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https://www.readbyqxmd.com/read/29614262/cost-effectiveness-analysis-comparing-lumen-apposing-metal-stents-with-plastic-stents-in-the-management-of-pancreatic-walled-off-necrosis
#1
Yen-I Chen, Alan N Barkun, Viviane Adam, Ge Bai, Vikesh K Singh, Majidah Bukhari, Olaya Brewer Gutierrez, B Joseph Elmunzer, Robert Moran, Lea Fayad, Mohamad El Zein, Vivek Kumbhari, Alessandro Repici, Mouen A Khashab
BACKGROUND AND AIMS: EUS-guided transmural drainage is effective in the management of pancreatic walled-off necrosis (WON). A lumen-apposing metal stent (LAMS) has recently been developed specifically for the drainage of pancreatic fluid collections showing promising results. However, no cost-effectiveness data have been published in comparison to endoscopic drainage with traditional plastic stents (PSs). The aim is to compare the cost-effectiveness of LAMSs to PSs in the management of WON...
March 31, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29429546/percutaneous-cholecystostomy-a-simple-bridge-to-surgery-or-an-alternative-option-for-the-management-of-acute-cholecystitis
#2
REVIEW
Agatha Stanek, Anthony Dohan, Jeffery Barkun, Alan Barkun, Caroline Reinhold, David Valenti, Christophe Cassinotto, Benoit Gallix
BACKGROUND: Percutaneous cholecystostomy (PC) is an alternative among high-risk surgical patients or those with multiple comorbidities, but its indications have not been clearly established in the literature. The aim of this paper is to provide the reader with an updated review of the literature summarizing what is known on this topic. DATA SOURCES: We reviewed articles from 1979 to 2016 using the PubMed/Medline Database on PC and especially those evaluating this option as a bridge to surgery...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29237201/implementation-of-a-checklist-before-colonoscopy-a-quality-improvement-initiative
#3
Omar Kherad, Sophie Restellini, Charles Ménard, Myriam Martel, Alan Barkun
BACKGROUND AND STUDY AIMS:  Checklists can prevent errors and have a positive impact on patient morbidity and mortality in different surgical settings, and possibly also in gastrointestinal endoscopy. The aims of this study were to reinforce commitment in safety culture and better communication among team members in endoscopy, and to prove the feasibility of successful checklist adoption before colonoscopy. PATIENTS AND METHODS:  The study involved a pre - post quality improvement intervention involving all consecutive patients undergoing a colonoscopy at a single academic endoscopy unit...
March 2018: Endoscopy
https://www.readbyqxmd.com/read/29202001/validating-bowel-preparation-scales
#4
Valérie Heron, Robin Parmar, Charles Ménard, Myriam Martel, Alan N Barkun
Background and study aim:  Few scales assessing bowel preparation quality have been validated, and direct between-scale comparisons remain scarce. The aim of the study was to compare inter- and intra-rater reliability, predictive abilities for clinical outcomes, and ease of use for each scale. Methods:  Colonoscopy video recordings highlighting five colonic segments after washing were viewed independently by three physicians, and cleanliness was evaluated using the Boston Bowel Preparation Scale (BBPS), the Chicago Bowel Preparation Scale (CBPS), and the Harefield Cleansing Scale (HCS) in randomized order...
December 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29158179/prognostic-factors-affecting-outcomes-in-patients-with-malignant-gi-bleeding-treated-with-a-novel-endoscopically-delivered-hemostatic-powder
#5
Rapat Pittayanon, Rungsun Rerknimitr, Alan Barkun
BACKGROUND AND AIMS: Endoscopic hemostatic techniques remain poorly effective for GI tumor bleeding. We assessed Tc-325 (Hemospray, Cook Medical, Bloomington, Ind, USA) for this indication and determined possible predictors of decreased recurrent bleeding and improved 6-month survival in affected patients. METHODS: This retrospective study identified 99 patients with active malignant GI bleeding (primary or metastatic) treated with Tc-325. Eleven patients were excluded because of incomplete data...
April 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29065439/do-adjuvants-add-to-the-efficacy-and-tolerance-of-bowel-preparations-a-meta-analysis-of-randomized-trials
#6
Sophie Restellini, Omar Kherad, Charles Menard, Myriam Martel, Alan N Barkun
BACKGROUND AND STUDY AIMS : Recommendations on adjuvant use with bowel preparations remain disparate. We performed a meta-analysis determining the clinical impact of adding an adjuvant to polyethylene glycol (PEG), sodium phosphate, picosulfate (PICO), or oral sulfate solutions (OSS)-based regimens. METHODS:  Systematic searches were made of MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials from January 1980 to April 2016 that assessed preparations with or without adjuvants, given in split and non-split dosing, and PEG high- (> 3 L) or low-dose (≤ 2 L) regimens...
