serrated adenomas/polyps (SSA/Ps) from non-neoplastic tissue may be challenging when white-light endoscopy (WLE) is used. Image-enhanced endoscopy (IEE) has shown accuracy in differentiating adenomas from hyperplastic polyps. The aim of this systematic review and meta-analysis was to evaluate the utility of IEE in diagnosis of SSA/Ps. METHODS: Studies were eligible if: they included patients undergoing colonoscopy with an endoscopy-based image-enhancement modality; endoscopic diagnoses, including SSA/P, were based on the appearance of polyps at IEE; and the corresponding histologic diagnoses of polyps were provided...
August 2016: Endoscopy
David Y Graham, Loren Laine
No abstract text is available yet for this article.
July 2016: Gastroenterology
Violeta B Popov, Christopher C Thompson, Nitin Kumar, Maria M Ciarleglio, Yanhong Deng, Loren Laine
BACKGROUND: Intragastric balloons (IGBs) are safe and effective in inducing weight loss in obese patients. The objective of this study was to review and analyze the available data of the effect of IGB on markers of nonalcoholic fatty liver disease (NAFLD) and liver enzymes. METHODS: Searches were performed of MEDLINE and Embase databases from inception through January 2016. Study inclusion criteria were the following: ≥5 overweight or obese adult patients undergoing intragastric balloon placement, with liver tests [alanine aminotransferase (ALT) or gamma-glutamyl transpeptidase (GGT)] or markers of NAFLD (e...
September 2016: Digestive Diseases and Sciences
Loren Laine
No abstract text is available yet for this article.
June 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Sunhee Park, Loren Laine
No abstract text is available yet for this article.
August 2016: Digestive Diseases and Sciences
Karl M Langberg, Neil D Parikh, Yanhong Deng, Maria Ciarlegio, Loren Laine, Harry R Aslanian
AIM: To use a survey to characterize and identify potential barriers to the use of digital chromoendoscopy (DC) by practicing gastroenterologists. METHODS: An anonymous, internet-based survey was sent to gastroenterologists in Connecticut who were members of one of three national gastrointestinal organizations. The survey collected demographic information, frequency of DC use, types of procedures that the respondent performs, setting of practice (academic vs community), years out of training, amount of training in DC, desire to have DC training and perceived barriers to DC use...
May 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
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