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Barkun AN

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https://www.readbyqxmd.com/read/27845340/plastic-vs-self-expandable-metal-stents-for-palliation-in-malignant-biliary-obstruction-a-series-of-meta-analyses
#1
Majid A Almadi, Alan Barkun, Myriam Martel
OBJECTIVES: Self-expandable metal stents (SEMS) are thought to have an advantage over plastic stents in achieving biliary drainage. METHODS: We performed a systematic search of MEDLINE, EMBASE, Scopus, CENTRAL, and ISI Web of knowledge databases, from January 1980 to September 2015, for randomized-controlled trials (RCTs) comparing SEMS vs. plastic stents in the palliation of malignant biliary obstruction. Primary outcomes were durations of stent patency, patient survival, and 30-day mortality...
November 15, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27554824/using-mobile-devices-for-inpatient-rounding-and-handoffs-an-innovative-application-developed-and-rapidly-adopted-by-clinicians-in-a-pediatric-hospital
#2
Aude Motulsky, Jenna Wong, Jean-Pierre Cordeau, Jorge Pomalaza, Jeffrey Barkun, Robyn Tamblyn
OBJECTIVE: To describe the usage of a novel application (The FLOW) that allows mobile devices to be used for rounding and handoffs. MATERIALS AND METHODS: The FLOW provides a view of patient data and the capacity to enter short notes via personal mobile devices. It was deployed using a "bring-your-own-device" model in 4 pilot units. Social network analysis (SNA) was applied to audit trails in order to visualize usage patterns. A questionnaire was used to describe user experience...
August 22, 2016: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/27478902/association-of-bile-duct-and-gallbladder-diseases-with-the-use-of-incretin-based-drugs-in-patients-with-type-2-diabetes-mellitus
#3
Jean-Luc Faillie, Oriana H Yu, Hui Yin, Dominique Hillaire-Buys, Alan Barkun, Laurent Azoulay
Importance: The use of dipeptidyl-peptidase-4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) analogues-a group of drugs used in the management of type 2 diabetes mellitus-may be associated with an increased risk of bile duct and gallbladder disease. To date, no observational study has assessed this possible association. Objective: To determine whether the use of DPP-4 inhibitors and GLP-1 analogues is associated with an increased risk of incident bile duct and gallbladder disease in patients with type 2 diabetes...
October 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27446879/safety-of-digestive-endoscopy-following-acute-coronary-syndrome-a-systematic-review
#4
REVIEW
Alastair Dorreen, Sarvee Moosavi, Myriam Martel, Alan N Barkun
Background. The safety of endoscopy after an acute coronary syndrome (ACS) is poorly characterized. We thus performed a systematic review assessing the safety of endoscopy following ACS. Methods. Searches in EMBASE, Medline, and Web of Science identified articles for inclusion. Data abstraction was completed by two independent reviewers. Results. Fourteen retrospective studies yielded 1178 patients (mean 71.3 years, 59.0% male) having suffered an ACS before endoscopy. Patients underwent 1188 endoscopies primarily to investigate suspected gastrointestinal bleeding (81...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27446828/age-is-the-only-predictor-of-poor-bowel-preparation-in-the-hospitalized-patient
#5
Julia McNabb-Baltar, Alastair Dorreen, Hisham Al Dhahab, Michael Fein, Xin Xiong, Mike O' Byrne, Imene Ait, Myriam Martel, Alan N Barkun
We examine the impact of key variables on the likelihood of inpatient poor bowel preparation for colonoscopy. Records of inpatients that underwent colonoscopy at our institution between January 2010 and December 2011 were retrospectively extracted. Univariable and multivariable logistic regression models were fitted to assess the effect of clinical variables on the odds of poor preparation. Tested predictors included age; gender; use of narcotics; heavy medication burden; comorbidities; history of previous abdominal surgery; neurological disorder; product used for bowel preparation, whether or not the bowel regimen was given as split or standard dose; and time of endoscopy...