February 2018: Endoscopy
https://www.readbyqxmd.com/read/28932092/systematic-review-and-meta-analysis-of-colon-cleansing-preparations-in-patients-with-inflammatory-bowel-disease
#7
Sophie Restellini, Omar Kherad, Talat Bessissow, Charles Ménard, Myriam Martel, Maryam Taheri Tanjani, Peter L Lakatos, Alan N Barkun
AIM: To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease. METHODS: Systematic searches were performed (January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high (> 3 L) or low-volume (2 L or less) regimens...
August 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28841650/transparency-ethics-in-practice-revisiting-financial-conflicts-of-interest-disclosure-forms-in-clinical-practice-guidelines
#8
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
#9
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/28319429/current-standards-and-new-developments-of-colorectal-polyp-management-and-resection-techniques
#10
REVIEW
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 5 mm 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...
September 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28288056/ottawa-criteria-for-appropriate-transfusions-in-hepatectomy-using-the-rand-ucla-appropriateness-method
#11
Sean Bennett, Alan Tinmouth, Daniel I McIsaac, Shane English, Paul C Hébert, Paul J Karanicolas, Alexis F Turgeon, Jeffrey Barkun, Timothy M Pawlik, Dean Fergusson, Guillaume Martel
OBJECTIVE: Create practice guidelines for the appropriate use of red blood cell transfusions in hepatectomy. BACKGROUND: Hepatectomy is associated with a high prevalence of transfusions. A transfusion can be life-saving, but can be associated with important adverse effects. Given the prevalence, the potential for benefit and harm, and the difficulty in conducting clinical trials, transfusion in hepatectomy is well-suited for a study of appropriateness. METHODS: Using the RAND/UCLA appropriateness method, an international, multidisciplinary expert panel in hepatobiliary surgery, anesthesia, transfusion medicine, and critical care rated a series of 468 perioperative scenarios for transfusion appropriateness...
April 2018: Annals of Surgery
https://www.readbyqxmd.com/read/28215904/worldwide-survey-on-opinions-and-use-of-minimally-invasive-pancreatic-resection
#12
Jony van Hilst, Thijs de Rooij, Mohammed Abu Hilal, Horacio J Asbun, Jeffrey Barkun, Uggo Boggi, Olivier R Busch, Kevin C P Conlon, Marcel G Dijkgraaf, Ho-Seong Han, Paul D Hansen, Michael L Kendrick, Andre L Montagnini, Chinnusamy Palanivelu, Bård I Røsok, Shailesh V Shrikhande, Go Wakabayashi, Herbert J Zeh, Charles M Vollmer, David A Kooby, Marc G H Besselink
BACKGROUND: The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow. The worldwide utilization of MIPR and attitude towards future perspectives of MIPR remains unknown. METHODS: An anonymous survey on MIPR was sent to the members of six international associations of Hepato-Pancreato-Biliary (HPB) surgery. RESULTS: The survey was completed by 435 surgeons from 50 countries, with each surgeon performing a median of 22 (IQR 12-40) pancreatic resections annually...
March 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28161216/the-impact-of-perioperative-red-blood-cell-transfusions-in-patients-undergoing-liver-resection-a-systematic-review
#13
REVIEW
Sean Bennett, Laura K Baker, Guillaume Martel, Risa Shorr, Timothy M Pawlik, Alan Tinmouth, Daniel I McIsaac, Paul C Hébert, Paul J Karanicolas, Lauralyn McIntyre, Alexis F Turgeon, Jeffrey Barkun, Dean Fergusson
BACKGROUND: Liver resection is associated with a high proportion of red blood cell transfusions. There is a proposed association between perioperative transfusions and increased risk of complications and tumor recurrence. This study reviews the evidence of this association in the literature. METHODS: The Medline, EMBASE, and Cochrane databases were searched for clinical trials or observational studies of patients undergoing liver resection that compared patients who did and did not receive a perioperative red blood cell transfusion...
April 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27845340/plastic-vs-self-expandable-metal-stents-for-palliation-in-malignant-biliary-obstruction-a-series-of-meta-analyses
#14
REVIEW
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...
February 2017: 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
#15
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...
April 1, 2017: 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
#16
COMPARATIVE STUDY
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
#17
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
#18
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
#19
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
#20
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
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