PREVALENCE, PREDICTORS AND OUTCOMES OF GASTROINTESTINAL(GI) BLEEDING FOLLOWING LEFT VENTRICLE ASSIST DEVICE (LVAD) IMPLANTATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 75 (11) ◽  
pp. 1498
Author(s):  
Muhammad Ishaq ◽  
Yamna Waseem ◽  
Muhammad Khan ◽  
Muhammad Shariq Usman ◽  
Safi Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Left Ventricle ◽  
Meta Analysis ◽  
Gi Bleeding ◽  
Assist Device ◽  
Ventricle Assist Device

scholarly journals Convolution neural network for the diagnosis of wireless capsule endoscopy: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Kaiwen Qin ◽  
Jianmin Li ◽  
Yuxin Fang ◽  
Yuyuan Xu ◽  
Jiahao Wu ◽  
...  
Keyword(s):  
Neural Network ◽  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Capsule Endoscopy ◽  
Meta Analysis ◽  
Wireless Capsule Endoscopy ◽  
Convolution Neural Network ◽  
Research Progress ◽  
Gi Bleeding ◽  
Wireless Capsule

Abstract Background Wireless capsule endoscopy (WCE) is considered to be a powerful instrument for the diagnosis of intestine diseases. Convolution neural network (CNN) is a type of artificial intelligence that has the potential to assist the detection of WCE images. We aimed to perform a systematic review of the current research progress to the CNN application in WCE. Methods A search in PubMed, SinoMed, and Web of Science was conducted to collect all original publications about CNN implementation in WCE. Assessment of the risk of bias was performed by Quality Assessment of Diagnostic Accuracy Studies-2 risk list. Pooled sensitivity and specificity were calculated by an exact binominal rendition of the bivariate mixed-effects regression model. I2 was used for the evaluation of heterogeneity. Results 16 articles with 23 independent studies were included. CNN application to WCE was divided into detection on erosion/ulcer, gastrointestinal bleeding (GI bleeding), and polyps/cancer. The pooled sensitivity of CNN for erosion/ulcer is 0.96 [95% CI 0.91, 0.98], for GI bleeding is 0.97 (95% CI 0.93–0.99), and for polyps/cancer is 0.97 (95% CI 0.82–0.99). The corresponding specificity of CNN for erosion/ulcer is 0.97 (95% CI 0.93–0.99), for GI bleeding is 1.00 (95% CI 0.99–1.00), and for polyps/cancer is 0.98 (95% CI 0.92–0.99). Conclusion Based on our meta-analysis, CNN-dependent diagnosis of erosion/ulcer, GI bleeding, and polyps/cancer approached a high-level performance because of its high sensitivity and specificity. Therefore, future perspective, CNN has the potential to become an important assistant for the diagnosis of WCE.

Abstract 141: Trends in Left Ventricle Assist Device Use, Outcomes and Costs among Medicare Beneficiaries, 1999 to 2008.

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Julianna F Lampropulos ◽  
Yun Wang ◽  
Mayur Desai ◽  
Nancy Kim ◽  
Jose A Barreto-Filho ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Left Ventricle ◽  
Hospital Mortality ◽  
Age Groups ◽  
Fee For Service ◽  
Technological Advancement ◽  
Medicare Beneficiaries ◽  
Assist Device ◽  
One Year ◽  
Ventricle Assist Device

Background: Over the last decade, left ventricle assist device (LVAD) technology has improved substantially, resulting in smaller devices requiring less invasive procedures, which has broadened its clinical indications to frail populations. During this time of technological advancement, we examined trends in use, mortality, and associated costs of LVADs among Medicare beneficiaries. Methods: Inpatient Medicare standard analytic files were used to identify 100% of fee-for-service (FFS) patients aged ≥65 years that received LVAD (ICD-9-CM codes 37.60, 37.62, 37.65, 37.66 and 37.68) from 1999 to 2008. We constructed a denominator file from Medicare administrative data to report operative rates per 1,000,000 beneficiary-years. Length of stay, hospital mortality, thirty-day and one-year mortality were ascertained through corresponding vital status files. Costs were defined as hospital payments made by Medicare. Results: Among Medicare FFS patients, the overall LVAD procedure rate increased from 13.8 per million beneficiary-years (365 procedures) in 1999 to 19.8 per million beneficiary-years (548 procedures) in 2008, a relative increase of 44 %. In addition, between 1999 and 2008 overall length of stay increased from 19.1 days to 23.8 days; hospital mortality decreased from 42.5% to 33.4%, 30-day mortality decreased from 38.9% to 30.7% and one-year mortality decreased from 54% to 47.1%. Total CMS payments for the hospitalizations in which LVADs were placed increased from $20,188,880 ($55,312/patient) in 1999 to $71,050,392 ($129,654/patient) in 2008. Over the study period, LVAD use increased in all age groups, most strikingly among the ≥75 years old, in whom incidence increased from 151 procedures in 1999 to 192 procedures in 2008, representing 35% of the LVAD implantation in the Medicare population in 2008. Conclusions: From 1999 to 2008, LVAD use increased substantially with a decrease in hospital, 30-day and one-year mortality.

Are Proton Pump Inhibitors More Effective Than Histamine-2-Receptor Antagonists for Stress Ulcer Prophylaxis in Critically Ill Patients? A Systematic Review and Meta-Analysis of Cohort Studies

2021 ◽  
pp. 106002802110590
Author(s):  
Na He ◽  
Yingying Yan ◽  
Shan Su ◽  
Qinggang Ge ◽  
Suodi Zhai
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Critically Ill ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Stress Ulcer ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Gi Bleeding ◽  
Ulcer Prophylaxis

Background: Histamine-2-receptor antagonists (H2RAs) have been largely replaced by proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) despite the inconclusive evidence concerning comparative effectiveness. Objective: To compare the effectiveness of PPIs and H2RAs on SUP in real-world setting. Methods: PubMed, Embase, and the Cochrane Library were searched from inception to September 19, 2021. We included cohort studies comparing PPIs with H2RAs in critically ill adult patients and explicitly reporting the outcome of gastrointestinal (GI) bleeding or mortality. Newcastle-Ottawa Scale was used to assess potential risk of bias. We conducted a random-effects meta-analysis and only the studies with adjusted effect estimates were pooled. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the overall quality of the evidence. Results: Thirteen cohort studies (N = 145 149) were eligible and 11 of them available for full texts were of low to moderate risk of bias. Meta-analysis of adjusted effect estimates indicated that PPIs were associated with a significantly higher risk of GI bleeding, compared with H2RAs (8 studies, odds ratio [OR] = 1.98, 95% confidence interval [CI] = 1.30-3.01, low certainty). Post hoc pooling analysis also suggested that PPIs were associated with a slightly higher risk of mortality in comparison with H2RAs (7 studies, OR = 1.27, 95% CI = 1.13-1.42, low certainty). Conclusion and Relevance: The systematic review of cohort studies showed that PPIs were associated with higher risks of GI bleeding and mortality, although the certainty of evidence was low. Overall, we suggest not excluding H2RAs for SUP, while further studies are essential for elucidating the risk stratification, optimal regimen, and specific duration.

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