scholarly journals Evaluation of the Serrated Lesions Detection Rate and Its Role as a Colonoscopy Quality Criteria

2021 ◽  
Vol 41 (03) ◽  
pp. 228-233
Author(s):  
Conceição de Maria Aquino Vieira Clairet ◽  
José Luis Braga De Aquino ◽  
Laurent Martial Clairet

Abstract Objectives To evaluate the serrated lesion detection rate in colonoscopy at a specialized clinic and its role as quality criteria for endoscopic examination. Methods This is an observational cross-sectional study with all patients that underwent colonoscopy between October 2018 and May 2019, performed by an experimented physician. A questionnaire was answered before the examination by the patient, and another questionnaire after the colonoscopy was answered by the medical team. All polyps identified were removed and sent to the same pathologist for analysis. Results A total of 1,000 colonoscopies were evaluated. The average age of the patients was 58.9 years old, and most of them were female (60.6%). In 62.5% of the procedures, polyps were removed, obtaining a total of 1,730 polyps, of which 529 were serrated lesions, being 272 sessile serrated lesions (SSL). This data resulted in a serrated lesion detection rate (SDR) of 29.2%, and of 14% when considering only the SSL detection rate (SSLDR). The right colon had higher rates, with 22.3% SDR and 15.3% SSLDR. Screening colonoscopies also presented a higher serrated detection rate, of 20%, followed by diagnostics and follow-up exams. Smoking was the only risk factor associated with higher serrated detection rate. Conclusions The serrated lesion detection rate is higher than the ones already previously suggested and the have the higher rates were stablished in the right colon and on screening exams.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keshu Shan ◽  
Hongpeng Lu ◽  
Zhixin Zhang ◽  
Jiarong Xie ◽  
Lu Xu ◽  
...  

Abstract Objectives Colorectal cancer on the right side of the colon has been suggested to be harder to detect by colonoscopy. The aim of this study was to evaluate whether a second forward-view examination of the right side of the colon could increase the adenoma detection rate (ADR) and/or polyp detection rate (PDR). Methods This was a single-centre randomized controlled trial. Patients undergoing colonoscopy were recruited and randomly assigned to the second forward-view examination (SFE) group, in which the right side of the colon was examined twice or the traditional colonoscopy (TC) group in which the colonoscopy was performed in a standard manner. The primary outcome was the ADR of right colon. The overall PDR and ADR, PDR of the right colon, per-adenoma miss rate of the right colon, and advanced lesion detection rate were also recorded and compared. Results A total of 392 patients were included in the study (SFE group 197 vs. TC group 195). The ADR and PDR of the right colon in the SFE group were significantly higher than those in the TC group (ADR 10.7% vs. 5.1%; P = 0.042); PDR 17.8% vs. 9.7%, P = 0.021). No significant difference was found in overall PDR/ADR, or advanced lesion detection rate between the two groups. Conclusions This prospective controlled study revealed that a second forward-view examination could modestly increase the ADR and PDR of the right colon during unsedated colonoscopies. This simple, safe and time-effective technique might be recommended for routine unsedated colonoscopy. Trial registration: Clinical Trials.gov, NCT03619122. Registered on 7/8/2018.


2021 ◽  
Author(s):  
Alexandre Oliveira Ferreira ◽  
Maria Pia Costa-Santos ◽  
Carolina Palmela ◽  
Luisa Glória ◽  
Marília Cravo ◽  
...  

Abstract BackgroundColorectal cancer (CRC) is a leading cause of cancer-related death. Colonoscopy has been shown to decrease the incidence of CRC by facilitating the detection and resection of adenomas and serrated lesions. Endocuff vision (EV) has been shown to increase the detection of adenomas. The aim of this study was to compare the detection of sessile serrated lesions during colonoscopy with and without EV.MethodsA total of 257 patients who underwent elective colonoscopy were prospectively enrolled. The patients were randomly allocated to one of two groups according to the use of EV (standard colonoscopy vs. colonoscopy with EV). We compared the rates of detection of serrated lesions (including hyperplastic lesions ≥ 10 mm) and adenomas.ResultsThe number of serrated lesions per colonoscopy was not significantly higher in the EV group (0.233 vs 0.156, mean difference 0.076, p = 0.381). None of the secondary endpoints regarding the detection rate of adenomas (65.9% vs 66.4%; OR 0.977, 95% CI 0.583–1.638; p = 0.931) or sessile serrated lesions (12.4% vs 7.8%; OR 1.671; 95% CI 0.728–3.836; p = 0.226) were superior in the EV group. The differences were not significantly altered after adjusting for either the Boston Bowel Preparation Score (BBPS) or withdrawal time.ConclusionEV did not increase the rate of detection of serrated lesions or adenomas.Trial registrationClinicalTrials.gov Identifier: NCT03856957. Registered 27 February 2019 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT03856957


2020 ◽  
Vol 29 (2) ◽  
pp. 175-179
Author(s):  
Melania Macarie ◽  
Simona Bataga ◽  
Simona Mocan ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
...  