2016: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27182692/pancreatic-duct-guidewire-placement-for-biliary-cannulation-for-the-prevention-of-post-endoscopic-retrograde-cholangiopancreatography-ercp-pancreatitis
#6
REVIEW
Frances Tse, Yuhong Yuan, Majidah Bukhari, Grigorios I Leontiadis, Paul Moayyedi, Alan Barkun
BACKGROUND: Difficult cannulation is a risk factor for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). It has been postulated that the pancreatic duct guidewire (PGW) technique may improve biliary cannulation success and reduce the risk of PEP in people with difficult cannulation. OBJECTIVES: To systematically review evidence from randomised controlled trials (RCTs) assessing the effectiveness and safety of the PGW technique compared to persistent conventional cannulation (CC) (contrast- or guidewire-assisted cannulation) or other advanced techniques in people with difficult biliary cannulation for the prevention of PEP...
May 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26865013/practical-guide-to-the-idea-development-and-exploration-stages-of-the-ideal-framework-and-recommendations
#7
C P Pennell, A D Hirst, W B Campbell, A Sood, R A Agha, J S T Barkun, P McCulloch
BACKGROUND: Evaluation of new surgical procedures is a complex process challenged by evolution of technique, operator learning curves, the possibility of variable procedural quality, and strong treatment preferences among patients and clinicians. Preliminary studies that address these issues are needed to prepare for a successful randomized trial. The IDEAL (Idea, Development, Exploration, Assessment and Long-term follow-up) Framework and Recommendations provide an integrated step-by-step evaluation pathway that can help investigators achieve this...
April 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/26409603/comparison-costs-of-ercp-and-mrcp-in-patients-with-suspected-biliary-obstruction-based-on-a-randomized-trial
#8
RANDOMIZED CONTROLLED TRIAL
Viviane Adam, Mamatha Bhat, Myriam Martel, Eduardo da Silveira, Caroline Reinhold, Eric Valois, Jeffrey S Barkun, Alan N Barkun
BACKGROUND: The optimal management of patients with suspected biliary obstruction remains unclear, and includes the possible performance of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). OBJECTIVES: To complete a cost analysis based on a medical effectiveness randomized trial comparing an ERCP-first approach with an MRCP-first approach in patients with suspected bile duct obstruction. METHODS: The management strategies were based on a medical effectiveness trial of 257 patients over a 12-month follow-up period...
September 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/26142037/hemostatic-powders-in-gastrointestinal-bleeding-a-systematic-review
#9
REVIEW
Yen-I Chen, Alan N Barkun
Topical hemostatic agents and powders are an emerging modality in the endoscopic management of upper and lower gastrointestinal bleeding. This systematic review demonstrates the effectiveness and safety of these agents with special emphasis on TC-325 and Ankaferd Blood Stopper. The unique noncontact/nontraumatic application, ability to cover large areas of bleed, and ease of use make these hemostatic agents an attractive option in certain clinical situations, such as massive bleeding with poor visualization, salvage therapy, and diffuse bleeding from luminal malignancies...
July 2015: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/25996612/adenoma-detection-rates-decline-with-increasing-procedural-hours-in-an-endoscopist-s-workload
#10
Majid A Almadi, Maida Sewitch, Alan N Barkun, Myriam Martel, Lawrence Joseph
BACKGROUND: Operator fatigue may negatively influence adenoma detection (AD) during screening colonoscopy. OBJECTIVE: To better characterize factors affecting AD, including the number of hours worked, and the number and type of procedures performed before an index screening colonoscopy. METHODS: A retrospective cohort study was conducted involving individuals undergoing a screening colonoscopy at a major tertiary care hospital in Montreal, Quebec...
