1,720,965 research outputs found
[Management of benign esophageal strictures: a literature review.]
Full text linkThe management of benign esophageal strictures is challenging. The first strategy includes endoscopic dilation using bougies or balloons. Although the immediate success rate of these is up to 90%, about 30-40% of patients experience recurrent dysphagia within the first year of follow-up. The management of refractory stenosis involves repeated sessions of endoscopic dilation. In order to obtain long-lasting functional results, alternative treatments have been developed, such as the use of self-expanding stents, particularly indicated in subgroups of patients with post-surgical stenosis or post-radiation therapy. If this approach fails, other possibilities are represented by self-decoding, PEG/J-tube positioning and, finally, reconstructive surgery
Endoscopic biliary self-expandable metallic stent in malignant biliary obstruction with or without sphincterotomy: systematic review and meta-analysis
Full text linkBackground and aim: To assess the rate of adverse events and the technical success rate of biliary stenting with or without EBS.
Methods: A literature search up to February 2017 was performed. Studies assessing adverse events (AEs) and technical success rates of stenting with or without EBS were considered.
Results: Seven studies (870 patients; 12 treatment arms) were included. Early AEs, i. e. those occurring within 30 days, were significantly lower in no-EBS vs. EBS-group (11 % vs . 20.1 %; OR: 0.36, 95 %CI: 0.13 - 1.00). Rates of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis were not significantly different in the two groups (no-EBS vs . EBS: 6.1 % vs 5 %; OR: 1.33, 95 %CI: 0.68 - 2.59). The rate of bleeding was significantly lower in patients without EBS (no-EBS vs EBS: 0 % vs 5 %; OR: 0.12, 95 % CI: 0.03 - 0.45). Rates of cholangitis were significantly lower in patients without EBS (no-EBS vs . EBS: 3.3 % vs. 7.4 %; OR: 0.38, 95 %CI: 0.17 - 0.83). Both late AEs and mortality rates did not significantly differ between no-EBS and EBS patients (19.9 % vs. 18.9 %; OR: 0.93, 95 %CI: 0.56 - 1.53, and 2.5 % vs. 2.9 %; OR: 1.18, 95 %CI: 0.22 - 6.29, respectively). The technical success rate for stent insertion also did not differ (98 % vs. 97.6 %; OR: 1.05, 95 %CI: 0.42 - 2.63).
Conclusion: EBS seems to be associated, in the first 30 days after the procedure, with an increased risk of cholangitis and bleeding. No difference was observed in the rate of post-ERCP pancreatitis
Chromoendoscopy is not superior to white light endoscopy in improving adenoma detection in Lynch Syndrome cohort undergoing surveillance with high-resolution colonoscopy: a real-world evidence study
No full textBackground: Endoscopic surveillance in patients with Lynch syndrome (LS) is crucial due to a genetically based high risk of colorectal cancer (CRC). We aimed to compare the adenoma detection rate (ADR) between high-resolution white light endoscopy (WLE) alone and WLE plus dye chromoendoscopy (CE) in a cohort of LS patients. Methods: In a context of real-world data, we retrospectively enrolled 50 LS patients who had non-randomly undergone WLE versus CE surveillance examinations from 2007 to 2019. The 2 groups were compared at baseline (BL) in terms of the rate of patients with lesions and the number of lesions, and at follow-up (FU), to evaluate a possible enhanced detection rate. Longitudinal analysis of the effect of the endoscopy type on the main outcomes was performed by generalized linear mixed models. Results: Forty-two patients had undergone at least one diagnostic colonoscopy. At BL and at FU analysis, we found no significant differences in detection rates and clinical-pathological features between WLE and CE groups. At the longitudinal analysis, an increase in the endoscopy rank (i.e., the position of each colonoscopy for all the colonoscopies that a patient had undergone) was associated with an increase in polyp detection rate (p = 0.006) and ADR (p = 0.005), while a trend toward significance (p = 0.069) was found for endoscopy type (CE vs. WLE) in the detection of serrated lesions. Conclusions: CE is not superior to high-resolution WLE in increasing the ADR. Even under standard WLE, an active and careful endoscopic surveillance of LS patients can prevent CRC
Prevalence of serrated polyposis syndrome in an FIT-based colorectal cancer screening cohort in Italy
Full text linkLifestyle factors and risk for colorectal polyps and cancer at index colonoscopy in a FIT-positive screening population
No full textBackground: Many countries have adopted the fecal immunochemical test (FIT) as the primary colorectal cancer (CRC) screening tool; however, its accuracy is limited. Epidemiological studies have shown that obesity and type 2 diabetes increase risk for the disease. Objective: The objective of this article is to evaluate the association of colorectal polyps and cancer with comorbidities and lifestyle factors in a population that is part of a FIT-based CRC screening program. Methods: Between 2005 and 2013, we analyzed 3894 FIT + patients who underwent total colonoscopy. The impact of lifestyle factors on polyps and cancer was assessed using individuals with a negative colonoscopy as the control group. A multivariate logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: We collected data from 3894 FIT + patients. Obesity (OR 1.29; 95% CI 1.05–1.60) and smoking (OR 1.45; 95% CI 1.24–1.71) were significantly associated with high-risk adenomas. Smoking and heavy alcohol drinking were both independently associated with high risk of CRC (OR 1.50; 95% CI 1.10–2.04 and OR 2.29; 95% CI 1.15–4.58) and colon cancer alone (OR 1.43; 95% CI 1.01–2.02 and OR 3.09; 95% CI 1.53–6.23). Positivity to first round of FIT was associated with high-risk adenomas (OR 1.47; CI 95% 1.26–1.71) and CRC (OR 1.74; 95% CI 1.29–2.36). No associations were found for diabetes. Conclusion: In our FIT + population, lifestyle factors are significantly associated with the risk of carrying high-risk adenomas and CRC. In the future, studies could be aimed at finding better screening strategies through the development of clinical algorithms based on lifestyle changes/comorbidities
Effectiveness of Plastic Stent for the Treatment of Incomplete Clearance of Common Bile Duct Stone: A Systematic Review and Meta-analysis
Full text linkBackground and aims: Common bile duct stones (CBDs) can typically be treated by endoscopic retrograde cholangiopancreatography (ERCP) in 85-90% of cases. However, in the remaining 10-15% of patients, bile duct stones cannot be extracted. In such cases, the placement of a temporary biliary plastic stent is recommended. Methods: We conducted a systematic review and meta-analysis (PROSPERO registration number: CRD42023459712; October 2023). An electronic search was carried out using the following databases: PubMed/MEDLINE, Scopus, and CENTRAL (last search: October 20, 2023). All published studies (both randomized clinical trials and non-randomized interventional studies) involving patients who had undergone ERCP for CBDs with incomplete biliary clearance were included. The risk of bias was assessed using the RoB 2.0 and ROBINS-I tools. The confidence in network meta-analysis tool was employed to estimate each study's contribution matrix within the network estimate. Results: Twenty papers (comprising 902 patients) were selected for qualitative and quantitative synthesis and were included in the standard meta-analysis, while only five studies (254 patients) were used for the network meta-analysis. The pooled success rate of stenting intervention in difficult choledocholithiasis was 79% (95% CI:71-87%). In the network meta-analysis model, ursodeoxycholic acid and single or double stenting resulted in a higher probability of being the most effective treatments. Conclusions: In cases of incomplete CBD clearance, the insertion of a temporary plastic stent achieves complete clearance in 79% of patients. Although not significantly superior in indirect comparison with stent alone, the adjunctive treatment with ursodeoxycholic acid appears to be the most likely to succeed
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
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
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