Background and Aims: The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called “interval cancer”, having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions. Methods: We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps’ development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease. Results: For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance. Conclusions: Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.


2019 ◽  
Vol 19 (4) ◽  
pp. 414-420
Author(s):  
Payam Mehrian ◽  
Abtin Doroudinia ◽  
Moghadaseh Shams ◽  
Niloufar Alizadeh

Background: Intrathoracic Lymphadenopathy (ITLN) in Human Immunodeficiency Virus (HIV) infected patients may have various etiologies and prognoses. Etiologies of ITLN can be distinguished based on the distribution of enlarged lymph nodes. Sometimes tuberculosis (TB) is the first sign of underlying HIV infection. Objective: We sought to determine ITLN distribution and associated pulmonary findings in TB/HIV co-infection using Computed Tomography (CT) scan. Methods: In this retrospective, observational, cross-sectional study, chest CT scans of 52 patients with TB/HIV co-infection were assessed for enlarged intrathoracic lymph nodes (>10 mm in short axis diameter), lymphadenopathy (LAP) distribution, calcification, conglomeration, the presence of hypodense center and associated pulmonary abnormalities. LAP distribution was compared in TB/HIV co-infection with isolated TB infection. Results: Mediastinal and/or hilar LAP were seen in 53.8% of TB/HIV co-infection patients. In all cases, LAP was multinational. The most frequent stations were right lower paratracheal and subcarinal stations. Lymph node conglomeration, hypodense center and calcification were noted in 25%, 21.4% and 3.5% of patients, respectively. LAP distribution was the same as that in patients with isolated TB infection except for the right hilar, right upper paratracheal and prevascular stations. All patients with mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Conclusion: All patients with TB/HIV co-infection and mediastinal and/or hilar adenopathy had associated pulmonary abnormalities. Superior mediastinal lymph nodes were less commonly affected in TB/HIV co-infection than isolated TB.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Getu Abeje ◽  
Woyneshet Gelaye ◽  
Getaneh Alemu

Abstract Background Both capillary and venous blood samples have been interchangeably used for the diagnosis of malaria in Ethiopia. However, Plasmodium parasites are thought to be more concentrated in capillary than in venous blood. Hence, selecting a sample source where parasites are more concentrated is indispensable approach in order to maximize the accuracy of blood film microscopy. Therefore, the present study aimed to compare the detection rate and the parasitemia level of Plasmodium species from conventional capillary and venous blood films, and buffy coat preparations. Methods A facility based cross-sectional study was conducted from Feburary to March 2020 among 210 febrile patients attending Hamusite health center, northwest Ethiopia. Capillary and venous blood samples were collected and buffy coat was prepared from each sample. Thin and thick blood films were prepared, stained, and examined microscopically following standard protocol. Data were analysed using Statistical Package for Social Sciences Software version 20 and Med-Calc software version 19.3. Results Capillary blood buffy coat (61/210, 29.0%) had significantly higher detection rate as compared to capillary (48/210, 22.9%) and venous (42/210, 20.0%) blood films (p < 0.001). However, no significant difference was observed between capillary and venous blood films (p = 0.070) in detecting Plasmodium species. The highest and the lowest mean asexual stage parasite counts were found in capillary blood buffy coat (4692.88) and venous blood (631.43) films, respectively showing significant variations (p < 0.001). Mean gametocyte count was also highest in capillary blood buffy coat (3958.44). As compared to capillary blood buffy coat, the sensitivity of venous blood buffy coat, capillary blood film and venous blood film were 73.8, 78.7, 68.9%, respectively. Conclusion Capillary blood buffy coat samples showed the highest sensitivity in detecting and quantitating malaria parasites that its use should be promoted in clinical settings. However, conventional capillary and venous blood films could be used interchangeably.


Author(s):  
Seyedeh Samaneh Miresmaeeli ◽  
Nafiseh Esmaeili ◽  
Sepideh Sadeghi Ashlaghi ◽  
Zahra Abbasi Dolatabadi

Abstract Background: Exceptional children, like other children, have the right to be educated in a safe environment. Disasters are considered as serious issues regarding safety and security of educational environments. Following disasters, vulnerable groups, especially children with handicaps and disabilities are more likely to be seriously injured. Thus, the present study aimed to evaluate the safety and disaster risk assessment of exceptional schools in Tehran, Iran. Method: The cross-sectional study was conducted in exceptional schools in Tehran, 2018. First, 55 exceptional schools in all grades were selected based on census sampling method and evaluated by using a checklist designed by Tehran Disaster Mitigation and Management Organization (TDMMO) and Ministry of Education in 2015. The data were analyzed using Excel software and statistical descriptive tests. Result: Based on the results, school facilities are worn and have unsafe elevators (least safety: 7.69%), yards (least safety: 9.52%), laboratories (least safety: 16.67%), libraries (least safety: 24.24%), fire extinguishing systems (least safety: 28.99%), and storage rooms and kitchens (least safety: 33.33%) which require immediate considerations. In total, the safety of exceptional schools in this study was 70.13%, which suggests medium-risk level. Conclusion: The educational settings must be reconsidered, along with identifying the risk and safety at school. In addition, a standard should be established for evaluating safety, especially in exceptional schools.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kochu Therisa Karingada ◽  
Michael Sony