August 2015: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25908910/establishing-a-clinic-based-pancreatic-cancer-and-periampullary-tumour-research-registry-in-quebec
#11
A L Smith, C Bascuñana, A Hall, A Salman, A Z Andrei, A Volenik, H Rothenmund, D Ferland, D Lamoussenery, A S Kamath, R Amre, D Caglar, Z H Gao, D G Haegert, Y Kanber, R P Michel, G Omeroglu-Altinel, J Asselah, N Bouganim, P Kavan, G Arena, J Barkun, P Chaudhury, S Gallinger, W D Foulkes, A Omeroglu, P Metrakos, G Zogopoulos
BACKGROUND: Enrolling patients in studies of pancreatic ductal adenocarcinoma (pdac) is challenging because of the high fatality of the disease. We hypothesized that a prospective clinic-based study with rapid ascertainment would result in high participation rates. Using that strategy, we established the Quebec Pancreas Cancer Study (qpcs) to investigate the genetics and causes of pdac and other periampullary tumours (pats) that are also rare and underrepresented in research studies. METHODS: Patients diagnosed with pdac or pat were introduced to the study at their initial clinical encounter, with a strategy to enrol participants within 2 weeks of diagnosis...
April 2015: Current Oncology
https://www.readbyqxmd.com/read/25855384/post-transplant-liver-function-score-as-an-early-surrogate-marker-of-long-term-outcome
#12
Mazen Hassanain, Eve Simoneau, Ahmad Madkhali, Nouf Al-Saati, Murad Aljiffry, Jean Tchervenkov, Jeffrey Barkun, Peter Metrakos
BACKGROUND: Currently, there is no universally accepted method to evaluate liver function post-orthotopic liver transplant (OLTx) and there are no early surrogate function markers to assess the impact of perioperative interventions in trial settings. MATERIAL AND METHODS: In total, 495 patients were included in the study. On multivariate analysis, PTLF score, defined as normal (score <4) or dysfunctional (score ≥ 4), was the only significant variable for determining significant complications (P=0...
2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/25575107/rates-of-minor-adverse-events-and-health-resource-utilization-postcolonoscopy
#13
Vladimir Marquez Azalgara, Maida J Sewitch, Lawrence Joseph, Alan N Barkun
BACKGROUND: Little is known about minor adverse events (MAEs) following outpatient colonoscopies and associated health care resource utilization. OBJECTIVE: To estimate the rates of incident MAE at two, 14 and 30 days postcolonoscopy, and associated health care resource utilization. A secondary aim was to identify factors associated with cumulative 30-day MAE incidence. METHODS: A longitudinal cohort study was conducted among individuals undergoing an outpatient colonoscopy at the Montreal General Hospital (Montreal, Quebec)...
December 2014: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25560847/stress-related-mucosal-disease-in-the-critically-ill-patient
#14
REVIEW
Marc Bardou, Jean-Pierre Quenot, Alan Barkun
Bleeding from stress-related mucosal disease in critically ill patients remains an important clinical management issue. Although only a small proportion (1-6%) of patients admitted to an intensive care unit (ICU) will bleed, a substantial proportion exhibit clinical risk factors (mechanical ventilation for >48 h and a coagulopathy) that predict an increased risk of bleeding. Furthermore, upper gastrointestinal mucosal lesions can be found in 75-100% of patients in ICUs. Although uncommon, stress-ulcer bleeding is a severe complication with an estimated mortality of 40-50%, mostly from decompensating an underlying condition or multiorgan failure...
February 2015: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25456406/the-operative-dictation-a-review-of-how-this-skill-is-taught-and-assessed-in-surgical-residency-programs
#15
REVIEW
Sinziana Dumitra, Stephanie M Wong, Sarkis Meterissian, Robin Featherstone, Jeffrey Barkun, Paola Fata
BACKGROUND: The operative dictation (OD) is the cornerstone of surgical communication, yet there appears to be a lack of formal education of this skill by training programs. We conducted a review of the literature to assess the teaching and quality of OD in surgical residency programs. STUDY DESIGN: Multiple databases were searched for studies pertaining to "OD," "surgical education," and "formal teaching." Of 50 the studies, 13 were retained and assigned to one or more of the following categories: (1) surveys of the surgical community evaluating current perceptions of formal OD education (n = 5), (2) studies assessing the quality of OD performed by residents (n = 5), and (3) educational interventions for improving OD skills (n = 4)...
