1,720,967 research outputs found
Aspirin vs. P2Y12 Inhibitor Rivalry: Which One Can be Continued During Gastrointestinal Bleeding
No full textDual antiplatelet therapy (DAPT) is the mainstay of secondary prevention treatment for acute coronary syndrome (ACS) and ischemic stroke, especially after coronary intervention. DAPT consists of aspirin and P2Y12 receptor inhibitor (e.g. clopidogrel), and the use of DAPT has been increased over time. The most serious and common adverse effect is gastrointestinal bleeding. Guidelines in managing such condition are available among Gastroenterologist Societies and Cardiologist Societies. Most guidelines are consistent with each other to continue the use of aspirin while withholding P2Y12. However, European Society of Cardiologist (ESC) guideline in 2017 recommends P2Y12 receptor inhibitor as the preferred antiplatelet for patient with upper gastrointestinal bleeding. This review will look on the guidelines and other supporting evidence for the justification on the antiplatelet of choice
Screening Colonoscopy for Colon Cancer in Women during COVID-19 Pandemic
Full text linkColorectal cancer (CRC) is one of the top three leading causes of death in both men and women. However, screening can help detect and prevent CRC. Multiple guidelines recommend CRC screening using stool-based screening and direct visualization via colonoscopy. Anatomically, women have a longer total colonic length, especially in the transverse colon, which makes it redundant; thus it is more difficult to perform complete endoscopy in women. Women also have a higher risk of developing right-sided colon cancer of the flat and depressed type, which is harder to detect than the other types. Moreover, women are less likely to undergo colonoscopy due to embarrassment, especially when the procedure is performed by male gastroenterologists, and the lack of available female gastroenterologists further complicates the problem. The current COVID-19 pandemic also decreases patients’ willingness to undergo screening due to the fear of contracting the COVID-19. Delay in diagnosis leads to more advanced tumors upon detection and ultimately decreases the survival rate, especially in women, as they have lower 1-year survival rate when CRC is detected in its later stages than in men. Innovative options for CRC screening have recently emerged, including colon capsule endoscopy, which can be performed in a clinic and may reduce the need for colonoscopy. However, sex-specific CRC screening guidelines and tools are not available. The objective of this review is to identify the barriers and challenges faced when performing screening colonoscopy in women, especially during the pandemic and to encourage the development of sex-specific CRC screening
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Current Guidelines on Antithrombotic Management in Patients Undergoing Gastrointestinal Endoscopy
Full text linkEndoscopic procedure is commonly used to make diagnosis or therapy. Endoscopy has risk on the procedure or after the procedure. Patient with antithrombotic therapy, both antiplatelet and/or anticoagulant, for underlying diseases has higher risk for bleeding and thromboembolic events in this procedure. The physician should consider risk and benefit for adjusting the antithrombotic therapy, in addition to minimize bleeding and thromboembolic events. For low risk procedure, adjustments in antithrombotic therapy usually not necessarily needed. For high risk procedure, there are several adjustments based on the type of medication and patient’s condition in specific. European Society of Gastrointestinal Guidelines Endoscopy (ESGE) and British Society of Gastrointestinal (BSG); American Society of Gastrointestinal Endoscopy (ASGE); and lastly Asian Pacific Association of Gastroenterology (APAGE) and Asian Pacific Society for Digestive Endoscopy (APSDE) have published guidelines to help physician to make decisions regarding antithrombotic therapy management during endoscopy. This article compares and contrasts the approach of each guideline, in design to help the decision-making process. However, each patient’s clinical condition may differ from one to another and should be considered carefully in making a final decision
Pancreas Divisum as a Rare Etiology of Recurrent Pancreatitis: A Rare Case Ever Documented and Reported In Indonesia
Full text linkPancreas divisum is an abnormal condition of pancreas duct that occurs from organogenesis. This abnormal condition defined as a failure in fusion between dorsal and ventral part of the pancreas. The incidence reported 4%-14% in general population. Majority patient with pancreas divisum will not present with any sign or symptom, but in some cases may present with signs of pancreatitis. We illustrate a case of 39 years old male with pancreas divisum presenting as acute recurrent pancreatitis. Diagnosis of pancreas divisum was determined through magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). Patient treated by sphincterotomy and dilation using Soehendra’s dilator catheter. This is the first pancreas divisum case successfully treated and reported in Indonesia
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Performance of Red Cell Distribution Width-to-Platelet Ratio as a Screening Tool of Liver Fibrosis Based on Transient Elastography in Chronic Hepatitis B Infection
Full text linkBackground: Identifying liver fibrosis is crucial for initiating antiviral therapy for hepatitis B infection. Liver biopsy is the gold standard for assessing the degree of fibrosis. However, a liver biopsy is an invasive procedure that carries some risks. This study aimed to evaluate the diagnostic capabilities of the red cell distribution width-to-platelet ratio (RPR) and compare its efficacy for determining the degree of fibrosis in patients with chronic hepatitis B infection with that of the aspartate aminotransferase-to-platelet ratio index (APRI) and the Fibrosis-4 index (FIB-4). Methods: This was a retrospective study conducted on patients with chronic hepatitis B infection who had transient elastography results at the Gastroenterology Hepatology Clinic, Dr. Hasan Sadikin General Hospital, Bandung, between January and December 2024. Statistical analysis was performed using receiver operating characteristic curves to determine the diagnostic values and cutoff points of the RPR, APRI, and FIB-4 to detect liver fibrosis based on Transient Elastography in patients with Chronic Hepatitis B infection. Results: A total of 114 patients with chronic hepatitis B infection were included in this study (42 with significant fibrosis and 72 with nonsignificant fibrosis). The area under the curve (AUC) of the RPR was 0.873 (p < 0.001) with a cutoff point of >0.0538, whereas the AUCs of the APRI and FIB-4 were 0.833 (p < 0.001) and 0.746 (p < 0.001), respectively. Conclusion: The RPR has a higher diagnostic performance than the APRI and is superior to the FIB-4 in assessing the degree of fibrosis in patients with chronic hepatitis B infection. The RPR is a simple and cost-effective test and has the potential to be a screening tool for patients with hepatitis B infection
Secondary Choledocholithiasis in Obstructive Jaundice Patient due to Choledochoduodenal-fistula Stricture
Full text linkCholedochoduodenal fistula (CDF) is a rare condition marked by an abnormal connection between the biliary duct and duodenum. The common etiology of secondary CDF are cholecystolithiasis, tumor, and duodenal ulcer. CDF may also caused by prior inflammatory condition or as a complication of radiation therapy. Management for this case is based on the patient condition. Herein we aimed to present a case of secondary choledocholithiasis due to stricture in the CDF which presented with cholangitis treated by self-expanding metal stent (SEMS) for biliary drainage. Patient admitted with jaundice, fever, right upper quadrant pain, and history of cholecystectomy. Diagnosis of CDF was determined by endoscopic retrograde cholangiopancreatography (ERCP) and followed by putting biliary stent for urgent biliary drainage. The follow up result after stent removal was excellent
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