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Adenoma and polyp detection rates during insertion versus withdrawal phase of colonoscopy: a systematic review and meta-analysis of randomized controlled trials.
No full textBACKGROUND AND AIMS: Colonoscopy is the preferred modality for colorectal cancer screening because it has both diagnostic and therapeutic capabilities. Current consensus states that colonoscopy should be performed with initial rapid passage of the instrument to the cecum, followed by thorough evaluation for and removal of all polyps during a deliberate slow withdrawal. Reports have suggested that polyps that are seen but not removed during insertion are sometimes quite difficult to find during withdrawal.
METHODS: We performed a comprehensive literature search of several major databases (from inception to March 2020) to identify randomized controlled trials comparing inspection and polypectomy during the insertion phase as opposed to the traditional practice of inspection and polypectomy performed entirely during the withdrawal phase. We examined differences in terms of adenoma detection rate (ADR), polyps detected per patient (PDPP), cecal intubation time (CIT), withdrawal time, and total procedure time.
RESULTS: Seven randomized controlled trials, including 3834 patients, were included in our final analysis. The insertion/withdrawal cohort had 1951 patients and the withdrawal-only cohort 1883 patients. Pooled odds of adenoma detection in the insertion/withdrawal cohort was .99 (P = .8). ADR was 47.2% in the insertion/withdrawal cohort and 48.6% in the withdrawal-only cohort. Although total procedure and withdrawal times were shorter in the insertion/withdrawal cohort, PDPP in both cohorts were not statistically significant (1.4 vs 1.5, P = .7).
CONCLUSIONS: Additional inspection and polypectomy during the insertion and withdrawal phases of colonoscopy offer no additional benefit in terms of ADR or PDPP
2021 Student Research Fellowship Program: SERF ABSTRACT Booklet
No full text2021 SERF Abstract Titles
A Comparison of Outcomes Between Laparoscopic and Robotic Appendectomy Among ACS NSQIP Hospitals
Post-COVID-19 Fatigue: Demographic Distribution and Relation to Chronic Illnesses.
Immunotherapy Followed by Consolidation Chest Radiation in Unresectable Locally Advanced Non-Small Cell Lung Cancer that is Not Amenable to Chemoradiation
The Attitudes, Perspectives, and Barriers Among Primary Care Physicians Towards Addressing Sexual Health of Perimenopausal-Aged Women
Rates of Ischemia Amongst Asymptomatic Patients with High Coronary Artery Calcium Scores
Community-based Study on Hip Fracture in a Rural Area in Northeast Indiana
A Comparison of the Accuracy of WATCHMAN and WATCHMAN FLX Device Sizing between CT, TEE, and Patient Specific 3D Models.
Effective Telehealth – Open Heart Readmissions
Why Should I Take My Medicine? A Review Of ED Visits For Seizures.
Lutheran Hospital Neonatal Follow-Up Clinic (NFC): Developmental Delay of Preterm Cohorts as a Function of Gestational Birth Age
Investigating Barriers and Facilitators of Intimate Partner Violence Screening in Perinatal Care
Difficult Airway Response Team (DART): A Novel Approach in a Non-Academic Level Two Trauma Center
The Effects of Integrative Palliative Oncology on Hospital Time, Hospice Referrals, and Advanced Care Planning
Impact of Gabapentin and Pregabalin on Neurological Outcome After Ischemic Strok
Scope of Artificial Intelligence in Gastrointestinal Oncology
No full textSimple Summary Gastrointestinal cancers cause over 2.8 million deaths annually worldwide. Currently, the diagnosis of various gastrointestinal cancer mainly relies on manual interpretation of radiographic images by radiologists and various endoscopic images by endoscopists. Artificial intelligence (AI) may be useful in screening, diagnosing, and treating various cancers by accurately analyzing diagnostic clinical images, identifying therapeutic targets, and processing large datasets. The use of AI in endoscopic procedures is a significant breakthrough in modern medicine. Although the diagnostic accuracy of AI systems has markedly increased, it still needs collaboration with physicians. In the near future, AI-assisted systems will become a vital tool for the management of these cancer patients. Abstract Gastrointestinal cancers are among the leading causes of death worldwide, with over 2.8 million deaths annually. Over the last few decades, advancements in artificial intelligence technologies have led to their application in medicine. The use of artificial intelligence in endoscopic procedures is a significant breakthrough in modern medicine. Currently, the diagnosis of various gastrointestinal cancer relies on the manual interpretation of radiographic images by radiologists and various endoscopic images by endoscopists. This can lead to diagnostic variabilities as it requires concentration and clinical experience in the field. Artificial intelligence using machine or deep learning algorithms can provide automatic and accurate image analysis and thus assist in diagnosis. In the field of gastroenterology, the application of artificial intelligence can be vast from diagnosis, predicting tumor histology, polyp characterization, metastatic potential, prognosis, and treatment response. It can also provide accurate prediction models to determine the need for intervention with computer-aided diagnosis. The number of research studies on artificial intelligence in gastrointestinal cancer has been increasing rapidly over the last decade due to immense interest in the field. This review aims to review the impact, limitations, and future potentials of artificial intelligence in screening, diagnosis, tumor staging, treatment modalities, and prediction models for the prognosis of various gastrointestinal cancers
“You phubbed me for that?” Reason given for phubbing and perceptions of interactional quality and exclusion
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When someone focuses on their phone, rather than the person in front of them (“phubbing” or “technoference”), this can lead to feelings of exclusion and dissatisfaction. Few studies have examined this phenomenon experimentally using a confederate during face-to-face interactions, and to our knowledge the published research has yet to examine the role that attributional information may have on the effects of being phubbed. Thus, we conducted an experiment investigating how attributional information influenced the effects of phone use on feelings of exclusion and interactional quality during a face-to-face interaction. We randomly assigned 99 young adults into one of three conditions: no phone use, important use, or trivial use. In the phone conditions, the participant\u27s interaction partner (a confederate) pulled out their phone 2 min into the interaction, gave either an important or trivial reason for use, and then interacted with their phone, making intermittent eye contact while continuing to interact with the participant. Phubbed individuals reported feeling more excluded, less close, and like the partner was more distracted in the phone use conditions, regardless of reason. However, individuals phubbed for an important reason reported feeling less excluded and like the partner was less distracted as compared with participants in the trivial condition. Results suggest that people take attributional information into account during the phubbing experience. Given the frequency of phone use during social interactions, these data suggest giving a good reason for use may help in relationships and interactions; yet, it may not alleviate all the potential negative effects
Romance and Dating in the Digital Age: Impacts of Computer-Mediated Communication and a Global Pandemic.