March 2015: Journal of Surgical Education
https://www.readbyqxmd.com/read/25390616/timing-of-rebleeding-in-high-risk-peptic-ulcer-bleeding-after-successful-hemostasis-a-systematic-review
#16
REVIEW
Sara El Ouali, Alan Barkun, Myriam Martel, Davide Maggio
BACKGROUND: Peptic ulcer rebleeding (PUR) usually occurs within three days following endoscopic hemostasis. However, recent data have increasingly suggested delayed rebleeding. 
 OBJECTIVE: To better characterize the timing of PUR (Forrest Ia to IIb) following initially successful endoscopic hemostasis. 
 METHODS: An exhaustive literature search (1989 to 2013), with cross-referencing, was performed to identify pertinent randomized controlled trial (RCT) arms...
November 2014: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25379843/being-a-surgeon-the-myth-and-the-reality-a-meta-synthesis-of-surgeons-perspectives-about-factors-affecting-their-practice-and-well-being
#17
Massimiliano Orri, Olivier Farges, Pierre-Alain Clavien, Jeffrey Barkun, Anne Revah-Lévy
OBJECTIVES: Synthesize the findings from individual qualitative studies about surgeons' account of their practice. BACKGROUND: Social and contextual factors of practice influence doctors' well-being and therapeutic relationships. Little is known about surgery, but it is generally assumed that surgeons are not affected by them. METHODS: We searched international publications (2000-2012) to identify relevant qualitative research exploring how surgeons talk about their practice...
November 2014: Annals of Surgery
https://www.readbyqxmd.com/read/25314356/adherence-to-guidelines-a-national-audit-of-the-management-of-acute-upper-gastrointestinal-bleeding-the-reason-registry
#18
MULTICENTER STUDY
Yidan Lu, Alan N Barkun, Myriam Martel
OBJECTIVES: To assess process of care in nonvariceal upper gastrointestinal bleeding (NVUGIB) using a national cohort, and to identify predictors of adherence to 'best practice' standards. METHODS: Consecutive charts of patients hospitalized for acute upper gastrointestinal bleeding across 21 Canadian hospitals were reviewed. Data regarding initial presentation, endoscopic management and outcomes were collected. Results were compared with 'best practice' using established guidelines on NVUGIB...
October 2014: Canadian Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/25232256/mcgill-brisbane-symptom-score-for-patients-with-resectable-pancreatic-head-adenocarcinoma
#19
Mohammed H Jamal, Suhail A R Doi, A James Moser, Sinziana Dumitra, Jad abou Khalil, Eve Simoneau, Prosanto Chaudhury, Adedayo A Onitilo, Peter Metrakos, Jeffrey S Barkun
AIM: To evaluate the ability of the McGill Brisbane Symptom Score (MBSS) to predict survival in resectable pancreatic head adenocarcinoma (PHA) patients. METHODS: All PHA patients (n = 83) undergoing pancreaticoduodenectomy at the McGill University Health Center, Quebec between 1/2001-1/2010 were evaluated. Data related to patient and cancer characteristics, MBSS variables, and treatment were collected; univariable and multivariable survival analyses were performed...
September 14, 2014: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/24946170/pancreatic-fistulae-after-a-pancreatico-duodenectomy-are-pancreatico-gastrostomies-safer-than-pancreatico-jejunostomies-an-expertise-based-trial-and-propensity-score-adjusted-analysis
#20
COMPARATIVE STUDY
Jad Abou Khalil, Nancy Mayo, Sinziana Dumitra, Mohammed Jamal, Prosanto Chaudhury, Peter Metrakos, Jeffrey Barkun
BACKGROUND: A pancreatic fistula (PF) is a major contributor to morbidity and mortality after a pancreaticoduodenectomy (PD). There remains debate as to whether re-establishing pancreaticoenteric continuity by a pancreatico-gastrostomy (PG) can decrease the risk of a PF and complications compared with a pancreatico-jejunostomy (PJ). The outcomes of patients undergoing these reconstructions after a PD were compared. METHOD: Patients undergoing a PD between 1999 and 2011 were selected from a prospective database and having undergone either a PG or PJ reconstruction...
December 2014: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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