PurposeThe COVID-19 pandemic lockdown has caught many educational institutions by surprise and warranted an abrupt migration from offline to online learning. This has resulted in an education change, without any time for due consideration, as regards its impact on musculoskeletal disorders (MSD) on students. The purpose of this study is to investigate MSD related to online learning during the COVID-19 pandemic lockdown.Design/methodology/approachA cross-sectional study was conducted on undergraduate students in India. In total, 261 students participated in this online survey.FindingsThe study finds that around 80% of students have reported some symptom in the head, neck and eyes since they started online learning. In total, 58% have reported MSD symptom in the right shoulder and 56% in the right hand fingers. Besides, more than 40 % of students experienced some MSD symptoms, in almost all the body parts studied, due to online learning. Correlation analysis is conducted between time spent on online learning per day and MSD symptoms.Originality/valueThis is the first study conducted on MSD and online learning during COVID-19 pandemic.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Raj Chandra ◽  
Abdul Munasib ◽  
Devesh Roy ◽  
Vinay K. Sonkar

Purpose Information is often available to consumers through their social networks. Focusing on dairy consumers in India, this paper aims to present evidence of peer effects in consumers’ attitudes towards various food safety attributes and food safety practices. Design/methodology/approach Unobserved individual heterogeneities are crucial confounders in the identification of social (endogenous) effects. The identification is based on exploiting within-consumer variation across different aspects of attitude (or practices) related to food safety. Findings This paper uses a novel identification strategy that allows for average effects across attributes and practices to be estimated. Using the strategy, though this paper cannot estimate endogenous effects in each attribute or practice, this paper is able to identify such effects averaged over attributes or practices. Research limitations/implications Cross-sectional study, caste affiliation is not defined at the right level of granularity. Practical implications The results suggest that information campaigns aimed at creating awareness about food safety can have social multiplier effects, and this also translates into changes in the practices followed to mitigate food safety risks. Social implications In health-related awareness and practices, there are well-established cases of multiplier effects. The most significant example of this is the Pulse Polio campaign in India, where an awareness drives through social multiplier effects had such a significant impact that in 2012 India was declared polio-free. Perhaps, a similar campaign in matters related to food safety could be very fruitful. Originality/value The methodology and the issue are unique. Little exists in assessing social networks in the context of food safety.


2018 ◽  
Vol 08 (02) ◽  
pp. 72-76
Author(s):  
Mahrukh Kamran ◽  
Sahar Mubeen ◽  
Iffat Raza ◽  
Sanobar Bughio ◽  
Hira Waseem ◽  
...  

Objectives: To determine the effect of serum TSH on thyroid dimensions of each lobe and to measure the amount of effect of per unit increase in serum TSH on thyroid dimensions of each lobe in euthyroids. Study Design: It was a cross-sectional study. Setting: The study was conducted at Ziauddin University Hospital, Clifton, Karachi. Methodology: Healthy participants aged 21 years and above were included through convenient sampling. Serum Thyroid stimulating hormone was evaluated and ultrasound of thyroid gland TG of 192 euthyroid participants was performed. Spearman correlation and regression analysis was applied to evaluate the relationship between TSH and TG dimensions Results: Relationship of increase in serum TSH with decrease in light lobe AP dimension was most significant. (r= -0.142 P-Value=0.001) and CC dimension least significant (r= -0.0098 P-Value=0.001). Where as in the left lobe AP dimension decreases significantly with increase serum TSH (r= -0.147 P-value=0.001). 11.7% of total variation in AP dimension, 3.5% of total variation in ML dimension and 6.5% of total variation in CC dimension in right lobe thyroid are because of serum TSH. While 9.5% of the total variation in AP dimension in left lobe is also due to serum TSH. Conclusion: Negative and significant correlation between serum TSH and thyroid dimensions was observed. Serum TSH inversely and significantly affects all the dimensions of the right lobe and only one dimension in the left lobe


Author(s):  
L. Kannan ◽  
Praveena P.

Background: Stress is a mental, physical and emotional response to life demands. Long hours of work, client demands, changing laws- creates stress and eventually hypertension among advocates. Well-being of the advocates are being questioned. Hence the main objective of the study is to evaluate the relationship between stress and hypertension among practising advocates.Methods: A cross-sectional study was conducted in a sample of 300 practising advocates at Madurai district court for a period of 1 year by simple random sampling method.Results: Around 133 (44.33%) and 167 (55.66%) of study participants were in level of high stress and low stress respectively. Among high stressed participants, a majority of 113 (84.96%) were found to be hypertensives and among the low stressed participants only 10 (5.98%) were hypertensives. The difference of observation was found to be statistically significant (p=0.0000).Conclusions: In conclusion the study explains that practising advocates with high perceived stress 113 (84.96%) were found to be hypertensives. Stress has a significant association with hypertension. The right way to manage stress is to implement coping strategies.


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