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Scholars have described communication to be the currency, if not the lifeblood, of human relationships in general and romantic relationships more specifically. Through communication romantic relationships are solicited, established, maintained, and dissolved. For example, if prospective partners are to find one another, they must first communicate their desire and availability for romance. With a centuries-long history of intertwining between communication mediums and pursuit of romance—even the earliest newspapers included personal sections1—it was no surprise when the Internet and digital technologies became coopted for love and sexual expression. In short, whatever uses people may have for digital technology, romance and sex are clearly among them
Independent Operating by General Surgery Residents: An ACS-NSQIP Analysis.
No full textOBJECTIVE: Surgical resident autonomy during training is paramount to independent practice. We sought to determine prevalence of general surgery resident autonomy for surgeries commonly performed on emergency general surgery services and identify trends with time.
DESIGN: We queried ACS-NSQIP for patients undergoing one of 7 emergency general surgery operations. We evaluated trends in independent operating (defined as a resident operating alone, without attending having scrubbed) over the study period. Other outcomes of interest: operative time, 30-day-mortality and complications.
SETTING: The ACS-NSQIP database.
PARTICIPANTS: Patients undergoing one of 7 emergency general surgery operations.
RESULTS: Data regarding resident involvement was only available for the years 2005-2010. 90,790 operations were performed, 922 (1%) by residents operating independently. Appendectomy accounted for 61% independent cases. Independent resident operating was associated with a longer operative time (65 versus 58 minutes, p \u3c 0.001), but lower risk of bleeding requiring transfusion (p \u3c 0.001) and progressive renal insufficiency (p = 0.02). Independent operating was not associated with increased risk of complications/mortality.
CONCLUSION: Independent resident operating is rare, even with increasing attention to its importance, and is not associated with increased complications or mortality. National data on this subject is old and not currently collected. There is need for a national registry on resident involvement to understand the current effect of independent operating on outcomes
Evaluation of Benefits Associated with Chemotherapy Dose-Banding Practices
No full text2021 ASHP Midyear Clinical Meeting / Virtual Meeting / Poster # 1130014
The objective of this study was to evaluate the benefit of applying a 10% rounding strategy with predetermined dose-bands to the current chemotherapy dosing policy at Parkview Health
From Isolation to Connection A Cross-Sectional Analysis of Older Adults’ Social Participation using the COV19-QoL Scale
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The current study evaluated the relationship between social participation and quality of life (QoL) for older adults during the COVID-19 pandemic. Community-dwelling adults (N = 230) age 65 or older completed an online survey providing demographic data to identify changes in lifestyle routine during the pandemic using the COVID-19 Quality of Life (COV19-QoL) scores. Analyses revealed significant differences in reported lifestyle routines in relation to the onset of the COVID-19 pandemic and significant differences in COV19-QoL scores across various demographic groups. Results demonstrated the close relationship between social participation and QOL, assisted with identifying individuals at increased risk, and indicated potential guidelines for intervention. The sample was primarily limited to individuals willing to use the computer and several of the sample groups had limited representation with less than 5% of the total participant population. The use of novel instruments that relied on self-report also limited study conclusions. Future research is needed to improve interventions for social isolation and loneliness and affirm the value of an occupational therapy (OT) perspective in response to the COVID-19 pandemic
Outcomes of two versus three incision techniques: Results from the subcutaneous ICD post-approval study.
No full textBACKGROUND: Traditionally, implantation of the subcutaneous implantable cardioverter defibrillator (S-ICD) requires incisions near the lateral chest wall, the xyphoid, and the superior sternal region (three-incision technique [3IT]). A two-incision technique (2IT) avoids the superior incision and has been shown to be a viable alternative in small studies with limited follow-up.
OBJECTIVES: To report on the long-term safety and efficacy of the 2IT compared to the 3IT procedure in a large patient cohort.
METHODS: Patients enrolled in the S-ICD post approval study (PAS) were stratified by procedural technique (2IT vs. 3IT). Baseline demographics, comorbidities and procedural outcomes were collected. Complications and S-ICD effectiveness in treating ventricular arrhythmias through an average 3-year follow-up period were compared.
RESULTS: Of 1637 patients enrolled in the S-ICD PAS, 854 pts (52.2%) were implanted using the 2IT and 782 were implanted using the 3IT (47.8%). The 2IT became more prevalent over time, increasing from 40% to 69% of implants (Q1-Q4). Mean procedure time was shorter with 2IT (69.0 vs. 86.3 min, p \u3c .0001). No other differences in outcomes were observed between the two groups, including rates of infection, electrode migration, inappropriate shocks and first shock efficacy for treating ventricular arrhythmias.
CONCLUSION: In this large cohort of patients implanted with an S-ICD and followed for 3 years the 2IT was as safe and effective as the 3IT while significantly reducing procedure time
